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.
The class was one of Michigan Law‚Äôs ‚Äúat home mini-seminars,‚ÄĚ which meant we hosted a dozen students at our home over the course of six evening sessions. 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.
We also drank beer, which makes death and disease more tolerable.
The class was a hoot. And it 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, disorganized, 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‚Äôs 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‚Äôs 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‚Äôt 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‚Äôs 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‚Äôs Lessons: How the WHO Mishandled the Crisis.