Of Plagues and Papers: COVID-19, the Media, and the Construction of American Disease History

Newspapers have long informed public understandings of medical history. The articles pictured above provide examples of journalistic writing on the history of pandemics.

Since the novel coronavirus began spreading around the world in January, news media organizations have been providing their readers with a primer in public health history. Within the United States, papers like the New York Times, the Washington Post, the Chicago Tribune, and the Los Angeles Times have all attempted to make sense of COVID-19 by looking backward, mining pandemics past to extract lessons for the present. This search for historical parallels has inspired comparisons to disease outbreaks from both the distant and more recent pasts—from well-known, global catastrophes like the Black Death (1347-50) and the influenza pandemic of 1918-19 to lesser-known, more local affairs such as the epidemic of typhus that swept through New York City’s Lower East Side in 1892 and the outbreak of bubonic plague that devastated much of San Francisco in 1900. Media commentary on these earlier contagions, much of which draws on input provided by professional historians, has provided a platform for exploring questions about how infectious diseases spread, about the kinds of interventions (both successful and unsuccessful) that societies have made use of in response to these, and about public health’s long-standing entanglement with stigmatization, the persecution of minorities and marginalized groups, and authoritarian politics. Taken together, these accounts serve as a reminder both of history’s vital role in contemporary society and of the media’s role as producers of history.

Pandemics and the Media in Historical Perspective

At this point in the current pandemic, it is difficult to say what the media’s historical account of COVID-19 will be. Despite this, it is not too soon to begin examining the stories that are (and are not) being told about the past in the media’s coverage of this public health crisis, for, as historians have shown, journalistic reporting both informs popular understandings of disease and contributes to the shaping of public responses to this. Since the late nineteenth century, the newspaper industry has been a particularly active participant in the chronicling of American medical history, and in constructing stories of health and illness that connect “then” and “now,” the popular press has advanced a remarkably consistent thesis—one that emphasizes humanity’s progressive triumph over disease. According to historian Bert Hansen, this celebratory narrative crystallized in the 1920s and 30s, when newspapers began regaling readers with biographies of history’s “health heroes,” praising past medical luminaries such as Ephraim McDowell, Florence Nightingale, Louis Pasteur, Sister Elizabeth Kenny, and (later) Alexander Fleming for their therapeutic innovations and the humanitarian spirit undergirding their work. Presenting medicine as a dignified profession, these stories engendered an increasingly optimistic outlook on doctors’ ability to vanquish disease, convincing readers that medical science would produce “ever-more-powerful and ever-more-numerous practical innovations.”[i] As Hansen demonstrates, newspapers were largely responsible for the growing cultural authority of the medical profession over the course of the twentieth century. 

The notion of historical progress in medicine, then, is one that has historically been ingrained by media organs. We can see this not only in twentieth-century hagiographies recounting the great deeds of long-dead doctors, but also in coverage of more recent developments. In her analysis of the Canadian press’ reporting on the SARS outbreak of 2003, for example, historian Georgina Feldberg finds that journalists fit this novel virus into a timeline of events showcasing science’s steadily increasing power over infectious disease. Reporters predicted that just as earlier epidemics of typhoid fever, cholera, and tuberculosis were laid low via the bacteriological and chemotherapeutic breakthroughs of the late nineteenth and early twentieth centuries, so too would this new contagion ultimately fall at the hands of medical science. The message communicated with SARS, Feldberg observes, was that scientists and medical doctors had learned and profited from earlier generations’ struggles with mass illness, developing new drugs and vaccines that could now be utilized as a first line of defense against disease.[ii] Thus, Canadians need not fear SARS. Providing readers with a sense of security, the disease histories produced during this pandemic stressed humanity’s gradual triumph over disease in a way designed to reproduce faith in biomedicine and its achievements. 

The emergence and spread of SARS-CoV-2 offers renewed opportunities for examining the media’s ongoing construction of medical history. As pandemics are media episodes as much as anything else, it is important to ask how news outlets are using the past to make meaning out of the current coronavirus outbreak. How has history been impressed into the service of reporting on COVID-19? What kinds of “lessons” are being drawn from the past? Has journalistic reportage furthered the optimistic narrative of progress over time, or have historically-informed discussions of our present pandemic broken with this long-established tradition? 

