In the summer of 2009, Samuel Cohn, historian of plague and malady, was contacted by the New York Times. A new strain of deadly flu was then sweeping the land, and the New York Times was concerned that the popular name for the new disease, “Mexican swine flu,” might lead to hate crimes targeting a vulnerable minority. This is what had happened to the Jews during the Black Death, the editors reminded Cohn, and the world needed a man with Cohn’s expertise to warn that it might happen again. The only problem: Cohn did not think it would happen again. In the historical case studies he was most familiar with, epidemics led not to acts of hate but to acts of compassion. Often that compassion crossed class and racial lines.
The New York Times declined to publish Cohn’s more optimistic op-ed. For that, we should be thankful. As Cohn tells us in the introduction to his 656-page tome, Epidemics: Hate and Compassion from the Plague of Athens to AIDS, the New York Times’s rejection launched a decadelong research program to discover who was right. This sort of research would not have been possible in an earlier era: To write his book, Cohn used computer search tools to locate all mentions of plague and sickness in the classical corpus, scan through hundreds of medieval documents, and scour thousands of epidemic reports in databases of newspapers from 19th- and 20th-century Russia, Italy, Germany, England, America, Canada, Australia, and India.
The results of this massive survey largely confirm Cohn’s original claim. In both the ancient world and the modern, the overwhelming majority of epidemics were not followed by selfishness, riot, persecution, or disorder but by compassion, solidarity, and self-sacrifice. The supreme example of the selflessness instilled by joint suffering came with the Spanish influenza of 1918, when ordinary people, especially young women, went to extraordinary lengths to care for the stricken. The Spanish flu brought the societies that suffered from it closer together, united around and inspired by the often mortal sacrifices made by nurses and neighbors to tend to the afflicted.
Not all societies struck by epidemic lived up to this standard, however. Cohn identifies three outliers, diseases that left violence in their wake. The first is the Black Death of 1346–53, the deadly legacy of which is so well known that even the hapless New York Times editors had heard of it. Cohn describes this plague as a sui generis happening in European history. No previous outbreak of bubonic plague and no later pandemic had such a devastating effect on European society. But even the Black Death’s extraordinary body count did not produce scapegoating everywhere: Jews were attacked in only a few locations (Germany, Spain, France, and the Low Countries). When the plague returned in less virulent waves during the 15th and 16th centuries, no scapegoats were killed at all.
Significant disease-related violence would not return to European shores until the 1800s, when large-scale riots, several with tens of thousands of rioters, accompanied breakouts of cholera, and then, later, a new strain of the bubonic plague. Similar disturbances on a slightly smaller scale would occur when these diseases arrived in North America and the Indian subcontinent. None of this violence was targeted at the sick, nor was any of it directed toward a scapegoated minority. In all of these cases, the main target of popular anger was the state. Again and again, poor communities subjected to quarantine, centralized isolation schemes, or invasive surveillance would rise in revolt against government action they believed was discriminatory or oppressive. Over the last two centuries, Cohn found, the main cause of pandemic-related disorder was not disease but government attempts to control diseased citizens.
The only modern case study to fit the received understanding of epidemic violence partially came with the smallpox epidemic of 1880. Cohn chronicles 72 separate episodes in which people murdered smallpox patients or burned down the medical stations, churches, or hospitals that sheltered them in order to keep the infection from spreading to their communities. This happened in the high age of lynch mobs, and it comes as no surprise to learn that a disproportionate percentage of those murdered were black.
But the outbreak of violence in the 1880s was almost as sui generis as the killing of Jews during the Black Plague. This violence was limited mostly to the United States, and even in the U.S., it was only the 1880 outbreak: Neither the smallpox pandemics that wracked revolutionary America nor the final smallpox outbreak in 1941 New York occasioned murder. Cohn is at a loss to explain why this particular epidemic prompted such a vicious response.
Cohn classifies smallpox, the bubonic plague, and cholera as “epidemics of hate” but admits he doesn’t know why the reactions to these diseases were so much more deadly than in “epidemics of compassion,” such as the yellow fever outbreak of 1878 or the Spanish flu. Virulence is surely a part of this story: In the epidemics of hate, one- to two-thirds of infected people died soon after contracting the disease. Disgust may have also played a role: Unlike the equally virulent yellow fever, plague and smallpox disfigure those stricken with it, while cholera leaves men dead in puddles of their own excrement. And it may not have been a coincidence that the worst violence happened in the 19th century, a time when old understandings of disease as a curse from God were being displaced by accurate bacteriology, but trust in medicine and public health was low and relations between the urban poor and their governments explosive.
Cohn’s book was published in 2018, two years before the outbreak of COVID-19. One cannot help but wish that more people had read it before our own pandemic began. We might have recognized that pandemic-related scapegoating was rare and that the precious time and energy that politicians and public intellectuals spent trying to ward it away could have been put to better use. Epidemics bring out the best, not the worst, in most societies. The true challenge is not how to stop a sick society from tearing itself apart in panic but how to convince a sick society that government and public health authorities can be trusted. Alas, Cohn’s book has been read little and heeded less. The lessons of his book were not learned, and the nations of the West have suffered through a foreseeable disaster.
Tanner Greer is a journalist and researcher focused on contemporary security issues in the Asia-Pacific and the military history of East and Southeast Asia.
