Beyond backlash against the role of experts, these critiques generally assume that pandemic policies—such as stay-at-home orders, business and school closures, or mask and vaccine mandates—were disproportionate. It follows that the policies “imposed” by “the experts” were not only ineffective or produced unintended consequences, but also that they were unnecessary. If so, then there must be some other—nefarious—reason why they were imposed: to advance personal interests or to assert control.
Placing COVID-19 in the context of the history of the 1878 yellow-fever epidemic allows us to see where this narrative goes astray. In 1878, as in 2020, many citizens, especially those in relatively unaffected regions of the country, protested the nationalization of public health. Some dismissed policies, such as quarantines, as more performative than effective—and could point to experts who supported their views. During both epidemics there were accusations by critics that Northern elites were sensationalizing the disease to expand the influence of the federal government’s expert bureaucracy. What’s more, the critics were not entirely wrong—in 1878, the sanitarians did take advantage of the crisis to push their own agendas, for better or worse. Their goal was to expand the power of the federal government and wrest political control from local, state, and commercial interests.
On balance, however, the American public reacted to yellow fever not by arguing that the threat was overblown but with fear and panic. Many fled, while others sought to keep epidemic refugees out of their communities, even if it meant economic ruin. In fact, it was the public’s demand for a government response that gave the sanitarians the political opening they needed to push their reforms through. And it was political support for federal intervention from Southern members of Congress, in particular—who were otherwise resistant to the expansion of federal powers—that ultimately paved the way for the nationalization of quarantine and the creation of the National Board of Health. Being at the front line of the epidemic, Southerners had no doubt that yellow fever threatened both their health and economy, whatever their complaints about Northern elites.
Here, too, there are surprising parallels to COVID-19. The data suggest that by the time political authorities—and it is worth emphasizing that these were political decisions, albeit informed by experts—began issuing stay-at-home orders in the spring of 2020, Americans across the country had already begun to withdraw from public life in the hopes of avoiding infection. During this first phase of the pandemic, at least, public policy tended to trail public behavior. Also as in 1878, many Americans in 2020 fled the disease for those regions that still remained relatively unaffected. And this, in turn, prompted local and state efforts to keep pandemic refugees out, or at least minimize the chance of importing disease.
Was the public reaction to yellow fever more justified than the public reaction to COVID-19? Were we somehow duped in 2020 in a way our forebears were not in 1878? It is striking to compare the mortality statistics in this respect. Though its impact varied significantly by region, it is estimated that the 1878 yellow-fever epidemic claimed the lives of a total of 20,000 Americans—roughly 0.04 percent of the total U.S. population at the time—over a period of about eight months. By contrast, in its first eight months, coronavirus killed 230,000 Americans, or about 0.07 percent of the total U.S. population. To date, COVID-19 has killed over 1 million Americans—or roughly 0.3 percent of the U.S. population.
Even granting significant room for error, especially given spotty historical records prior to 1900, COVID-19 was apparently a far greater risk to the nation, at least according to the crude criterion of aggregate mortality. And yet, the 1878 epidemic gave rise to mass panic and forced a transformation of the politics of public health. All this at a time when the country was far more familiar with deaths from infectious diseases, not to mention considerably higher mortality overall. What’s more, yellow fever struck a nation that was far less equipped, in terms of scientific, medical, technological, and public resources, to deal with such public health threats than we are today.
This brings us to a second flawed assumption in the skeptics’ narrative. If the social and political crisis caused by COVID-19 was largely the fault of self-interested experts, then it would be surprising indeed to find so many parallels between the government’s responses to the epidemics of 2020 and 1878. Why? Because the United States of 1878 lacked the very institutions skeptics blame for the COVID-19 disaster: expert bureaucracies.
As seen above, the public-health experts of the day tried and to some extent succeeded in establishing such institutions and expanding their influence in response to the 1878 epidemic. The bureaucracies they did establish, moreover, were quite limited by contemporary standards—with staffs that numbered in the double-digits, modest and unreliable funding, and carefully delineated authorities. Whatever role experts played or sought to play in the government’s response, no one could characterize the politics of the 1878 epidemic as “rule by experts.”
This suggests that these dynamics may have a lot less to do with our modern expert institutions than we tend to think. This is not to deny the importance of these institutions, nor to absolve the experts (in 2020 or 1878) of all error, misbehavior, or self-interest. But epidemics of infectious diseases, it seems, have a logic of their own, which is surprisingly consistent through time.
This is confirmed by the longer history of epidemics, which, as Charles Rosenberg has shown, evinces a remarkably persistent pattern from Ancient Greece to the present. “Like the acts in a conventionally structured play,” Rosenberg writes, “the events of a classic epidemic succeed each together in predictable narrative sequence.” First, doctors discover a handful of “suspicious” cases. They then “either suppress their own anxiety or report their suspicions to authorities, who are usually unenthusiastic about publicly acknowledging the presence of so dangerous an intruder.” Why such reluctance? Because “to admit the presence of an epidemic disease” is always to “threaten interests,” whether economic or political, and to “risk social dissolution.”
The collective response only comes after “bodies accumulate,” and the reality of the threat becomes undeniable. Once acknowledged, however, the public reaction flips from denial to panic: “Those who were able might be expected to flee contaminated neighborhoods, while men and women remaining in stricken communities could be expected to avoid the sick and the dying.” Public authorities, desperate to reestablish order—or at least give off the appearance of control—grasp for whatever policy tools are most readily available. “Ever since the fourteenth century,” Rosenberg observes, “the institution of quarantine has provided a feared yet politically compelling administrative option for communities during epidemic.”
The next stage in the dramatic narrative is the collective search for a cause—whether natural, artificial, or supernatural. The public, looking for an explanation, will often settle for a scapegoat—the sinful, the poor, the uneducated, the foreigner. This search is only partially scientific—determining whether the disease has a local source or was “transported” from elsewhere, or, with Covid, whether it came from zoonotic sources or a laboratory accident. It is also a quest for meaning—an overarching narrative that can make sense of the otherwise “dismaying arbitrariness” of disease and the vulnerabilities and limits it forces us to confront.
Adding to the chaos is the fact that such crises have no identifiable endpoint, despite the suddenness with which they began. “Epidemics,” observes Rosenberg in the aftermath of the AIDS epidemic, “end with a whimper, not a bang,” as “susceptible individuals flee, die, or recover, and incidence of the disease gradually declines.” The public eventually moves on, while experts struggle to determine what went wrong.
If both COVID-19 and yellow fever fit this general historical pattern, then it becomes a lot harder to see how uniquely modern phenomena, such as our expert bureaucracies—or other modern phenomena such as digital disinformation, for that matter—could be blamed entirely for our mishandling of the COVID-19 crisis. It may be psychologically comforting to think so, lending meaning to the “dismaying arbitrariness.” “When threatened with an epidemic,” Rosenberg concludes, “most people seek rational understanding of the phenomenon in terms that promise control, often by minimizing their own sense of vulnerability.” It is much more difficult to accept the alternative—that no one really is in control.