Okay, since @KevinMKruse now seems to have given his imprimatur to this piece in the @washingtonpost today about #nCoV2019 & past plagues, it seems time for a mini-thread about #medhist & hot takes. #epitwitter: you might want to listen in on this, as it effects you, too. https://twitter.com/KevinMKruse/status/1225440048407089153

The @washingtonpost piece by Eisenberg et al. makes 3 main points: 1) that the #BlackDeath (the #plague pandemic usually dated to the mid-14thC) is the most commonly invoked analogy when people think of epidemics; 2) that not all "plague" epidemics/pandemics were alike; and 3) ..

... that there's an "outbreak narrative" that "we replay .. as a script with each new outbreak — whether real or fictional." First, some background on what #histmed (History of Medicine) is: it's probably pretty much as you would assume from its name. The field of history that ..

.. looks at health, disease, & all the interventions that get done to promote the first & mitigate the second. It's also a field that is in the midst of a colossal transformation of late, b/c various aspects of the palaeosciences (scientific methods to reconstruct the past) ...

... have transformed the kinds of questions we can ask about the history of infectious diseases. (See my TL for threads about #plague, #leprosy, #TB.) New work in #genetics, and new rigor in #bioarchaeology, have put new pressure on historians (who normally work w/ written ..

... records) to rethink how we've been telling our stories about the major infectious diseases of #GlobalHistory. The biggest transformation is that we can now talk, not speculatively, but concretely about which diseases affected past populations. We know from ample scientific ..

.. evidence now not simply that #YersiniaPestis caused both the #JustinianicPlague & the #BlackDeath, but we (or the trained scientists, that is) can talk down to the level of individual nucleotides on the genome what those strains of disease looked like. So, back to the 3 points

... of the @washingtonpost piece. 1) is the #BlackDeath the most frequently invoked pandemic? Without a doubt. @RichardNevell can chime in w/ some statistics from @Wikipedia. And this is not surprising. Everybody will have heard of it from their early school days; there's movies

.. videogames, & who knows how many books on what is usually called "the largest pandemic in human history." 2) The second point they raise is whether all #plague outbreaks can be compared to the #BlackDeath. This is an odd argument for 2 reasons. I've been a historian of ...

.. medicine my entire career. Yes, prior to the palaeogenetic confirmation that yes, #YersiniaPestis was the causative organism of the #BlackDeath, there was a lot of debate about that question. And there continues to be debate about plague's mechanisms of transmission, etc. ...

But precisely b/c #plague is not a human disease, the way it manifests in human populations (when there is a spillover event) will vary considerably. The argument is odd for a second reason b/c nobody besides the authors (to my knowledge) thinks the #JustinianicPlague--the 6thC

.. outbreak of #plague centered on the Mediterranean--was "flu-like." That is an issue that is, and will continue to be debated amongst historians & palaeoscientists. The point here is that an epidemic can be both "not like the #BlackDeath" & very severe in its own right. This ..

... brings us to the 3rd point: the implication that outbreak narratives are just hype. The answer is no: there are a lot of other diseases in the world besides plague, and there have been a lot of other disastrous epidemics. The 1918-19 Flu Pandemic may have only killed 2% of ..

.. the world's population (as opposed to ca. 50% estimates for places struck by the #BlackDeath). But what population will not be affected socially by a 2% mortality? Especially when those are otherwise healthy young adults? I agree, then, that the Black Death is not a good ...

.. measure to be used for all epidemic diseases. In fact, I'm not sure *any* pre-1900 epidemic is a suitable model for what the world has faced in the past half century. Unmentioned by Eisenberg et al. is the field of Emerging Infectious Diseases. This is a robust specialty ...

... that draws in traditional epidemiology, Global Health, various fields of zoology, etc., etc. What we are watching w/ the new coronavirus is what EID was created for: novel diseases spilling over from animal reservoirs, for which we do not have the medical & public health ...

... interventions in place (antibiotics, vaccines, antiretrovirals, social mobilization measures, etc.) to react quickly or effectively. As has been noted recently (& will always be noted by trained historians), how we deploy historical analogies matters. And it matters now, too.