Historian Frank Snowden: May we be ‘forever changed’ by coronavirus

Snowden discusses the history of public health, how COVID-19 and other epidemics hold up a mirror to society, and advice he’d give to world leaders now.
Frank Snowden

Frank Snowden (Photo credit: Liana Miuccio)

Yale historian Frank Snowden has long been fascinated by the ways epidemics hold up a “mirror” to the social, cultural, and political conditions in which they arise. His most recent book, “Epidemics and Society: From the Black Death to the Present,” published by Yale University Press in 2019, is the result of 40 years of research on the topic.

Since the outbreak of COVID-19, Snowden, who is the Andrew Downey Orrick Professor Emeritus of History, has been featured in The New Yorker, The New York Times, and The Wall Street Journal for his historical expertise. He recently spoke to YaleNews from Rome, where he had traveled for research before the outbreak began. His current research in a Vatican archive is now on hold due to the global coronavirus outbreak. Interview edited and condensed.

When you started your book, had you envisioned that the world would be facing an epidemic crisis?

The most obvious answer is “No, of course not.” On the other hand, there’s another answer. I think the single most distressing question I have heard during this outbreak came from President Trump, who asked, “Who could have known?” That struck me as an extraordinary thing to say because everyone should have known.

Since 1997, with the outbreak of the avian virus, public health officials, virologists, and epidemiologists have been saying that we are going to experience a major pandemic in the not-distant future. They thought that we are particularly susceptible as a society to pulmonary viruses.

In 2005, [director of the National Institutes of Allergy & Infectious Diseases] Anthony Fauci appeared before the U.S. Congress, which was looking into these possibilities, and he had an interesting analogy. He said meteorologists could tell residents of the Caribbean with certainty that they were going to experience hurricanes in their future. They wouldn’t be able to give an exact date and they wouldn’t be able to predict the strength of the hurricane, but they definitely know that one is coming. It’s exactly the same with regard to medical science and a pandemic. Fauci said he couldn’t say when and he couldn’t say if it’s going to be worse than the Spanish influenza or not. But he could say with absolute certainty that it’s coming.

So we failed to be prepared despite such a warning?

Since then, we’ve kind of lived on a diet of feast and famine, so that when there’s an outbreak of something — SARS or Ebola — there’s a great spending of money and scientific research. Organizational structures are set up, and then, when the outbreak goes away, human nature takes over and people want to forget about it. The funding dries up and the institutions are dismantled.

One reason I want to talk to journalists is that I feel as though, almost by accident, a microphone was put in my hand and I have the chance to use it to talk about preparedness. Many of the journalists I’ve spoken to say they are alarmed by a rejection of science and believe that engaging in a continuous discussion with scientists and public health experts is something that can be fruitful. That’s an idea that I’ve been trying to promote. I don’t know if anything will come of it, but if it does, I could retire from this unusual role in which I’ve found myself and go back to being a historian who goes into archives and writes, which is what I like best.

How do epidemics hold up a mirror to society?

Epidemic diseases reach into the deepest levels of the human psyche. They pose the ultimate questions about death, about mortality: What is life for? What is our relationship with God? If we have an all-powerful, omniscient, and benign force, how do we reconcile that force with these epidemics that sweep away children in extraordinary numbers?

Epidemics also place really enormous strains on family bonds. If you read Giovanni Boccaccio and Daniel Defoe, who both wrote about bubonic plague, you see parents deserting their children and spouses deserting each other, and friendships falling apart in the face of these events. There’s an enormous impact on people’s personal lives and their families and the societies in which they live.

A large epidemic disease such as we are seeing now with coronavirus places enormous strains on the economy, and as people are threatened with hunger and unemployment, their social moorings come unstuck in these stressful situations. There is also the question of people’s relationship with authority. Do those authorities, and do we as people, really care what happens to other people? Is that something that is a real priority or is that something we just say on Sunday?

When we answer those questions, haven’t we gone a long way to saying who we are, what we stand for, what we believe in, what’s important to us?

How do our physical environments affect which epidemics flourish?

Diseases are not all the same. I think of each one as individual, each with its own personality. Not every microbe can afflict every society, because each society has particular vulnerabilities dependent on the kind of society we are. Cholera is a disease of the Industrial Revolution. It found pathways around the world because human beings created those pathways: enormous cities with extraordinary overcrowding, no sanitary infrastructure, no sewage, no paved streets, people living on top of each other, and the most ghastly hygienic situation. The conditions were perfect for the flourishing of diseases like typhoid or cholera that are transmitted by the oral/fecal route.

Today, in the industrial world, it would be unthinkable that cholera could ravage the city of New York or Paris or Rome because we have robust sanitary infrastructures. In resource-poor settings it is different, because they have the kinds of conditions that I was talking about.

On the other hand, we are nearly 8 billion people, and we live in enormous cities that are hugely congested, and all of those cities are linked by rapid air travel, so what happens medically in Jakarta in the morning can happen in New Haven and Paris by the evening. With all these international linkages created by globalization, there is an opportunity for a very different kind of disease to flourish, and it seems that coronavirus is now exploiting this very condition.

How has our relationship with the environment helped to spur epidemics?

The world we’ve created is so populous, and also so unregulated and greedy that we have enormously invaded the habitat of wild animals. That is putting extraordinary pressure on them, so human beings are forcibly brought into contact with species that may be reservoirs of an extraordinary range of diseases that human populations have never encountered before.

We can see this in Ebola, where the palm industry invaded the forests of West Africa, felled the trees, and drove out the bats. There are many, many hundreds of species of bats, and many of those species harbor hundreds of coronaviruses. Many of them are lethal to human beings.

The bats were driven from the forest canopy that was their original home and moved closer to human habitations, nesting in the thousands in a tree near the home of a 2-year-old boy. He played in the tree near his home in Meliandou in Guinea and was contaminated by the bats, thousands of them, shedding their excrement and their viruses, which he inhaled. Genomic studies have determined that all of the cases of Ebola in West Africa are descendants of this one child and his encounter with bats.

So part of the story of epidemics is that, as a world, we don’t care sufficiently about the planet. We are not dealing very well with our forests and the animals that live in them. We seem to think that everything in the forest is up for grabs, for profit.

Are the poor and marginalized the most severely impacted by epidemics?

Here we go back to what I said earlier, that epidemics each have their own personalities. Some choose only particular groups disproportionately. Some, if I could be facetious, are more democratic; they affect everyone in a society. So it’s not true to say that the single key to epidemic disease is poverty.

But if you just think about the advice given by the Centers for Disease Control about how to protect yourself: Practice social distancing and wash your hands as many times as we can in the course of the day. But what meaning does that have if you live in a shantytown in Mexico City or the favelas in Brazil or the slums in Mumbai? How can you have social distancing when you live 10 people to a room in a tenement where people are piled on top of each other? How can you stay inside if you don’t have any funds to buy provisions and you don’t have a water supply? It’s a mockery also to talk about washing hands when there isn’t a water supply. How do you stay inside if you are homeless?

Is there any advice you’d want to give to world leaders right now?

Yes. There was a doctor who had been in the frontlines during SARS, and he was asked, “What needs to happen now?” He responded, “Let’s hope we can be forever changed.” We are now dealing with coronavirus, and let’s hope we can be forever changed by this, and make certain we are prepared so that the needless and preventable death and suffering of so many people doesn’t have to recur.

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