Few events are as compelling as an epidemic. When sufficiently severe, an epidemic evokes responses from every sector of society, laying bare social and economic fault lines and presenting politicians with fraught medical and moral choices. In the most extreme cases, an epidemic can foment a full-blown political crisis. Thus, Thucydides describes how the repeated visitations of plague to Athens in 430-426 BC provoked widespread social disorder and the breakdown of civic norms.

‘Men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane,’ writes Thucydides. ‘All the burial rites before in use were entirely upset and… many had recourse to the most shameless sepulchres.’

As the plague progresses, Thucydides describes how Athenians were swept up in a wave of hedonism and lawlessness, threatening the foundations of Athenian democracy: ‘Men now coolly ventured on what they had formerly done in a corner… fear of gods or law of man there was none to restrain them.’

The resulting crisis, Thucydides claimed, undermined Athenians’ faith in the rule of law and the democratic principles that underpinned the Greek city state, paving the way for the installation of a Spartan oligarchy known as the Thirty Tyrants. Even though the Spartans were later ejected, Athens never regained its confidence.

Covid-19 appears to have engendered a similar crisis in our world, the main difference being in scale. Whereas the crisis Thucydides describes was confined to Athens, the coronavirus pandemic has destabilized governments from Brazil to Belarus, not just that of a 5^th century city-state. The political reckoning has been particularly rapid in the United States, where Donald Trump’s inability or unwillingness to check the spread of the coronavirus was a key factor in his recent election defeat. Now, the lockdowns and social distancing measures look set to plunge the world into the worst economic depression since the 1930s, raising the spectre of further political instability.

Given the wide-ranging social, economic and political impacts of Covid-19, it is natural to assume that the same must have been true of past epidemics and pandemics. But is this the case? Do pandemics really have the historical impacts that are often claimed for them or are these claims simply the product of particular narratives and readings of history?

For instance, in numerical terms, the most devastating pandemic of all time was the 1918-19 ‘Spanish influenza’. Coinciding with the end of the First World War, the Spanish flu is estimated to have killed between fifty to one hundred million people worldwide. However, while 1919 was the first year since records began that the death rate exceeded the birth rate, those that survived generally enjoyed longer and healthier lifespans and, in many instances, benefited from higher wages too. Moreover, while the global death toll was immense, in developed industrial countries the mortality rate averaged two percent, meaning the Spanish flu left most of society unaffected. Indeed, the Spanish flu appears to have made little impression on public memory and social institutions, hence its historiographical characterisation as the ‘forgotten pandemic’.

Narrating Epidemic Crises

A crisis is normally conceived of as an isolated moment in time in which our lives are shattered and plunged into disorder – what the cultural anthropologist Hendrik Vigh has called ‘a momentary malformation in the flow of things’. Vigh observes that for many people crises are ‘endemic rather than episodic’ and cannot be delineated as an aberrant moment of chaos or a period of decisive change. This is particularly the case for those living at the margins of society for whom crises are ever present. Indeed, social critics such as Naomi Klein argue that instability is baked into the capitalist system, hence the way that in the last few decades neoliberal societies have lurched from one financial crisis to another.

Nevertheless, crises have long been regarded as a way of accessing deeper historical truths. As Janet Roitman has argued in Anti-Crisis (2013), a crisis ‘marks and generates history’. This is particularly the case for epidemics and pandemics which, unlike other natural disasters such as famines, are not limited to a particular region or moment in time but may come to encompass the whole globe. As the medical anthropologist Christos Lynteris puts it, disease outbreaks involve a ‘radically different ontological order’, a mode of being that is simultaneously ‘pathological and infectious’. Or to put it another way, one could conceivably outrun a famine but those who try to flee a plague may become unwitting carriers, contaminating new communities and introducing the pathogen to new places.

What is also not widely appreciated is that the roots of the term ‘crisis’ lie in the Ancient Greek word krinô (meaning to separate, choose, cut, decide, judge) and can be traced back to Hippocrates, whose scientific method influenced Thucydides’ approach to history. For the Hippocratic school of medicine, prognosis took precedence over diagnosis, the point being to identify the turning point of a disease in order to intervene and bring about a satisfactory resolution to the illness. Similarly, Thucydides hoped that by tracking the social and moral dissolution that envelopes Athens under the strain of the plague, his history could serve as a ‘great case-book of social pathology’, enabling readers to recognise similar historical patterns in future and intervene so as to restore order and stability. In this way, it has been argued, Thucydides applied a medical template to epidemic crises that has coloured our interpretation of them ever since.

The Black Death and demographic change

Perhaps the standout example of the transformative power of disease is the fourteenth century Black Death. Caused by the plague bacillus, Yersinia pestis, the pandemic coincided with the transition from medieval to early modern European society and was greatly enhanced by new shipping networks linking Venice and Genoa with Constantinople, Tunis, London and Bruges. The larger broad-bellied ships required for these long voyages provided perfect conveyances for plague-carrying rats and were soon sparking outbreaks across Europe.

