A review of Epidemics and Society – From the Black Death to the Present
The book can still be ordered at Yale University Press.
By Simon Ballam and Dardis McNamee
“Epidemics […] hold up the mirror to human beings as to who we really are,” said Professor Frank Snowden in a recent interview with Isaac Chotiner of the New Yorker magazine. As the Coronavirus rages around us, this is a chilling insight. Even for urbane, religious sceptics the uncomfortable feeling that we may have brought this horror on ourselves cannot be far away. Snowden maintains his academic cool, but leaves no doubt that the hubris of homo scientificus is largely to blame: Several times in the last century, experts have proclaimed infectious diseases to be defeated, only for them to rise up again.
To say that Snowden’s book – just out last November – is timely is likely the understatement of the year. His engaging narrative traces in relentless chronology the plagues of antiquity, through to the Spanish influenza in the early 20th century, and up to the devastating outbreaks of SARS and Ebola in the last few years. But without sparing us the horror, he also documents the imaginative tenacity of the men and women who found solutions, or at least, recurring hope.
It was the great trading port of Venice that developed and perfected a systematic regime of quarantine. Although they misunderstood the nature of the virus and how it was transmitted, they got the basic procedures right: Ships were kept off-shore for 40 (quaranta) days, fumigated, their cargo laid out in the sun and the crew and passengers offloaded onto islands in the lagoon. The choice of 40 days was prompted by the need to engage divine providence, 40 being a magic number in the Judeo-Christian Bible. It was actually overkill (the bubonic plague virus lived about 26 days) but erred on the right side. May our political leaders today heed the lesson.
The Habsburg Empire created an equivalent land barrier, a cordon up to 20-miles wide, stretching a thousand miles from the Adriatic to the Rumanian mountains. It was patrolled by local militia who knew the terrain, who enforced a 28-day quarantine in normal times, 48 days in emergencies. The rules were strict: anyone caught trying to slip through could be summarily executed. It was not dismantled until the late 19th century, when powerful business interests found it too restrictive. Again an uncomfortable parallel to the current stand-off between the guardians of public health and of the national economy.
It is this fatal nexus between healthcare and politics that Professor Snowden dissects with brutal clarity. His insights are disturbing. The boundless faith in the advancements of science in the post-WWII years led, by the 1970s, to a belief that, as Australian virologist and Nobel laureate Frank Macfarlane Burnet proclaimed that at least in the West, there was a “virtual absence of serious infectious disease today.” The improved hygiene and sanitation combined with better nutrition and a safer food supply had, gradually over more than a century, defeated cholera and thyphoid; quarantine had worked against the plague, vaccination against small pox and quinine against malaria. Then came penicillin, the first true wonder drug.
By mid century, the advances seemed too rapid to keep track of. And with a belief in “microbial fixity,” writes Snowden, most in the profession assumed that “the diseases we have are the ones we will face.” Needless to say, they were tragically wrong.
Already in 1945, he notes, Alexander Fleming, the inventor of penicillin,had warned in his Nobel acceptance speech that the drug’s efficacy would be biologically limited, that viruses would mutate and adapt to protect themselves against every new drug developed. What Fleming did not foresee was that pharmaceutical business interests and vote-catching over-regulation would strangle so much medical research, fatally slowing down further development in the race to survive.
At the moment, Darwinian evolution is on the side of the bugs.
A extensive review of Yale historian Frank Snowden’s Epidemics and Society: From the Black Death to the Present will appear in the summer issue of Metropole, published at the end of May.
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