Coronavirus pandemic: Is it 'unprecedented'? Historians tell us what we can learn from the past
No historian could have predicted the current coronavirus pandemic and the effect it has had on the world. But is it unprecedented? Historians tell us what past pandemics have taught us.
It's a word often used today to describe the situation the world is in. From the global spread of the coronavirus pandemic to measures to tackle it, to rising racism and xenophobia - it all seems 'unprecedented' if the present discourse is to be believed.
But is it so? After all, epidemic diseases are almost as old as "civilisation" itself. "We’ve had to deal with epidemics of infectious disease since we settled down in kind of semi-permanent settlements, since we started farming, that is, about 10, 12,000 years ago," says Laura Spinney, author of Pale Rider: The Spanish Flu of 1918 and How It Changed the World.
So to understand whether the COVID-19 pandemic and the response to it are truly unprecedented or not, we spoke to historians from India and abroad, to learn what the history of epidemics and pandemics has taught us in dealing with such situations and how much we are following those lessons.
History repeats itself
"It is not unprecedented in any way. Only politicians and ignorant people would call the current pandemic unprecedented. The moment we developed faster modes of transport, from let's say in the mid-19th century, we have seen several global pandemics. We tend to forget, but the way Cholera or Malaria had spread back then, is reminiscent of our current situation," says Professor Deepak Kumar, a renowned historian from JNU, who has written authoritatively on the history of science and medicine in India.
Professor Christian McMillen of University of Virginia agrees with him. He says "in 1851, when the French delegate to the International Sanitary Conference spoke about cholera’s spread around the planet, he could almost have been talking about our world in 2020: “Add now the communications between the peoples, today so numerous and more and more rapid; the navigation by steamship, the railways, and on top of that this happy tendency of the populations to visit each other, to mix, to merge, a tendency that seems to make of different peoples a sole and large family, and you will be forced to admit that for such a disease, so widespread and under these conditions, cordons and quarantines are not only powerless and useless, but they are, in the very great majority of cases, impossible."
However, science historian Syed Irfan Habib, thinks it is unprecedented "in the sense that, in recent history or recent memory there is no reference to what we are going through. There have been epidemics and plagues all over the world, but the difference is that no epidemic has spread the way COVID-19 has spread. It's truly a multinational, global phenomenon. It's like globalisation of the disease. So I don't think that something like this has ever happened in history. Epidemics were there, but they would be more or less constricted to particular geographical areas."
Listen the full conversation with professor Syed Irfan Habib here:
Professor Burton Cleetus of Jawaharlal Nehru University doesn't think so. "There have been so many pandemics of this scale, and even bigger. Of course post globalisation, we haven't faced something like this. But if we take the case of plague. It travels through the trade route - from Hong Kong to Colombo to Mumbai to Karachi, then the mediterranian to Europe. So it goes all the way. Except Latin America maybe, which was a little isolated earlier. So, many of the epidemics did not reach Americas as it has reached now. That's the only difference. Asia and Europe have always been the main centres to get affected by pandemics and that's the case today as well," said Professor Cleetus who has worked extensively on the history of diseases and medical science in India.
Globalisation, a vector or a casualty?
One change this pandemic could bring is the end of globalisation as we know it. Prof. Habib thinks the coronavirus pandemic is a function of modern globalisation and we might be writing the obituary of globalisation very soon. "We extol the virtues of globalisation and rightly so, but we also have something like what we're going through today. The virus spreads from connect, that's why we're talking about distance or lockdown or confinement or isolation. So we are almost at the end of globalisation. You'd stop seeing the virtues of globalisation, like the way we have seen till now."
Laura Spinney also sees the hand of globalisation in the breakneck speed in which the coronavirus spread all over the world. She thinks we are already seeing the economic consequences of this pandemic which could trigger larger destabilisation of global orders.
Prof. Deepak Kumar sees an impending strengthening of sovereign borders as the countries would begin to look more inward even after the pandemic passes.