Some scholars claim the pandemic killed a third of Europe’s then population between 1347 and 1353; others say up to one half. Whatever the true mortality there is little doubt the Black Death represented a massive external shock to medieval society and, together with the famines that preceded it, contributed to a declining or stagnant population in Europe for almost 150 years afterwards. The result was a demographic, economic and political crisis.

A smaller population meant less demand for grain putting downward pressure on the price of basic foodstuffs. At the same time, a diminished population fuelled competition, exerting upward pressure on wages and challenging the villeinage system of forced labour that underpinned the feudal system. The result was a wave of popular uprisings across Europe, including the Jacquerie in France in 1358, the revolt of the Florentine Ciompi or wool carders in 1378-82, and the 1381 Peasants’ Revolt in England.  

The demands of English peasants included the abolition of an inequitable poll tax and the removal of a statute, passed in the wake of the Black Death, that sought to restrict wages to pre-pandemic levels. The Florentine carders meanwhile demanded a more equitable fiscal policy and the right to establish guilds, fore runners of trade unions. Today, we take collective wage bargaining and trade unions for granted, but in the fourteenth century these demands threatened the basis of the feudal system, hence the observation of the French chronicler Jean Froissart that: ‘Never was any land or realm in such great danger as England at that time.’

This economic levelling also spurred a series of social and cultural changes, including the right of everyone except the lowliest manual worker to wear furs – a privilege that previously had been the preserve of nobles and clerics. In most cases the political reforms were short-lived. For instance, Wat Tyler, the leader of the English rebels, marched to London to petition King Richard II with 60,000 peasants at his back. Demanding that ‘all men should be free and of one condition’, the rebels occupied the Tower of London, ransacked the palaces and mansions of wealthy Londoners, and executed the Archbishop of Canterbury and the Lord Chief Justice, as well as other hated representatives of the nobility. Within a few weeks Wat Tyler and other leaders of the revolt had been arrested and executed and the crisis was over. Nonetheless, the movement resulted in concessions to peasants: the poll tax was abandoned, and wage bargaining expanded over time, leading to the emergence of a new yeoman class.

The collapse of the Aztec and Incan empires

Similar claims have been made about the crisis that enveloped the Aztec and Incan empires following the Spanish Conquest of Central and South America in the early sixteenth century. In Plagues and Peoples, McNeill argued that ‘disaster is to be expected whenever some previously remote and isolated tribe comes into contact with the outside world and there encounters a series of destructive and demoralizing epidemics.’

In the case of the Aztecs and Inca, the root cause of crisis and societal collapse was the introduction by Columbus and, later, the conquistador Hernan Cortez, of smallpox, measles and other Old World diseases to which Amerindian populations of modern-day Mexico, Guatemala and Peru had little or no immunity. The result was that within a century of Cortes’s arrival in the Gulf of Mexico in 1518 the population of Central Mexico had been reduced, according to some estimates, from 25 million to 1.5 million. A similar demographic catastrophe occurred in the Andes, wiping out perhaps as many as six million Quechua and Aymara Indians and bringing the Incan empire to its knees.

But is this the whole story? In recent decades, Nahuatl scholars have questioned the role of disease in clearing the way for the Spanish, arguing that the size of pre-Conquest populations has been consistently exaggerated, as has the extent to which smallpox and measles were responsible for dramatic population declines in the Americas. These pathogens may have contributed to the die-offs in Central and South America in the sixteenth century, but just as important was the exploitation by the Spanish of pre-existing political tensions and rivalries between the Aztecs and other indigenous groups, such as the Tlaxacelta, and the encomienda system which saw the extraction by the Spanish of indigenous property and the enslavement of Indians in gold and silver mines. By this reading, had the indigenous peoples of Central and South America simply experienced the new pathogens, their populations would have declined and recovered, as happened in Athens in the Fifth century. In other words, the collapse of the Aztec and Inca empires was a process that had as much to do with the appalling violence inflicted on them by the conquistadors and the turbulence of colonization as to the immediate crisis engendered by Indians’ susceptibility to imported European pathogens.

Cholera and revolution

With the possible exception of yellow fever, no disease is more closely associated with revolutions and political crises than cholera. Beginning in 1830, recurrent epidemics of cholera sparked widespread rioting and protests in Paris, London and other European capitals. Similar protests occurred in Asiatic Russia and New York City, where in 1832 cholera was carried to the Lower East side of Manhattan by the newly opened Erie Canal, sparking outbreaks in the Five Corners district and killing nearly 3,000 people. These were decades marked by revolutions, wars and social and political reforms. For example, the 1831-32 cholera epidemic reached Britain during the profound political crisis over the Great Reform Bill of 1832, a year which some historians have argued saw the only real possibility of a political revolution in modern British history. Cholera next swept across Europe in the revolutionary year of 1848. Further cholera epidemics coincided with the overthrow of the Second Empire in France in 1871 and with pogroms against Jews in Russian Poland in 1892.

