On 7 September 1854, in the middle of a raging cholera epidemic, the physician John Snow approached the board of guardians of St James’s parish for permission to remove the handle from a public water pump in Broad Street in London’s Soho. Snow observed that 61 victims of the cholera had recently drawn water from the pump and reasoned that contaminated water was the source of the epidemic. His request was granted and, even though it would take a further 30 years for the germ theory of cholera to become accepted, his action ended the epidemic.
As we adjust to another round of coronavirus restrictions, it would be nice to think that Boris Johnson and Matt Hancock have a similar endpoint in sight for Covid-19. Unfortunately, history suggests that epidemics rarely have such neat endings as the 1854 cholera epidemic. Quite the opposite: as the social historian of medicine Charles Rosenberg observed, most epidemics “drift towards closure”. It is 40 years since the identification of the first Aids cases, for instance, yet every year 1.7 million people are infected with HIV. Indeed, in the absence of a vaccine, the World Health Organization does not expect to call time on it before 2030.
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