Use historical knowledge to defeat the pandemic

Een militair ziekenhuis in Kansas tijdens de uitbraak van de Spaanse griep (1918-1919). Bron: Wikimedia/ courtesy of the National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C., United States
A military hospital in Kansas during the outbreak of the Spanish flu (1918-1919). Source: Wikimedia/ courtesy of the National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C., United States

To solve the corona crisis, we need more than just a biomedical and technical strategy. Prof. Dr Beatrice de Graaf (History and Art History), together with three other historians, pleas for a multidisciplinary approach on media platform the low countries, in which the social, cultural, economic and psychological dimensions of society also need to be taken into account. They state that history serves as a toolbox we can use to realise this approach.

By Beatrice the Graaf, Lotte Jensen, Rina Knoeff and Catrien Santing

What began as a medical crisis has now expanded to become a social and political crisis of unprecedented proportions

The situation is clear: what began as a medical crisis has now expanded to become a social and political crisis of unprecedented proportions. As we previously argued in NRC Handelsblad, navigating our way out of this crisis requires a broad, multidisciplinary approach. This is what is known as a ‘wicked problem’, one in which the solution becomes part of the problem. In this case, the short-term saving of lives (by applying harsh measures) leads not only to financial malaise for large sectors of society, but also to a disproportionate sacrifice of healthy years in the longer term.

The closure of gyms, for instance, leads to inactivity and overweight, while the closure of education results in loneliness and suicidal thoughts among students and young people. Besides the insights of virologists, we therefore also need knowledge from other disciplines, such as economics, psychology and cultural studies, to emerge from the crisis in a balanced fashion. That is all the more important, as we are dealing with a ‘slow-onset disaster’, a silent killer. It also means that after applying the medical miracle, the vaccine, the crisis will not magically be over, as the social consequences will be perceptible for a long time to come.

Without wishing to dismiss any part of the contribution of medical and other specialisms, we argue for better use of historical knowledge in the collective battle against today’s coronavirus crisis. Historians, after all, have deep knowledge of societies and epidemics. The past is effectively an accessible reservoir of knowledge and experience that can be instructive for the future. Of course, every crisis is bound by its culture and its era, but recurring patterns can be discerned, from which we can distil a few valuable insights. We mention four here.

Firstly, history shows that epidemic diseases cannot be described from a purely medical perspective, but that they are uniquely social occurrences. The way in which people react to diseases, the political and social interventions, the reporting in the media and the search for moral and social causes for outbreaks are socially, culturally and historically determined.

New infectious diseases are systematically coupled with thinking in terms of scapegoats, political unrest and social reform movements

This point is clear from two impressive works offering an overview of the subject: Epidemics. Hate and compassion from the plague of Athens to AIDS (2018) by Samuel Cohn and Epidemics and Society. From the Black Death to the Present by Frank Snowden. Both authors point to the need to place epidemics in a broader social and historical context and not to view them as purely medical problems. New infectious diseases, for example, are systematically coupled with thinking in terms of scapegoats, political unrest and social reform movements. In view of these social dimensions, Richard Horton, editor-in-chief of The Lancet claims that Covid-19 should not be termed a pandemic but a syndemic, emphasising the fact that a pandemic is not exclusively a medical issue, but that it is also embedded in a broader social and ecological context.

Secondly, historical research shows that pandemics remarkably often follow the same course. In a 1989 article the historian Charles E. Rosenberg compared the course of an epidemic with a play in four acts. At first just a handful of suspicious cases crop up, but as the disease spreads faster, social unrest grows. Besides going in search of medical and social explanations, people also assign scapegoats who are presumed to have causes the crisis. The unrest then culminates in a crisis, which is also political in character. Invariably riots and protests break out, as forms of social discontent or inequality come to the surface. To sum it up: an epidemic might end from a medical perspective, but the psychological and social disruption leaves deeper marks.

For that very reason, it is important throughout the crisis – and that is the third insight – to pay attention to the issue of a sense of purpose and mental resilience. The past reveals countless rituals to give meaning and coping mechanisms, which are also relevant for dealing with the current crisis. We single out one of them here, namely the cultural forms of resilience. Historical research shows that cultural media (stories, songs, sermons, processions, pictures and charity concerts) had many functions. They not only offered an outlet for emotions such as fear and uncertainty but also provided comfort and meaning because they connected people. In particular, the disaster song genre fulfilled this role: singing and mourning together offered comfort and hope.

Culture is indispensable for increasing psychological and social resilience

We can draw an important lesson for the current crisis: culture is indispensable for increasing psychological and social resilience. Stories, poems, music, theatre and other art forms offer a medium in which people can escape, reflect and mobilise. For that very reason it is also important in times of crisis to continue to invest in culture in the broadest sense of the word.

A fourth and final historical insight is that humanity will always have to deal with new infectious diseases, that risks can never be 100% offset and that we will have to learn to live with the idea that every human being is mortal. Governments currently like to talk about exit-strategies, as if there were a clear, straight line out of the crisis. They make use of ‘dashboards’ showing at what ‘R number’ or reproduction number cinemas and theatres can reopen. Such infographics seem to appeal to our modern urge for control, but more importantly, they suggest that interventions are determined purely by biomedical data.

We will have to learn to live with the idea that every human being is mortal

If we can learn something from the past, then it is that a top-down, biomedical approach does not sufficiently do justice to the complexity of the current crisis. It would be far better to speak of adaptive strategies. Of course the vaccine will help us, but in order to find the right exit strategy it is also essential that we pay attention to social, economic, psychological and cultural dimensions of societies. We therefore argue for the development of an alternative choreography, in which social and cultural coping mechanisms also play a role. History can function as a toolbox in that process.