2020: SummerHis Biggest Fear Is We'll Go Back to Normal

We’re going to start this story in a place you might not expect. Let’s go back to spring 2010, when Alexandre White, who is today an assistant professor of sociology and history of medicine at Johns Hopkins University, was an Amherst senior. White was not normally a fine-arts kind of guy. But he was creating a sculpture, and he was really into it. “We were doing a section on welding, using a bunch of old construction material—pipe connectors, that sort of thing. I ended up welding a 6-foot-tall mosquito.” That’s right: a mosquito. White—someone who had never given much thought to a mosquito beyond slapping it—poured himself into his project, because that’s what a liberal arts education is for: exploring, experimenting, engaging. And the result amazed everyone, including White himself: “My mosquito was actually on the cover of Amherst’s art review magazine, The Frame.”

Looking back on it, he’s still proud of that work. But now he’s got a theory about what it was really all about. “I think before I even realized it, my unconscious was engaging with another fascination,” he says. That enormous metal mosquito was less random, in retrospect, than it might have seemed at the time. “A mosquito is a vector,” White says, “and it’s the vector that has caused humans the greatest levels of death from infectious disease throughout history.”

It wasn’t until two years later, at the London School of Economics and Political Science, that White really found himself immersed in the destruction left in a vector’s wake. His career would continue in the shadow of that 6-foot-tall mosquito, studying the place where disease and sociology intersect most profoundly. White is a historian of epidemics.

Epidemics, too, often begin in a place you might not expect. They may begin with the buzz of a mosquito, or with, say, a bat halfway around the world, which is how SARS-COV-2 seems to have begun. Viruses are funny beings—they find their own life only in the lives they can infect, and so they follow the seemingly random paths we animals take, highlighting connections we might not have realized were there.

Again, consider White’s academic trajectory. “I was a black studies major at Amherst,” he says. What does black history have to do with epidemiology? It’s all connected. “It was at Amherst that I became interested in understanding primarily European colonization, and the way it produced very real lived effects for people around the world today.”

White comes from a line of Amherst alumni—his great-grandfather Frederick Parker (one of a handful of black students at the College in that era) graduated in 1920, at the tail end of the influenza pandemic. White’s own graduation came in the wake of a financial recession, which may be one reason why his interests turned to the concepts of systemic crisis and risk.

But the mosquito still loomed. Undertaking his master’s degree in London, White began studying HIV and tuberculosis infection in South Africa. “I was looking at how apartheid structured certain aspects of the way these two diseases affected the South African population,” he says, “and the ways in which the two diseases and the political responses to them were categorizing new political subjects.” A very brief explanation of South African history: the black townships in Cape Town that came to characterize life under apartheid were partly created and upheld as quarantines during the bubonic plague of 1901. Those in power capitalized on a vulnerable population made even more vulnerable by illness. This example, which was a subject of White’s doctoral work at Boston University, is only one of many in which a society doesn’t become its best self in the face of crisis; in fact, we often double down on our most problematic tendencies.

White’s academic lens highlights how societies politicize outbreaks to marginalize and ostracize. But he sees reason for hope in our health crisis.

Epidemics are, first and foremost, biological phenomena—particular diseases are caused by particular pathogens that affect bodies in particular ways. “But the way we humans choose to manage them, societally or globally, often reproduce or allow to reemerge certain aggressive responses that betray some of our most deep-seated and prejudiced feelings about one another,” White says. He notes that in times of pandemics we often see upticks of what could be called social viruses: “If a country has a history of racist or xenophobic responses or policies, and those ideologies exist within the society, then it’s entirely likely that we might see some of the worst applications of those policies play out during an epidemic.”

White said this to me in March. By June, the headlines were proving his point. Black and Latinx communities were hit hard by COVID-19 on multiple fronts. Early data from National Public Radio found that in 21 U.S. states, African Americans were dying at significantly higher rates than white Americans. For example, as of late May, African Americans represented 27 percent of all COVID-19 deaths in Wisconsin, even though the state’s black population is only 6 percent. Black and Latinx Americans were also more likely to lose their jobs as a result of the lockdowns, and to have “essential worker” positions that put them at greater risk of getting sick.

