No One Is in Control

In 1878, a wave of yellow fever swept through the American South and spread out through the Mississippi River Valley. Along with cholera, “yellow jack,” as it was known—after the yellow quarantine flags displayed on ships afflicted by the contagion—had long been a scourge of the American South. As far back as the 1790s, Congress considered, but never implemented, a national quarantine system in response to a yellow fever outbreak early in the decade.

This time was different. Aided by modern transportation—steamboats and railroads—yellow fever spread all the way into the lower Midwest and parts of the Northeast, killing thousands of Americans and sending many more fleeing inland and north. The disease rent communities, overwhelmed local infrastructures, and disrupted the economy of the entire nation. The considerable death toll and social and economic disruption forced a transformation of the politics and policies of public health—establishing a new institutional basis for scientific and medical expertise in the federal government and prompting political backlash against an emerging technical-bureaucratic elite.

The result was a fragile partnership between science and government, which laid the groundwork for many of the institutions familiar to us today. But this partnership enshrined, rather than resolved, the political tensions that underlay the country’s response to yellow fever—tensions that have come to the surface again during the COVID-19 pandemic.

As we emerge from the worst pandemic of the last hundred years and try to make sense of, and learn from, our collective experience of crisis, the similarities between the yellow fever epidemic of 1878 and the coronavirus pandemic are of more than mere historical interest. By placing today’s crisis and politics in historical context, we are able to see that the standard explanations of what went wrong during our own pandemic miss the mark. COVID-19 was not a disaster because of the unchecked power of experts, nor because we simply failed to “follow the science.” Both explanations exaggerate to the point of falsity the importance of technical expertise in our political life.

The United States of 1878 was, of course, a very different country. There were essentially no federal mechanisms for regulating the economy or providing many of the public goods and services we now take for granted. There were no federal institutions devoted to protecting public health or regulating drugs and medicines. There was no formal system of science advice in government, nor for funding scientific research in universities. The modern research university itself was only just emerging. Medical science was in its infancy. There was no biomedical industry to speak of. The country had one small industrial research laboratory, founded two years before by Thomas Edison.

Contrast this state of affairs with what took place 142 years later: on January 9, 2020, the World Health Organization announced that a novel coronavirus was the etiologic agent behind a new disease first identified in Wuhan, China. The next day, the genetic makeup of the virus, later named SARS-CoV-2, was made publicly available on the internet. By the time governments began implementing “lockdown” policies, vast teams of researchers in both academia and the private sector were already cooperating with federal authorities to develop and deploy genetic-based diagnostic tests and vaccines for COVID-19.

Yet despite these considerable differences, the last several decades of the nineteenth century were marked by profound social, political, demographic, and economic upheaval much like we see today. Then, as now, the country was riven by political, geographical, and racial conflict; frayed by distrust and animosity; and disoriented by rapid scientific, medical, technological, and demographic change.

Even more surprising—and disturbing, given the astonishing scientific and medical progress that has taken place since 1878—are the many similarities in how the country responded to the yellow fever and COVID-19 outbreaks. In both 1878 and 2020, experts, social reformers, and their political allies bemoaned the inefficiency of America’s decentralized and multi-layered political system, pressing for a unitary national response with expanded federal powers and attendant institutional innovations. They also saw the crisis as an opportunity to implement long sought-for social and political reforms. In 1878, the culmination of the reform effort was the creation of a National Board of Health. Although short-lived, it nevertheless set an important precedent for federal involvement in public health and medical research, and provided a model for future partnerships between science and government.

Aligned against this movement, in both 1878 and 2020, were many politicians and large swaths of the public who saw these efforts as a ploy by coastal elites to consolidate power. Rather than nationalizing public health, their arguments went, we should be wary of expanding the powers of the state and protect individual freedom instead, adapting policies to the particularities of local circumstances and needs.

This history reveals that the social and political dynamics of infectious disease outbreaks are surprisingly persistent over time—and surprisingly impervious to the scientific and medical progress our country has enjoyed over the past century and a half. This of course does not mean that scientific and medical progress and expertise are unimportant, especially when it comes to protecting public health. On the contrary, the outsized role that technical expertise has come to play in our public life is one of the distinctive features of modern society—something that clearly differentiates our world from that of 1878. But this fact makes it all too easy to exaggerate the importance of such expertise in understanding the complex social and political dynamics engendered by crises such as epidemics.

