When confronted with present problems such as the coronavirus, it is sometimes best to look to the past. In the course of writing “Get Well Soon,” my book about society’s responses to outbreaks of diseases in history, I found countless examples of wise and compassionate leadership in the face of pandemics. I also, alas, found the opposite.
As I learned, leaders faced with epidemics like the coronavirus outbreak are always at risk of making one of four disastrous mistakes. Some will even stumble into two or three of these pitfalls. Trump and his administration seem determined to make all of them.
The first of these errors is the inclination to deny the disease exists. Or, if it exists, to say it’s not a big deal. Trump recently claimed of the coronavirus: “When you have 15 people [infected] — and the 15 within a couple of days is going to be down to close to zero — that’s a pretty good job we’ve done.” It’s not going to be down to zero anytime soon. It’s true most people will be fine, even if they contract the coronavirus. The fatality rate was initially estimated at 2 percent (the seasonal flu typically has a fatality rate of 0.1 percent), and its R0 (or R naught) — the number that describes how many people the disease spreads to for every person infected — has been estimated at between 1.4 and 2.5. That doesn’t sound too terrible. However, that’s approximately the same fatality rate as the influenza epidemic of 1918, which had an R0 of 1.8 and still killed 30 million people (675,000 of them Americans).
That outbreak was dreadfully mishandled by President Woodrow Wilson. As the epidemic surged, government officials continually said everything was under control, with Royal Copeland, the health commissioner in New York, claiming: “You haven’t heard of our doughboys getting it, have you? You bet you haven’t, and you won’t.” Headlines in newspapers such as the El Paso Herald read: “Vicious Rumors of the Influenza Epidemic Will be Combatted.” If officials had taken the reports from around the world seriously and accepted the flu of 1918 wasn’t just “going to go away,” many lives might have been saved.
The next thing leaders tend to do wrong is suppress scientific information. During the influenza epidemic of 1918, so much of the poor handling of the official response stemmed from the fact that newspapers were encouraged not to write anything that would damage “morale” during World War I. Suppressing information meant that an ill-informed public had no idea what was going on and, understandably, panicked when people began dying. Snake oil remedies abounded. At least one man who refused to wear a mask was shot in the street, while others slit the throats of relatives who contracted the disease. The American Red Cross reported “a fear and panic of the influenza, akin to the terror of the Middle Ages regarding the black plague, has been prevalent.” In rural Kentucky, people began starving to death because they wouldn’t venture outside for food. Not only were there few programs in place to stem these ill effects, but many people just plain didn’t know what was going on. Officials at that time thought coverage with accurate information would damage America’s chance of winning the war.
Trump, likewise, seems concerned the facts might damage his chances of getting reelected and has claimed coverage of the coronavirus is the Democrats’ new “hoax.” All official messaging is being run through Vice President Pence, while officials from other agencies, such as Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases, have been told not to share any information without clearance. Curtailing scientific information rarely leads to better results — instead, it leads to confused and unprepared citizens who begin turning to conspiracy theorists for information.
The third thing lousy leaders do during epidemics is blame vulnerable minorities. Of course, they don’t even always have to take that step, since ordinary citizens routinely scapegoat minorities for many troubles, including diseases, all by themselves. During the Black Plague, the blame fell upon Jews. Hundreds were burned to death because of an anti-Semitic conviction that Jews were poisoning the wells with bubonic plague. Pope Clement attempted to put an end to the hysteria in 1348 by claiming anyone who thought Jews were responsible had “been seduced by that liar, the devil.” Despite urging the clergy to protect Jews, his effort was, at best, only mildly effective. But at least it was an effort.
Clement’s entreaties differ remarkably from, for instance, the San Francisco Health Office officials who, in 1876, declared without evidence that smallpox was being spread by “unscrupulous, lying, and treacherous Chinamen who have disregarded our sanitary laws.” In 1901, Manhattan sanitation superintendent Frederick Dillingham would take a different tack, saying, “No one knows the harm that has been done by these Italians” regarding smallpox. Around that time, immigrant homes in New York began being raided under the direction of the Bureau of Contagious Diseases. Residents showing the slightest sign of illness were taken from their families and shipped to North Brother Island. Many never saw their children again.
Today, the Trump administration has made immigrants the scapegoat and claimed “the Democrat policy of open borders is a direct threat to the health and well-being of all Americans.” Moreover, Trump is considering closing the southern border — despite the fact the virus is not coming from Mexico. All of this despite consensus among public health experts and epidemiologists that travel bans do little to stop outbreaks and may even make them worse, which suggests the administration is more interested in pointing fingers than in doing the right thing. By contrast, Pope Clement looks impressive.
Fourth and finally, bad leaders tend to say anyone who fell ill was a sinner — or at least had it coming. For an example, you can look to the first White House news briefing on AIDS with Ronald Reagan’s press secretary, Larry Speakes. When asked about the disease devastating the gay community, he giggled at the reporter. “I don’t have it! Do you? … There’s been no personal experience here.” The implication that AIDS was for other, mockable people carried through into much of Reagan’s presidency. He didn’t publicly address the crisis himself until 1985 and hesitated to share the information with those in school, claiming: “AIDS information cannot be what some call ‘value neutral.’ After all, when it comes to preventing AIDS, don’t medicine and morality teach the same lessons?” Ordinary citizens appear to have gleaned unkind lessons from such remarks, as in 1988 when the magazine Christianity Today reported that 37 percent of readers felt that “AIDS is a judgment from God on homosexuals and drug users.” One result of such discourse is that people who have the disease are more likely to keep quiet for fear of shame, and those who might advocate for better treatments can be embarrassed out of doing so.
With six deaths from coronavirus in the United States as of Monday afternoon, we haven’t reached this point yet, but it seems possible that we will. Where President Dwight D. Eisenhower facilitated a free vaccination program for children with the release of Jonas Salk’s polio vaccine — and declared the unpatented vaccine would be available to “every country that welcomed the knowledge, including the Soviet Union” — Trump has notoriously made unsubstantiated declarations, such as his claim that “tremendous infectious disease is pouring across the border,” even when we’re not in the middle of public health crises. With Pence leading the government’s coronavirus response — the same Pence who is a conservative Christian opposed to Planned Parenthood and who bungled an HIV outbreak as governor of Indiana — it doesn’t bode well for the kindness with which inevitable victims of the disease will be treated.
All of this might seem cause for some despair. But there are also so many moments of hope when it comes to combating diseases. Those moments occur when people come together, and work from a place of calm compassion and unity rather than fear or scorn. It’s often easier to blame people who get sick than to deal with the fact that any one of us might get sick. When diseases are killing people, it’s human nature to want to show you are different from the people who get those diseases, and perhaps not as vulnerable. But while humans discriminate, diseases never do. They won’t this time, either. We are a scientifically advanced country, with the potential to care for our citizenry if we confront problems head on without attempting to find scapegoats. If only our leaders would start acting like it.