Dr. Howard Markel. Courtesy of the University of Michigan.

Dr. Howard Markel, a local Jewish medical expert at the University of Michigan, speaks about his research into pandemics and how the U.S. is handling the COVID-19 outbreak. 

Throughout the coronavirus pandemic, the term “flatten the curve” has been used by a number of health officials and federal and state leaders as a public health strategy to slow down the spread of the virus. The term was coined by Dr. Howard Markel, a local Jewish medical expert and professor at the University of Michigan. 

Markel is the George E. Wantz, M.D. Distinguished Professor of the History of Medicine and Director of the Center for the History of Medicine at the University of Michigan. He has written multiple books about infectious diseases, including Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 and When Germs Travel: Six Epidemics That Invaded America since 1900 and the Fears They Unleashed. 

The term “flatten the curve” was coined by Markel while he was conducting research on the 1918-1919 Spanish Flu pandemic, which he did following the SARS pandemic in 2004. 

“I was eating a very bad noodle dish while we were working late at night,” Markel said. “The noodles were in some kind of Styrofoam container so they all formed one big flat noodle, and it was a joke that the flattened noodles were like the curve. And that’s where flatten the curve came from.”  

After the SARS pandemic in 2002-2004, Markel was asked by the George W. Bush administration to work with the Centers for Disease Control and Prevention (CDC) to help develop guidelines for a national response for future pandemic outbreaks. 

“The one thing we were concerned about back then was avian influenza, or bird flu, so that was the emergency or the thing that spurred this on,” Markel said. “The bird flu became a big problem for birds, but not for humans.” 

During the Obama administration in 2009, there was also a flu pandemic, known as the H1N1 pandemic. According to Markel, that one was not much more lethal than seasonal flu, and did not require the same extensive measures of quarantining and lockdowns. But now the COVID-19 pandemic is different: a much more serious outbreak that has necessitated extreme measures. 

“Because these measures are so disruptive, economically and socially, you only use them for very deadly pandemics, such as the 1918-1919 flu pandemic and now with the coronavirus pandemic,” Markel said. 

Markel’s research focused mainly on response measures known as non-pharmaceutical interventions, which use isolation, social distancing and lockdowns to slow down the spread of the virus.  

During that time, cities throughout the U.S. had their communities quarantine, self-isolate, close schools and limit public gatherings. Throughout Markel’s study, he found that cities that enacted these measures early on were much more effective than other cities that lifted their measures too early and saw another rise in the number of cases. 

His findings from his research on the 1918 pandemic are very similar to how the country is reacting today to the lockdown and social distancing guidelines. 

“The people got restless, just as they did in 1918, and they wanted the various things lifted back then and currently,” Markel said. “So, even though we lifted all those regulations, the virus is still circulating and is still out there. We’re now seeing bumps in several places, and so the curve is no longer flat. We have done all of these measures and we have endured a lot of economic problems, all for nothing because now we have a rise in cases.” 

Markel’s research is reproducible and has helped influence policies that remain in place today for the country’s response to pandemics. Michigan Governor Gretchen Whitmer has even used some of Markel’s graphs during her press releases throughout the course of the coronavirus pandemic. 

As the country begins to open, Markel believes that we are going to see another rise in cases and that as a whole, “we are not out of the woods yet.” Markel reminds people to continue to wash your hands, stay home if you’re sick, wear a face mask and try to minimize your exposure to the public. 

“All our research does is help you hide for awhile from an infectious disease but it doesn’t cure it. The thing that ultimately will cure it is a vaccine,” Markel said. “The epidemic has certainly not gone away, and if we don’t start doing these measures again, a lot of people are going to get sick and some of them are going to die. It is a very viscous virus.” 

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