When asked to explain past events, historians are quick to assert the importance of context. If you want to understand how or why something happened, you must attend to local circumstances. But there is something about epidemics that has elicited an opposite reaction from historians: a desire to identify universal truths about how societies respond to contagious disease.
Charles Rosenberg, for instance, found inspiration in Albert Camus’s La Peste and crafted an account of the archetypal structure of an outbreak.2 Epidemics unfold as social dramas in three acts, according to Rosenberg. The earliest signs are subtle. Whether influenced by a desire for self-reassurance or a need to protect economic interests, citizens ignore clues that something is awry until the acceleration of illness and deaths forces reluctant acknowledgment.
Recognition launches the second act, in which people demand and offer explanations, both mechanistic and moral. Explanations, in turn, generate public responses. These can make the third act as dramatic and disruptive as the disease itself.
Epidemics eventually resolve, whether succumbing to societal action or having exhausted the supply of susceptible victims. As Rosenberg put it, “Epidemics start at a moment in time, proceed on a stage limited in space and duration, follow a plot line of increasing revelatory tension, move to a crisis of individual and collective character, then drift toward closure.” This drama is now playing out with Covid-19, first in China and then in many countries worldwide.
But historians have not limited themselves to description. Rosenberg argued that epidemics put pressure on the societies they strike. This strain makes visible latent structures that might not otherwise be evident. As a result, epidemics provide a sampling device for social analysis. They reveal what really matters to a population and whom they truly value.
One dramatic aspect of epidemic response is the desire to assign responsibility. From Jews in medieval Europe to meat mongers in Chinese markets, someone is always blamed. This discourse of blame exploits existing social divisions of religion, race, ethnicity, class, or gender identity. Governments then respond by deploying their authority, with quarantine or compulsory vaccination, for instance. This step generally involves people with power and privilege imposing interventions on people without power or privilege, a dynamic that fuels social conflict.
Another recurring theme in historical analyses of epidemics is that medical and public health interventions often fail to live up to their promise. The technology needed to eradicate smallpox — vaccination — was described in 1798, but it took nearly 180 years to achieve success. In 1900, health officials in San Francisco strung a rope around Chinatown in an attempt to contain an outbreak of bubonic plague; only white people (and presumably rats) were allowed to enter or leave the neighborhood. This intervention did not have the desired effect.