“COVID-19, and epidemics in general, expose sharply the inequalities within society,” White told me in June, after the world felt changed—not only by the biological disruption of the virus but also by the social disruption resulting from a pandemic of a different kind. After the killing of George Floyd in police custody in Minneapolis, protests spread across the country, with many people holding signs that read, “I can’t breathe.” Some protesters wrote those words on their face masks, making a connection between racist systems even clearer. “Though the phrase ‘I can’t breathe’ became a lament and a rallying cry for change after the murder of Eric Garner at the hands of the NYPD [in 2014],” says White, “COVID-19 has added layers to its meaning. While death from murder by asphyxiation or through respiratory failure due to COVID-19 have different causes, the structural agents that have led to both police violence and the disproportionate rates of COVID-19 deaths in black American populations have the same roots—structural, intentional systems of racism that have produced our deeply unequal nation.” While the events of this spring may have felt extraordinary as we lived through them, to a scholar like White, they make perfect sense. Someday, when historians look back at this time, these events may even feel inevitable.

But they didn’t feel inevitable when news about a certain novel coronavirus first hit. White couldn’t know then exactly what would unfold; he’s a historian, not a prophet. Still, he understood this was not good. “I knew it could be highly pathogenic. The responses in the first month or two in China made me recognize this was a situation that the world had potentially never seen before,” he says. “It’s one thing to write about history. It’s another thing to see it play out.”

We humans have experienced epidemics and pandemics, but not like this, not in living memory. The Black Death wiped out massive swaths of Europe, but that was centuries ago, before international boundaries became this fluid, before we began passing in and out of one another’s airspace as easily as mosquitos, as viruses. Our societal response to this novel pathogen—shutting down cities and countries, putting our very way of life into a medically induced coma—is itself novel. To be clear, White understands the necessity of the lockdowns. But watching them go into effect was breathtaking for all of us, White included. “The quarantining of an entire city larger than New York,” he says, speaking of Wuhan, “and the scale of controls taking place across China, made me recognize that these were particular responses on a population level we haven’t seen before. In that regard it was extremely sobering.”

Another sobering development is a social response that isn’t novel in the slightest. “What I find particularly troubling, in this current pandemic but also in many earlier responses, is the way in which concerns over the economic penalties associated with a pandemic and the biological risks often raise or produce very aggressive forms of racial and xenophobic systems of policing and control,” White says.

In the early days of the current pandemic, President Trump referred to COVID-19 as the “Chinese flu.” The World Health Organization warns against naming outbreaks after geographical regions, in part because the resulting names are often inaccurate. (The 1918 influenza that people still refer to as the “Spanish flu” did not originate in Spain.) But the concern over how we label an epidemic has far greater implications than fact-checking. The insistence on linking a viral pathogen to a particular group of people has an ugly precedent, echoing responses to cholera and bubonic plague and, more recently, HIV/AIDS.

Along with many other countries, the United States has a track record of using public health concerns to justify discriminatory policy. “Consider the Asian exclusion acts of the late 19th and early 20th centuries. In the 2014 Ebola epidemic, seemingly banal practices such as traditions of burial or even the provision of food suddenly become highly pathologized as being culturally linked causes of disease spread,” White says. “Often, during epidemics, certain behaviors and practices that can be stereotyped to racial and ethnic communities become the focus of stigma as a result of their supposed connection to hygiene.”

The structural agents that have led to both police violence and racial disparities in COVID-19 death rates “have the same roots.”

It may seem small to bicker over what we call a disease, but words matter. Remember how HIV/AIDS was once called a “gay cancer”? “In the early ’80s, the association of the disease as a specifically gay-related syndrome simultaneously pathologized LGBT populations and also suggested that those outside the community had nothing to fear from the disease,” White says. “You could argue quite easily that the attachment of homophobia not only limited response to the gay community but also reduced the vigilance and testing for symptomatic people who were outside the gay community. It’s not effective health intervention to associate or stigmatize a population during the epidemic. It’s actually counter-effective.”

Even putting aside politicized responses, we are left with an enormous challenge. COVID-19 is a new disease, so answers about how best to cope are evolving. White is absolutely on board with social distancing, but words matter here, too: counterintuitively, it is one of the most pro-social things we could possibly do and can be a surprisingly powerful symbol of our human interconnection. “We may be physically distancing,” White says, “but these practices are being carried out because of compassion and care for each other. And we need to do it for... as long as we need to.”

