History lesson: Coronavirus is the latest pandemic, not the last

Lessons from the history of pandemics.

(Louise O’Brien/TNH)

by Ken Arnold, Abbie Doran, and Danielle Olsen

The authors are the International Cultural Initiatives Team at Wellcome, an independent health and medicine foundation.

Jacob Burinescu, a Romanian Jewish immigrant, lived in New York City’s Lower East Side. He ran a cleaning business and was a member of the Yiddish theatre community. When the mistakenly labelled Spanish flu arrived in 1918, he started caring for actor friends — until he contracted the disease himself. His was one of an estimated 50 million deaths across the world during that pandemic.

Two decades earlier, Taipingshan, a densely populated Chinese settlement in Hong Kong, was struck by the third pandemic of bubonic plague. The British colonial occupiers sought to contain the disease by forcibly removing householders who seemed sick. The violent cultural tensions that ensued cast a long shadow over the city’s history. Originating in Yunnan, China, the disease subsequently spread to British India, where it killed millions.

And two decades before that, physician and scientist Robert Koch announced that he’d identified the bacterium causing anthrax — a biomedical breakthrough that heralded the birth of modern bacteriology. His work also led to the identification of the microbial agents that cause tuberculosis and cholera, helping to consolidate the concept of infectious diseases, which in turn led to a number of public health innovations. His discoveries helped transform scientific approaches to slowing and halting epidemics around the world, and he was awarded a Nobel Prize in 1905.

Spread across three continents and separated by half a century, these anecdotes brought together overlapping narratives of microbes, migrations, and metropolises as part of the Contagious Cities project. In four cities — Geneva, New York, Hong Kong, and Berlin — we at the foundation Wellcome set about examining the very different but also tellingly similar consequences of the fact that bacteria and viruses inhabit us, just as we inhabit cities.

As all of us around the globe construct a narrative around our experiences of the coronavirus pandemic, it’s useful to remember that we are not on entirely new ground here.

Contagious Cities worked with scientists and historians to explore what happened during past medical emergencies and how the narratives of epidemics are constructed. Our collaborative enquiries not only drew on academic expertise, but also on the voices of those who lived during times of disease and on insights provided by artists: idiosyncratic investigators driven more by personal reflection than institutional agenda.

“As all of us around the globe construct a narrative around our experiences of the coronavirus pandemic, it’s useful to remember that we are not on entirely new ground here.”

The last of the Contagious Cities exhibitions closed in Berlin last September. Two months later, in mid-November, the medical case of a 55-year-old from China’s Hubei province was opened. This now appears to be the first record of a patient with COVID-19.

Epidemiologists have for decades been insisting that their key question wasn’t whether a new pandemic would happen, but when. We’re all now living through deadly proof of their foresightedness. Looking back at the Contagious Cities initiative, what might have been perceived as a somewhat obscure and distant topic now seems all too relevant.

Language and metaphor were dominant concerns across much of the project. One of the more encouraging aspects of the coronavirus crisis so far has been the relative rarity in official circles of indulging in blame. Yet there have been some instances.

The crassness of hearing one national leader talk about a “Chinese disease” harked back to the long, sorry history of identifying outbreaks with scapegoat origin groups: syphilis was termed the “French disease” by Neapolitans, the French had it as an “Italian disease”, the Dutch called it Spanish, the Russians pointed the finger at Poland, while the Turks decided it was a “Christian disease”.

Similarly, the time-honoured inclination to describe public health efforts in militaristic terms has again proved irresistible this time round. First China then South Korea, Iran, Italy, and soon the whole world has become engaged in a “war” against a secret enemy. The virus must be beaten in battle, or at the very least “sent packing” as Britain’s prime minister has promised.

One of the artists commissioned for Contagious Cities, Mariam Ghani, dramatised linguistic and visual metaphors for infectious illness that she found in archival collections of scientific and public health footage. Her film is an elegant but also menacing meditation on how strongly the language of disease influences attempts to deal with it.

In stark contrast, Angela Su’s video work was inspired by traditional Chinese medicine and cosmology. Its fantastical imagery and story-telling presents a radical alternative to the typical outbreak narrative.

An altogether different way of thinking about the interplay of humans, microbes, and other creatures was evoked in the title of the exhibition co-developed with the Museum für Naturkunde in Berlin: Koexistenz. In place of the binary distinction between eradication and submission (winning or losing a war), it posited a more complicated notion of cohabitation. The show featured artist Simon Faithful’s installation, An Arbitrary Taxonomy of Birds. The microbial sphere with which both we and birds share the planet made its appearance in a category he dubbed, “those who transmit avian flu”.

Uncertainty is another hallmark of pandemic. Neither Jacob Burinescu in early 20 th-century New York, nor the middle-aged patient in Hubei late last year likely knew what ailed them, where they had picked it up, nor how it would end. We, too, are still far from clear about which of the medicines and vaccines under development might allow patients to be cured and the world to be spared future ravages of COVID-19.

The affront that epidemics and pandemics threaten us with is not just their deadly toll, but also the way they scramble our ability to predict and plan for the future. Who might get it, and how badly? How long will the pandemic last? What will the world’s economy, or its social fabric, be like when this is over? And what will the endgame look like? That much uncertainty is paralysing.

Two things we have become certain of in this age of coronavirus, however, are the importance of social distancing and self-isolation. These now ubiquitous and ominous word-couplets get to the core of the slow-burning predicament COVID-19 presents to everyone, whether infected, or not. In an age when health has, arguably, become an obsession, we are all too aware of the potential damage to our wellbeing of these precautions against infection.

Those who study the Japanese phenomenon of hikikomori, in which mostly young male, digital obsessives lock themselves away in their bedrooms, describe the serious mental health consequences of this very specific version of social withdrawal. The form of self-isolation that we are now being encouraged to adopt — a voluntary, more liberal version of quarantine than in earlier times — is in most ways a very different experience. But its full implications for our mental health might end up being just as serious as the disease’s physical consequences. Ironically, the digital technology that often facilitates the hikikomori-sufferer’s loneliness is likely to be one means by which we balance physical distance and social sanity.

And finally, focusing particularly on Hong Kong’s experience of SARS, Tai Kwun’s exhibition “Far Away, Too Close” grappled with the tricky, sometimes dangerous notions of proximity and distance — concepts that of course now flit across our minds daily as we learn to negotiate supermarket aisles and street corners. Perhaps there’s some solace in recognising we’ve been here before.

Originally published at https://www.thenewhumanitarian.org on March 31, 2020.