The following is an excerpt from an interview with Elena Conis, a professor at the University of California, Berkeley School of Journalism with expertise in medicine, public health and the environment. For the full interview, listen to the latest episode of the History Factory Plugged In podcast.

Jason Dressel: Elena, thank you for joining us today. Odd times we’re in right now, aren’t they?

Elena Conis: Very odd. Certainly something I never imagined I would live to see in my own lifetime.

Jason: We were struck by your article in TIME magazine. So, 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.

Elena: As a historian of medicine and public health, really what I study is one epidemic after another. I also study things that we didn’t think were epidemics at the time, but then we look back and call them epidemics. And it’s very familiar to me through the books, but absolutely, that knowledge now suddenly has a resonance that it never had before.

Jason: What are some of these other pandemics that Americans have faced, and is there any one that reminds you specifically of what we’re facing now with COVID-19?

Elena: When Europeans first started coming to what we now call the Americas, they brought a ton of diseases with them. And then they ended up carting some diseases back to the old world, as they called it. Some of the worst diseases that they brought to the Americas were smallpox and measles, and they were horrible epidemics for centuries. They got worse and worse through the 1700s, and 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.

They would strike terror in some cities, largely because they were worried about whether it was going to be a really bad epidemic or a mild epidemic. Sometimes, it would just be a mild outbreak with a much lower mortality rate. Either way, the markets would panic, and people would start quarantining and not allowing goods or traders in from other cities. It wreaked havoc on local economies. So, thinking about what COVID is doing to not just to a domestic economy right now but the global economy really makes me think about quite a few of the pandemics that we’ve dealt with in the past.

I’ve been thinking a lot about polio, which probably many of us were vaccinated against when we were kids. But our parents and grandparents are old enough to remember what polio was like. In the ‘40s and the early 1950s, we had such horrible epidemics of polio, which caused in the worst cases paralysis that sometimes led to death.

These epidemics were seasonal. Some years, they were really bad. Other years, they weren’t so bad. But when they were bad, places would just shut down. And this is what COVID makes me think of, when swimming pools close, movie theaters close. Restaurants, churches. Festivals canceled. People stayed home from school. We call it social distancing now.

Jason: Have there been consistent themes of how Americans have responded to pandemics? Or has each one been unique, based on when it occurred and where it occurred, and, obviously, the tools and resources that Americans did or didn’t have at that time to respond to it?

Elena: Americans have responded historically to pandemics and epidemics much as people in other parts of the world have. Usually, there’s a good deal of panic, which leads to xenophobia that was either pre-existing or takes shape anew—even if it’s not warranted.

Then there’s the effect on society. What happens to the social institutions that we have? Which ones end up crumbling under the weight of epidemics, and which ones barely withstand and come bouncing back? What’s interesting to me is how the epidemics tap into or open up fissures that are already there.

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. We can see that now with the enormous amount of research and investment going into finding—if not a cure, a means of preventing this virus from spreading.

Going back to polio, one of the reasons why polio also comes to mind is that it would come back as a seasonal disease year after year until we finally had an effective vaccine.

So, people were living with this scary threat until we finally had the vaccine. And for the last several decades, we keep thinking, “Oh with this epidemic, we will stop it with the vaccine.” And almost never do we come up with the vaccine as quickly or as immediately effective as we would like. So sadly, history makes me think that we may have a long road ahead of us with this new infection. I really hope I’m wrong.

Jason: Is there precedent for the federal government stepping in to responded to pandemics like this in the past, where they’ve provided that level of support in terms of bailouts to big industry and relief to smaller businesses and compensating citizens directly?

Elena: I don’t think we’ve ever seen the federal government step in to this scale. But on the other hand, the reason why we have the federal public health infrastructure that we have is because back in the 19th century and the early 20th century, we saw, increasingly, a need for the federal government to coordinate responses to epidemic diseases—namely yellow fever and also plague.

In the late 1800s early 1900s, there were a handful of epidemics of plague that hit the West Coast of the U.S. because it was coming from Asia. And these epidemics were just terrifying. Speaking of leaders denying the truth at the time, the governor of San Francisco wanted to keep it quiet that there was plague in the city, because he didn’t want the rest of California to put an embargo on goods coming out of there.

Then, when the state found out about it, the governor wanted to keep it quiet also. Ultimately, what ended up happening was they had to turn to the federal government for help. They ended up creating the first steps toward the major public health institutions that we have at the federal level today. I think it’s fair to say the federal government has actually grown in response to lots, if not most or all, of our past epidemics.

Jason: 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 well known for responding admirably during a time of crisis like this?

Elena: I can think of lots of examples of companies or enterprises that probably aren’t even worth mentioning now because they don’t exist. But most were opportunistic in the face of epidemics and tried really hard to peddle, for instance, their cholera cure or their polio preventive. To try to make as much money off of an epidemic as they could.

But thinking about Fortune 500 companies being a step ahead of the federal government on this one actually also makes me think of the polio era and when we finally had a polio vaccine that was proven effective in 1955. We were just going to leave it to the companies to sell on an open market. And actually, 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 kind of forced to step in and say, “Okay, okay, okay. . . . We’ll make sure that the companies are paid, all the manufacturers of the vaccines paid fairly and that all of their product is distributed equitably. That there is no black market, that there is no stockpiling of the vaccine for shareholders or company presidents, families and things like that.” It was the public, including the business community, that looked to Washington for some help to control the mayhem. So, a little different from what’s going on now, but still reminds me of that era.

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