The following conversation is an excerpt of a podcast first recorded in March 2020, about a week after the United States began to implement COVID-19 precautions and restrictions. Elena Conis is a UC Berkeley professor, author and historian of U.S. public health and medicine, with a special focus on the history of infectious diseases and vaccines. Read on for her thoughts on epidemics and pandemics throughout history, as well as some extremely prescient predictions of what was to come during COVID-19.
Jason Dressel: Thank you for joining us today. Odd times we’re in right now, aren’t they?
Elena Conis: Very odd. Certainly, times I never imagined I would live to see in my own lifetime.
JD: We were struck by your article in reviewing your work. The first thing I thought was it must be very surreal to suddenly feel like we are living through a lot of what you have studied from a historical perspective.
EC: As a historian of medicine and public health, what I study is one epidemic after another, and things that we didn’t think were epidemics at the time. It’s something that’s very familiar to me through the books, but absolutely that knowledge now suddenly has a resonance that it never had before.
JD: What are some of these other pandemics that Americans have faced? And is there anything that reminds you specifically of what we’re facing now with COVID-19?
EC: You know, there are so many to talk about, and there are some that COVID makes me think of more than others. But one place to start talking about our history is the point of contact when Europeans first started coming to what we now call the Americas. And one reason it started there is because they brought a ton of disease with them, and then they ended up bringing some diseases back to the Old World, as they called it back then. Some of the worst diseases that they brought to the Americas were smallpox and measles. They were just horrible, horrible epidemics for centuries. They got worse and worse through the 1700s. Finally in the 1800s, we had a smallpox vaccine that started to offer some protection against it. But even with protection, there were still smallpox epidemics every once in a while. And they would really strike terror in some cities, largely because they were worried about whether it was going to be a bad smallpox epidemic or a mild one.
But either way, the markets would panic, and people would start quarantining goods and not allowing goods in or traders in from other cities. So, it just wreaked havoc on local economies.
But thinking about what COVID is doing to not just our domestic economy right now — the global economy — really makes me think about quite a few of the pandemics that we’ve dealt with in the past.
You asked me which one it makes me think of the most. And right now, I’ve been thinking a lot about polio. Many of us were vaccinated against it when we were kids, but our parents and grandparents were old enough to remember what polio was like in the 1940s and the early 1950s. We had such horrible epidemics of polio, which caused, in the worst cases, paralysis that sometimes led to death. It really took a toll on kids, especially school-aged kids, some of whom ended up paralyzed for life and, in the worst cases, ended up in these contraptions called iron lungs.
These epidemics were seasonal. Some years they were really horrible. Other years they weren’t so bad. But when they were bad, places would just shut down. Swimming pools, movie theaters closed; restaurants, churches, festivals were canceled. People stayed home from school. We call it social distancing now. Back then, they would recommend that people don’t mix with other groups and avoid strangers and things like that. It was such an intense time of isolation for communities that experienced outbreaks of polio. I certainly have never lived through anything like that, but like I said, my grandparents surely did.
JD: I see your point of the parallels with respect to the social isolation aspect of it. That raises another question I had. Have there been consistent themes of how Americans have responded to pandemics, or has each pandemic been unique based on when and where it occurred and the tools and resources that Americans had at that time to respond to them?
EC: Yeah, that’s such a good question. And in a way, I think Americans have responded historically to pandemics and epidemics as people in other parts of the world have.
Usually, there’s a good deal of panic. Usually, it leads to xenophobia that was either preexisting or takes shape anew. People find groups that they blame for the latest disease or the latest epidemic and point that blame even if it’s not warranted.
Then really there’s the effect on society. What happens to the social institutions that we have? Which ones end up really crumbling under the weight of the pandemic, and which ones end up flourishing? Schools really can suffer during epidemics. So can all kinds of businesses. And we’re seeing that right now. And for instance, like if you’ve got a lot of inequality in the society, an epidemic will show you who’s the most vulnerable and will make that inequality even worse than before. It could be economic inequality or a different kind of inequality. Epidemics have a way of doing that.
But we often also in the U.S., especially in modern times, respond with a lot of resilience and a lot of scientific and technical expertise. And we can see that now, an enormous amount of research investment going into finding, if not a cure, a means of preventing this virus.
JD: Do you have any sense of what business communities were like in the past in terms of how they responded to pandemics? Were there particular industries or companies or brands that were particularly well known for responding admirably during a time of crisis?
EC: Thinking about Fortune 500 companies being ahead of the federal government on this one also makes me think of the polio era and when we came up with a polio vaccine that was proven effective in 1955. We were just going to leave it to the companies to sell it on an open market. The companies making it were quite happy to do that. The public was skittish, and then some of the companies were uncomfortable that the public was uncomfortable. So President Eisenhower, who wanted nothing to do with the polio vaccine, its distribution and ensuring access to it, was forced to step in and say, “OK, the federal government will play a role here that will make sure that the companies or the other manufacturers of the vaccine are paid fairly and that all of their product is distributed equitably to ensure there is no black market or stockpiling of the vaccine for shareholders, company presidents, families and things like that.
So it was the public, including the business community, that that looked to Washington for some help to control the mayhem.
This interview has been edited for length and clarity.
To listen to the whole episode, click here or listen in the player below: