What does the past tell us about COVID-19 and our future?

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3D render of a medical image with virus cells

By Ellen J Amster, McMaster University

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During this pandemic, historians have been consulted like the Oracle of Delphi. Is COVID-19 like the Black Death? The 1918 flu? What lessons of history can be applied to today?

But can history show us what we want to know?

In some ways, yes. In others, no. And we need to broaden what we ask.

As a historian of medicine, North Africa and France, I find we are using some lessons but ignoring others. Pandemic histories are useful, but how they connect with race, public health, revolution, labour, gender and colonial histories will help us explain the present and predict the future.

Lessons learned: COVID-19 responses using pandemic history

Some history lessons have been put to use right away, like social distancing.

At University of Michigan, Dr. Howard Markel compared cities in the United States during the 1918-19 flu pandemic and showed the U.S. Centers for Disease Control and Prevention how early, strict social distancing measures worked to slow infection rates. Countries around the world now use his concept, “flattening the curve.”

Not bad for the history of medicine, a field the Lancet declared “moribund” in 2014.

Lessons ignored: Poverty and racism make you sick and dead

Other pandemic lessons have been ignored, and they tragically unfold anew.

The poor, the vulnerable and workers die in greater numbers. Social reformer Dr. Rudolph Virchow wrote in 1848:

“Medical statistics will be our standard of measurement; we will weigh life for life and see where the dead lie thicker, among the workers or among the privileged.”

Poor neighbourhoods have the highest death tolls. Reformers’ maps from the 1800s demonstrated this in the United Kingdom (Edwin Chadwick, 1834) and France (Réné Villermé, 1832). The same pattern has emerged in 2020 in New York (the Bronx) and Montréal (North Montréal).

A pandemic is not the great equalizer, contrary to Madonna’s “Reflections from the Bathtub.”

Inequality of income, housing, work and opportunity are the inequities that made death “a social disease” for social reformers Chadwick, Villermé and Virchow. We now call these factors the “social determinants of health.”

That is why structural racism can be a death sentence. Data show that pandemics have disproportionately affected African Americans and Indigenous Peoples. Virchow demanded social justice as the solution: full employment, higher wages and universal education.

Policy-makers had months to protect vulnerable populations from COVID-19. Why didn’t they?

History explains that too.

Cholera: Change happens when people rise up

If history shows one thing, it’s that rich people and politicians do not want to pay for sewers, schools, hospitals, old age pensions or worker safety. The deaths of the poor themselves did not move politicians in France, Germany or Britain to big policy changes.

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