“Epidemic diseases are not random events that afflict societies capriciously and without warning,” writes Yale historian Frank Snowden. “On the contrary, every society produces its own specific vulnerabilities. To study them is to understand that society’s structure, its standard of living, and its political priorities.”
Today’s tragedy can be, sometimes, tomorrow’s possibility. According to Snowden, pandemics don’t only reflect a society’s existing vulnerabilities — they present an unprecedented opportunity for transformational change. In his new book, Epidemics and Society, Snowden explores how infectious diseases across time have altered the outcomes of wars, inspired political reform, demolished revolutions, transformed entire societies’ relationships with God, and fundamentally changed the course of human history.
According to Snowden, we face a “fork in the road” as a species. We could either use coronavirus as a justification to retreat into xenophobia, ethnonationalism, and tribalism — as we’ve already seen in many places; or we could use it as an opportunity to build a better, more just world. Epidemic diseases throughout history have prompted both sets of responses, but the history of this moment is not yet written. How we respond to coronavirus will be one of the most important choices of our lifetimes.
I spoke with Snowden by phone. A lightly edited transcript of our conversation follows.
Something you discuss in the book is that epidemic diseases, whether it’s bubonic plague or smallpox or Ebola, do not afflict societies in completely random ways. If the impact of epidemic diseases isn’t random, what factors explain how they impact societies?
The world of microbes is populated with an infinite number of species, all of which are in constant evolution. Each has its own qualities and therefore can find environmental niches to exploit that are quite different. Societies get the diseases that they have created the channels and the pathways for. Epidemics tend to reach our greatest vulnerabilities and exploit them.
Asiatic cholera of the 19th century is the classic disease of industrialization. Society at the time was rampantly, suddenly, and chaotically urbanizing. There is no sanitation. The air is filled with foul odors. There are no sewers or toilets or guaranteed clean water. It’s in that kind of environment that a disease transmitted through the contamination of food and water with human fecal matter is able to flourish. And that’s what typhoid and Asiatic cholera were at the time.
Today, in New York or in Rome or London, we don’t need to fear Asiatic cholera because we’ve had a sanitary revolution. We have sewer systems. We have water that’s pure and safe to drink. We have sanitary customs, we have paved streets, we have whitewashed buildings, we’ve got building codes. So we’re not vulnerable to that kind of disease. But that doesn’t mean that now we’re invincible — that bulwarks of civilization protect us against the natural world.
What are the social conditions that made us vulnerable to coronavirus?
We’ve created a different kind of world — the world of globalization. That’s very different from the age of industrialization, and it creates different vulnerabilities. Globalization encompasses enormous population growth. We’re now approaching 8 billion people as a species, and that is accompanied by an enormous density of population.
We also have a myth of infinite economic growth although the planet has finite resources. And that forms our relationship with the environment. We’re constantly invading and destroying great swaths of animal habitat. That brings us into contact with animals that we didn’t encounter very often in the past. Therefore, we are exposed to the infinite reservoirs of microbes that they carry and there is a spillover of diseases we never encountered before. Avian flu is a spillover from wild fowl. Ebola is a spillover from bats. MERS is the same story. And coronavirus today is once more a spillover via the wet markets in a place like Wuhan [the Chinese city where the coronavirus outbreak originated].
We’ve also created mass air travel — millions of people travel on a daily basis. So a disease that breaks out in Jakarta in the morning can easily begin its course in London or Paris or Mexico City in the evening. Those links make us enormously vulnerable to diseases that can travel on airplanes with us and then begin fresh in our overcrowded, teeming cities.
I want to follow up on something you said there. Clearly, globalization has a lot to do with the spread of coronavirus. But I’m wondering if the problem is globalization itself, or if a deeper problem is the gap between the reality of globalization and the myths we still tell ourselves about national borders and nation-states being wholly separate entities.
Right now, we don’t only have a more interconnected world; we have an interconnected world full of nationalist leaders who deny that interconnection. I wonder if that combination of a truly interconnected world and resurgent nationalism is part of what stops us from addressing global problems, like a pandemic, in a coordinated, global way.
I entirely agree. What is happening is not something that is ordained to happen: The ideas in people’s heads make an enormous difference. Just because we have these vulnerabilities in a globalized world doesn’t mean we have to succumb to them. There is a bright side to this story, which is that it is possible to manage this global world that we’ve created in ways that are different from those we have established.
It’s true that the ideas in our heads haven’t yet caught up with the reality in which we live. You mention, for example, the idea of national boundaries. If there’s one thing that this pandemic seems to be teaching, it’s the eerie lack of reality of national borders. A disease transmitted by the air like coronavirus simply has no respect for borders — it has no respect for walls.