As yellow jack ravaged the South in 1878, many fled northward into neighboring towns, cities, and states, precipitating a refugee crisis. In inland Memphis—where about half the population was infected with yellow fever, killing more than 10 percent of its residents—thousands of “terrified inhabitants fled the city,” resulting in the complete collapse of the city’s municipal government.

The populations of uninfected regions swelled with epidemic refugees seeking safety, pushing local resources past their limits. Those who fled the contagion were often met by “shotgun quarantines”—vigilante groups of armed citizens enforcing local or impromptu quarantines with double-barreled shotguns. Denied shelter or provisions, many epidemic refugees died, if not of the disease, then of starvation or exposure.

Officials were not entirely defenseless. In the wake of past epidemics, many Southern states had established state and local boards for public health policy. But, besides lacking coordination, state and local health boards varied widely in their capacities. Most had no authority or money to impose quarantines and could only advise local lawmakers about the best course of action. Some were perceived to be untrustworthy, if not corrupt—liable to downplay or hide evidence of new outbreaks. In some states, such as Mississippi, quarantine authority was highly localized—a patchwork of policies that were enforced by local volunteers, often at gunpoint. Where they were enforced, quarantines were routinely violated by citizens who found them unduly burdensome or were trying to flee disease.

In a familiar dynamic, the tension between public health and economic freedom shaped the political debates surrounding yellow fever. State and local health boards saw it as their task to strike a balance between protecting public health and minimizing disruption to local commerce. Representatives from local industry were typically included as advisors, and boards were sometimes accused of being beholden to business interests, especially in coastal regions heavily dependent on the free flow of commerce through southern ports and waterways. The stakes were high on both sides: inadequate health measures meant the uncontained spread of a virulent disease, while strict quarantines, including travel restrictions, could mean economic ruin.

At stake was more than commerce, however. As historian Howard Kramer observes, many quarantined people were “summarily ejected from their homes,” with “streets and whole sections of towns...blocked off,” while “intercourse with other infected communities” was “absolutely forbidden.” School openings were delayed in some locales, first until October—on the optimistic assumption that the epidemic would soon abate—then until November, and in some instances indefinitely. Voter turnout for the midterm election was severely reduced in some southern counties. There were supply-chain disruptions, creating food insecurity in various locales.

Adding to the confusion was the fact that experts did not agree about the best means of containing the disease. There were multiple competing theories about the causes of disease. Though the bacteriological revolution was underway in Europe, it was only beginning to influence medical opinion in the United States. One prominent American physician of the period dismissed the germ theory as “this terribly fatal pseudo-science of men who study disease in cap and gown.”

The older miasma theory remained popular. Defenders of this theory—known as “anti-contagionists”—pointed to unsanitary environmental circumstances as the primary source of disease. They emphasized the need to improve local sanitary conditions and hygiene practices, especially among the poor and uneducated. The “contagionist” view, which was increasingly favored by 1878, pointed to the obvious “portability” of yellow fever and emphasized quarantines and travel restrictions as the best means for containing disease. For its part, the public simply took it for granted that yellow fever was contagious, shunning the afflicted and fleeing disease-ridden communities.

Desperate for a semblance of control, many politicians looked to quarantines as a blunt but effective tool for containing disease, but experts remained divided over the issue. Some contended that quarantines were unworkable or unnecessary to prevent transmission, thus doing more harm than good. One group of medical experts went so far as to characterize them as “a return to the barbarous and inhuman quarantine of the dark ages.” Perhaps the most common expert response was to advocate a combination of quarantine and hygienic measures—a pragmatic strategy that hedged against scientific uncertainty while bowing to conflicting political pressures.

The underlying problem was that, even among those who accepted contagionism and germ theory, no one really knew how yellow fever was transmitted. It would be almost thirty years before Major Walter Reed and his colleagues discovered that the Aedes aegypti mosquito was the disease vector—leading to highly effective efforts to control yellow fever by reducing mosquito populations. In 1878, however—as in the early days of the coronavirus pandemic—the leading theory was that the disease was transmitted by “fomites,” inanimate objects that had been contaminated by the disease and were transported via trains, ships, and articles of clothing.

