Pandemics and the Shape of Human History
It’s impossible to say how many people died in the first New World pandemic, both because the records are sketchy and because Europeans also brought with them so many other “virgin soil” diseases, including measles, typhoid, and diphtheria. In all, the imported microbes probably killed tens of millions of people. “The discovery of America was followed by possibly the greatest demographic disaster in the history of the world,” William M. Denevan, a professor emeritus at the University of Wisconsin-Madison, has written. This disaster changed the course of history not just in Europe and the Americas but also in Africa: faced with a labor shortage, the Spanish increasingly turned to the slave trade.
The word “quarantine” comes from the Italian quaranta, meaning “forty.” As Frank M. Snowden explains in “Epidemics and Society: From the Black Death to the Present” (Yale), the practice of quarantine originated long before people understood what, exactly, they were trying to contain, and the period of forty days was chosen not for medical reasons but for scriptural ones, “as both the Old and New Testaments make multiple references to the number forty in the context of purification: the forty days and forty nights of the flood in Genesis, the forty years of the Israelites wandering in the wilderness . . . and the forty days of Lent.”
The earliest formal quarantines were a response to the Black Death, which, between 1347 and 1351, killed something like a third of Europe and ushered in what’s become known as the “second plague pandemic.” As with the first, the second pandemic worked its havoc fitfully. Plague would spread, then abate, only to flare up again.
During one such flareup, in the fifteenth century, the Venetians erected lazarettos—or isolation wards—on outlying islands, where they forced arriving ships to dock. The Venetians believed that by airing out the ships they were dissipating plague-causing vapors. If the theory was off base, the results were still salubrious; forty days gave the plague time enough to kill infected rats and sailors. Snowden, a professor emeritus at Yale, calls such measures one of the first forms of “institutionalized public health” and argues that they helped legitimatize the “accretion of power” by the modern state.
There’s a good deal of debate about why the second pandemic finally ended; one of the last major outbreaks in Europe occurred in Marseille in 1720. But, whether efforts at control were effective or not, they often provoked, as Snowden puts it, “evasion, resistance, and riot.” Public-health measures ran up against religion and tradition, as, of course, they still do. The fear of being separated from loved ones prompted many families to conceal cases. And, in fact, those charged with enforcing the rules often had little interest in protecting the public.
Consider the case of cholera. In the ranks of dread diseases, cholera might come in third, after the plague and smallpox. Cholera is caused by a comma-shaped bacterium, Vibrio cholerae, and for most of human history it was restricted to the Ganges Delta. Then, in the eighteen-hundreds, steamships and colonialism sent Vibrio cholerae travelling. The first cholera pandemic broke out in 1817 near Calcutta. It moved overland to modern-day Thailand and by ship to Oman, whence it was carried down to Zanzibar. The second cholera pandemic began in 1829, once again in India. It wound its way through Russia into Europe and from there to the United States.
In contrast to plague and smallpox, which made few class distinctions, cholera, which is spread via contaminated food or water, is primarily a disease of urban slums. When the second pandemic struck Russia, Tsar Nicholas I established strict quarantines. These may have slowed the spiral of spread, but they did nothing to help those already infected. The situation, according to Loomis, was exacerbated by health officials who indiscriminately threw together cholera victims and people suffering from other ailments. It was rumored that doctors were purposefully trying to kill off the sick. In the spring of 1831, riots broke out in St. Petersburg. One demonstrator returning from a melee reported that a doctor had “got a coupl’ve rocks in the neck; he sure won’t forget us for a long time.” The following spring, cholera riots broke out in Liverpool. Once again, doctors were the main targets; they were accused of poisoning cholera victims and turning them blue. (Cholera has been called the “blue death” because those suffering from the disease can get so dehydrated that their skin becomes slate-colored.) Similar riots broke out in Aberdeen, Glasgow, and Dublin.
In 1883, during the fifth cholera pandemic, the German physician Robert Koch established the cause of the disease by isolating the Vibrio cholerae bacterium. The following year, the pandemic hit Naples. The city dispatched inspectors to confiscate suspect produce. It also sent out disinfection squads, which arrived at the city’s tenements with guns drawn. Neapolitans were, understandably, skeptical of both the inspectors and the squads. They responded with an impressive sense of humor, if not necessarily a keen understanding of epidemiology. Demonstrators showed up at city hall with baskets of overripe figs and melons. They proceeded, Snowden writes, “to consume the forbidden fruit in enormous quantities while those who watched applauded and bet on which binger would eat the most.”
Eight years later, while the fifth pandemic raged on, one of the most violent cholera riots broke out in what’s now the Ukrainian city of Donetsk. Scores of shops were looted, and homes and businesses were burned. The authorities in St. Petersburg responded to the violence by cracking down on workers accused of promoting “lawlessness.” According to Loomis, the crackdown prompted more civil unrest, which in turn prompted more repression, and, thus, in a roundabout sort of way, cholera helped “set the stage” for the Russian Revolution.
The seventh cholera pandemic began in 1961, on the Indonesian island of Sulawesi. During the next decade, it spread to India, the Soviet Union, and several nations in Africa. There were no mass outbreaks for the next quarter century, but then one hit Peru in 1991, claiming thirty-five hundred lives; another outbreak, in what is now the Democratic Republic of the Congo, in 1994, claimed twelve thousand.
By most accounts, the seventh pandemic is ongoing. In October, 2010, cholera broke out in rural Haiti, then quickly spread to Port-au-Prince and other major cities. This was nine months after a magnitude-7.0 earthquake had devastated the country. Rumors began to circulate that the source of the outbreak was a base that housed United Nations peacekeeping troops from Nepal. Riots occurred in the city of Cap-Haïtien; at least two people were killed, and flights carrying aid to the country were suspended. For years, the U.N. denied that its troops had brought cholera to Haiti, but it eventually admitted that the rumors were true. Since the outbreak began, eight hundred thousand Haitians have been sickened and nearly ten thousand have died.
Epidemics are, by their very nature, divisive. The neighbor you might, in better times, turn to for help becomes a possible source of infection. The rituals of daily life become opportunities for transmission; the authorities enforcing quarantine become agents of oppression. Time and time again throughout history, people have blamed outsiders for outbreaks. (On occasion, as in the case of the U.N. peacekeeping troops, they’ve been right.) Snowden recounts the story of what happened to the Jews of Strasbourg during the Black Death. Local officials decided that they were responsible for the pestilence—they had, it was said, poisoned the wells—and offered them a choice: convert or die. Half opted for the former. On February 14, 1349, the rest “were rounded up, taken to the Jewish cemetery, and burned alive.” Pope Clement VI issued papal bulls pointing out that Jews, too, were dying from the plague, and that it wouldn’t make sense for them to poison themselves, but this doesn’t seem to have made much difference. In 1349, Jewish communities in Frankfurt, Mainz, and Cologne were wiped out. To escape the violence, Jews migrated en masse to Poland and Russia, permanently altering the demography of Europe.
–Elizabeth Kolbert newyorker.com