Epidemics and Society Quotes

“As poorly transmissible as it was, however, SARS exposed the absence of “surge capacity” in the hospitals and health-care systems of the prosperous and well-resourced countries it affected. The events of 2003 thereby raised the specter of what might have happened had SARS been pandemic influenza, and if it had traveled to resource-poor nations at the outset instead of mercifully visiting cities with well-equipped and well-staffed modern hospitals and public health-care systems.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Laënnec stressed the importance of emotional shocks and “sad passions” (passions tristes)—grief, disappointed hope, religious zealotry, and unrequited love—that depress the body’s “animal energy.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Echoing Fleming’s warning, theorists of emerging diseases argue that antibiotics are a “nonrenewable resource” whose duration of efficacy is biologically limited.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Alexander Fleming issued a prophetic warning. Penicillin, he advised, needed to be administered with care because the bacteria susceptible to it were likely to develop resistance. The selective pressure of so powerful a medicine would make it inevitable.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Such pervasive and violent opposition to the city’s public health program prevented the plan from being implemented as every municipal initiative provoked a violent backlash and drove Naples to a state of near anarchy. The Times of London commented that the port was afflicted with something worse than cholera—“medieval ignorance and superstition.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“As Claude Bernard had prophetically suggested, the laboratory bench became the emblem of the newly emergent medical science and the locus of medical epistemology.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Epidemics afflict societies through the specific vulnerabilities people have created by their relationships with the environment, other species, and each other.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Public health policy needs to be informed by history. A policy that either ignores the past or draws misguided lessons from it can all too easily result in serious mistakes and a colossal waste of resources.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“The experiences of SARS and Ebola—the two major “dress rehearsals” of the new century—serve as sobering reminders that our public health and biomedicine defenses are porous. Prominent features of modernity—population growth, climate change, rapid means of transportation, the proliferation of megacities with inadequate urban infrastructures, warfare, persistent poverty, and widening social inequalities—maintain the risk. Unfortunately, not one of these factors seems likely to abate in the near future. A final important theme of Epidemics and Society is that epidemic diseases are not random events that afflict societies capriciously and without warning. On the contrary, every society produces its own specific vulnerabilities.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Societies, especially in the developed world, were thought to be on the verge of becoming invulnerable to new plagues. Unfortunately, this expectation has proved to be spectacularly misplaced. Well into the twenty-first century smallpox remains the only disease to have been successfully eradicated. Worldwide, infectious diseases remain leading causes of death and serious impediments to economic growth and political stability. Newly emerging diseases such as Ebola, Lassa fever, West Nile virus, avian flu, Zika, and dengue present new challenges, while familiar afflictions such as tuberculosis and malaria have reemerged, often in menacing drug-resistant forms. Public health authorities have particularly targeted the persisting threat of a devastating new pandemic of influenza such as the “Spanish lady” that swept the world with such ferocity in 1918 and 1919.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“A second reason for concentrating on epidemic diseases is historical. Since our interest here is history, it is important to stress that, throughout human history until the twentieth century, infectious diseases have been far more devastating than other categories of illness. Indeed globally they remain leading causes of suffering and death. One of the goals of Epidemics and Society is to explain this feature of the history of human disease.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“One of the overall themes structuring Epidemics and Society is an intellectual hypothesis to be tested through the examination of widely dissimilar diseases in different societies over time. This hypothesis is that epidemics are not an esoteric subfield for the interested specialist but instead are a major part of the “big picture” of historical change and development. Infectious diseases, in other words, are as important to understanding societal development as economic crises, wars, revolutions, and demographic change. To examine this idea, I consider the impact of epidemics not only on the lives of individual men and women, but also on religion, the arts, the rise of modern medicine and public health, and intellectual history.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Preface to the Paperback Edition The coronavirus, a severe acute respiratory syndrome, has unleashed a pandemic since the original publication of Epidemics and Society. Coronavirus disease (COVID-19) is still too new and too poorly understood to allow us to assess its ultimate impact, but its broad contours have become sufficiently clear, and several of its features relate closely to the themes of this book. Like all pandemics, COVID-19 is not an accidental or random event. Epidemics afflict societies through the specific vulnerabilities people have created by their relationships with the environment, other species, and each other. Microbes that ignite pandemics are those whose evolution has adapted them to fill the ecological niches that we have prepared. COVID-19 flared up and spread because it is suited to the society we have made. A world with nearly eight billion people, the majority of whom live in densely crowded cities and all linked by rapid air travel, creates innumerable opportunities for pulmonary viruses. At the same time, demographic increase and frenetic urbanization lead to the invasion and destruction of animal habitat, altering the relationship of humans to the animal world. Particularly relevant is the multiplication of contacts with bats, which are a natural reservoir of innumerable viruses capable of crossing the species barrier and spilling over to humans.