While I wasn't live for the 1918 flu pandemic, I recall the glory years of antibiotics and vaccination in the 1960s and 1970s when it looked like infectious diseases would be controlled and no longer kill on a large scale. Then came the 1980s and it became obvious that was not the case.
When I was first starting in medicine, a lot of young men were dying of a strange disease. They tended to be from certain neighborhoods, like West Hollywood in LA or the Castro in SF. I remember that it wasn't even clear initially that it was an infectious disease. It took a while to sort out, and a lot of activism to get enough funding to develop a test for it and later a treatment. An excellent book on this history is Randy Shilts' "And the Band Played On."
I remember my colleagues being afraid to treat patients with AIDS, as this new disease became known. They were afraid of the infection and the inevitable death. I remembered my mother, who as a nurse became infected with hepatitis. It went on to become chronic active hepatitis. That taught me that my choice of medicine as a career was not without risks. Yes, I would use precautions, I would double glove, but I would not refuse care.
Finally, in the 1990s, a treatment was discovered for HIV, and it became a manageable disease. So, healthcare personnel became more comfortable treating HIV patients. And, we became more used to using more protective equipment.
In the last couple decades, we have had a few pandemics. Several have not made it to the US. We have become better at managing these pandemics. Yet each has cost too many lives. Now, we are again seeing something that kills a lot of people, though not as many as HIV in the early days. The mortality is greater than most seasonal flu illnesses, maybe in the range of the pandemic of 1918. And, it is a new virus, so none of us are immune. It has spread faster, and has overwhelmed health systems, forcing doctors to choose who they should treat based on who they have a chance of helping. While we are all taught the concept of triage--dividing patients into those who will survive regardless, those who will die regardless, and those for whom treatment will make a difference--it is rare to have to make these decisions. And, healthcare personnel are becoming infected and dying, despite knowing to use PPE (personal protective equipment).
Leaders have not understood the seriousness quickly enough. Again, many people will die as a result.