Similarities and dissimilarities between past pandemics and this one
"The COVID-19 outbreak is the latest in a long line of pandemics known to humans. Compared to the enteric fever outbreak in Central America in the 16th century that killed about 15 million people, or the 19th century cholera outbreaks which killed 100 million people in India alone, the mortality rate in the current pandemic is negligible," says Manikarnika Dutta, a DPhil scholar at the University of Oxford whose research is mainly in the domain of history of medicine and public health.
Professor Christian McMillen says that he cannot help but draw eery parallels between the past and the present. But in what ways have the past pandemics been similar to the current one?
"If we look at outbreaks like Cholera and the bubonic plague in the Europe, you'd see a lot of similarities in the way we have tried to contain the spread of coronavirus," says Mridula Mukherjee, the Chairperson of the Centre for Historical Studies, Jawaharlal Nehru University.
Listen to full conversation with Professor Mridula Mukherjee here:
Laura Spinney thinks that it has been an arms race between humans and diseases for a very long time. "They had no vaccine for the flu in 1918. We are much advanced compared to 1918 but even today we don’t have that vaccine yet. So, we have anti-viral drugs for treating the sick and we do have antibiotics which will be useful for treating the bacterial complications in some cases, as they did also in 1918, interestingly," says Spinney.
We have strategies of containment, strategies that are collectively known as social distancing. And those are surprisingly unchanged since 1918, or even since much, much before that. Things like quarantine, isolation, wearing masks," she adds.
Professor Kumar, on the other hand, thinks that our methods of protection against epidemic diseases and thinking around it have changed a lot since the ancient times. "In our age-old traditions of Ayurveda or Unani the focus was more on building immunity against diseases rather than dealing with the cause of it. That changed in the mid-19th century with the advent of colonialism. But before the paradigm shift in the mid-19th century with Pasteur's germ theory of diseases, both the Europeans and the Asians - the colonisers and the colonised - believed in spread of bad smells or “miasmas” as the source of infection or an imbalance in the body’s delicate “four humours” (five in the case of Indian traditions)."
But when the plague or 'Black Death' ravaged entire Europe in the 14th century, Peter Baldwin's book 'Contagion and the state in Europe, 1830-1930' tells us that the containment measures and the response was very similar to that of today.
"Mass gatherings were halted, Churches were closed, burial became a problem. As with coronavirus, plague outbreaks led to the enforced quarantine of infected households and the creation of specialist task forces that monitored and controlled contagion. This corona pandemic is almost a repetition of that," says professor Cleetus.
Listen to the full conversation with Professor Burton Cleetus here:
Professor Habib recounts the story of a "huge plague in the Maharashtra region in 1897-98". "Even back then strict laws were introduced to punish people who did not abide by the rules laid out by the government to contain the outbreak. Local confinement and fear were used to keep people away from each other. The British dealt with these outbreaks in India in a high-handed manner. They would put the infected people in prison cells and in those days they would not be not looked after the way the system looks after people today," says prof. Habib.
Another feature which is common to past pandemics and this one, is the re-ignition of dormant xenophobia and racism. Dr Alex Rosenberg of Duke University finds disinformation and scapegoating to be recurring features of the pandemics.
The social consequences of epidemics have sometimes been as deadly as the diseases themselves. Outbreaks have always been blamed on certain ethnic groups. During the 'Black Death', it was rumoured that Jews were intentionally spreading the disease by poisoning wells, rivers and springs. As a result, Jewish people across Europe were tortured and killed.
During later outbreaks in the late 16th to early 17th centuries, this fear was quickly transferred to all outsiders.
Today, Asians around the world have become the target of racist and xenophobic attacks. US President Donald Trump insists on calling the novel coronavirus 'Chinese Virus'. In India, there are several reports of people from the North-East being harrassed, discriminated against and even spat on.
"We have to look who generates the discourse. During the colonial period it were the Europeans who generated the discourse around diseases. If we look at the history of diseases, the notion was that all diseases start from the topics. Whether it's malaria or Cholera, the notion was that all starts from the tropics as the tropics are unhygenic. Along came the notion that the cultural, behavioral and religious practices of tropics are responsible for that. India was known as the 'Homeland of Cholera'. Today, China is being branded and the whole thing has become about their eating habits," says Professor Cleetus.