Adherents of this view recommended supplementing quarantines and travel restrictions with hygienic measures, including rigorous fumigation and harsh disinfectant procedures. In an early example of “hygiene theater,” one Mississippi physician recommended that local residents disinfect everything with carbolic acid or “sulphate of iron,” and urged public officials to burn soiled mattresses and boil bedding. Whatever the effectiveness of such measures, Dr. Pelaez reasoned, “perhaps the public was psychologically appeased by these recommendations.”

The chaos generated by the yellow fever epidemic of 1878 convinced a growing number of Americans that the federal government must assume a greater role in controlling infectious diseases. As President Hayes put it in his 1878 State of the Union address, “the fearful spread of this pestilence has awakened a very general public sentiment in favor of national sanitary administration.” This provided an opening for those reformers who had long sought a more prominent role for government in promoting public health.

Nowadays, the insinuation that experts may be taking advantage of a national crisis to implement their own pet policies or establish a greater role for themselves may arouse suspicions of right-wing paranoia in polite circles. But public-health experts in the 1870s were quite explicit about taking advantage of periodic outbreaks of infectious diseases. Outbreaks took far fewer lives in aggregate than more mundane causes—such as inadequate water supplies, malnutrition, limited medical care, and endemic diseases—but provided political opportunities to implement reforms experts believed necessary.

Indeed, “sanitarians”—as public-health experts were called—had been agitating for a centralized federal institution devoted to public health for decades, and not only to control infectious diseases. They emphasized long-term goals such as building federal infrastructure for providing expert advice, promoting public hygiene, funding medical research, and standardizing data collection. By the 1870s, calls for a national institution were growing louder, backed by the American Medical Association and the newly created American Public Health Association and National Association of State Health Commissioners.

As yellow fever broke out again in 1878, the politics were ripe for reform. Congress was once more in the midst of a heated debate over whether to nationalize quarantine powers. “[N]o seaport town having any commerce will ever adopt and adhere to any quarantine regulations which will interfere to any great extent with their commercial interest,” argued Casey Young, representative from Tennessee. A national-quarantine system was necessary and justified “by the federal government’s constitutional right to regulate commerce.”

Opponents of a national quarantine, many of them from regions whose economic interests were threatened by the proposal, responded that quarantine “was a police power, and as such belonged to the states.” They argued that quarantine powers exceeded the federal government’s authority to regulate interstate commerce. Moreover, they contended, “a uniform quarantine law could not meet the needs of special local circumstances.”

Yet, by 1878, the yellow-fever crisis had persuaded enough Americans that epidemics were, indeed, both national and economic in nature. Some from Northern and inland states had felt the effects of yellow fever directly for the first time and many more were forced to confront its effects indirectly due to disrupted commerce. Responding to political pressure, Congress passed its first national-quarantine law in April 1878. The following year, it passed yet another public-health law—what came to be known as the “yellow fever bill.” Backed by leading public-health reformers, the new bill created a National Board of Health—precisely the kind of institution they had long sought.

The National Board of Health consisted of eleven members appointed by the president and approved by the Senate. These included prominent medical experts from a variety of states as well as a representative of the Justice Department and medical officers from the Army, the Navy, and the Marine Hospital Service. The distinguished surgeon and medical reformer John Shaw Billings was tapped as director. Their charge was to investigate the nature of epidemic diseases, advise state lawmakers on best methods for their containment, and assist them in implementing public-health policies.

Reflecting the divisions within the broader expert community, the board members were divided over the underlying cause of yellow fever and the best means to control it. But they did generally agree on one thing: that the practice of quarantine was archaic and out of step with the best science of the day. Congress, however, was explicit: it vested the new institution with power over quarantine and appropriated funding for just this purpose. Somewhat reluctantly, the National Board of Health developed a plan for a modified and limited quarantine system, which included travel restrictions and emphasized hygienic measures and fumigation techniques. To help implement this new “scientific quarantine,” the board sent teams of inspectors to those regions of the country where yellow fever was most prevalent. In some places, such as Memphis—which had been decimated by the 1878 epidemic—these interventions were welcomed, and local and state public-health experts eagerly collaborated with their federal colleagues. But tensions arose elsewhere, thanks to conflicting political visions in addition to disagreements over public-health policy itself.

