"Fear of the plague and fear of the poor went hand in hand."Pandemics VSI, p. 21
I was halfway through the book, always waiting until – finally – the author would talk a little more about the diseases themselves. What did the Plague look like? What are the symptoms of Cholera? But then I realized. It's not a book about diseases. It's about pandemics.
Pandemics are social
My first takeaway from this book: Pandemics are a social phenomen, and not a biological one.
The author (Christian McMillen) is a professor of history, which might also be a factor in the social and historical focus, rather than the focus on biology. If you are interested in the diseases, I would recommend the introduction to Infectious Disease.
Of course, the parameters of the the pandemics are set by the specifics of the infectious disease. Does it spread via the air? How deadly is it? How can it be treated? But given this setting, a pandemic is best understood as a social phenomenon, and even all the solutions on the biological level, like vaccines and medication, are embedded in the society. Success of vaccines depends on a good health infrastructure, an informed public, high level of equality and so on.
"Pandemics" is my first of the Very Short Introductions book series. Not surprisingly, I bought this because of the Covid pandemic. And it was very eye opening to view the current pandemic through the lense of historical pandemics.
Ignorance of History
My second biggest takeaway is very lame, but: People don't learn enough from history. I myself am very guilty of this, since my knowledge of history is mediocre at best. It's a bit better thanks to the VSI to Pandemics
I mean, just read the following snippet about the Spanish Flu which killed 17 - 100 million people worldwide.
"In the United States [...] pamphlets suggested the flu spreading across the country was in most ways not no worse than the average annual flu."Pandemics VSI, p. 99
Many themes repeat themselves:
- Inequality and bad health infrastructure lead to worse pandemic outcomes.
- People get used to the suffering and dying, accepting a "new normal".
- Closeness to animals is a sure way to start a pandemic.
- Some groups spread misinformation, some (state) actors supress bad news
- False overconfidence helps the spread of the disease
- The diseases often stigmatizes certain groups of people
The historic view also helps with the question whether the pandemic will overthrow the social order. Today, 1yr+ into the Covid pandemic, it's clear that it has not changed the overarching order, and also the historical account shows the same.
However, pandemics can also be catalysts of change, like changing how our health systems works. The influenza pandemic (1918/19) had a strong impact on the field of virology.