As previously mentioned, at this early stage in the crisis, offering a definitive answer to these questions seems premature. Nevertheless, as we enter the fifth month of the pandemic, it is clear that two distinct, countervailing COVID-19 chronologies have already emerged. The first of these fits the pattern documented by previous historians and engages with the past to provide reassurance and a sense of security. While perhaps less enthusiastic about modern medicine’s disease-fighting capacities than either Hansen or Feldberg suggest, this narrative’s ultimate goal is to convince the public that when it comes to epidemics, contemporary societies are in a much better position than their historical predecessors. In competition with this optimistic account is a darker, less reassuring one, which highlights America’s failure to learn the lessons of the past and stresses persistent problems in the country’s response to epidemics. Locating these within the context of broader social, cultural, political, and economic realities, this counter-narrative eschews notions of historical progress, preferring instead to highlight a recurring theme in the annals of public health: humanity’s inability to vanquish the discriminatory behaviors, stigmatizing attitudes, and structural injustices that both facilitate the spread of infectious disease and concentrate their associated hardships among the marginalized. Aiming to elucidate some of the differences between these competing constructions of medical history, the analysis offered here advances a more complex account of the media’s relationship with history than hitherto acknowledged. 

“We Have Never Been More Prepared”: Connecting COVID-19 to Narratives of Medical Progress Over Time 

In many ways, the most frightening thing about novel coronavirus is the uncertainty surrounding it. “How far will it spread? How long will it last? How many people will it kill?” asks a typical COVID-19 news brief. Our collective inability to answer even the most basic of questions about the pandemic has engendered a great deal of historical reflexivity. And as members of the media look to the past for clues as to how COVID-19 might unfold, questions about chronological continuities and discontinuities leap to the fore. To some, it seems that our present crisis constitutes a radical rupture in the annals of global health. A piece attempting to determine appropriate religious responses to the pandemic, for example, begins by noting how throughout history, Christians have distinguished themselves by their “service to the infirm.” Today, however, the act of “sharing the bread and the wine with the infected” is one that will likely only accelerate the spread of the novel coronavirus. Now, “we show our solidarity by not sharing.” Such behavior “does not seem like the stuff of legend,” the article’s author confesses, but “faithfulness in our time” might need to assume a different guise than that it took in the past. The implication here is that COVID-19 cannot be usefully connected to prior outbreaks of infectious disease; this time, things really are different. The strategies that worked in the past are no longer viable because COVID-19 is unlike anything we have seen before. 

Scholars critical of the “history-as-lessons” approach to the past similarly warn of the dangers of attempting to draw instructive analogies between historical and contemporary public health crises. Most notably, in a piece published in The Lancet, medical historian Robert Peckham argues that in the process of probing the past for insights into how to combat COVID-19, analysts run the risk of overlooking important differences between this and earlier epidemics—and in particular, of ignoring the social and political contexts that shape disease environments. History, Peckham argues, is not “a series of interlinked crises”; overlooking this truth creates myriad “blind spots” that handicap the effectiveness of public health responses to infectious disease outbreaks. Thus, instead of falling prey to the temptation to “corral and straightjacket the past into summary lessons,” we need to focus on the “complex place-and-time specific variables that drive contemporary disease emergence.”

Compelling as this is, there is nevertheless something about epidemics that encourages historians and journalists to “identify universal truths about how societies respond to contagious disease.” Despite the fact that COVID-19 is a new virus, many believe that when it comes to the epidemiological, political, and socio-cultural aspects of the current pandemic, “we have seen it all before.” And while this recognition might make us somewhat “jaded,” there nevertheless remains a sense that something can be learned from the past—that COVID-19 is similar enough to historical pandemics so as to make examination of these relevant and applicable to the problems of the here and now. Here, the turn to history is undertaken so as to remind readers that our present moment is not unique. Others have dealt with things like this before. By studying their struggles, we can better prepare for and survive COVID-19.

