April 15, 2020
Ida Milne is historian and lecturer of European History at Carlow College in Ireland, specializing in the history of disease.
What should we consider when curating the history of this pandemic?
The COVID-19 crisis will inspire some of today’s schoolchildren to pursue careers in health care or science. Others will seek to study the pandemic from a humanities/social science perspective. What information might they choose to be observe and collect during this episode? And what sorts of records might the rest of us collect or preserve in order to enable such future studies? After all, historical research draws on and is shaped by all the archival evidence generated by those living through a historical moment.
For the past 16 years, I have worked on the history of the 1918-19 influenza pandemic, looking at the impact on both Irish society and the wider world. The COVID-19 outbreak is the nearest comparative pandemic, in terms of social and economic impact, to what happened a century ago. A key lesson is that the history of disease extends well beyond the narrow confines of science and medicine; the 1918 flu infiltrated just about every aspect of society.
My work explores this infiltration from as wide a perspective as possible, looking at the responses of government, public health officials and medical care providers, as well as the ways in which flu pandemics silenced commerce and the social life of communities. Schools, theatres, libraries and public buildings were closed for weeks; sports fixtures and concerts, cancelled; court cases, postponed. In Ireland, society fell silent as the ill were confined to their homes or hospital beds while the healthy isolated themselves to avoid contagion. This response was replicated all over the world as the disease passed through.
The more I studied the Spanish flu, the more questions arose: Did different socio-economic groups suffer more or less than others and if so why? What did survivors observe from it? What surprised me that they did not?
We know the Spanish flu left traces in state, institutional, society and business records. It is mentioned in diaries and memoirs and newspapers. The pandemic’s deadly consequences are also inscribed on the physical landscape, in burial grounds and some public memorials. Most poignantly, though, the 1918-1919 pandemic lingers in human memory. Many of those who lived through it experienced the pandemic both as an immediate crisis, but also as something that lasted over the long term, with effects on health or family well-being. The trauma it inflicted could also be economic: A primary breadwinner who either died or endured chronic ill health (a common occurrence) sometimes resulted in the loss of the family home.
Direct evidence of the impact of the Spanish flu – documents, diaries, newspaper accountants, records, etc. — enables historians and researchers from many disciplines to tell the story of the deadliest pandemic the world has ever known.
Despite the vastness of this event, there are still gaps — glaring black holes — in the written and oral records that we cannot fill. Those of us who have worked on the 1918-19 influenza pandemic know the frustration of these voids – questions whose answers we can only surmise. In general, institutions under pressure and facing staff shortages, either due to a pandemic or some other crisis, may allow their record-keeping to fall by the wayside. The Irish Local Government Board’s files, including its Poor Law Union health records from 1918-19, were deliberately destroyed in 1921 during the revolutionary period.
We can learn from 1918 and do better, as citizen or institutional archivists.
One of the most notable gaps in the historical record from the 1918-19 pandemic, at least in an Irish context, is the voice of the medical practitioner. We have, to date, only one memoir from a doctor working in an Irish hospital — D.W. Macnamara’s account of how the disease overwhelmed Dublin’s Mater Hospital. In his colourful description, Macnamara wrote that most contemporary medical treatments were about as effective in stopping the flu ‘as a black beetle would be to halt a steamroller.’
This sounds eerily familiar. Last week, a local history website unearthed a rare nurse’s account, in a letter home to her family. In many countries, archivists and historians are already trying to collect medical workers’ oral histories. In early April, The Royal College of Physicians in Ireland issued a called for oral histories from medical workers, having noted that this documentation was a black hole in the 1918-1919 archives.
In the current pandemic, medical workers are scrambling to find effective treatments and rapidly expand and improve critical care. But they can also bear witness to their own fears and of medical politics. For anyone assembling such as record, other key questions arise:
- What other workers’ voices should be included? The corona virus pandemic has shone a light on the unacknowledged value of jobs like supermarket clerks, couriers, agricultural and cleaners, all of whom are now seen as vital front line workers who keep society going while most people are advised to stay at home.
- How have some of these jobs become more important, or more dangerous?
One of the key things to remember is that this is a “novel” or new virus. We started with little knowledge of its properties. But through the collection of patient data, treatment protocols and control measures, we learn about how COVID-19 behaves. It’s also true that public health officials and medical doctors change what they think they know as new studies and more data become available. Medical journals like The Lancet currently have early COVID-19 studies available free online. For researchers tracking the evolution of the scientific record, several important questions arise:
- Do these studies agree or disagree, as time and research moves on, and if so how?
- How are patient treatments and public health or economic measures influenced by new COVID-19 medical studies, and how do these change as the science evolves?
The pandemic has become one of the most extensively covered events of our era. Even newspaper death notices, sad as they are, provide a valuable resource about the scale of death in the crisis, as the pages of obituaries in Italian newspapers attest. Researchers building an era of this event can also pose a range of questions to guide their work:
- How has the media covered this story, and what angles became more important as the pandemic progressed?
- What has changed in the story of the crisis?
- How have newspaper headlines evolved?
- Do journalists ask probing questions or follow the official line from national governments?
