Contagion: Commonalities Among Epidemic Diseases

UnknownNicholas Bagley:

‘A couple of weeks ago, my wife (also a law professor) and I wrapped up the final session of a seminar that we co-taught called Contagion. We wanted to offer an introduction to the outbreaks of infectious disease that have reshaped American life and law.

…Really more of a book club than a formal class, we focused on a different disease each time we met: cholera, Spanish flu, polio, AIDS, SARS, and Ebola.

…The class …had a surprising coherence. Every disease provokes its own unique dread and its own complex public reaction, but themes recurred across outbreaks:

  • Governments are typically unprepared,, and resistant to taking steps necessary to contain infectious diseases, especially in their early phases.
  • Local, state, federal, and global governing bodies are apt to point fingers at one another over who’s responsible for taking action. Clear lines of authority are lacking.
  • Calibrating the right governmental response is devilishly hard. Do too much and you squander public trust (Swine flu), do too little and people die unnecessarily (AIDS).
  • Public officials are reluctant to publicize infections for fear of devastating the economy.
  • Doctors rarely have good treatment options. Nursing care is often what’s needed most. Medical professionals of all kinds work themselves to the bone in the face of extraordinary danger.
  • In the absence of an effective treatment, the public will reach for unscientific remedies.
  • No matter what the route of transmission or the effectiveness of quarantine, there’s a desire to physically separate infected people.
  • Victims of the disease are often thought to deserve the affliction, especially when those victims are mainly from marginalized groups.
  • We plan, to the extent we plan at all, for the last pandemic. We don’t do enough to plan for the next one.
  • Historical memory is short. When diseases fall from the headlines, the public forgets and preparation falters.

Not every one of those themes was present for every disease; the doughboys who died of the Spanish flu, for example, were not thought to deserve their fate. But the themes were persistent enough over time to establish a pattern.

The books we assigned were outstanding. If you want to learn about the intersection of infectious disease, history, and public health, you could do worse than to start with them:

  • Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866.
  • Alfred W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918.
  • David Oshinsky, Polio: An American Story.
  • Randy Shilts, And the Band Played On.
  • Thomas Abraham, Twenty-First Century Plague: The Story of SARS.
  • David Quammen, Ebola: A Natural and Human History of a Deadly Virus.
  • Laurie Garrett, Ebola’s Lessons: How the WHO Mishandled the Crisis….’

Via The Incidental Economist

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