Examples of this kind of historical writing abound. One is a piece appearing in the Los Angeles Times about mid-twentieth-century American film. “Want to Understand How a Pandemic Upends Everyday Life?” its author asks. “The Movies Can Tell You.” Summarizing the plots of feature films such as 1939’s Pacific Liner (which revolves around a cholera epidemic threatening to overtake a cruise ship heading for San Francisco) and 1950’s Panic in the Streets(which uses the spread of disease as a metaphor for exploring the ways that crime, poverty, and political subversion can decimate society), this article counters the assumption that the current moment is new and unprecedented. Hollywood has been thinking about “the potential for some kind of global disaster” for almost a century and, in doing so, has “prepar[ed] us for this moment.” American cinema offers “lots of possibly helpful dos and don’ts” on the subject of pandemic preparedness, and, by taking note of these, Americans can learn about “the best ways to safeguard the public health.” One lesson, extracted from That Mothers Might Live, a 1938 biopic about the nineteenth-century Hungarian physician Ignaz Semmelweis, is that if people want to prevent themselves from becoming infected, they need only “wash their hands.”

At a time when the world lacks effective, widely accessible means of diagnosing and treating the novel coronavirus, messages such as these assume special importance. The fact that medical experts are presently unable to combat COVID-19 with either drugs or a vaccine has also sparked interest in the distant past, when human responses to epidemics were entirely behavioral in nature. A particular fixation here has been with the Black Death—the mid fourteenth-century outbreak of bubonic plague that swept across Eurasia and North Africa, leaving tens of millions dead in its wake. In a late-February 2020 op-ed encouraging governments around the world to “Go Medieval,” for example, a New York Times science writer argues that the “harsh measures” characteristic of this era (including quarantines, the closing of borders, and the forced confinement of citizens within their “poisoned cities”) likely “worked” to save lives—and, as such, “might still serve a purpose.” Acknowledging that these authoritarian purposes are often “brutal,” the editorial contends that in the case of COVID-19, the “iron fist” might be more effective than the “latex glove” (vaccines, antibiotics, hospital ventilators, thermal cameras, etc.) characteristic of modern public health. 

Calculated to assure readers that past civilizations possessed successful, non-pharmaceutical means of handling epidemic disease, the goal of articles such as these is to convince readers that societies can effectively defend themselves from the threat of lethal pathogens even in the absence of therapeutic interventions. If these measures “worked” in the past, they will work now as well. Another example of this is an article in the Chicago Tribune entitled “Why Soap Works.” Though an ancient invention, its author exclaims, soap remains “one of our most effective defenses against invisible pathogens.” Despite modern advances such as robotic surgery and gene therapy, it remains the single-most valuable medical intervention in history, providing a safe, simple, inexpensive means of warding off the threat of infectious disease. 

It is not only in the distant past that media organizations have found evidence of the effectiveness of non-medical solutions to epidemic disease. In their attempts to find historical analogues for the current moment, many journalists have settled on the 1918-19 influenza pandemic, which the Washington Post calls “the only thing comparable in human history” to COVID-19. Taking an explicitly comparative approach, media organizations all across the world have published articles bearing such inquisitive titles as “Coronavirus vs. Spanish Flu: Which is Worse?” and “How Does Coronavirus Compare to Spanish Flu?” Answers to this question vary; some news outlets contend that “The Coronavirus May Be Deadlier Than the Spanish Flu,” while others aver that “COVID-19 Will Not Be as Bad as Other Epidemics We Have Faced.” Regardless, the common sentiment, as an Australian doctor interviewed for an ABC News segment opined, is that “we probably haven’t seen a virus like this one since 1918.” Moreover, most historians and journalists believe that the 1918-19 flu offers instructions for the present; this is evident in headlines touting “The Single Most Important Lesson From the 1918 Influenza,”addressing “What the 1918 Flu Pandemic Can Teach Us About COVID-19,” and suggesting that “Treatment Pioneered in 1918 Could Save COVID-19 Patients.”

