I am concerned that your checklist may be overfit to the current pandemic, in which case the fact that it doesn’t trigger for substantially different past events like an ebola outbreak isn’t necessarily such a good sign.
Consider, for instance, the 14th-century “Black Death”. That was a real biggie; it killed something on the order of half the population of Europe. Let’s see how the checklist does for that.
Transmissibility: no, it doesn’t spread from human to human, it goes via fleas and the like; no, it isn’t spread by coughing and sneezing; I don’t know whether it can spread before symptoms appear but I’ll guess it can; obviously there were no academic papers at the time. 1⁄3.
Harm: yes, very high mortality rate; no, I don’t think it lasts more than two weeks (when it kills you it usually takes ~10d); yes, had there been actual hospitals >5% of patients would have needed them; there were no vaccines or effective treatments at the time. 3⁄4.
Spread: yes, well over 2000 people; yes, found in many countries (though at the time nowhere was “industrialized”!); yes, present in places with strong travel links; yes, spread despite attempts at lockdown. 4⁄4.
Institutional response: yes, lockdowns were attempted; there were no WHO-like organizations (but I wonder what the Church had to say); there weren’t newspapers; I’m not sure to what extent “medical supplies” were really a thing at the time. Let’s say 3⁄3 here.
So the Black Death gets 11⁄14. That’s a smaller fraction than your 13⁄16, so at best it passes marginally. Given that the Black Death was much worse than COVID-19 is likely to be, that seems like cause for a little concern.
(I’ve attempted to answer the questions on the basis of modern knowledge; perhaps in the 14th century they would have said it does seem to spread from human to human, and that it spreads by coughing and sneezing. Dunno what the fairest thing to do is.)
… But it’s possible that the Black Death was actually mostly pneumonic plague rather than bubonic (same bacterium but in the lungs), in which case I think those first two questions would have had “yes” rather than “no” answers and the checklist comes out looking better.
Thanks for doing this, I think it’s a great point.
I might consider altering the “airborne” requirement and include “insect-based transmission” or something like that (in which case I’m not sure what to do about malaria, which I’m fairly sure would then hit a 16⁄16 yet not be causing stock market crashes, probably because it’s a long standing and regular problem.
The other issue is length of the illness for severe patients. The ambiguous wording in the original questionnaire doesn’t make this clear, but this is intended as the length of hospitalization for patients who don’t die, as a way to look at strain on healthcare facilities. I’m not sure how long plague lasts in patients who don’t die from it.
In any case, these will be some important points to consider for my next iteration, and also point out the important issue of long-standing diseases with fairly stable annual fatalities.
I am concerned that your checklist may be overfit to the current pandemic, in which case the fact that it doesn’t trigger for substantially different past events like an ebola outbreak isn’t necessarily such a good sign.
Consider, for instance, the 14th-century “Black Death”. That was a real biggie; it killed something on the order of half the population of Europe. Let’s see how the checklist does for that.
Transmissibility: no, it doesn’t spread from human to human, it goes via fleas and the like; no, it isn’t spread by coughing and sneezing; I don’t know whether it can spread before symptoms appear but I’ll guess it can; obviously there were no academic papers at the time. 1⁄3.
Harm: yes, very high mortality rate; no, I don’t think it lasts more than two weeks (when it kills you it usually takes ~10d); yes, had there been actual hospitals >5% of patients would have needed them; there were no vaccines or effective treatments at the time. 3⁄4.
Spread: yes, well over 2000 people; yes, found in many countries (though at the time nowhere was “industrialized”!); yes, present in places with strong travel links; yes, spread despite attempts at lockdown. 4⁄4.
Institutional response: yes, lockdowns were attempted; there were no WHO-like organizations (but I wonder what the Church had to say); there weren’t newspapers; I’m not sure to what extent “medical supplies” were really a thing at the time. Let’s say 3⁄3 here.
So the Black Death gets 11⁄14. That’s a smaller fraction than your 13⁄16, so at best it passes marginally. Given that the Black Death was much worse than COVID-19 is likely to be, that seems like cause for a little concern.
(I’ve attempted to answer the questions on the basis of modern knowledge; perhaps in the 14th century they would have said it does seem to spread from human to human, and that it spreads by coughing and sneezing. Dunno what the fairest thing to do is.)
… But it’s possible that the Black Death was actually mostly pneumonic plague rather than bubonic (same bacterium but in the lungs), in which case I think those first two questions would have had “yes” rather than “no” answers and the checklist comes out looking better.
Thanks for doing this, I think it’s a great point.
I might consider altering the “airborne” requirement and include “insect-based transmission” or something like that (in which case I’m not sure what to do about malaria, which I’m fairly sure would then hit a 16⁄16 yet not be causing stock market crashes, probably because it’s a long standing and regular problem.
The other issue is length of the illness for severe patients. The ambiguous wording in the original questionnaire doesn’t make this clear, but this is intended as the length of hospitalization for patients who don’t die, as a way to look at strain on healthcare facilities. I’m not sure how long plague lasts in patients who don’t die from it.
In any case, these will be some important points to consider for my next iteration, and also point out the important issue of long-standing diseases with fairly stable annual fatalities.
Thanks for bringing it up.