I’m hoping that the Trumpian wall will not become the metaphor for our age because that will disarm us and make us much more vulnerable to different microbes or a resurgence of this one — all of which is more or less inevitable in our future. The most dangerous thing right now would be the triumph of the idea that the European Union should be dismantled. Coronavirus has shown that what we need is more collective action. The tragedy was not that Europe wasn’t divided into little pieces, but that it didn’t succeed in having a common response.
This isn’t a disease that is affecting just part of the global world as we’re seeing now — it’s a disease of humanity. It’s going to involve everyone. And I think we need to have a consciousness that keeps up with the reality that we’re actually facing and proposes solutions that deal with the real problem. Denigrating entire ethnic groups takes us nowhere in terms of dealing with factual biological reality.
I think what you’re getting at is that coronavirus seems to have brought us to a kind of global fork in the road. On the one hand, coronavirus could affirm the nationalist sentiment that we need a more closed world, that we need to build walls, that all of our forays into globalization were wrong. Or we could begin to recognize that a globalized world requires more global cooperation.
On this point, there’s a line from the book that’s been stuck in my head ever since I read it: “One of the horrors of an epidemic of plague was that it broke the common bonds of humanity.” Is this the norm? Do epidemics tend to bring divided communities together under a banner of solidarity, or do they tend to further exacerbate existing divisions and break societies apart?
It’s a terrible worry. I use the analogy of epidemics as mirrors that reflect who we are back upon us. I find that helpful and also scary. It’s helpful because it does allow us to tease out what it is that we’re seeing in that mirror. It’s scary because it means that we see both our darker and our brighter selves.
That does give us hope in one sense: Our destiny is what we are wise enough, collaborative enough, and willing enough to create. We have a choice here. You’re right that we’ve come to a fork in the road with coronavirus. We’re going to have a miserable, deadly period for some months now. But after that, we will have a chance to construct a better world that’s more scientific, more rational, more humane, more international. Or we can adopt pseudo-solutions that will condemn us to repeating this awful experience that we’re now going through.
My hope is that our brighter selves will prevail. My fear is that there are many interested parties working day and night to make certain that we will have a more divided and hateful world. Right now, large sectors of the conservative right in our country reject the scientific explanations for Covid-19 and claim instead that this is something else — something foreign. That leads to violence and ethnic conflict.
What does it actually look like when our darker selves prevail?
In the era of the bubonic plague, as you mentioned, one sees this tension between pseudo-ideas and ideas that were a way forward. The pseudo-ideas included, once again, divisiveness, xenophobia, witch-hunting, blaming, finding a guilty party — the great “other” that we can attack.
In Strasbourg, France, the citizens of Strasbourg rounded up the community of 200,000 Jews, brought them to the Jewish cemetery, and said that it was their religion that was leading them to poison the wells where Christians drank — and that was the source of the bubonic plague. They had either to renounce their religion or be killed on the spot. Half of the Jews held to their religion, and they were burned alive at that very moment, that very day.
This is part of the violence, the divisiveness, the xenophobia that can emerge from a time of epidemic plague. The reason being that these are events that touch the depths of our psyches as human beings. They reach down and pose the questions of, what are we as mortals? What about our death? What about our bonds to our fellow human beings, to our families, our communities, our friends? What authority do we give to the political and sanitary officials who are dealing with this?
All of these things are revealed by plagues and create enormous anxieties; therefore, they bring out these extraordinary responses. Either we can respond with immediate fear and anxiety or we can use our intelligence to see that if we’re going to survive, we’re each dependent on one another and we have to figure scientifically, how does this work? What are its mechanisms? That seems to me the opportunity offered by each pandemic.
The history of epidemic diseases is not all doom and despair because people haven’t always chosen to go down the wrong fork. Although there have been these outbursts of horrors during times of pandemics, it’s the history of pandemic that has left enormous positive [impact]. Modern public health is something that was developed during the centuries of bubonic plague, and we’re still dependent on it today. It’s saving our lives as we speak.
The potential for progress is really there. But it’s a choice that we have before us. We’re at a fork in the road. Where will we go? Coronavirus is a great moral drama that’s taking place right before our eyes. And the script has not yet been written.
What does it look like when we choose to write that script in a positive way? Could you talk about a society that, when faced with a horrible epidemic, chose their better selves?