What exactly can we learn from 1918? One of the most vocal participants in the media’s response to this question has been Howard Markel, a University of Michigan historian who in the last few months has penned numerous op-eds in the New York Times and Washington Post, while also appearing as a guest on radio programs such as NPR’s On Point. A strong proponent of social distancing, Markel’s advice largely derives from a 2007 study he and several colleagues conducted on America’s response to the 1918-19 flu. Analyzing historical records from 43 different cities, Markel’s team concluded that early, prolonged implementation of “non-pharmaceutical interventions” (NPIs)—such as isolation of the sick, voluntary home quarantining of potentially exposed persons, and the banning of large gatherings—significantly slowed the spread of the virus and produced noticeably lower death rates from influenza.[iii] On the basis of these findings, Markel advises that while draconian measures such as quarantines and lockdowns will likely only facilitate the spread of the virus, social-distancing measures like school closures will help decrease the death rate from COVID-19. “My research on the long history of epidemics,” he recently explained, “has taught me that when it comes to outbreaks of contagious respiratory infections, closing schools can help prevent many thousands of illnesses and deaths.”

Taking their cues from Markel, numerous journalists have penned articles devoted to the divergent experiences of two American cities during the 1918 pandemic: St. Louis and Philadelphia. When evidence of the flu’s severity became clear, officials in St. Louis adhered to the advice of public health experts and quickly instituted a variety of social-distancing policies. By contrast, Philadelphia opted to carry on with business as usual, holding a Liberty Loan parade dedicated to raising funds for the U.S. military even after local medical experts warned that a public event such as this would gravely endanger residents’ health. The result was “the deadliest parade in American history.” Within three days, flu patients filled the city’s hospital beds. Within a week, 45,000 Philadelphians succumbed to infection and, ultimately, 12,000 died. For the media, this incident provides an object lesson in how not to prepare for a pandemic. Serving as a cautionary tale, Philadelphia’s experience highlights the way that misinformation and government censorship can facilitate the spread of infectious diseases. What the 1918 flu teaches us, one piece concludes, is that things like “war efforts” should not be prioritized over public health.

On September 28, 1918, Philadelphia held a Liberty Loan Parade that allowed influenza to spread like wildfire through the city.

What happened in Philadelphia was entirely preventable, media outlets concur. Moreover, it could happen again. Raising the prospect of “a repeat of that kind of mass manslaughter,” a New York Times op-ed warns that such a scenario would be unimaginably frightening—especially given coronavirus’ exceptionally high fatality rate (3.4 percent, compared to just 2.5 percent for the 1918 influenza pandemic). What brings this into the realm of possibility is the fact that President Trump has consistently downplayed the severity of COVID-19—prioritizing the state of the economy over the health and well-being of the nation’s inhabitants. Articles with titles such as “Trump is Ignoring the Lessons of 1918 Flu Pandemic That Killed Millions” draw parallels between the current president and political leaders of a century ago, observing that media self-censorship and governmental denialism “made everything worse” in this earlier public health crisis. According to John Barry, historian and author of The Great Influenza: The Epic Story of the Deadliest Plague in History, the Trump administration is not being entirely truthful about the severity of COVID-19, preferring to discuss only the “best-case scenarios” and ignoring other, more likely possibilities. As Barry advises, the lesson of the influenza pandemic of 1918 is clear: “don’t hide the truth.”[iv]

As commentaries such as these make clear, the news media has given voice to those who question America’s ability to learn the lessons of pandemics past. Despite this, many news analysts find it unlikely that the United States will repeat Philadelphia’s experience from World War I. A report in the Washington Post, for example, observes that whereas public officials in 1918 failed to correctly prioritize the citizenry’s health, in 2020 this has fortunately not been the case, as fear of coronavirus have led cities to cancel St. Patrick’s Day parades, postpone upcoming music festivals, and ban mass gatherings. 

