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COVID-19 is not the first pandemic in history and is unlikely to be the last, thus it is important to clarify the historical aspects of pandemics.

Ieva Lībiete (pictured), Assistant Professor and Head of the Anatomy Museum at Rīga Stradiņš University (RSU), will speak about this at the international COVID-19 conference Impact, Innovations and Planning on 28–29 April.


Why is the subject you are going to talk about at the conference important to society?

At the conference, I will look back at the history of medicine and try to answer a question that is relevant today: how do pandemics really end? How people decide that an epidemic in a particular place is over and they can return to normal life. This is a little-studied topic in the history of medicine, as most researchers have been interested in how epidemics started, how they spread to the scale of a pandemic, and how society reacted to them. Very few researchers have looked into how pandemics end. This is largely due to a lack of historical sources, as people stopped writing about it during the decline of epidemics.

Looking back in history, what were the most devastating pandemics?

Traditionally, the plague pandemic of the 14th century, more commonly known by its Gothic name, the Black Death, has been considered the most devastating. It is estimated that an average of 30–60% of the entire European population may have died in this pandemic, which lasted from 1346 to 1353. Some historians believe that this pandemic contributed to the collapse of feudalism and even, in some ways, to the Renaissance. This epidemic has left its mark not only on the history of medicine, but also on literature and art. Mortality was so great and present in everyday life that the Danse Macabre, or dance of death, an allegory of the all-conquering power of death, emerged in art at that time. It was a literary, musical or illustrative representation of the procession of the living and the dead, in which the living are ranked according to their social status. A striking example of Danse Macabre from the 17th century is just a stone’s throw away – as a fresco in Tallinn’s St. Nicholas Church.


'Danse Macabre' by Bernt Notke

Can you give an example of a pandemic ending?

To answer this question, I find it useful to distinguish between biological and social pandemics, where a biological pandemic is a certain biological reality, and a social pandemic is society’s response to that biological reality. And these pandemics – social and biological – do not always coincide and overlap in time. Strictly speaking, in the biological sense, there has been only one pandemic that is completely over. It was black pox, caused by the variola vera virus and completely eradicated in the late 1970s. More often than not, the end of a pandemic is considered to be the point at which the incidence drops to endemic levels, when society accepts the disease as part of everyday life and learns to live with it. One thing is clear from the study of medical history: epidemics and pandemics have never ended suddenly in history, and this has always been not only a biological and medical decision, but also a social and political one.

How could knowledge of the history of pandemics help us to cope with them today and in the future?

We cannot easily draw parallels with epidemics of the past and today, if only because the world we live in today is very different from what it was during the plague, black pox, or even the relatively recent Spanish flu. I will say as I say to my students of the history of medicine: knowing the history of medicine teaches us humility and helps us to be healthily critical of contemporary developments.