On that occasion, thousands of Jews fled across the border to Hamburg by train. As Richard Evans recounts in Death in Hamburg, the sudden influx of Jewish immigrants prompted demands for quarantines and disinfection measures to prevent cholera spreading to the local population. The wealthy Hamburg merchants who dominated the city’s administration refused to believe that cholera could be carried in water and rejected initiatives for the construction of a sand-filtered water supply that might have prevented discharges from cheap lodging houses and insanitary barracks where the migrants were housed from entering the River Elbe. The result was that cholera-laden discharges soon reached Hamburg’s water intake point, sparking a major outbreak. In the space of six weeks 10,000 people died and 40,000 fled Hamburg.

As with cholera outbreaks in other cities in Europe and North America, the disease hit the poorest hardest since they tended to live in overcrowded, unhygienic dwellings where they shared toilet facilities and were unable to take simple precautions such as boiling water. The episode incensed working class voters and supporters of the Social Democratic Party who used the episode to castigate the state administration for serving the interests of a rich minority and neglecting the health of the mass of ordinary people. The result was that in the 1893 national elections all the city’s Reichstag seats fell to the Social Democrats.

Cholera epidemics also sparked widespread conspiracy theories. For instance, during the 1832 Parisian cholera epidemic, the German poet Heinrich Heine reported that the Parisian sanitary commission ordered mounds of rubbish that could be a source of contamination to be hauled beyond the city limits. In response, ragmen who made their living sorting through the debris spread rumours that those who had died of cholera had been poisoned by the health authorities and took to the streets in protest. ‘The more extraordinary these reports were, the more eagerly they were received by the multitude’, noted Heine in an echo of today’s coronavirus conspiracy theories.

To many observers, the  protests recalled the mass uprisings that had marked the French Revolution and seemed of a part with the political turmoil of the 1830 July revolution. ‘For fifty years Paris has been the scene of distressing events,’ the official medical report for the 1832 cholera outbreak noted. ‘The violence of the [political] parties has armed citizens against one another; their blood has flowed in the streets, and horrible battles have created a spectacle.’ Unlike the Black Death, there was no demographic deficit after cholera. Nor, according to Evans, is there evidence that cholera provoked permanent political change or significant social movements. ‘[Cholera] epidemics,’ he concludes, ‘were less causes than consequences of revolutionary upheavals, and the government reactions associated with them.’

There is little doubt that fear of revolutionary upheaval combined with concern about urban overcrowding spurred major sanitary reforms in Paris, London and other newly industrialised European cities .The result was a gradual amelioration of living conditions and improvements to the health of the urban poor that drew the sting out of mass protests. With the expansion of the hospital system and the advent of new medical technologies, such as vaccines, in the twentieth century it was now possible to regulate the health of populations, thereby avoiding the recurrent cycle of epidemics and crises that accompanied cholera outbreaks in the nineteenth century.

Covid-19 and the politics of life

The question raised now is whether we have reached the limits of these medical responses, or if the crises that have accompanied Covid-19 are a temporary blip that will disappear once new coronavirus vaccines become widely available and governments begin to reopen their societies. According to the French sociologist Michel Foucault, the central question facing modern liberal states is how to balance the health of populations with the need to keep economic goods and service circulating. Foucault termed this logic, which takes the administration of life and populations as its subject, biopolitics and biopower. During the plague epidemics of the seventeenth and eighteenth centuries, states had little choice but to resort to blunt instruments such as cordon sanitaires and quarantines to prevent pathogens crossing borders. The result was widespread disruption to trade. But with the arrival of more sophisticated medical systems and modern forms of biopolitical management in the nineteenth century, it became possible to persuade individuals to regulate their health for the common good, making all of us complicit in the central calculus of biopower: namely, who to make live and who to let die.

Covid-19 has thrown these political choices into sharp relief. Should governments impose strict lockdowns in order to protect lives and prevent health systems being overwhelmed, or should they allow some economic activities to continue knowing that it could result in higher deaths for the elderly and other at-risk groups?

Both choices have consequences for political stability: lock down too hard and for too long and you risk mass protests by people whose businesses have been shuttered or who resent the curtailment of their civil liberties. Relax the restrictions too early or fail to offer adequate protection to hospitals and care homes, and you risk the ire of health workers and the elderly. Given the way that the coronavirus has exposed glaring inequalities in access to health care and the role that income, occupation, and race play in adverse health outcomes, particularly for blacks and other ethnic minorities, it is little wonder that these frustrations have spilled into the open – hence the Black Lives Matter protests that swept the United States and Europe following the death in police custody of an unarmed black man, George Floyd, in Minneapolis in May 2020.

Belarus, Brazil, Angola and Thailand have seen similar mass protests, albeit sparked by a different combination of factors. It is too early to say whether Black Lives Matter and other pandemic-inspired protests will result in significant political reforms. Perhaps the reason we are inclined to view pandemics and other crises as moral and political turning points is that we have been conditioned to view them through a medical-historical lens. History suggests it might be better to regard pandemics less as crises than as occasions for political ‘reckoning’ that may – or may not –  see the resolution of long-standing social and economic grievances.