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 Lawâ€™s â€śat home mini-seminars,â€ť 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 whoâ€™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.
- DoctorsÂ rarely haveÂ good treatment options. Nursing careÂ is often what’s needed most. Medical professionals of all kindsÂ work themselves to the boneÂ 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, thereâ€™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 donâ€™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, Americaâ€™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, Ebolaâ€™s Lessons: How the WHO Mishandled the Crisis.