Manikarnika Dutta also points out how the British colonial state implemented public health measures in India in the 19th century as they did not want to expatriate British soldiers and civilians to get the disease from India, carry it back to Britain, and cause mass infections.
"19th century British doctors arbitrarily categorised cholera into Asiatic and English, saying the type of cholera most people survived was English and the one causing mass deaths was Asiatic. Cholera was stigmatized and labelled as a ‘Bengali disease’," says Dutta.
Medical historian Mridula Ramanna has similar opinions. "This had been the characteristic response of the authorities, to attribute any epidemic that they could not control to India and what was invariably termed the 'insanitary condition' of Indians," she observed.
However, professor Deepak Kumar does not see the present phenomenon as xenophobic and racist, he says that "Chinese have to bear the brunt now. I won't call it xenophobia. It is extreme selfishness and the return of sovereign borders to protect economic interests"
What did we learn?
"The first thing we can learn from past epidemics is that if people have basic rights, only then you'll be able to handle emergency situations better. If you have a sound, well-funded public health infrastructure down to the village or mohalla level, and have enough beds for every thousand people, you'll be in a better position. I think our biggest problem today is that our public health infrastructure is weak. We have even allowed it to weaken further by pushing private healthcare, but when there is a moment of crisis we have to rely on the public health infrastructure. We know these things. It's not like we have to reinvent the wheel," says Professor Mridula Mukherjee.
Professor Kumar agrees with her. He cites the example of Ronald Ross, who won the Nobel prize for discovering that mosquitoes act as the vector for malaria by carrying the plasmodium parasite. Kumar says that Ross kept emphasising on hygiene, and sanitation in prevention of Malaria, rather than just vaccines.
Professor McMillen speaks about how our over-reliance and overconfidence on biomedicine to the exclusion of a robust public health infrastructure has hurt us.
"With the discovery of antibiotics in the 1940s confidence in medicine only accelerated—and kept doing so in the 1950s, 60s and 70s in the “golden era” of medicine," he says.
This overconfidence is highlighted in the 1961 claim of infectious disease specialist T. Aidan Cockburn. He said "we can look forward with confidence to a considerable degree of freedom from infectious diseases at a time not too distant in the future".
Another feature we have learnt from the history of epidemics is the importance of governance with empathy, thinks Professor Habib.
"In the past, during epidemics we have seen lack of empathy from governments and rulers. In the 19th century, during colonial rule their parameters of governance were different. They were not governments for people. They never bothered to bring in empathy, care or concern. People were treated as subjects, not citizens. Subjects don't have rights, citizens do. Today we live in a world of citizenship where everyone has rights. All the governments in the world should keep that in mind," warns Habib.
Kumar emphasises on this as well and says, "The British used violence and force 120 years ago when the plague broke out in Bombay and Pune. But the use of force in the time of pandemic doesn't work. We have to understand that pestilence almost always brings famine along with it. So back then, there were riots. Even today the marginalised and the poor are disproportionately more affected."
"When cholera began to make its way out of India in the 1820s, it defined the contours of a new world economy, revealing its connections and also, more starkly, its divisions." -Mark Harrison, Historian
Spinney says that we must learn from history that the "best way to impose a set of public health measures is not to impose them in the authoritarian way that the Chinese did. People don’t like to be told what to do. But if you want people to comply with you voluntarily, two things are needed. The first is they have to be properly informed about the threat they face, so that they understand why you’re asking them to do these things and to restrict their normal lives in certain ways. And the second thing is they have to trust the authorities, they have to trust that those authorities are acting in their collective interest."
In the past pandemics have changed the course of history, but every epidemic and pandemic "forces us to reckon, again and again, with the obvious fact that the natural — or non-human — world has a powerful effect on the human world," opines McMillen.
Frank M. Snowden, a professor emeritus of history and the history of medicine at Yale told The New Yorker that "Epidemics...reflect our relationships with the environment—the built environment that we create and the natural environment that responds. They show the moral relationships that we have toward each other as people, and we’re seeing that today."
Professor Kumar says no matter how powerful we feel as a race being on top of the food chain, these pandemics and epidemics have historically made us realise that we are nothing but prey to nature. "The viruses have been there and will be there, we have to learn and adapt to live with it," he adds.