Science  /  Journal Article

Emerging Diseases, Re-Emerging Histories

The diseases that prove best suited to global expansion are those that best exploit humans' global networks and behaviors in a given age.

... of them. That fact suggests that we should be looking beyond circumstances of emergence, and even beyond the “crisis control” model of epidemiological interventions. We need to look at what allows persistence. 2 “NO, WE HAVE NOT YET BEEN IN THIS MOVIE”: HISTORIANS' RESPONSES TO COVID‐19

... of them. That fact suggests that we should be looking beyond circumstances of emergence, and even beyond the “crisis control” model of epidemiological interventions. We need to look at what allows persistence. 2 “NO, WE HAVE NOT YET BEEN IN THIS MOVIE”: HISTORIANS' RESPONSES TO COVID‐19

One of the first statements about COVID‐19 by trained historians of medicine was that of two French historians of 20th‐century medicine, Guillaume Lachenal and Gaëtan Thomas. At the end of March 2020, they claimed there was a radical disjuncture between the world's newest threat and any “lessons” that could be learned from older pandemics. They were skeptical that those who invoke the 1918 flu pandemic as a model have any ground to stand on, given the drastic ways world economies and physical infrastructures have changed in the past century; they made no attempt to look at earlier histories. Particularly memorable was their use of an Instagram post from the Hollywood actress, Gwyneth Paltrow. She had starred in the 2011 movie Contagion , which depicted the emergence of a new virus and the worldwide efforts to contain it. Paltrow, boarding a flight to France in February 2020 (by which point SARS‐CoV‐2 was known to have spread well beyond east Asia), posted a photo of herself wearing a filtered mask, offering as explanation and justification the comment, “I have already been in this movie.” Lachenal and Thomas responded: “No, we have not yet been in this movie. Maybe it is our responsibility as historians to say it. For history, to follow again Marc Bloch, is a science of change and newness.”

In the 2 months since then, a variety of other historians have weighed in with their thoughts, some suggesting limited parallels in how epidemic responses (public health or political) have been handled in the past, some entirely demurring the call to analogize. Interestingly, the observation that history has already played a very significant role in the COVID‐19 outbreak has not been mentioned by any of these commentators. The social distancing recommendations, including the discourse about “flattening the curve” of the outbreak by disrupting normal social relations (including most economic transactions), derive from historical studies of the 1918 flu pandemic.

The range of opinion among historians of medicine is of less interest to me than the fact that there has been no organized response to the new disease by my discipline in the first 4 months after the outbreak was publicly announced by the Chinese government. This did not surprise me. I was a graduate student in the early 1980s when HIV/AIDS was first described clinically, and have no recollection of it ever being publicly discussed at the time. In later years, I could find no published work by historians that dated before the mid‐1980s. A similar inarticulateness among historians—or even complete silence—prevailed when the West African Ebola outbreak occurred in 2014. In that case, I felt empowered to make an immediate intervention as a teacher, because, by that point, I had developed a method for investigating disease emergence as a historical phenomenon. To judge from the download data, the “Ebola Archive” I created was used by investigators from around the world. But although a session devoted to the Ebola outbreak at the 2015 meeting of the American Association for the History of Medicine was well attended, as co‐organizer Stephen Casper noted, both before and afterward it was marked by silence.

I think there is reason to dig into that silence. But now is not the time. Rather, I would like to push forward and propose an analytical framework for our present moment. As the title of this essay suggests, I adopt here the notion of “emerging diseases,” a term and concept coined in the 1990s upon sober realization that humankind's long history with infectious diseases was not over (as some had proclaimed in the 1970s with the control of smallpox and other long‐term foes), but had simply taken a new turn. My stance is that every infectious disease we have was at one point “emerging.” The approach presented here is not focused on the ecology of disease emergence per se. Rather, it asks: Why, once a disease has emerged—once a zoonotic spillover or environmental infection has happened—why does that disease become pandemic?

All global diseases—all diseases that have become pandemic—are diseases we (humans) have made . Or certainly, “made possible.” For to become pandemic—pan (all) + demos (people)—is by definition to spread through human networks and thereby create the same ...