As configured in articles like this, the past is a place that helps us predict what the future might hold and, as such, helps us gain some mastery over the present situation. Everything about COVID-19 “feels unprecedented,” but history shows us that humanity has overcome a number of severe pandemics over the centuries. Indeed, one of the central features of the media discourse surrounding COVID-19 is that many of the lessons from earlier pandemics have, thankfully, already been learned. “The world was a very different place” in 1918, notes a New York Times op-ed, adding that “the medical reality is quite different” today. Whereas public health in the early twentieth century was only “in its infancy,” another retrospective concludes that the 1918 influenza pandemic brought into existence the kinds of disease control measures “being enacted today across the world.” Striking a very similar note, an article entitled “The World Changed Its Approach to Health After the 1918 Flu” explains that influenza itself was “not a reportable disease in 1918” and, as such, “most governments were caught unawares by the pandemic.” By contrast, in the “post-flu years,” nations across the globe “took steps to consolidate healthcare, and to expand access to it.” Optimistic, reassuring, and celebratory, accounts such as these hew to a narrative of progress over time, using history to keep fears of a COVID-19 apocalypse at bay. Indeed, the goal of such writing is to suggest that humanity’s disease-preventing powers have advanced to such an extent over the last century that a repeat of the devastation of 1918-19 is unthinkable. “In the history of medicine,” declares historian Howard Markel in a typical iteration of this message, “we have never been more prepared to confront this virus than we are today.”

If much of the historical journalism on the novel coronavirus seeks to promote a sense of security by emphasizing the vast strides public health has made over the last hundred years, so too have many reports and editorials fixated on advances in medical therapy since 1918. “Medics were almost helpless” in the face of the 1918 flu, notes one article. “People didn’t really have any knowledge of virology or infectious diseases,” adds another piece, noting that the only available remedies were “homemade” products like opium that “weren’t overly effective.” Echoing this, another report explains that “back then, we didn’t yet have a vaccine or antivirals….nor did we have antibiotics” for secondary infections. Comparing 1918 and 2020, a doctor interviewed for an ABC News clip explains that “a century ago, medical knowledge was obviously well behind where it is today,” before adding that “modern medicine means much better care is available now than it was then.” And importantly, because of this, objective and scientific mindsets have replaced the kinds of “mystical…more fatalistic” attitudes popular in 1918. Speaking to this, an article in The Guardian informs its readers that current church authorities are “vocal in their public health guidance,” urging congregants to “wash their hands and not sprinkle holy water.”

At times, these celebratory accounts invoke the past so as to scold publics judged insufficiently appreciative of modern medicine’s contributions to human well-being. Looking at the growth of the anti-vaccination movement (and increasing skepticism toward science more generally) over the course of the last few decades, some commentators have used COVID-19 to remind Americans of “the threat certain diseases posed before vaccinations.” A New York Times op-ed, for example, argues that the current pandemic should prompt us to “imagine the world before vaccines,” when smallpox and other diseases much more deadly than coronaviruses were a regular feature of human existence. Up until quite recently, this piece continues, childhood infections such as polio regularly caused paralysis and death, and the public responded with heartfelt appreciation when vaccines for them appeared. Today, by contrast, “people have lost that sense of awe and gratitude.” The lesson here is that in reflecting back on a time in which people knew what it was like to “feel vulnerable and unprotected,” we can regain a proper respect for modern medicine and its achievements. Quite consciously aimed at the anti-vaccination movement, articles such as these impress history into the service of a very typical agenda: spreading “a little sense of celebration and appreciation of science and public health.”

Xenophobia, Biological Racism, and “Outbreak Narratives”: Problematizing Histories of Medical Progress

Aiming to inspire faith in our ability to meet the challenge of COVID-19, a substantial amount of the news media’s coverage of the current pandemic invokes the past to remind audiences of all of the recent medical advances that mitigate against the recurrence of a 1918-like event. Yet if part of the media’s response to COVID-19 looks to the past for security, comfort, and reassurance, it bears noting that much of the historical thinking occasioned by the present pandemic serves to do something other than calm frayed nerves and mollify worried publics. In addition to self-congratulatory accounts of ever-advancing medical progress, newspapers also produce a less rosy counter-narrative, one that highlights distressing continuities between then and now. These stories take as their theme not progress over time but the stunning lack of it. And they examine the history of public health not from a reductive medical standpoint but from an incredibly holistic, socio-cultural one. While a fair amount of the writing in this vein comes from professional historians themselves, those outside of academia also engage the broader dimensions of the country’s response to epidemics, highlighting a number of persistent problems in American disease control efforts. Among these are racism, economic inequality, and xenophobia.

