Medical Historian Says Pandemics Are 'Looking Glasses' For Societies | KUNC

Medical Historian Says Pandemics Are 'Looking Glasses' For Societies

Apr 29, 2020
Originally published on April 30, 2020 12:23 pm

In his book, Epidemics and Society: From the Black Death to the Present, Yale medical historian Frank Snowden explores how, for centuries, disease outbreaks have transformed societies across the globe.

Pandemics "serve like looking glasses" that reveal societies' flaws — and their commitments — Snowden said on NPR's Morning Edition.

Take cholera. When the disease swept Paris in the 19th century — an epidemic that killed some 20,000 Parisians — the fear fueled repression of the working class. Not only did they represent a political and economic threat to the more powerful, they were now also a health threat, Snowden said.

But it also paved the way for the sanitary revolution. The reform movement, pioneered in Great Britain, brought public health infrastructure, like sewage systems, drainage, and the efficient delivery of clean water to industrial cities.

Right now, it's the COVID-19 pandemic that's testing our health and character.

It's clear that the outbreaks are disproportionately affecting certain populations, including communities of color, those lacking health insurance and poor people.

As far as society's response to its impacts, only time will tell, Snowden says.

"We're waiting to see whether, in fact, part of the coronavirus' impact will be to encourage us to take a closer look at our society, to right some of those inequities and to address the causes that enabled our vulnerabilities to be exploited by this virus," he says.

Snowden was researching in Rome when the coronavirus spread to Italy and decided to stay to write about Italians' response.


Interview Highlights

On Rome's response to the coronavirus outbreak

The local Rome newspaper, Il Messaggero — or The Messenger — said that this was the first time in three millennia that the people of Rome had ever been obedient. ... And although there's a lot of suffering, people do actually accept that the only weapon that there is is social distancing and that the lockdown is the only way that we'll all get through this.

On how pandemics are a test of a society

They're very, very interesting to study because one of the things that they do is they serve like looking glasses in which societies see their own reflection. They reflect our deepest worries and concerns about our own mortality, about our attitudes towards religion and God. What is our consent to authorities and how far do we trust them? What are our commitments to our families, our friends, our neighbors? So I do believe that this is a series of events that really shows what the real commitments of society actually are.

On how the American response to the coronavirus pandemic is different from other countries

America is experiencing this disease differently from the way that Italy, for example, is. There has been more trouble obtaining the kind of compliance that the Roman newspaper was so proud of, because America has a fragmented system in which you have 50 state authorities with all of the governors saying each a different thing. And on top of that, you have the federal authorities saying yet another thing. And we have the president contradicting the World Health Organization. ...

So there are all of these factors that you don't see in the European Union, where you have a unified message. And I think that's created a different experience entirely of the disease.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

STEVE INSKEEP, HOST:

The English novelist Daniel Defoe is best known for writing Robinson Crusoe. Another of his novels from centuries ago is "A Journal Of A Plague Year (ph)." Medical historian Frank Snowden says that novel describes a real-life disease that swept through London in 1665.

FRANK SNOWDEN: You read in "Journal Of A Plague Year" by Defoe that parents left their children, that priests and authorities fled the city of London, that husband and wife deserted each other.

INSKEEP: The bubonic plague tested people's character as well as their health. It revealed what people really valued or did not. Frank Snowden is the author of a nonfiction book, "Epidemics And Society: From The Black Death To The Present." And he says he's been keeping his own real-life journal of a plague year - or more precisely, a coronavirus year. He was researching in Rome when the pandemic arrived. And he decided to stay, writing about the Italian response.

SNOWDEN: The local Rome newspaper, Il Messaggero - The Messenger - said that this was the first time in three millennia that the people of Rome had ever been obedient. And in my experience, it's rather like that. People line up for buying groceries. That's the only thing you're allowed to do outdoors. And some people say, well, we're all in it together. And so there is a sense that people really do understand the reasons for this. And although there's a lot of suffering, people do actually accept that the only weapon that there is is social distancing, and that the lockdown is the only way that we'll all get through this.

INSKEEP: Is a pandemic like this a test of character of a society historically?

SNOWDEN: Oh, I absolutely believe that pandemics - they're very, very interesting to study because one of the things that they do is they serve like looking glasses in which societies see their own reflection. They reflect our deepest worries and concerns about our own mortality, about our attitudes towards religion and God. What is our consent to authorities? And how far do we trust them? What are our commitments to our families, our friends, our neighbors? So I do believe that this is a series of events that really shows what the real commitments of society actually are.

INSKEEP: Is there anything distinctive about the way that Americans have experienced pandemics and responded to them?

SNOWDEN: That would probably be difficult to generalize. Now, I can say, though, that America is experiencing this disease differently from the way that Italy, for example, is. And I think there has been more trouble obtaining the kind of compliance that the Roman newspaper was so proud of because America has a fragmented system in which you have 50 state authorities, with all of the governors saying each a different thing.

And on top of that, you have the federal authorities saying yet another thing. And we have the president contradicting the World Health Organization and saying, well, actually, we don't accept the term COVID-19. We want to call it something else. So there are all of these factors that you don't see in the European Union, where you have a unified message. And I think that's created a different experience entirely of the disease.

INSKEEP: Many people have observed that this pandemic seems a little bit easier to avoid if you're well off. It's easier to isolate yourself, easier to get someone to deliver everything rather than going out for stuff. You are, perhaps, more likely to work the kind of a job that you can change the hours or work at home. What kind of a test of character is it of a society when it turns out that the poor are more vulnerable to a pandemic?

SNOWDEN: Well, it is true that a respiratory disease, by its very nature, can infect anyone. And we see that this pandemic has affected the rich and famous. But it's not actually a disease that is democratic and of equal opportunity. For example, what are the self-protective pieces of advice that the CDC, the government, the WHO give? They say you should practice social distancing. And you should wash your hands. What meaning do those have if you can't, in fact, stay home from work if you're sick because you don't have days off?

If you aren't covered by insurance, what happens if you live in poor and deficient overcrowded housing, where nine people might live in an apartment and in the midst of a larger building which is really, really overcrowded? And so we see that in New York City, there's a correlation between the proportion of people who are sickened and die per 100,000 of population that maps onto the zip codes. It's killing Hispanics, Native Americans and African Americans at a much greater rate because in America, economics and race are inflected together.

INSKEEP: I guess we might like to think that that would cause us, as a society, to reach out to the less fortunate. But you write that the opposite happens, doesn't it? Sometimes this phenomenon causes the wealthy to turn against the poor because they see the poor as dangerous vectors of disease.

SNOWDEN: Yes. I was thinking of the 19th century response to the working class. Working classes were called the dangerous classes. There was a ferocity in the repression that reflected the fact that the powerful actually were very frightened and afraid. And they were afraid politically, economically and medically. And I think all of that comes together in one package.

That doesn't mean, however, that this is the way the response always is. And we're waiting to see whether, in fact, part of the coronavirus, its impact, will be to encourage us to take a closer look at our society, to right some of those inequities and to address the causes that enabled our vulnerabilities to be exploited by this virus.

INSKEEP: Frank Snowden is a medical historian at Yale University and author of "Epidemics And Society: From The Black Death To The Present." He joined us via Skype from Rome, where he's in lockdown. Thanks so much.

SNOWDEN: Thank you very much. It's been a pleasure to be with you.

(SOUNDBITE OF ED CARLSEN'S "LOOSE") Transcript provided by NPR, Copyright NPR.