Epidemiologist looks to the past to predict second post-pandemic 'roaring 20s'

Photo: Doral Chenoweth / AP
It has been almost exactly a year since the SARS-CoV-2 coronavirus was identified by Chinese scientists as the source of a new, deadly respiratory disease.
Since more than 1.5 million people died worldwide, economies around the world have closed multiple times and societies have isolated themselves in their homes, watching vacations go by without being close to family and friends. We have a year ahead of the most logistically demanding public health campaign ever.
But here the Yale professor and social epidemiologist Dr. Nicholas Christakis cold comfort, as outlined in his new book Apollo's Arrow: The Profound and Enduring Impact of Coronavirus on Our Lifestyles. And that's because he sees a pattern. "One of the arguments in the book is that what happens to us seems alien and unnatural to so many people, but epidemics aren't new to our species - they're just new to us," said Christakis, whose expertise it is like our behavior influences contagion in society.
Here is the consolation Christakis' observations of disease over millennia could have: epidemics and pandemics are ending. They always end. They ended before we had vaccines to respond to them. And how we react to these germs - for example through social distancing - determines the force with which they hit our society.
While the distribution of Pfizer and Moderna vaccines will be one of the greatest public health challenges of our time, it is also one of humankind's great achievements.
If we can vaccinate a sufficient portion of the population (around 75% estimated) we will bring the pandemic to a halt much sooner and with fewer deaths than it could have ended on its own.
Diseases are not new to our species - they are just new to us
Dr. Nicholas Christakis
"We are the first living generation of people ever exposed to this threat that enables them to respond with effective drugs in real time," said Christakis. "It is wonderful."
Then, when the pandemics are over, there is often a time when people are looking for full social interaction and which Christakis predicts as the second "roaring 20s" after the 1918 flu pandemic.
"During epidemics, religiosity increases, people become more celibate, they save money, they become risk averse, and we see it all now as we have done during epidemics for hundreds of years," said Christakis.
The economies of ancient civilizations also collapsed in times of disease.
"A lot of people seem to think that it is our government's actions that are slowing the economy down - this is wrong," he said. "It's the virus that is slowing the economy because even in ancient times the economy collapsed when epidemics broke out, even when no government said it would shut down schools and restaurants."
Christakis predicts that that future won't come until society has had time to distribute the vaccine, likely by 2021, and time to recover from the socio-economic havoc he likely wreaked by 2023. But the vision he sets for 2024 and beyond is one that is full of isolated experiences: crowded stadiums, crowded nightclubs, and thriving arts.
"In 2024, all of these [pandemic trends] will be reversed," he said. "People will relentlessly seek social interactions." This could include "sexual licentiousness", liberal spending and a "reversal of religiosity".
In the coming year, these predictions are based on people's continued adherence to social distancing measures. That's because even with two vaccines approved for sale in the United States, there are currently only enough doses to reach 150 million Americans.
Scientists need to develop other vaccine candidates, the government needs to evaluate and approve them if they are safe and effective, and people need to take them to reach the broad enough segment of the population needed to eradicate the pandemic. It will also continue to learn about the vaccines, including how long the immunity they confer and whether they are safe for children.
The coming year will test the world's endurance of maintaining social distance, washing hands, wearing masks and avoiding the crowds, the 14th century's answer to epidemics and breakwater strategies around the tidal wave contain the violence that is now being felt around the world US.
Christakis warns that we have already proven ourselves vulnerable to the poor leadership, lack of coordination, and misinformation that was prevalent during a pandemic. "As a society we were very immature," said Christakis. "Immature and typical, we could have done better."
Misinformation, division, and denial are also features so typical of a pandemic that they may be "required," Christakis said. However, there are still reserves of expertise and it is possible that we will come together to have a challenging year ahead of us.
"Our world has changed, a new deadly pathogen is circulating, we are not the first people to face this threat and we will ask a lot of ourselves," said Christakis. "And we just have to grow up."
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Nicholas Christakis
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