“COVID 19” could have been a cool name for a rocket or a sports car. It’s much cooler than “EBOLA” or “Swine Flu.” On February 11, 2020, when the World Health Organization, which claims exclusive naming rights for pandemics, pronounced “COVID 19” as the official name for this scourge, their marketing department had done its homework. They gave us a snappy name with a warning in it: expect another some other year. This coronavirus, SARS CoV-2, was called “novel” because it was different from the first one, dubbed Severe Acute Respiratory Syndrome Coronavirus or SARS-CoV, that hit some parts of Asia hard in 2003 and then fizzled out before a vaccine was needed.
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The timing of these epidemics seems so random. Why 2003 for the first one? Why 2019 for this one? And what if this novel corona virus had burst across our globe in 1999?
Imagine lockdown in March of 2000. Where were you?
I was 48 and scrambling to build my career in academic psychiatry at the University of Cincinnati: taking care of patients, growing a new residency training program, writing academic papers and fiction, teaching, and doing research projects. My wife had spent the past decade as a public health doc focusing on AIDS programs in the US and East Africa. We had one son in college and three at home in middle school and high school. We owned one desktop computer, which we all shared in our study, with email and the internet through the modem on our land line. None of us had a cell phone.
COVID 1999 would have shut down our schools and colleges, forcing home schooling for all our boys. That would have required me or my wife to spend at least half-time playing teacher for the teenagers. They were doing most of their work on paper back then. The lockdown might have accelerated the switch to computer-based schoolwork. Communication with the school would have been by mail, email, fax, and land line calls. Imagine the fights over who gets the phone next and why. We probably would have paid for a second land line and bought a second desktop computer. Or a third?
Working from home would have been tougher for my wife and me, and everyone else. Our internet band was a thin thread in 2000—slow and unreliable and anything but broad. Most business communication would have been by phone, fax, conference calls, and snail mail, with the demand for email escalating in a frenzy. Imagine the fights over who gets the computer next. And ours was a tortoise compared our current laptops. No wonder pandemics jack up domestic violence rates.
In health care those were the days of paper charts. Telemedicine was the telephone. The only way to get care then would have been to show up in the office, the clinic, and the pharmacy. How much more exposure from infected patients would health care workers have had in 1999 when all those with symptoms had to show up in person to get help? For health care workers the rates of infection and burnout would have been higher, and the supply of health care workers would have dwindled faster. More hospitals and clinics would have closed.
And more people would have lost jobs in 2000 because for most jobs working remotely would have been impossible. More businesses would have closed and closed forever. Our economy would have taken an even bigger hit than it has. Instead of a long year or two with no rebound, imagine five years, or longer.
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Think about the number of times in the past 18 months when you’ve talked to someone you care about by Zoom, WebEx, Teams, WhatsAPP, or some other platform. None of these existed in 1999. How much greater would your isolation have been twenty years ago with only the phone for safe contact?
In the past 18 months we have lost over 700,000 people to COVID 19 in the US alone. How many more would have died by this time in 2001?
And how much longer would it have taken to develop a vaccine against COVID 1999? The rapid development of mRNA vaccines in less than a year would have been impossible. Maybe the Johnson and Johnson vaccine would have taken the same amount of time, but fewer options for rapid vaccine development would have meant so many more unvaccinated people severely infected, hospitalized, and dying. This fact lead columnist Megan McCardle to take us through a similar thought exercise in her opinion piece in the Washington Post in April 2021.
What do we learn from these what-if exercises? First, we have very recently become a more resilient species for handling pandemic threats because we’re now more robustly linked to each other in meaningful ways that save lives. The cell phone has brought these benefits of the internet into many rural and developing communities around the globe. Though the internet was not invented to manage pandemics, we now have an effective alternative to face-to-face contact for many kinds of work, school, and commerce. This technological growth spurt has accidentally allowed us to drastically reduce our exposures to the SARS CoV-2 virus. We can count the timing of this spurt in our social evolution as one of our blessings.
Second, the internet has in some ways flattened the inequalities of our society and in other ways magnified them. More people now have cheap access to knowledge and communication than ever before. On the other hand, twenty years ago maybe this same fact would have reduced our capacity in this country to turn a pandemic into a political fight over masks and vaccines, needlessly delaying our ability to contain COVID 19.
We’ll never know, but this pandemic would have been a whole lot worse in 1999. How much better will we do with COVID 29? If only Google could tell us….