As a means of highlighting the differences between these two competing narratives, consider a piece published in The Guardian on the subject of “What the 1918 Flu Teaches Us About Coronavirus.” Beginning with the observation that this earlier pandemic is generally known as the “Spanish Flu,” the paper contends that “we should applaud ourselves” for resisting the desire to give COVID-19 a “stigmatizing name.” On account of official World Health Organization guidance, which since 2015 has prohibited all reference to places or peoples in disease nomenclature, the “new plague is not the Chinese flu or the pangolin flu.” Instead, “it’s the rather more mundane COVID-19.”

In contrast with the rather triumphal tone of The Guardian, myriad journalists and academics question the extent to which the novel coronavirus is detached from stigmatizing labels. Drawing attention to President Trump’s tweets about “The Chinese Virus,” to other social media posts that pin the pandemic on the “dirty” eating habits of Chinese men and women, and to the experiences of Asian Americans lambasted with discriminatory greetings such as “hey corona,” these writers find little in contemporary disease-naming practices worthy of applause—official designations notwithstanding. Seeing COVID-19 as simply “the latest chapter in a story… centuries in the making,” they connect past and present pandemics in a way that unsettles notions of progress over time. 

President Trump’s attempts to brand Covid-19 “the Chinese Virus” demonstrate the continued appeal of racist disease nomenclature.

At the center of this “dark and complex history” is the idea that the spread of infectious disease is often accompanied by maladies of a more cultural sort. The “diseases of xenophobia and racism,” an article on CNN asserts, are “harder to contain” and “far more lethal” than biological pathogens. “Outbreaks often have been attributed to marginalized groups in society,” a report in the Washington Post declares. Extending this thread, a New York Times editorial speaks of how again and again in the history of public health, the vulnerable groups blamed for the spread of infections (be they foreigners, the poor, prostitutes, or others) experienced “violent attacks.” This scapegoating “is a symptom of disease, if not a biological one.” 

Within the United States, historical examples of this trend abound. Given the frequency with which President Trump and his political allies have used COVID-19 to hurl racial epithets at China, it is perhaps not surprising to learn that much of the media discussion here focuses on the long history of anti-Asian othering in American public health. As one writer notes, from the very beginnings of their migration to the United States in the nineteenth century, Chinese-Americans faced “food and hygiene slander” as the popular press regularly deemed them “uncivilized, unclean, [and] filthy beyond all conception.” Reports such as these spurred vigilante violence, including an event in 1871 during which twenty Chinese-Americans were hanged in the deadliest lynching incident in US history. White Americans believed that Chinese immigrants posed a threat to public health; such sentiments drove racist immigration legislation like the Chinese Exclusion Act (1882) and the Geary Act (1892). When an outbreak of bubonic plague struck San Francisco in 1900, local authorities quickly blamed Chinese residents, quarantining their communities even while allowing white Americans living nearby to freely go about their business. As a Washington Post op-ed explains, medical experts contended that the plague existed only among “rice-eaters,” not “meat-eaters.” In addition to infringing upon their rights, officials routinely ignored Chinese-Americans’ health needs; as a result, over one-hundred died.

Media stories such as these highlight the fact that the racialization of disease is not new. Invoking the past to show how counterproductive racism is as a disease-control strategy, they argue that those diagnosed with (or suspected of having) COVID-19 deserve compassionate medical care.  As historian Howard Markel explains, this includes not only protection of “individual rights” but also the provision of “adequate housing,” the recognition of “economic and recreational needs,” and the accommodation of the various “emotional, psychological and social difficulties patients invariably experience in isolation.”