A powerful example is the sanitary movement of the 19th century, which was a real attempt to deal with the extraordinary mortality of the age of the Industrial Revolution. At the time, people in London or Manchester or Paris or Naples or New York were living in enormous, unplanned, filthy, overcrowded urban centers. There was the [emergence] of the idea that this didn’t need to result in mass death and disability, that something could be done about it.
Top medical doctors started thinking about correlations between the patients they saw and the social conditions in which they lived. They began with the idea of “social medicine”: that medicine was not just about individuals, [but] also the social factors that caused the illness.
This idea was channeled by the sanitary movement. They set up enormous investigation into how people live throughout Britain. Physicians went to every community and wrote back about what the exact conditions were in the places they inhabited. You had a central board of health that put it together and developed an enormous series of ways to reform this chaotic and unplanned society.
Just imagine the scale of this project. It meant retrofitting every place in Britain with sewers, with clean water, with clean houses, regulated houses. For the first time, we see the state insisting on sanitary rules, on building codes, on maximum occupation requirements. It took two-thirds of a century to carry out at enormous cost. And I would argue it saved millions of lives in Britain in the 19th century. People in Britain became much healthier.
And so astonishing was this example, this way of thinking about disease, that it was taken up in France. And then it spreads to Belgium and the Netherlands and United States and Italy. This was an amazing moment to which we owe broad boulevards, urban parks, all kinds of aspects of the world in which we live. I think this was our brighter angels. And it was the reaction to the legacy that was created by typhoid and cholera.
When European societies faced this fork in the road, I’m curious about what factors made the difference between choosing their better or worse selves. Was it leadership from the top? Was it demand from below? What was it that made the difference?
It needed not only cooperation from below but leadership from the top. One of the legacies of these epidemic diseases has been the molding of the modern state. Epidemic diseases required health authorities. They required great taxation. They required legislative authorities. They required administrative census data. They required hospitals. They required a navy to quarantine ships. They required police powers to quarantine people by land.
We see this in the political thought at the time through the writings of people like Thomas Hobbes and John Locke, the founders of modern liberalism. They argued that life was nasty, brutish, and short, as indeed it was during the time of plague, and that you needed to create an authority to make people safe.
The sanitary movement helped sculpt a modern state with enormous new powers that could be used in beneficent ways. Of course, power has its own problems — it can have negative results. But we can’t survive without political power, without states, and without sanitary authorities. They’re part of our survival kit. And I think the coronavirus shows how quickly life could once again become nasty, brutish, and short without them.
That’s interesting because a core part of our national mythos in the United States since the 1980s has been the idea that government is the problem. In the 1990s, Bill Clinton, a Democrat, got up and pronounced that “the era of big government is over.”
I’ve been thinking of those words a lot today in the wake of coronavirus as the death counts continue to rise exponentially, as states bet against one another for health care resources, as we still lack a federally coordinated plan for addressing the epidemic. If anything is going to shatter that anti-government paradigm, maybe it is a global pandemic of this scale.
I think there is a libertarian streak in the US that’s having catastrophic effects on health. The United States had no national plan. It had refused to listen to the scientists who said that a new pandemic was an inevitability in our future. It trimmed the national government’s health budgets.
So our coronavirus response has resembled the cacophonous noise that comes from a symphony with no director — in which every instrument player decides to make his own different music. The national government says one thing. Governors in states say another. The CDC says a third thing. Municipal governments have their own sound. School boards intervene in ways that are their own. It’s mayhem and pandemonium.
We tend not to realize just how much we need the state until it abdicates its responsibility to keep us safe. Now, we’ve seen that. This administration’s response has been like going back to the pre-Hobbesian days of the war of all against all.
I think the lack of preparedness is the great tragedy that we’re experiencing today. And that’s not just about having more ventilators, although that’s included. It really is about our minds, our hearts, and our intellects. Change has to begin there. If we try to dismantle the World Health Organization and put walls up, I think we’ll find that when the next disease comes, we could experience an even greater catastrophe than this one.
What should we do? What does the road map after coronavirus look like?
We need a huge rethinking collectively, not by any single person. If anyone presents you with a blueprint saying “I know the answer,” I think we should all run as fast as we can from that person. That’s not what I’m thinking. I’m thinking we need to put our heads together collectively and devise a society that works in a different way: [one] that is prepared, that rethinks our relationship with climate, with our great cities, and rethinks this myth that we can grow infinitely in our numbers and in our economic systems until there’s only standing room and nothing but smog to breathe.
That’s a mammoth collective project. It’s not doom and gloom, though. I think this actually holds its excitement — it’s inspiring. We can build a different world, a better world, a world where our grandchildren can live better.