By late March 1863, hundreds had died in Alexandria, Virginia. The mortality rate had almost doubled in just one night, and even quadrupled in other parts of the country. Three thousand people were dead in less than a month in North and South Carolina. The numbers in Louisiana, Georgia, and parts of Mississippi were equally as high. As a smallpox epidemic tore through the country, more than 49,000 people died from June 1865 to December 1867, the years an official count was kept.
Smallpox exploded at this time not because of a lack of protocols or knowledge—a vaccine even existed—but because political leaders simply didn’t care about the group that was getting sick. Government inaction or delay—due to racial discrimination, homophobia, stigma, and apathy—have shaped the course of many epidemics in our country. In the 1980s, for example, HIV spread as the government barely acknowledged its existence.
Now the United States is facing the coronavirus pandemic. Once again, the threat a disease poses has been magnified by the slow speed with which the government has reacted. And although this disease is not concentrated within any one community, it is poised to exacerbate existing inequalities. The lesson of past outbreaks of infectious diseases is that public officials must take them seriously, communicate honestly, and tend to the most vulnerable. If the United States has not always lived up to that standard, we now have the perfect opportunity to apply the lessons of our past mistakes.
When the first cases of smallpox broke out among troops during the Civil War, military officials—on the Union and Confederate sides alike—immediately quarantined the infected in a tent or a makeshift hospital to prevent the transmission of the virus. But when smallpox began spreading among formerly enslaved people, officials either ignored it or argued that the virus spread viciously among black people because of racial inferiority and unsanitary habits.
The outbreak shouldn’t have happened. Medical authorities had long-established procedures to respond to epidemics, and smallpox was not a mystery. In the summer of 1721, at the height of a smallpox epidemic in Boston, an enslaved African named Onesimus explained the process of inoculation, which had been prominent for centuries in Asia and Africa, to the Puritan minister Cotton Mather. The process of injecting lymph, the colorless fluid that oozed from under a smallpox vesicle, into a healthy person created a mild version in its host, who thereby gained immunity. In 1796, Edward Jenner, an English physician, developed a vaccine for smallpox by using the lymph from infected cows. While many Civil War doctors doubted the efficacy of the vaccine or simply struggled to properly administer it, preventive protocols to protect the population did exist. Quarantine as a practice had originated in 14th-century Venice.
Yet federal and military authorities forced freedpeople—sick and well—into makeshift camps, placing them, in effect, under lockdown together, leading to the explosive spread of the virus throughout the African American community.