By Irene Mariah and Shiv Akhil Vasandani
Man laid the foundation for civilizations by developing agriculture, art, social structure and politics over thousands of years. Cities were built and trade routes were forged. The shift from agrarian life resulted in the formation of communities. Every year, our world became more integrated and interdependent. We traded products along with services and ideas more widely than ever, crossing cultural, geographic and political boundaries but most importantly, we also traded diseases. Large numbers of people living in close proximity to each other and to animals, often with poor sanitation and nutrition, provided fertile breeding grounds for ‘diseases’ and their vectors. New overseas trading routes spread the novel infections far and wide, creating global pandemics.
As the world struggles to come to terms with the outbreak of the novel coronavirus and ponder over its possible consequences, not only in the long term but also for the foreseeable future, one might wonder if there are any takeaways from the history of pandemics. One such pandemic to look at is the Cholera Pandemic. Cholera was a disease unknown in Europe before the 19th century. Endemic to North India, it was spread westward by trade after the conquest of the region by the British, which opened up trading routes across Afghanistan and Persia and into Russia. Industrialization in the U.K. not only stimulated trade with the subcontinent, but it also created perfect conditions for the cholera to spread, causing Vibrio cholerae to multiply in the overcrowded, insanitary and unhygienic towns of the new industrial era.
Moreover, this disease was responsible for bringing New York City, then home to a quarter million residents and one of the busiest ports in the world, to a standstill, striking panic in residents and wreaking havoc on the great commercial hub’s economy.
Globalization and Cholera
Globalization is a complex and multi-faceted set of processes having diverse and widespread impacts on human societies worldwide. It can be defined as “changing the nature of human interaction across a wide range of spheres including the economic, political, social, technological and environmental...... the process of change can be described as globalizing in the sense that bound- aries of various kinds are becoming eroded. This erosion can be seen to be occurring along three dimen- sions: spatial, temporal and cognitive.” (Lee, 2003).
Before 1817, cholera was confined to India’s Bay of Bengal. However, following trade and migration between India and Europe, by the 1830s, cholera had spread internationally. The global spread of cholera was the driving force behind the first International Sanitary Conference in Paris, in 1851. The global health significance of cholera is underscored by its inclusion as one of four priority diseases in the 1969 and 2005 International Health Regulations.
Diseases do not respect borders. Although global health is a classic trans border issue, it receives limited attention on an international scale. When we compare the epidemiological patterns of the disease alongside the changing patterns of human migration, transportation and trade, we see that the particular form which globalization has taken in the present, has created social conditions that have not only influenced the transmission of diseases, but also the incidence and vulnerability of different individuals and groups to the disease.
From being a local disease, cholera became a widespread pandemic of the 19th century, estimated to have killed millions of people. Cholera traveled the same routes around the globe as European imperialism did. The disease, in this sense, was an integral part of the process of globalization.
Merchants and Trade
During the Cholera Pandemic, local merchants made frantic efforts to reduce panic and calm the public by suppressing information. However, this was in vain. Cholera was not good for business and the economy was badly hit. Businesses became inactive in towns where people were paranoid and afraid of dying. The very news that cholera was moving westward across the globe prompted the wealthy citizens of New York to fly out of the city. Roads were empty in every possible direction, as reported by the local newspapers. Merchants from other continents stopped on their way and went back to their home land where, incidentally, they themselves were hosts to the disease.
In addition to human suffering, the cholera outbreak caused panic which disrupted social and economic structures and impeded development in affected countries.The Industrial Revolution that had transformed economies and set up the path for sustained growth, faced setbacks. The lack of labor resulted in shutting down of merchant mills, packaging houses and factories. Merchants lost their profits and thus those indirectly dependent upon them lost their jobs. Creameries, breweries and distilleries that made 1000 bushels per day were all at a loss. The money that poured in from global trade stopped. The Commercial Revolution had caused a population explosion which added to the trouble. The British GDP, which was then 3.0%, started to fall drastically.
The public became gripped with widespread fear of the disease and distrust of authority figures, most of all doctors. Unbalanced press reporting led people to think that more victims died in the hospital than their homes, and the public began to believe that victims were taken to hospitals where they were killed by doctors because of anatomical dissection, an outcome they referred to as “burking.” This fear resulted in several 'cholera riots' in Liverpool. Unjustified panic-induced reactions by other countries included curtailing and restricting travel from countries where the outbreak had occurred and import restrictions on certain foods. This lead to economic distress. For instance, the cholera outbreak in Peru in 1991 cost the country US $770 million due to food trade embargoes and adversely effected tourism.
On the other hand, there were those who made money off the pandemic. Hotels and boarding houses were filled to capacity. Hotels wrote to the local papers asking them to run notices that they were cholera-free and open for business. Doctors charged exorbitant fees for treating the patients. It is reported that they even prioritized who to treat according to the economic status of the patient. New jobs opened up, especially for nurses, night watchmen and construction workers, whom the city hired for cleaning up.
Cholera, mercifully, was seasonal. As the summer waned, cases declined. By mid-August, the pandemic had greatly diminished. By the end of the month, residents began to return and businesses reopened.The U.S. witnessed these cholera outbreaks three more times before the century was through, the last one being in 1873. New York was much more populous by then, as was the U.S., but new scientific knowledge meant that the disease, by then known to be caused by a bacterium transmitted primarily through contaminated water, took a far, far smaller toll.
Total economic losses due to the pandemic are difficult to estimate, but one thing was clear: after it ended, society recovered. With all the technological advancements in medicine, cholera has now become a rare disease to catch. It has become treatable with vaccinations and the bacteria, which normally spreads through water, is being attenuated because of the constant improvement in water filtration technology. Preventing requires overcoming a range of obstacles, as does responding to a pandemic once it begins. Globally, long term vulnerability to pandemics may decrease as development standards rise, but a more highly interconnected world may actually promote the occurrence of infectious disease pandemics.
Now, the world is confronting another disease which has induced severe financial disruption, as American cities from New York to San Francisco isolate and quarantine people, and as some of their biggest employers encourage employees to work from home, and the stock market roller coasters in response to the spread of COVID-19. We notice that past experiences with the cholera pandemic are analogous to our experience with COVID-19 because we see similar patterns emerging of initially not taking it seriously, believing this is no worse than the normal seasonal flu. Historians, as Robert Peckham notes, tend to believe that “analogies create blind spots.” Each pandemic takes place in its own context. The national and global financial systems will still exist on the other side of a disease. But we are certain that none of the pandemics in the past can tell us what COVID-19 might be capable of changing.
Globalisation and Cholera: Implications for Global Governance, Kelly Lee and Richard Dodgson
What History’s Economy-disrupting Outbreaks Can Teach Us about Coronavirus Panic, Elena Conis
Cholera, World Health Organisation
The Spread of Cholera in 19th Century London, ESRI
How Coronavirus Echoes Europe’s 19th Century Cholera Pandemic, Richard J Evans
Pandemics that Changed History, History.com Editors
Global pandemics and Impact of Cholera, World Health Organisation
Globalization and infectious diseases: A review of the linkages, World Health Organisation