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By SARA ARTHURS
Much of what is happening during this pandemic may feel new and strange — but disease outbreaks have been a fact of life throughout human history. And there are things learned from past pandemics that are shaping how we respond to this one.
The history of cholera in America “holds a lot of lessons” and that experience helped Americans develop public health practices that have been used since, said Jacqueline D. Antonovich, assistant professor of history at Muhlenberg College in Pennsylvania.
Cholera had previously existed in Asia, but in the 19th century it spread across the globe.
She said people say it’s a modern idea that transportation allowing us to fly all over the world quickly helps disease spread rapidly. But, in the 19th century, it was a similar phenomenon — there were suddenly faster ships available. So people could travel across the ocean in the time it took the cholera bacteria to incubate, bringing it from one continent to another.
New York City had big outbreaks of cholera in 1832, 1849 and 1866. During that time, Antonovich said, there were improvements in sanitation and science. During the first two outbreaks, “the response from the city was really inadequate.” There was no permanent board of health, just temporary boards that were created, and made up not of doctors but of business owners looking out for the city’s economic interests.
By 1866, by contrast, New York had created a metropolitan board of health that had the power to enforce orders and levy fines. Historians say that this — along with improvements in sanitation, and germ theory — made a difference, she said. In 1866 New York had a larger population, but there were fewer deaths.
When the Spanish flu pandemic began in 1918, we were at war, and “only decades into” understanding germ theory, Antonovich said. Government transparency was a “huge issue.” All the countries involved in World War I were censoring the press, she said. (The “Spanish” flu actually is believed to have started in Kansas. It got its name because Spain was one of the few places where people were openly writing about it.)
There was a fear that “if you’re completely transparent you may cause people to panic,” but if you’re not, people tend to fear everything, Antonovich said. And what they see with their own eyes might not match up with what they are hearing.
“I see certain parallels today” with government officials at first downplaying the coronavirus outbreak, she said.
On the other hand, now we can all get lots of information from social media, but she said we must figure out what to believe.
“We tend to blame the other when pandemics happen,” said Antonovich, who was preparing to teach a history of public health class about AIDS. HIV was at first called GRID, or “gay-related immune deficiency.” And some people, especially religious figures, advocated quarantining all gay men, Antonovich said.
In the cholera outbreaks, the wealthy blamed the poor, she said.
And in the early 1900s, there was a bubonic plague outbreak in San Francisco’s Chinatown. Health officials quarantined Chinatown, but while Chinese people couldn’t leave, white people were allowed to go in and out, she said. And the quarantine was gerrymandered so its borders bypassed businesses owned by white people.
Today if people refer to COVID-19 as a Wuhan or Chinese disease, there are effects on the Asian-American population, she said.
“It’s more than just a pedantic argument… These words have power,” Antonovich said.
Elizabeth Buchanan is assistant professor at the University of Findlay. She teaches global history, which includes teaching on the “Black Death,” which is “probably the most fatal pandemic in recorded history”.
“Humans have tended to want to blame someone” when things like this happen, Buchanan said. During the Black Death, there were massacres of Jewish people, who were blamed for the plague.
The plague has a long history dating back to the Bronze Age, and has been found in tests on bodies from 3000 B.C., Buchanan said.
But the most famous outbreak peaked in Europe between 1347 and 1351, reappearing every generation until the 17th century. The death toll was estimated at 75 to 200 million people throughout Eurasia including China, Europe and northern Africa, Buchanan said.
The death rate was aggravated “by war, famine, poverty and weather,” Buchanan said.
Buchanan said one similarity between the current pandemic and the Black Death is that people’s physical condition before they got sick was a factor in how they fared. With wars going on, famine caused by agricultural failures, and high poverty rates, many people were physically weakened even before they got the plague, she said.
Cities at the time were dirty and unhygienic, and the wealthy residents tended to flee to other communities “while the poor tended to suffer and die,” Buchanan said.
She said the Black Death hit cities the hardest — but there is some evidence of the Black Death having hit rural areas. Earlier this year there was a report of a mass burial site discovered in the rural United Kingdom. Carbon dating put it at the 14th century, and when they sampled the remains, researchers found this bacterium.
Doctors were “terribly at risk” then as now, she said.
The plague still exists today, but with modern antibiotics, people are more likely to survive if they get sick.
One theory that has been posed is that the Renaissance grew out of the Black Death, Buchanan said.
Ohio Northern University history professor Russ Crawford recently researched past pandemics, including the Black Death and flu pandemics for a presentation for students.
He found in an old newspaper article that, during the Spanish flu, the president of ONU closed literary societies, the primary form of social gathering, and ordered other activities and meetings abolished.
“But we didn’t cancel the football season,” he said.
Joy Bennett, curator/archivist at the Hancock Historical Museum, recently researched the Spanish flu in Hancock County. She found newspaper articles mentioning a school closure in Arlington, and encouraging parents not to let their children gather in groups.
“A lot of it was exactly what we’re seeing today,” she said.
She also read that stores were prohibited from having sales, so there wouldn’t be a large crowd of people all in the store at once.
Bennett also found in her research that the Red Cross had refused to allow black nurses to help in the fight against the pandemic until near the end.
She said doctors and scientists likely learned a lot from the Spanish flu about the importance of quarantine and social distancing.
Bennett found research about soldiers coming home and throwing parties with a population that was by that point tired of quarantine. It led to “the deadliest” part of the pandemic. She said she sees similarities with people recently urging that we let up on social distancing.
Bennett said that the era of the flappers and the Roaring 20s followed the more somber time of World War I and the Spanish flu pandemic, perhaps as young people who had survived both the war and the flu were now “celebrating” being alive.
Crawford said he suspects that there’s more fear now than there was in 1918 — in part because of Twitter, and in part because our popular culture has included a lot of movies about pandemics and zombies.
At the same time, he said, within our lifetime there have been other outbreaks that might have become more deadly and widespread — but didn’t — which may mean people aren’t taking it as seriously.
Antonovich said the things we’re seeing public health leaders advocate for, like social distancing, are direct lessons from other epidemics and pandemics such as the 1918 flu and the 19th century cholera.
“We’ve had a lot of practice with this,” she said.
Antonovich has asked her students to “keep a coronavirus diary,” writing at least a paragraph every day about what is going on in their family or community. She said this could take the form of a picture of the grocery store floor with tape telling you where to stand, or a video on TikTok.
She hopes to archive the diaries of those students who are willing at Muhlenberg. That way, future generations will be able to learn from the coronavirus pandemic of 2020.