This conflict was nowhere more apparent than in the fraught relationship between the National Board of Health and the Louisiana Board of Health. For the National Board of Health and its allies, public health was a national concern, with state and local interests acting as so many obstacles. As one sanitarian described it: it may be necessary to “place the power with those who are likely to remain free from, and above the influence of, all individual or local interests.”

By contrast, Joseph Jones, the secretary of Louisiana’s board, believed that public health should be protected at the local level and that quarantine authority, in particular, was the natural prerogative of states. He and his allies saw the National Board of Health as an imposing, alien force that threatened to deprive them of their right to govern themselves. A former Confederate officer, Jones characterized the board as “an inquisitorial system of espionage and detention.” The local press went even further, accusing the new federal bureau of “manufacturing yellow fever in the Mississippi Valley” with a view to “frighten[ing] the national legislative body to give it more funds” and expand its influence.

Such sentiments were not confined to states’ rights proponents nor even to Southerners. A coalition of local and state health officials from states ranging from Georgia and Alabama to New Jersey and New York banded together to protect state quarantine authority from federal encroachment. They protested the concentration of a power “in the hands of the National Board of Health, or of any other agent of the federal government.”

Yet it was not resistance from states’ rights advocates that caused the biggest problems for the National Board of Health. On the contrary, the clash that would prove fatal was, perhaps ironically, one within the federal bureaucracy itself.

Congress had limited the board’s existence to a period of four years, after which its authorizing legislation would have to be reenacted. In the years that followed the board’s creation, Billings continually petitioned Congress for more funding, but to no avail. Congress insisted that its original appropriation of $500,000 was intended to cover the four-year period. Meanwhile, political support for the National Board of Health began to weaken, beginning with the resistance from local commercial interests. Adding to the board’s troubles was the fact that, as John Duffy points out, “no major epidemics of yellow fever or Asiatic cholera occurred during the next few years, and, as memories of the 1878 outbreaks receded, so did enthusiasm for a national public health board.” Rivals within the federal bureaucracy smelled blood.

The Marine Hospital Service had long sought a role as the nation’s preeminent public health institution—and had backed legislation to vest it, rather than a new independent board, with federal quarantine powers. Its new director, John Hamilton, accused the board of fraud, waste, and incompetence. (He even attributed the death of the service’s longtime director, John Woodworth, to “persecution” from the National Board of Health and its allies.) In 1883, after Congress declined to reenact its authorizing legislation, the National Board of Health was effectively shuttered. Hamilton saw to it that the board’s quarantine powers and even some of its funding were transferred over to the Marine Hospital Service.

Like the board, the service’s ambitions went beyond quarantine powers. A few years later, in 1886, it quietly established the Hygienic Laboratory in New York City—the nation’s first federal laboratory for medical research, which would eventually expand its scope to cover research on chronic diseases and basic science. In the next century, the Marine Hospital Service would be renamed the U.S. Public Health Service, and its Hygienic Laboratory would grow to become the largest and most important medical research organization in the world—the National Institutes of Health.

Historians often attribute the fate of the National Board of Health to the baleful influence of economic interests, partisanship, and “know-nothing” politicians in Congress, who stymied the efforts of well-meaning reformers. But one cannot ignore the role that bureaucratic conflicts played in undermining the board as well. What drove these conflicts, fundamentally, were clashing visions of the appropriate roles of both expertise and the federal government in democratic society. Rather than a resolution of this tension, the creation of the National Board of Health represented a temporary compromise. It was for this reason a “fragile” institution, as Robert Kohler puts it, born of political opportunism and practical need at a moment when Americans were deeply divided about the proper scope of the federal government and the role of technical experts within it.

What can we learn from the history of yellow fever? Given the prominence of technical experts in both the events of 1878 and those of 2020—not to mention today’s preoccupation with “the science” (whether to demonize or deify it)—the lessons may seem counterintuitive. But the parallels show that the role of such experts is not nearly as important for understanding the dynamics engendered by epidemics as we tend to think.

