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Learning From Past Pandemics: Putting Coronavirus In Historical Context

Smallpox_Hospital_west_facade_jeh.jpg
Jim Henderson
/
Public Domain
The Renwick Smallpox Hospital on Roosevelt Island in Manhattan, New York opened in 1856 to treat smallpox patients, and closed in the 1950s.

COVID-19 is not the first pandemic to sweep across the world, and it will probably not be the last. Elizabeth Fenn is a history professor at the University of Colorado Boulder. She joined KUNC's Colorado Edition to explain what we can learn from past pandemics.

Interview Highlights

These interview highlights have been lightly edited for length and clarity.

Henry Zimmerman: Tell us a little bit about what it is you study and why it's important to understand the history of pandemics.

Elizabeth Fenn: I study and teach the history of epidemic disease specifically in the United States. But it's impossible to isolate the United States because these things often unfold in a global context.

My own particular expertise is in the only human disease we have ever eradicated, which is smallpox. Smallpox crossed the Atlantic Ocean with Christopher Columbus, and swept the Americas with really devastating consequences for Native peoples.

There were other very important epidemics, both for Native peoples and for all Americans. Some of the ones that are particularly comparable to coronavirus are some cholera epidemics that swept the United States and the world in the 1800s. Epidemics of yellow fever, even HIV/AIDS and influenza in 1980 are also comparable. These epidemics often reveal the fault lines in the societies where they strike.

Let's talk about smallpox and cholera. Can you tell us a little more about those two examples?

The first smallpox epidemics occurred in the Americas beginning in 1520. Smallpox assisted Hernán Cortés' conquest of Mexico of the Mexica or Aztec peoples. It appears that smallpox exploded out of Central Mexico.

Aztec_smallpox_victims.jpg
Public Domain

Then, a smallpox epidemic struck North America between 1775 and 1782. And if you recall your high school history classes, you might recognize that period as almost exactly the period of the American Revolution. So smallpox disrupted the Revolutionary War. It afflicted George Washington's Continental Army quite severely. The British offered many African Americans freedom during the Revolutionary War, and many of those African American escapees succumbed to smallpox.

Smallpox also swept the West and came through areas like Colorado. It wreaked havoc on indigenous populations. The disease was enhanced in its spread — and this is quite relevant to today — by a transportation revolution. And that transportation revolution was the horse, which expedited travel across broad expanses of territory. Today we talk about the way airlines have enhanced the spread of coronavirus.

Since we are talking about history, we know that these two epidemics we're talking about did come to an end. Could you tell us how we managed to defeat them or if that's even the right way to frame that question. And how did the people living in what is now Colorado — you mentioned indigenous people — how did they respond to those past pandemics?

We actually had several of them sweep the United States (in) 1832, 1849 and 1866. In the aftermath of those epidemics — and then in the aftermath also of a terrible, nationwide yellow fever epidemic — we gradually began to develop a public health infrastructure.

That public health infrastructure helped with sanitation. The streets of New York, for example, were cleaned up. We implemented toilets and others such measures to prevent the spread of epidemic disease.

Now, later on in the 1870s, germ theory emerged as the new paradigm for infectious disease. It took a while to gain traction, because it seemed counterintuitive to many people who assumed that bad air, or miasmas, spread disease. But germ theory and then the development of antibiotics in the 1820s and 1830s revolutionized treatments for infectious disease, at least bacterial diseases.

I think most of us alive today have lived through a heyday during which we really had little fear of infectious disease. HIV and AIDS in the 1980s kind of popped that bubble, revealing how vulnerable we actually are.

As to the question of native peoples in Colorado and elsewhere, they learned very quickly through experience that these new contagions — smallpox, measles, influenza, typhus, typhoid, whooping cough — they learned that these diseases were contagious very quickly.

They often implemented the same kinds of strategies that we use today: quarantine, for example. People didn't understand germs, but they sure understood that these diseases were somehow communicable among people.

They also implemented traditional treatments through shamans and other healers. They sometimes used sweat baths and things like that. They used vision quest isolation to treat epidemic disease. So, they resorted to their own toolkit at a time when I would say neither the indigenous toolkit nor the European toolkit was particularly effective.

The one exception was that Europeans and Africans had adopted a strange immunization technique that they used against smallpox, in particular.

One thing to keep in mind is that frankly, COVID-19 is nothing compared to say, plague, with a case fatality rate of 40% to 60%. We're talking about 1%, perhaps, for COVID-19. Think about a 40% to 60% case fatality rate, or a 38% case fatality rate, which smallpox tends to generate.

This conversation is part of KUNC's Colorado Edition for April 15. You can find the full episode here.

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