"Civilization Evolved by Fighting Infectious Diseases, and It Will This Time Too"

[Special Edition] Interview - How Will Life Change After COVID-19?

1946 Cholera Outbreak Leads to Daegu Lockdown
Public Outcry Erupts as 'Lockdown' Is Discussed Amid COVID-19
Infectious Diseases Have Influenced Human Civilization Since Its Formation
Trigger for Modern Hygiene Institutions
Proactive Investment in Expanding Public Healthcare

Since the outbreak of the infectious disease "COVID-19" in January 2020, the world has been walking a path it has never taken before. This infectious disease, which disrupted relationships and erected high barriers to interaction, instantly froze the global economy. The world trapped by the infectious disease demands changes to traditional ways of life. The path is always daunting and distant. Even if we fall and break, let us move forward together, holding onto hope, pushing and pulling each other. / Photo by Hyunmin Kim kimhyun81

[Asia Economy Reporter Choi Dae-yeol] The plague that swept through Europe in the 14th century brought down the Western Middle Ages. As clergy members who treated patients died in large numbers, the authority of religion declined, eventually leading to the Reformation. With countless people lost, labor became scarce, and one pillar of the Middle Ages, the manorial system, also collapsed. Thus, modernity arrived.

The situation in Daegu in October 1946, often described as a riot or uprising, also had infectious disease at its root. Cholera spread amid the lax quarantine system around the time of liberation. The lockdown of Daegu to stop the spread triggered a public outburst. Coincidentally, this year in February, when COVID-19 cases surged in South Korea, the backdrop was again Daegu. The particularly strong backlash against calls for lockdown measures, mainly from political circles, likely stems from trauma lingering from decades ago.

Considering that dozens of cases still occur daily domestically and hundreds of thousands worldwide, the COVID-19 crisis is ongoing. Despite 8 million infections in less than half a year, the forecast that "this is just the beginning" (Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases) makes us more apprehensive. However, humanity has not been paralyzed by fear because it has experience overcoming or controlling numerous infectious diseases since the dawn of civilization.

Looking back at the past to diagnose the present and prepare for the future is an immediate task before us. We asked experts who study the history of medicine and healthcare how humanity dealt with infectious diseases in the past. Professor Park Yoon-jae of Kyung Hee University, who researches the history of Korean medicine and healthcare centered on modern times, leads the Humanities Korea+Integrated Medical Humanities Research Group. Professor Yeo In-seok of Yonsei University Medical School, who is rare as a physician specializing in Western ancient and modern Korean medical history and medical philosophy, teaches and produces research outcomes in these fields.

Professor Park Yoonjae, Sogang University

- How did attitudes toward infectious diseases in the past differ from today?

▲Professor Park Yoon-jae (Park)= The 19th-century pansori 'Byeonggangsoejeon' includes the phrase 'Sinsa Year Strange Disease.' This refers to cholera, which began in India in the early 19th century and spread to Britain and Europe. The Sinsa Year was 1821, when cholera also spread in Joseon, causing great shock throughout society. There were far fewer means to counter it compared to now, so fear was inevitable. People who were healthy suddenly lost all body fluids through vomiting and diarrhea, becoming emaciated to the bone. Tuberculosis was considered a disease with no cure, slowly killing patients. Some even took their own lives after contracting tuberculosis.

▲Professor Yeo In-seok (Yeo)= During the Joseon Dynasty, public institutions like Hwalinseo were established to treat and provide relief during infectious disease outbreaks. However, these efforts were more ritualistic than medical, such as performing rites to appease spirits, as infectious diseases were believed to be caused by vengeful ghosts. Nonetheless, the state issued specialized medical texts like Heo Jun's 'Byeokyeok Sinbang' and Jeong Yak-yong's 'Magwa Hoetong' to cope with epidemics, which was unprecedented.

- How does society change after experiencing infectious diseases?

▲Yeo= Infectious diseases have influenced human civilization since its inception. For example, although the climate south of the Yangtze River in China is favorable and fertile, civilization arose in the dry and barren Yellow River region to avoid infectious diseases. The development of the Jiangnan region in China began much later during the Song Dynasty. This shows that the establishment of civilization itself was a way to avoid infectious diseases. In modern times, infectious diseases also influenced the legitimacy of state authority and coercive power. Patients were forcibly isolated, and personal freedoms restricted, but the majority of society accepted these measures.

▲Park= Modern administrative systems enabled states to implement hygiene policies. In East Asia, including Korea, cholera triggered the establishment of modern hygiene institutions. Considering the historical context, this can be seen as a form of enlightenment. To effectively prevent epidemics, the general public must first understand what infectious diseases are. For example, in late Joseon, when Ji Seok-young tested the smallpox vaccination method by first inoculating his brother-in-law, his family strongly opposed it. After confirming that it prevented smallpox, they accepted it. This laid the groundwork for new ideas to take hold.

Professor Yeon In-seok, Yonsei University College of Medicine

- What constitutes proper quarantine measures?

▲Park= During the Japanese colonial period, police-led measures to control cholera involved isolating anyone showing similar symptoms. Given the authoritarian rule in the 1910s, these methods were coercive and violent. Since quarantine inherently involves enforcement, some coercion is unavoidable, but whether these measures effectively prevented epidemics and reduced harm requires closer examination. For example, the 1910 plague outbreak in Manchuria led to border closures along the Amnok River, which was likely the only option at the time, but the efficiency of such forced measures is debatable. Determining the level of quarantine also requires considering the characteristics of the disease itself. As revealed during the COVID-19 response, active cooperation from citizens is a crucial factor.

- There are calls to expand public healthcare in light of the COVID-19 crisis. What are your thoughts?

▲Yeo= Even countries in Europe with well-established public healthcare systems suffered significant damage. This shows that such systems are not a panacea. In places like Italy, healthcare systems are influenced by the political orientation of the government. Attempts to reduce costs and maintain only the minimum healthcare infrastructure led to situations that societies could not handle when crises struck. The COVID-19 crisis has fostered consensus that investing proactively in seemingly unnecessary areas is necessary. People have realized that some systems must be maintained despite a certain degree of inefficiency.

- COVID-19 may resurge, or entirely different infectious diseases may emerge. How should we prepare?

▲Park= Every epidemic changes society. The key is how well society transforms into a better one. While we will continue social distancing and focus on vaccine and treatment development, we also need to consider how to respond to diseases, the role of the state, and international cooperation, taking into account societal realities and human nature. The current situation, where wild infectious diseases attack humanity, also means that all modern people enjoying the fruits of reckless development cannot be free from responsibility.

This content was produced with the assistance of AI translation services.