Publication Date

April 22, 2020

Perspectives Section

From the President


Medicine, Science, & Technology

Mary Lindemann

Mary Lindemann

Historians know a lot about epidemics and have written extensively and intelligently on the subject across time and cultures. What can this accumulated knowledge do to help us understand our encounter with the novel coronavirus and the disease it causes, COVID-19? How might historians use what we know to analyze what is happening now and place it in a historical framework? How can we use that knowledge to inform, even shape, public reactions and policies?

The first response from fellow scholars might be that it is too early to write about an ongoing crisis as history. Writer Sloane Crosley warned authors recently in the New York Times that this isn’t the time for their books on the virus. I began composing this column on March 16, five days after the World Health Organization declared COVID-19 a pandemic and advised a policy of social distancing. Soon thereafter (sooner in some countries than others), schools, universities, restaurants, cafés, and coffee shops closed around the world. Remote teaching has begun, and toilet paper has flown off supermarket shelves. Conferences have been canceled, sporting events shut down, and even Spring Break was shelved when Miami Beach was declared off-limits in late March. I am very much aware that what I am writing now might be mostly irrelevant by the time my readers open their print-run Perspectives or click the online version in May 2020. By then, we may be mired even more deeply in what has become a public health, economic, and political crisis of still uncertain dimensions, or the virus may be passing slowly into history—though it will disappear neither entirely nor rapidly, and we will surely experience more microbiological threats in the future. At this moment, historians are eyewitnesses; the time for rigorous historical investigation of a major disease and its impact lies in the future.

Historians know a great deal about epidemics in the distant and recent past, but do we have a legitimate role to play right now? Perhaps our first job is to guard against too-quick comparisons and analogies, choosing instead to fight panic with evidence and context. One respected academic compared the ongoing crisis to hurricanes striking a hundred major cities at once. Well, no. The pattern of concern, cost, and destruction differs; COVID-19 will cause no immediate structural damage, no loss of electricity, no failure of water systems, no flood surges.

The time for rigorous historical investigation of a major disease and its impact lies in the future.

COVID-19 is a major crisis, but we have to understand what kind of crisis it is. Comparisons with the global influenza epidemic of 1918–19 might be more relevant. It too was a new virus that caused a worldwide pandemic with mortality rates that remain hard to comprehend. Five hundred million people were infected, and mortality estimates range from 17 to 50 million, with some not improbable conjectures running up to 100 million. The most recent estimates indicate that about 650,000 people died in the United States alone. Now, as then, we are dealing with viral respiratory infections.

But the two epidemics are not identical, and we should be careful about drawing quick conclusions that flatten the differences between them. The 1918 flu affected mostly young adults, in their 20s, 30s, and 40s, and killed more rapidly, with a case mortality greater than 2.5 percent. Case mortality estimates for the COVID-19 virus range from 1 to 3.5 percent; its symptoms appear mild or moderate for most sufferers and tend to pose the most danger to older adults with underlying health problems. But no one is immune, and we are seeing some recent unsettling news about changing demographic trends. In an “average” flu season (for example, in 2017–18), the United States saw about 45 million symptomatic cases and 61,000 deaths, also heavily weighted to the elderly population, those already ill, or those with suppressed immune systems.

COVID-19 has also been compared to the plague, usually called the Black Death, that washed across the world in several pandemics. For many generations, the cause was believed to be the bacterium Yersinia pestis (once called Pasteurella pestis), first identified during the Hong Kong plague of 1894. But in the mid-20th century, a series of historians took another look at the evidence and raised concerns about diagnosing the 14th-century plague as identical to the pandemic of the late 19th and early 20th centuries. More recently, historians and historical epidemiologists working closely with geneticists have convincingly determined that Y. pestis was, in fact, the pathogen.

So who really cares about plague today? Well, to start with, anyone living in an area where burrowing rodents are common; plague is endemic among many of their populations. But there is a lesson specific to our discipline as well: it was historians and historical epidemiologists who applied differing historical and epidemiological methods to develop a series of interpretations over time that reflected the ways successive generations of scholars worked and the (often a priori) ideas they held. Simply put, the epidemics of the past are not inevitably the epidemics of today or the future, even if comparable viruses or bacteria cause them. They differ because we differ: among other changes, we live in a global culture, in (generally) more densely populated environments, and in a far more mobile society.

Comparisons with other epidemics should be made cautiously.

Comparisons with other epidemics should be made cautiously. In assessing the widespread and popular responses to epidemics, we are sure to find reactions of fear, hatred, and scapegoating; we see it happening today, directed especially at China and, more painfully yet, at Asian Americans. But historians who have probed the records more deeply have also found that epidemics call forth expressions of compassion, self-sacrifice, and civic responsibility. Relatively few people abandoned their families and homes, shirked their responsibilities, or fled—even in the face of the 14th-century plague that killed off, at a conservative estimate, one-third of Europe.

Historical study of epidemics can give us a more nuanced picture of the human response and of the impact of epidemics across the globe—material that is interesting and relevant, and that has produced marvelous works of scholarship that use epidemics to explore broader historical topics (one need only mention Charles Rosenberg’s classic The Cholera Years). Still, the real value of the historian, both for examining epidemics in the past and for exploring how we live with this epidemic today, lies elsewhere. Scientists and physicians can describe how epidemics and diseases spread, and what can be done to prevent them; but it is the humanists, the social scientists, the ethicists, and certainly the historians who understand that successfully fighting an epidemic depends not only, or even principally, on scientific knowledge, vital as it is.

Rather, historians can help to explain why certain cultures, groups, and individuals have reacted to epidemics in particular ways; how hard or easy it is to change those ways; or why fear and loathing so often have deeper and more varied roots than the knee-jerk dread of infection. Historians understand the cultural, social, intellectual, religious, and philosophical differences that condition human responses. We also understand, perhaps as well as any working scholars, that all epidemic situations require us to balance privacy and individual rights against the good of the larger society. We are able to embed “resistance” to “rational measures” in a broader milieu of attitudes and assumptions. Herein lies our unique value, our civic contribution, and the area where our knowledge is critical to a situation that is not quite as exogenous or capricious as it may at first seem.

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Mary Lindemann
Mary Lindemann

University of Miami