The media’s acknowledgment of the social, cultural, political, and economic dimensions of public health is one of the more notable features of their coverage of COVID-19. These discussions may represent a break with historical coverage of earlier pandemics. In her analysis of Canadian newspapers’ reporting on SARS, for example, Feldberg faulted journalists for ignoring the impact that phenomena like “improved standards of living” had on the decline of infectious diseases such as tuberculosis. Accusing the media of overlooking the fact that “welfare and social spending promote public health,” Feldberg concluded that the media built accounts of SARS on a “narrow historical vision.”[v]

Fortunately, this does not always appear to be the case with COVID-19. Instead of simply focusing on viruses, drugs, and vaccines, a number of media voices have adopted a broader historical vision, one that (among other things) looks at how cultural ideologies shape epidemiological realities. While academics have been at the forefront of this call for understanding how non-medical factors play into the rise and fall of epidemics, they are not the only commentators engaging with these matters. In an op-ed published in the New York Times, for example, science fiction author Max Brooks urges readers to “keep a sharp eye out for the kind of stigmatization that harks back to the early days of AIDS”—a pandemic whose salvation “didn’t come from a lab.” Tackling the economic dimensions of COVID-19, a reporter with the Washington Post explains that in the history of epidemics, “the wealthy have often done better than the poor… because they tend to be resilient as a function of having greater resources.” Like the aforementioned articles, pieces like these acknowledge the way that pandemics lay bare a society’s underlying structure. The upshot of such analyses is that because their spread is often a product of things beyond biology, epidemics cannot be laid low absent correction of the structural phenomena that undergird them. 

This includes public health. Rising to the challenge of the present moment, notes Rice University media scholar Kirsten Ostherr, means coming to terms with the racist ideas about illness perpetuated by governmental organizations. Historically, film has served as a key medium through which agencies like the United States Public Health Service and the World Health Organization have advanced these ideas. This is evident in films such as The Eternal Fight (1948) and The Silent Invader (1957), which depict black and brown peoples as threats to the physical well-being of vulnerable white populations. The “racialized contagion narrative” marketed in these cinematic pieces, Ostherr observes, teach that “disease comes from nonwhite people” and that “modern technologies, guided by nationalistic ideologies, can stop its spread.” Entirely overlooked is the role that imperialistic traditions of natural and human resource exploitation play in fostering the spread of pandemics. As Ostherr suggests, these films “cause a lot more harm than good”—particularly as they fuel racist attacks against minorities and “misdirect our attention toward false ideas about where the real risks lie.” An essential step in reducing the harm caused by COVID-19, then, is putting a stop to the racist, xenophobic imagery generated by official public health institutions. “We don’t need any more racist contagion narratives,” Ostherr concludes.

Films like the WHO’s The Eternal Fight (1948) commonly present Asian, African, and Middle Eastern countries (in this case, Egypt) as threats to Western health.

Representation matters. Words matter. The things we believe and think about disease matter.  This has been one of the central themes in historically-informed media conversations around COVID-19. A prime example is a recent Washington Post op-ed entitled “Why Treating the Coronavirus Like the Black Death is So Dangerous.” Co-authored by three academic historians, the piece examines the kinds of frames and scripts we resort to when talking about pandemics. Since the turn of the twentieth century, these researchers argue, we have become accustomed to imagining these as profoundly cataclysmic, world-changing events—as things that bring “massive societal changes.” From a historical standpoint, however, this has not always been the case. For example, while many accounts assumed the Plague of Justinian (541-2 CE) had a “massive impact” on the Roman Empire, the evidence in favor of this is actually quite scant. There is “no evidence that the Justianianic Plague transformed people’s lives,” this article concludes; as such, we ought not assume that COVID-19 will radically remake the world. We assume this because our “standard model” for thinking about pandemics is the Black Death—a view nurtured by popular movies like Outbreak (1995) and Contagion (2011). But not all pandemics are the Black Death. What we need to do, these authors suggest, is rethink ouroutbreak narratives.

Clearly, this is far from a reductionist account of public health. Pieces such as these register recognition of the complexity of disease outbreaks, and they are geared toward doing something other than inspiring confidence in modern public health. Whereas some media histories emphasize how life was “very different back then” and how, eventually, humans “got a handle on” the infectious maladies threatening them, here, the emphasis is on continuity and on how the recurring racialization of disease undercuts any notion of progressive change over time. Instead of being about replacing cynical attitudes with enthusiasm for humanity’s ability to meet the challenges pandemics pose, these accounts foster a skeptical outlook. Here, there is no “air of triumph.”[vi] This countervailing narrative undermines the claim that disease-based journalism seeks to reproduce faith in biomedicine. 

