But can history show us what we want to know?

In some ways, yes. In others, no. And we need to broaden what we ask.

As a historian of medicine, North Africa and France, I find we are using some lessons but ignoring others. Pandemic histories are useful, but how they connect with race, public health, revolution, labour, gender and colonial histories will help us explain the present and predict the future.

Lessons learned: COVID-19 responses using pandemic history

Some history lessons have been put to use right away, like social distancing.

At University of Michigan, Dr. Howard Markel compared cities in the United States during the 1918-19 flu pandemic and showed the U.S. Centers for Disease Control and Prevention how early, strict social distancing measures worked to slow infection rates. Countries around the world now use his concept, “flattening the curve.”

Not bad for the history of medicine, a field the Lancet declared “moribund” in 2014.

Lessons ignored: Poverty and racism make you sick and dead

Other pandemic lessons have been ignored, and they tragically unfold anew.

The poor, the vulnerable and workers die in greater numbers. Social reformer Dr. Rudolph Virchow wrote in 1848:

“Medical statistics will be our standard of measurement; we will weigh life for life and see where the dead lie thicker, among the workers or among the privileged.”

Poor neighbourhoods have the highest death tolls. Reformers’ maps from the 1800s demonstrated this in the United Kingdom (Edwin Chadwick, 1834) and France (Réné Villermé, 1832). The same pattern has emerged in 2020 in New York (the Bronx) and Montréal (North Montréal).

A pandemic is not the great equalizer, contrary to Madonna’s “Reflections from the Bathtub.”

Inequality of income, housing, work and opportunity are the inequities that made death “a social disease” for social reformers Chadwick, Villermé and Virchow. We now call these factors the “social determinants of health.”

That is why structural racism can be a death sentence. Data show that pandemics have disproportionately affected African Americans and Indigenous Peoples. Virchow demanded social justice as the solution: full employment, higher wages and universal education.

Policy-makers had months to protect vulnerable populations from COVID-19. Why didn’t they?

History explains that too.

Cholera: Change happens when people rise up

If history shows one thing, it’s that rich people and politicians do not want to pay for sewers, schools, hospitals, old age pensions or worker safety. The deaths of the poor themselves did not move politicians in France, Germany or Britain to big policy changes.

Like the 19th-century economist Thomas Malthus, some elites even argued that such deaths are “natural,” or in Texas recently, beneficial to society.

So how does change come?

Change came because people rose up in a series of political revolutions across Europe in 1848. Workers rose in massive strikes and revolutionary action. The fear of Marxist revolution brought health care and the welfare state to the people in Bismarck’s Germany.

And cholera pandemic also showed elites their vulnerability. If enough people are sick, if the air and water are contaminated, even rich people can die. Today you can tour the magnificent sewers of Paris and drink filtered water in Hamburg, because the rich realized they can get sick too.

Madonna was right on that one.

Health and rights are inseparable

If enough people get sick and hungry and angry, there will be revolution.

We wave flags for France on July 14, the anniversary of the storming of the Bastille in 1789 that launched the French revolution. But the day before, “bread riots” broke out and people carried food away. The combination of tyranny and physical suffering started the revolution.

Health and human rights are inseparably tied together. A government that does not allow its citizens to survive, to eat, to breathe, to live, is illegitimate. By what right does it rule? The current protests in the U.S. demanding recognition of African American lives illustrates this fundamental nature of politics.

A contemporary example of revolution to demand health and rights was the Arab Spring in 2011. A young man, Mohamed Bouazizi, lit himself on fire and his fellow citizens saw themselves in his suffering: I also cannot eat, work, have shelter or raise a family in this country. Tunisia toppled its president and wrote a new constitution.

Authoritarianism is bad for health, because public health relies on good governance.

Democracy is good for health. In 1794, French revolutionaries created the first public health system, for the “citizen-as-patient.”

Lessons from COVID-19 to global health history

COVID-19 is also teaching history new lessons.

For one, pandemics were widely considered a thing of the past.

The “developed” world expected that modern sanitation and medicine would eliminate infectious disease as a primary cause of death, known also as the “epidemiologic transition thesis.”

But “re-emerging infectious diseases” challenge this story. They are produced by modern economic and social practices.

Environmental destruction opens pathways for viruses to jump from animals to humans; COVID-19, SARS, AIDS, H1N1 and the 1918 flu are all such “zoonotic” diseases.

Modern injustices like labour exploitation, inhumane incarceration and overcrowded refugee camps directly contribute to disease spread by creating unsafe living and working conditions.

COVID-19 is helping societies rethink their histories, and how we should write history itself.

Ellen J Amster, Associate Professor, Hannah Chair in the History of Medicine, McMaster University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Featured Illustration: A Cholera Patient, Random Shots No. 2. Cartoon by British satirist Robert Cruikshank, circa 1832. Welcome Library.

The protests illustrate the fundamental nature of politics—health and rights are inseparably tied together. A government that does not allow its citizens to survive, to eat, to breathe, to live, is illegitimate. The U.S. is having an Arab Spring, perhaps an “American Spring.” George Floyd, like Khalid Said (Egypt) or Hamza Al Khatib (Syria), was an outrageous public killing by police that showed ordinary citizens the bankruptcy of the state and their own dim futures. Structural racism allowed a comfortable majority to look away while African Americans were sacrificed, but now with 100,000+ dead, high unemployment, a staggering economy, and soon to come, overwhelm of health infrastructure, there is no looking away. The Trump regime threatens the physical survival of African American citizens and all citizens. Trump has been clear about his intentions from the beginning–to dismantle the republic with the aid of his white alt-right allies. Recent history shows what Trump offers, and what the American future could be.

