Outbreak!

The Coronavirus outbreak has the city's public-health infrastructure in the spotlight, as they were in other recent episodes like the Ebola scare of 2014 and the Legionnaires outbreak in 2015.

Certainly, most public health work occurs without the adrenaline and media attention that an outbreak brings, even if the stakes of fighting obesity, addressing Diabetes or preventing the spread of Hepatitis—to name just a few campaigns—are just as high.

But emergencies like the current one do remind New Yorkers of the importance of our disease-response apparatus, and of the complex environment in which it operates: a city with millions of residents and millions more commuters and tourists who crowd onto subways, commuter trains, buses, elevators, airplanes and ferries to get to or around the city ... and then disperse to neighborhoods, outlying towns or more distant places.

The response to the current threat is occurring as we speak, and to some degree it's being evaluated in real time. Years from now, a more robust review will be possible. Chances are, there will be high and low points seen in the city's performance.

Such was the case in the famous 1947 smallpox outbreak, when New York successfully vaccinated millions. While considered a public health achievement of the highest order, hindsight has permitted some scholars to find flaws in the vaccination campaign: that it suffered from logistical problems, failed to give full information to the public, and might have been carried out even after the threat of a serious outbreak had been all but eliminated. There might be lessons from that episode to guide the current effort. Already, it seems the city and state have been offering more (and more candid) information than their counterparts in the 1940s did.

The deeper lesson from the history is that no public-health crisis response is ever perfect. It has to be evaluated on the broad strokes. Mistakes are inevitable. Perfection is impossible. Historians will ask: Did the response save lives and prevent illness where possible, without doing undue harm in the process? And the survivors will be able to judge.

- Jarrett Murphy, executive editor

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