Conclusion: A Break with the Past?

Many of the disease histories emerging out of the media’s coverage of COVID-19 are rich and multi-faceted, engaging not only with biological and epidemiological matters but also with the myriad social, cultural, political, and economic factors that shape the human illness experience. This is encouraging, for as historical analysis reveals, both the spread of epidemics and the way that societies respond to them are strongly influenced by things like racial prejudice, class biases, gender norms, attitudes toward sexuality, political ideologies, and ideas about morality. Yet acknowledging the centrality of these non-biological factors now does not guarantee that their role as a driver of health outcomes will be remembered. Indeed, history shows that the post-epidemic “return to normalcy” is often accompanied by forgetting, as complex understandings of disease cede ground to reductive and simplistic interpretations. 

As an illustration of this tendency, consider the histories of the 1918-19 influenza that appeared in the decade following this deadly pandemic. Between 1921 and 1929, the United States Army Medical Department published a series of volumes chronicling the military’s wartime struggle against infectious disease. Entitled The Medical Department in the World War, this history laid out an analysis of influenza drastically different than those circulated in 1918 and 1919. While earlier interpretations stressed the role that environmental conditions (housing, clothing, the availability of nursing care, etc.) played in determining morbidity and mortality rates from the flu, this new analysis instead positioned race as the key driver of the disease’s spread. When attempting to explain, for example, why the case fatality rate for black soldiers was much higher than those for white soldiers, The Medical Department in the World War neglected to mention many of the things that Army doctors had earlier reported on—including living conditions (like the fact that the army housed black soldiers in tents instead of barracks), dietary regimes (under which black soldiers received fewer and less nutritious meals than their white counterparts), and pervasive racism in American combat units. Instead of acknowledging these unsettling realities, Surgeon General Merritte Ireland insisted that “the troops of all races were housed, clothed, fed, and officered with the same painstaking care.” Consequently, Ireland continued, “their relative susceptibility to infectious diseases was not influenced by extraneous economic circumstances.”[vii] According to this official history, blacks died at higher rates than whites on account of their biological inferiority, not because of racism. 

In an era of militant white supremacism, the likelihood of this scenario repeating itself seems high. As such, it is incumbent upon the media to continue grappling with COVID-19’s environmental and social dimensions and to persist in documenting the historical relationship between infectious diseases and the structural factors that fuel their spread. Doing this will not only help put an end to narrow-minded narratives that serve only to perpetuate faith in biomedicine, but will also help ensure that our collective discourses of public health serve as a means of correcting the systemic inequalities that make pandemics like this one possible. And that is a lesson of history well worth learning. 


[i] Bert Hansen, Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America (New Brunswick, NJ: Rutgers University Press, 2009), 5.

[ii] Georgina Feldberg, “Making Disease History: TB and the Public Health Legacy of SARS in Canada,” in SARS in Context: Memory, History, and Policy, ed. Jaclyn Duffin and Arthur Sweetman (Montreal: McGill/Queen’s University Press, 2006), 116.

[iii] Howard Markel, Harvey B. Lipman, J. Alexander Navarro, Alexandra Sloan, Joseph R. Michalsen, Alexandra Minna Stern, and Martin S. Cetron, “Nonpharmaceutical Interventions Implemented by US Cities During the 1918-1919 Influenza Pandemic,” Journal of the American Medical Association 298, no. 6 (2007), 644-54.

[iv] Barry, it should be noted, is far from the only historian to cast doubt on the idea that modern societies have learned the lessons of pandemics past. For another example of this, see Cindy Ermus, “The Danger of Prioritizing Politics and Economics During the Coronavirus Outbreak,” Washington Post, March 13, 2020, https://www.washingtonpost.com/outlook/2020/03/13/danger-prioritizing-politics-economics-during-coronavirus-outbreak/.

[v] Feldberg, “Making History,” 117.

[vi] Hansen, Picturing Medical Progress, 151.

[vii] Carol R. Byerly, Fever of War: The Influenza Epidemic in the U.S. Army during World War I (New York: New York University Press, 2005), 172.

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