On the political Right, a dominant narrative claims that our government’s pandemic response was both misguided and disproportionate, driven by self-interested members of the “expert class.” There are weak and strong versions of this argument, ranging from legitimate critiques of expert error or particular policies to full-blown conspiracy theories, according to which the COVID-19 crisis was manufactured by a globalist network of elites to advance their own interests at the expense of individual freedoms.

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.

Here we come to a second historical lesson, seemingly opposed to the first. If the skeptics exaggerate the experts’ power to manipulate us and control our lives, their opponents are guilty of the same error in reverse: they exaggerate the experts’ power to protect us from the vicissitudes of nature and society.

Of course, the fact that epidemics throughout history tend to follow the same general pattern does not mean that they are all identical. But discerning persistent patterns across time allows us to identify what is and is not unique about our own experience. And, clearly, one thing that makes the coronavirus pandemic so distinctive when compared to past outbreaks is the prominent role that scientific and medical expertise has played (however much skeptics may misconstrue its role in our political crises).

Indeed, one of the most obvious differences between COVID-19 and, say, the 1878 yellow fever epidemic, is our ability to identify, understand, and combat disease—exemplified most powerfully in the rapid development and deployment of effective vaccines. Our ability to achieve such feats is due in part to the reform efforts that began in the late nineteenth century—spurred by crises like 1878—which gave rise to many of the expert institutions familiar to us today. But it is also due to astonishing advances in science, technology, and medicine since that time—advances that have enabled staggering, and at times even frightening, feats, from the moon landing to the invention of chemical and atomic weapons to the mass production of penicillin to the prospect of the first human-caused global pandemic.

But we are also, because of these same developments, susceptible to a peculiarly modern form of hubris. It is the expectation that, with enough public expenditures and political will, we can marshal the country’s technical resources to solve any problem that confronts us. As Vannevar Bush—one of the architects of modern science policy—once put it, this is the “fallacy,” encouraged by the “spectacular success” of organized research during World War II, that “any problem can be solved by gathering enough scientists and giving them enough money.”

Implicit here is the assumption that all human challenges are, fundamentally, nothing more than technical problems to be resolved through technical means. It follows that if we are unable to solve a given problem, then there must be some irrational obstacle preventing us from doing so: human obstinance or ignorance or political intransigence. What this ideology cannot countenance is that there could be problems that are not merely technical, perhaps not solvable at all. Underlying this attitude is an article of Enlightenment faith: a belief that with enough scientific and technological progress, we can become masters of our own fate.

From this point of view, the violent recurrence of infectious disease epidemics in our time is particularly disturbing. For it suggests that, despite all our progress since the nineteenth century, we are not as invulnerable as we like to believe. It becomes tempting, therefore, to blame our plight on someone or something—demagogues, disinformation, the uneducated. If only we “followed the science,” this reasoning goes, then we could solve the problem. These follow-the-science ideologues and their skeptical critics share the same unshakeable faith in the capacity of technical experts to master reality—whether to manipulate or to save us.

The parallels between the 1878 yellow fever epidemic and our own coronavirus pandemic should disabuse us of this belief. Despite our technical sophistication, our response to COVID-19 has been plagued by many of the very same tensions and conflicts on display in 1878—from expert error and inconsistent policy to popular backlash and political polarization.

Is this simply because we have not progressed enough since 1878? Of course, more scientific and technological progress would have helped us during COVID-19. And such progress likely will aid us in our effort to manage the next public-health crisis, just as the advances made since 1878 aided our response to COVID-19. But history suggests that however important it is for grappling with such crises, technical expertise, by itself, is not sufficient to resolve them. The reason is that these crises bring forth dynamics that are not merely technical in nature, but rooted in deeper social and political forces. As Thucydides long ago observed in his account of the plague of ancient Athens, it is not the disease itself, however virulent, that ultimately threatens the social order, but the lawlessness, conflict, and mutual animosity it engenders among the people.

Both the skeptics and the “follow-the-science” ideologues fail to face the intransigently complex reality that epidemics force upon us—have always forced upon us. We, of course, need experts. But they can no more deliver us from this reality than they can be blamed for all its contingency. Expertise is indispensable to understanding and confronting the complex problems that beset our society—and the global crises that, from time to time, threaten it. But, as Vannevar Bush once elegantly put it, by itself, “science is not enough.”