- Are governments seeking to control news coverage to prevent criticism that might destabilise public compliance with containment measures?
Cartoons are a useful resource for my own research: W.K. Haselden, the Daily Mirror cartoonist, captured the fear Londoners felt about the 1918-19 influenza pandemic. One particularly vivid cartoons shows Londoners on the Tube swiftly veiling their faces as a passenger sneezes. Others express conflicting advice from medical doctors. ‘Cover your face!’ ‘Don’t cover your face!’ ‘Stay indoors!’ ‘Get fresh air!’ The conflicting advice from that era is mirrored in this one, as doctors desperately search for something that can alleviate suffering and contain the spread of the disease.
Government messages/public service announcements
Various government broadcast different messsages about contending with the outbreak, using a range of styles that vary from region to region. Charles Rosenberg, the great Harvard medical historian, wrote that each epidemic is handled according to local custom. The management of COVID-19 in Asian countries has been influenced by their experiences with two recent corona virus outbreaks: SARS1 and MERS. For this reason, people in Asian countries are more used to preventive or containment measures, like mask wearing. Researchers creating an archive of the COVID-19 crisis can collect government public health posters, online graphics and television advertisements.
Public reaction and public opinion are vital sources of information. As people watch such crises unfold, their evolving attitudes — to the disease, containment measures, self-isolation, fear – not only change but offer valuable insights into the social impact of such an event. For example, sociologists will likely conduct entire studies about panic-buying based on early reports of hoarding. Researchers documenting the story of this pandemic can focus on other questions:
- What did consumers buy in bulk?
- Who made money out of the crisis?
- What does joining crowds of shoppers tell us about their understanding of the disease?
- Why do various groups believe they will not catch the virus?
Advertisements and marketing are a rich indicator of both public interest and public fears. The ways in which fear is presented to consumers in the market place offers rich insights into our response to the pandemic. Just consider what retailers are promoting as impulse buy items near the check-out counters. Here are other questions to pose:
- How is fear of the disease presented to us in the market place?
- How do print, online or broadcast advertising change in response to the crisis? In 1918-19, newspaper advertisements for cure-all potions swiftly changed to include claims about their ability to cure influenza soon after the pandemic began.
- What do we actually know about the properties of disinfectants that are said to kill the virus?
- And, why do normally rational people indulge in risky behaviour by queuing in shops?
In this era, social media platforms provide the most immediate public responses to news about the pandemic. When we try to analyse tweets and Facebook or Instagram posts, we can consider the angle from which they are written. Sometimes, fear may show in the form of anger or ostrich-like behaviour. If someone tweets, ‘It’s not going to affect me,’ they may actually mean, ‘I hope it’s not going to affect me.’
Another common attitude in swiftly changing epidemics – something very apparent in the newspapers of 1918 – is criticism directed to people who are exaggerating or downplaying the scale of the crisis. ‘It’s all over-hyped, far too much talk about it.’ Researchers compiling public and social media response to the COVID-19 crisis can ask key questions:
- Are such claims valid or is it a manifestation of the speaker’s own fear? Is fear useful to get people to take precautions? How do heightened tensions show in behaviours in your family, community on social media?
Far-fetched explanations are a frequent component of public responses to the health crises. This phenomena isn’t difficult to understand. People often want a simple cure or answer – an insight that will make the problem go away easily. A case in point: the notion that 5G cell towers are causing so many people to fall ill. If those towers could be knocked down or set on fire, the theory goes, the disease will disappear. Archivists documenting public response to the pandemic should gather conspiracy theories and pose key questions about them:
- Where did a theory originate and why is it attractive? In the case of the 5G theory, the proposed solution seems far more attractive than waiting a year of longer for a vaccine.
Your own networks
Good researchers pose questions to those around them. We can also record oral histories, explore fears about the disease, jobs, and the long-term health of the economy. Maybe some will say they think that climate change is more important than the pandemic.
We must look for and record the positives too, because societies in crisis can show great kindness. During the 1918-19 influenza pandemic, neighbours risked their own lives to nurse neighbours while communities rallied to set up food kitchens to bring meals to the very ill. Such responses are happening all around us already: document it. Good news is often ignored, but it can be both consoling to observe in the present and important to record for the future.
This article was originally published on April 15 2020.
Ida Milne lectures in European history at Carlow College, Ireland. She specialises in the history of disease, and was awarded a PhD from Trinity College, Dublin, in 2011 for her research on the social history of the 1918-1919 influenza pandemic in Ireland. A unique feature of this work was the collecting of oral histories with survivors and the families of victims, looking at the immediate crisis and long term impacts. Her book, Stacking the Coffins, Influenza, War and Revolution in Ireland 1918-19 published by Manchester University Press in May 2018, has been given a Highly Recommended rating by Choice Reviews. Between 2014-2108 she held a prestigious Irish Research Council Marie Curie Actions international development award to research the social history of childhood disease, which once killed or maimed so many Irish children. She is a member of the Royal Irish Academy historical sciences committee, and is co-chair of the Oral History Association international committee, and health and environment chair of the European Social Sciences History Conference.
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