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“But epidemic diseases are an ineluctable part of the human condition, and modernity, with its vast population, teeming cities, and rapid means of transport between them, guarantees that the infectious diseases that afflict one country have the potential to affect all. The public health disaster of West Africa was founded on the failure to make decisions regarding health from the perspective of the sustainable welfare of the human species as a whole rather than the unsustainable interests of individual nations. To survive the challenge of epidemic disease, humanity must adopt an internationalist perspective that acknowledges our inescapable interconnectedness.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Infectious diseases, in other words, are as important to understanding societal development as economic crises, wars, revolutions, and demographic change.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“But epidemic diseases are an ineluctable part of the human condition, and modernity, with its vast population, teeming cities, and rapid means of transport between them, guarantees that the infectious diseases that afflict one country have the potential to affect all. The public health disaster of West Africa was founded on the failure to make decisions regarding health from the perspective of the sustainable welfare of the human species as a whole rather than the unsustainable interests of individual nations.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“A public health infrastructure and guaranteed access to it are the essential means needed to sound the alarm, provide timely information, isolate infectious cases, and administer treatment.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Ebola reached the brink of spreading uncontrollably and internationally; it was on the verge of being transmitted across Africa and beyond, with incalculable consequences. Such a degree of unpreparedness resulted from a combination of circumstances, which are still in effect today. One is the treatment of health as a commodity in the market rather than as a human right. Well before Ebola erupted, market decisions prevented West Africa from having tools to confront the emergency.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“The renewed outbreak of Ebola in 2018 is a reminder that, especially in nations of such severe deprivation, continued challenges are inevitable. Indeed, in that context one of the bitterest ironies of the 2013–2016 crisis is that the expense of combatting the epidemic is estimated to be threefold the cost of setting up a functioning health infrastructure. Such an infrastructure perhaps could have prevented the outburst altogether while providing access to care for other afflictions. Emergency response to contain a conflagration already under way is expensive, inefficient, and inhumane.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Coercion threatened to complicate the task of governance, and it was of no visible use in containing the epidemic.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Everywhere people avoided seeking medical treatment and hid whatever ailments they had in order not to be taken into custody.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“New state decrees included provisions that the dead be unceremoniously disinfected, packed into double body bags, and hastily buried—normally in unmarked graves—by officially appointed gravediggers wearing protective equipment. This new regulation prevented family members and friends from honoring loved ones, and it negated religious observance. The discovery of a body by a search team thus furnished ample potential for physical confrontations, just as a similar decree had led to clashes in plague-stricken Bombay in 1897–1898. This tense atmosphere was inflamed by multiple conspiracy theories. One Canadian reporter wrote that people “tell me stories about witchcraft, Ebola witch guns, crazy nurses injecting neighbours with Ebola and government conspiracies.”29 Untori, or plague spreaders, were said to be at work, as in the days of the Black Death described by Alessandro Manzoni. Some regarded health-care workers as cannibals or harvesters of body parts for the black market in human organs. The state, rumor also held, had embarked on a secret plot to eliminate the poor. Ebola perhaps was not a disease but a mysterious and lethal chemical. Alternatively, the ongoing land grab was deemed to have found ingenious new methods. Perhaps whites were orchestrating a plan to kill African blacks, or mine owners had discovered a deep seam of ore nearby and wanted to clear the surrounding area.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“The state also depended on the army, which many observers viewed as the most reliable tool available, rather than the health-care system, to deal with the crisis. Not surprisingly, therefore, the campaign at the outset was thoroughly militarized. Many of the coercive means adopted echoed early modern Europe’s effort to defend itself against bubonic plague, such as extraordinary executive powers, sanitary cordons, quarantines, curfews, and lockdowns. Compulsory treatment facilities surrounded by troops even closely resembled lazarettos”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“The illness of Brantly and Writebol was a politically transformative experience, as fear spread across the United States with the realization that the country could be in danger from Ebola.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Hospitals fared equally badly. They seldom possessed isolation wards, electricity, or running water and had no diagnostic facilities, protective equipment for staff, or training in response to a public health emergency. Already overcrowded, they also lacked surge capacity in the event of an emergency.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“War drove a majority of the limited number of Liberian doctors away from the country; thus, as Ebola began, more Liberian physicians lived in the United States than in Liberia, where 218 doctors and 5,234 nurses remained to serve a population of 4.3 million.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“For example, there were virtually no health-care workers. West Africa had the world’s fewest trained physicians, nurses, and midwives per capita. Liberia had 0.1 doctor per 10,000 citizens, and comparable figures for Sierra Leone and Guinea were 0.2 and 1.0, respectively, as contrasted, for example, with 31.9 doctors per 10,000 in France and 24.5 in the United States.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“Ebola is highly infectious from person to person, but only through direct contact between a healthy person and an infected person’s bodily fluids.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“In the words of a 2009 report, “Three nations have deforested more than 75 percent of their land, forcing the inexorable meet-up between Ebola-carrying bats and people.”9 This transformation allowed Ebola to “spill over” from bats to humans in West Africa in the wake of deforestation.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present

“The areas where Ebola outbreaks have occurred since 1976 map perfectly onto the geography of deforestation in Central and West Africa.”
― Frank M. Snowden III, Epidemics and Society: From the Black Death to the Present