When the need for social distancing stops, what will the world look like? “I hope this affects us for the long term. I hope it is a moment of recognition of things that need to change,” White says. “This pandemic has exposed a level of fragility. It has shown us in some ways how cruel our society can be, how blind our system is to inequality and health disparities. It’s critical that we produce a more equitable social system that cares for those who might not have the financial means or capacity to care for themselves.”

In that statement, we can turn back to what White once said about the sculpture he created in 2010. Though they are such small creatures, he wrote of mosquitos, I wanted to demonstrate in real terms the danger these insects represent for millions of people.... This sculpture hopefully captures in some small way the terror these animals can cause if steps are not taken to protect those at most risk. That concern for those at most risk has been at the heart of White’s work all along, and never more so than now.

“Pandemics of this nature will always take lives,” he told me in April. “But it’s how we respond to a pandemic that affects the scale of the disaster. My fear is we’ll end up losing lives not just to the disease but as a result of poor preparation and planning and the weakness of our own public health system.” He sighs. “Actually, that’s already happening, so that fear is already out of date. My biggest fear now is that we’ll go back to ‘normal’ in 18 months and operate as though nothing has changed, nothing has happened. My biggest fear is that we’ll learn nothing.”

By June, we could see that normal as we once knew it is likely gone; we have to put something else in its place, and we all play a role in helping shape what that will be. That is the underlying message in White’s academic research, the point he drives home in his teaching and the reason he has begun trying to get his message out to the general public, as he did in a March 24 Washington Post op-ed about the xenophobic history of epidemic messaging.

His forthcoming book Epidemics and Modernity: A Social History of International Disease Response is an effort to deepen that message. Beginning with the International Sanitary Conference in Paris in 1851, which was the first international disease control effort, White’s work will help connect the dots between how certain diseases become understood as “global threats” while others do not. Going back to Cape Town in 1901: bubonic plague was not the only epidemic of concern. The city was coping with a smallpox outbreak, too, and smallpox can be just as biologically devastating. But bubonic plague was perceived to be the greater threat to economic trade with Europe, and so it was the focus of the response—with grave results. The creation of the apartheid townships was never about protecting the health of black citizens; it was about cordoning them off from white Europeans.

White’s particular academic lens highlights how societies politicize outbreaks to marginalize and ostracize. Even so, he sees reason for hope in our current health crisis. “I’m inspired by the stories of how communities step up and respond in the absence of clear governmental support,” he says. Health care workers traveling to harder-hit regions to help out; younger folks bringing groceries to their older neighbors. Viruses can also spur social change. Following the 1918 influenza pandemic, multiple countries instituted socialized health care. In the United States, White says: “Within 20 years after the 1918 flu, we had the creation of the New Deal and the model of an American social welfare state. This was also in large part the result of the Great Depression, but the point is we’ve done it before. It strikes me that we need something similarly dramatic now. This pandemic has been disastrous on an epidemiological level, but the economic results could and should have been mitigated, and that only comes with a more equitable and fair society.”

The conversation about how to build that equitable society has been forced not only by health disparities revealed by COVID-19 but also by police brutality that results from the same system. By mid-June, police brutality protests were having a dramatic, tangible effect on policy in several major cities, and Congress had introduced a police reform bill. Suddenly—finally—white America seems to be waking up to the reality that black America has been living all along. Societal change can be painful, but as Ta-Nehisi Coates, who has written extensively about racism in America, said in early June, “I see hope. I see progress right now.”

One of the many ironies of the spring of 2020 was that just as people were staying home to keep virus exposure at a minimum, the need to march in the streets felt urgent to many. Who showed up at these protests? People of all ages, but especially the young, those with the lowest statistical risk of getting gravely ill. At a time when the world feels unsafe on multiple fronts, the passion and drive of the rising generation can be a spot of great hope. That’s certainly true for White: “I look to my students, as they go out after college, and hope they will be able to envision a post-COVID-19 world where social responsibility is taken seriously and incorporated again into our society.”

Naomi Shulman’s work has appeared in The New York Times, in The Washington Post, on New England Public Radio and elsewhere. For Alexandre White’s reading list about the connection between health outcomes and racism, go to amherst.edu/magazine.

Illustration by Andy Martin, with photo by Jared Soares