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In the midst of the COVID-19 pandemic, it is difficult to assimilate the global transformation that has taken place in just a few short months.As we each struggle to make sense of this life-altering event, it might be helpful to reflect on the history of pandemics in general. 

In his book, “Epidemics and Society”, published last year, Frank Snowden does just that.1 Exhibiting diligence and deep knowledge, Snowden demonstrates how pandemics have shaped history and how history has shaped pandemics.  In doing so, he helps us understand the complex interplay among biological, social, economic, environmental, and political factors as pandemics have come and gone throughout human history.

As an example of pandemics shaping history, Snowden relates the story of Napoleon’s attempt to suppress the slave rebellion in what is today’s Dominican Republic.  The rebels understood that yellow fever, to which most African slaves were immune, could help them defeat the French army. When the French arrived in late winter, the rebels embarked on a guerilla warfare strategy forcing them to stay huddled in the ports until the weather warmed up enough for yellow fever to spread among the soldiers. Within months, the decimated French army surrendered and Napoleon decided that without this foothold in the New World, he would sell the Louisiana territory to the U.S. and turn his attention eastward to Russia and India.  

But history has also shaped pandemics. The bubonic plague in Europe, the most lethal of all pandemics to date, would likely have been dramatically less severe had there not been a robust shipping industry that brought the rats (rattus rattus) that carried yersinia pestis from far flung ports in Asia. Likewise, urbanization facilitated the spread of diseases such as cholera.

Another fascinating theme in Snowden’s book is the impact of pandemics on the gradual development of public health and advances in medicine. He carefully traces the first quarantines in Italy to control the spread of bubonic plague, the development of smallpox vaccine by Edward Jenner, and efforts to improve sanitation in response to cholera. He describes advances in science and medicine that led to Louis Pasteur’s germ theory, the development of antibiotics, polio vaccine, and anti-viral drugs. 

Even with all those advances, Snowden argues that microbes possess formidable advantages in their Darwinian battle with humans: “they enjoy enormous mutability, and they replicate a billion times more quickly than humans.” 2  As this millennium has already seen outbreaks of SARS, MERS, Ebola, Zika, and now COVID-19, there is a compelling need for health care professionals to help find ways to advance our knowledge and skills in managing pandemics.

In our discussions with providers across the country, we’ve been struck by the many examples of courage, commitment and creativity they’ve exhibited in confronting the immediate challenges of this pandemic. Applying that same approach and collaborating across sectors, from providers and health information technology to public health and pharmacy, we can all help define the longer term solutions that will protect us from the ongoing threat of this and future pandemics. 

1Epidemics and Society From the Black Death to the Present, Frank M. Snowden, New Haven & London, Yale University Press, 2019

2IOM Emerging Infections: Microbial Threats to Health in the United States, Washington, DC: National Academy Press, 1992

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Dr Lustick

Dr. Martin Lustick

Senior Vice President, NextGen Advisors

Dr. Martin Lustick is a principal and senior vice president with NextGen Healthcare focused on supporting provider organizations in their successful transition from volume to value-based care.

Dr. Lustick earned a BA in History from Cornell and an MD from Columbia. After completing his pediatric residency at Children’s Hospital National Medical Center in Washington, DC, he was in clinical practice for 17 years with Kaiser Permanente of the Mid-Atlantic States. While there, Dr. Lustick held various management and leadership roles, including chief operating officer for the 800-physician medical group. He oversaw development of their hospitalist program, population health capability, and open access delivery model.

Dr. Lustick then served as chief medical officer for ThompsonHealth—a small health system in Canandaigua, NY—where he provided clinical oversight for hospital, SNF, nursing home, IT, and out-patient physician practices.

In 2005, Dr. Lustick assumed the role of SVP & CMO for Excellus BCBS which covers 1.6 million lives comprised of Medicare, Commercial, and Medicaid. In his 13+ year tenure there he led a variety of strategic initiatives, including a patient-centered medical home program which served as the foundation for the plan’s value-based payment strategy. He also led the implementation of an automated authorization program for care management services, development of a clinical quality improvement strategy, and creation of innovative programs in management of low back pain, screening and prevention, opioid addiction, and chronic disease management.

Dr. Lustick has also been very active in the community, serving on boards and committees confronting issues such as: healthcare capacity planning, Health Information Exchange, mental health, substance use disorders, social determinants of health, and childhood obesity.