Frédéric Vagneron

post-doctoral fellow at the Centre Alexandre-Koyré in the One Health Major Area of Interest research network, has recently written an article on the Russian flu pandemic of 1889-1890.

(Interview conducted in June2020)

In what way did French analysis of the 1889-1890 Russian flu pandemic mark a turning point in epidemiology statistics?

In analysis of this pandemic, particularly in France, an entirely new tool—excess mortality calculations—was used to capture the effects of the disease. That conceptual and practical statistical tool remains a compass today for rendering intelligible such uncertain, complex phenomena as heat waves or the emergence of a new virus, like SARS-CoV-2, that are likely to trigger controversy, at least when they first appear. In 1890, statistics were also used to show that flu was a contagious disease, a question that had been hotly debated until then.

In 1889-1890 in France, public concern about population decline (depopulation) became more acute than concern about the Russian flu pandemic. What’s the situation in our current health crisis? Has the COVID-19 pandemic brought to light other societal conc

The way figures were used in 1889-1890 can serve as a reminder that statistics are always intimately connected with how data is collected and processed, and what the interpretative contexts of the time—the medical, demographic or political debates—may be. Figures are used to construct a way of understanding the present or past—or a way of remaining ignorant of them. In 1889-1890, there were two simultaneous developments in France: the flu was captured in unprecedented fashion by way of the excess mortality figure; but then the peak in mortality was positioned within another statistical series, that of population decline within the country. The effect was to undermine the impact and scope of the epidemic as social “fact.” The flu came to look like an accident compared to another demographic and political “fact”—depopulation—which more preoccupying and therefore seen as more urgent than public health, particularly by the French elites of the time, who had their eye on trends in French population size compared to the German population.

 

Today we are coping with an even more impressive avalanche of figures, quantifications that are then used as the basis for constructing “social facts.” Some of those facts seem substantial enough to resist the passage of time. For example, the inegalitarian effects of this pandemic by age or housing type and location. This points us in the direction of social issues such as aging and housing, the second dating back at least to the early nineteenth century and the first to the late nineteenth century. In both cases, statistics have played a decisive role in making those inequalities visible. While the high excess mortality from COVID-19 among older persons and residents of the Seine-Saint-Denis département [just outside Paris, with large numbers of poor residents living in cramped quarters] can be measured and spatially represented, that does not mean—just as it did not mean in the past—that public policymakers are going to use that information to make changes. These are enduring, familiar “social issues.” Nothing says that the data will lead to strong action to bring about profound changes in the way older people or people living in notoriously constricted, not to say unhealthy, housing are treated. In the economic crisis context that lies ahead, those “facts” may once again fail to get a hearing.

Lockdown was one of the responses to the COVID-19 pandemic. More broadly speaking, how would you analyze the reactions of the public authorities and French society at large?

Whether or not one is a historian, it is hard to abstract oneself from a pandemic situation that is still evolving. We need to be cautious and we need to investigate, but that’s still difficult because of the effects of lockdown. 

The public authorities concentrated on an objective: to avoid overwhelming the hospital system. In France, for reasons that need to be elucidated, the pandemic was spreadin so rapidly in March that there was no real alternative to lockdown. France might have taken the same measures as Germany at the national level, which would have resulted in a more restricted, locally targeted lockdown or one aimed to protect certain population groups, like dependent people in nursing homes. But it is always easy to declare retrospectively what should have been done differently, when in fact this was a new virus—unknown three months prior—and the disease it causes varies widely by individual. Under the circumstances, we need to understand and explain why it became indispensable to close down the country, given the lasting social and economic risks that that implied. 

What is regrettable is that the COVID-19 event was not understood as an episode in a series of health crises that have been occurring at least since the 1980s—and despite the severity of the current pandemic. This time it was a bat or a pangolin; yesterday it was farmed chickens or pigs, or civets …. The “guilty party” changes each time but the context remains the same: exploitation of the environment, subjection of other species to our own—untenable actions that benefit solely a minority across the globe. This perspective should lead us to think of all these episodes as a bundle of crises rather than looking at each epidemic “wave” separately and in emergency conditions. All of them point to our ways of living, our domination of the environment, other animal, and vegetal species, when the fact is that we live in a connected ecosystem.