Mark Honigsbaum, a medical historian and author of The Pandemic Century, has spoken to the JC about the Covid-19 pandemic and "the lessons that we keep forgetting” about pandemics. 

The Pandemic Century, for which an updated paperback edition containing a new chapter on the Covid-19 pandemic is being published on June 4, deals with nine epidemics and pandemics since the Spanish Flu of 1918-19. 

“One of the key lessons” that emerged from his research, Mr Honigsbaum said, “is the cycle of panic and neglect.” 

“Immediately after outbreaks, there is usually an increase in research funding” towards investigating rare diseases that have the potential to develop into serious epidemics, Mr Honigsbaum said, “but then the funding goes right down. The problem is that there is never enough money to fund this kind of work.”

“It is estimated that we need to spend at least $8 billion on research platforms for coronaviruses and other neglected viruses,” he said. 

“We should be weighing that against the tanking of the global economy to the tune of $3 trillion – that is the calculation that we need to be doing.” 

“I think there was a failure to prepare properly for this pandemic,” Mr Honigsbaum says. 

“Specifically in Britain, we’ve spent the last three years preparing for the wrong crisis – Brexit. We know now that this diverted nearly all the resources of the civil service to that, meaning that pandemic planning was neglected.” 

In 2016, NHS England carried out a pandemic simulation to test whether the health service had the capacity to manage an outbreak of influenza. The findings of the simulation, which have not been fully released, showed that there was a lack of medical ventilators and critical care capacity. 

“None of these things seem to have been taken seriously and acted on,” Mr Honigsbaum said, “and that was a massive mistake.” 

Worryingly, Mr Honigsbaum said that there was evidence that the rate of emergence of diseases with pandemic potential appears to be increasing.

He noted that since the SARS outbreak of 2002, there had been a number of serious epidemic and pandemic eruptions including the swine flu pandemic of 2009, Ebola in 2014 and Zika in 2015-16. 

Mr Honigsbaum said that “spillover events” in which pathogens cross the species barrier and begin infecting humans are “occurring all the time”. 

“Farming has got a lot to do with it, increased connectivity, roads, rail and also jet travel,” he said, adding that the increasing proximity of humans and animals in forested areas was facilitating the process. 

Mr Honigsbaum said that one of the core lessons that needed to be drawn from the coronavirus pandemic in Britain was the urgent need to restore capacity at local levels of government. 

“We don’t have resources, expertise or laboratory testing at a local level,” he said, “I have much more confidence in my local council to direct local communities on how to distance and go about social activities safely, and to run contact tracing.” 

“If they could get the results back quickly, and then send people who are trained and who know their areas, they could rapidly chase down infection chains and speak to people on terms they would understand,” he explained.

Mr Honigsbaum, who has a Jewish background, speculated that there might be a genetic factor at play when it came to explain the high death toll among British Jews. 

“It is a bit of an epidemiological, immunological and genetic puzzle,” Mr Honigsbaum said.

“We are at such an early stage, we don’t know if there might be some genetic element,” he suggested, “there is the same puzzle around Jews as there are around BAME groups.” 

Black, Asian and Minority Ethnic (BAME) communities have recorded a disproportionate share of the national death toll according to Public Health England, while British Jews are also over-represented.

“Different religious and ethnic groups have different underlying propensities to certain conditions,” Mr Honigsbaum said. 

Mr Honigsbaum also suggested that the elderly demographic profile of the mainstream Jewish community may also be a “key factor”, while in strictly Orthodox settings “very large families and very tight communities” may have facilitated the spread of the virus. 

“This virus spreads very efficiently within family groups and community clusters,” he said, adding that “religious rituals” may have initially made it harder for the strictly Orthodox to socially distance.