George Floyd is America—Why Protestors Are In the Street

Why are people in the street? Protestors tell the NYT, “George Floyd was the last straw.” (Michael Sampson II), “It could be my father, my brother, my uncle, my cousin, my friend.” (Victoria Sloan). “If you’re not standing up for George Floyd, who’s going to stand up for you?” (Beth Muffett). In Egypt, Syria and Tunisia, national uprising also centered on an innocent whose brutal death demonstrated the oppression and suffering in society. What happened in these countries in 2011 can provide a glimpse of possible futures for the U.S.

In Tunisia, Mohamed Bouazizi lit himself on fire (December 14, 2010) and the Arab Spring began, as his fellow citizens saw themselves in his suffering—I also cannot eat, work, have shelter, or raise a family in my country. Beaten by police when he tried to create a fruit stand, Bouazizi burned himself to protest a regime that makes citizens’ survival impossible. In Egypt, police beat the young Khalid Said to death in broad daylight. In Syria, 13 year-old Hamza al-Khatib was detained by police when he demonstrated with junior high classmates. He was tortured, his penis hacked off, shot several times in the chest, and his corpse was released to his parents (May 2011). Egyptians and Syrians chanted, “We are all Hamza al-Khatib.” “We are all Khalid Said.” and marched for regime change. What does it mean to be murdered by police? The police are not accountable to the people. It means human life is not valued in this system. Can such a government be legitimate? By what right? Like Khalid Said and Hamza al-Khatib, Americans now march for George Floyd, and like the Arab Spring, electoral posters will soon bear his image reminding us to vote.

African Americans have long lived the world of George Floyd and Mohamed Bouazizi while white America turned away. But none are free in a country where police can kill fellow citizens with impunity. The festering wound of structural racism has rotted the foundations of the house, and Trump is the end of the line. One can say this is the logical conclusion of America, a state founded on slavery. But the Constitution promises a different vision. The Black Lives Matter movement is the fight for the true republic itself.

The US can now turn left or right, realize the promise of the constitution or disintegrate from internal contradiction. There aren’t sidelines. The Arab Spring offers a few endings, and two seem most analogous. We can be Syria, or we can be Tunisia.

Authoritarianism and Civil War, Syria and Trump’s America

Hitler and his brownshirts didn’t have 4-Chan to plan their “Boogaloo” (race war), but their American children, Trump and his alt-right “accelerationists” (don’t forget Steve Bannon training “gladiators” in Italy) are clear about drawing tactics and goals from their fascist forbearers. Like Mussolini and French fascists from Georges Sorel (1847-1922) to Renaud Camus, the alt-right is goading its followers to “accelerate” violent revolution and race war to destroy government and “purify” white civilization. A Minneapolis alt-right protestor casually smashed windows; “Proud Boy” Wesley Somers set fire to the Tennessee courthouse, Trump blows the dog-whistle for his alt-right paramilitaries, who hear even from Russia. Commentator John Buell at Informed Comment asks if “Trump sees in COVID-19 his Reichstag moment?” Der Stern depicted Trump’s “Sein Kampf.” The parallels write themselves: Hitler campaigned to replace republic with white nationalism, denounced the press, and had the German parliament (Reichstag) set fire, a chance to blame the Left, use crisis to suspend constitutional civil liberties, claim extraordinary powers, censor the press, impose martial law, and encourage civil violence. He even hid in a bunker.

Now as Trump puts together his mail-order dictator kit, Bashar al-Assad in Syria lights his way (another pal of Vladimir Putin). What does Trump need to stay in power? A faceless secret police and spy apparatus, arbitrary detention, military force against civilians, police violence as a terror tactic, hamstrung elections, a corrupt judicial authority, and a nation based on race ideology.

Assad has it all, and if we follow, we can expect Syrian outcomes. Even if you’re ready to join up with Mitch McConnell for Trump’s Christian, white-supremacist “Fox Nation,” civil war will be a constant. Civilian killing will be a constant. Only violence can keep a minority in power over a resistant majority.

Black Lives Matter—Tunisia and the Future of the American Republic

The Tunisian revolution was also live-tweeted, filmed, and facebooked, the swollen, bruised faces of DC protestors could be Tunis in 2011. Tunisia was bedeviled by its own Islamic version of “accelerationists,” but despite assassinated politicians they nevertheless persisted and stayed the democratic process. Tunisia’s opposing parties came together to draft a new constitution (2014) with greater protection for human rights. The crisis of COVID-19 has accelerated the disintegration of American democracy, and we have one opportunity in November for an orderly transfer of power to preserve social order, peace, and public welfare. Let’s be like Tunisia, and recognize ourselves in George Floyd, whose death is a crime against all citizens. Tunisia brought reconciliation by addressing historic injustice. America has a long way to go to address structural racism, but we can begin by listening to the voices of African Americans to guide the nation to reform. And vote. Ninety percent of Tunisians voted in 2011, the first historic free election. Could Americans reach 91% in November?

The United States can go beyond the Arab Spring and open a new chapter in history by addressing structural racism. Only when black lives matter can we be free. As Al Sharpton said, “Make America Great? Great for who and great when? We’re going to make America great for everybody for the first time.”

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Bonus Video added by Informed Comment:

Syrians in rebel-held Idlib pay tribute to George Floyd | AFP