Cholera was a wholly new disease for Americans in the 1830s. It had appeared in North America for the first time on June 6, 1832, after arriving from Ireland on a boat called The Carrick and quickly moved through Quebec and Montreal down the East Coast. The consequences were devastating. An otherwise healthy individual might have stomach pains in the morning, suffer vomiting and diarrhea shortly after, and die, sometimes within hours. The diptych was a popular form of visually representing the experience of cholera’s quick work: On one side was a person in the bloom of health, and on the other, the same figure, sick with a blue tint and pinched face. Cholera was significantly more deadly than covid-19 and killed much more quickly; it had a 50 percent mortality rate and killed millions worldwide.
Writings from the 19th-century cholera pandemics can help connect us to the terrifying, rapidly changing experiences of pandemics past. For example, facing the deep uncertainty of the 1849 Cincinnati outbreak, Harriet Beecher Stowe tried staying strong. Worried her husband might get sick on the journey from Brattleboro, Vt., she told him not to come home, explaining in a letter dated June 29 that even though cholera had taken 116 lives in the city that day and “the air was of that peculiarly oppressive, deathly kind that seemed to lie like lead on the brain and soul … none of us are sick and it is very uncertain whether we shall be.” But on July 26 she had to write that their “dear little” Charley was dead. “I write as though there were no sorrow like my sorrow, yet there has been in this city,” she reflected, “scarce a house without its dead. This heartbreak, this anguish, has been everywhere, and when it will end God alone knows.”
The popular gothic stories of the period captured the experience of cholera well — and some medical literature even adopted gothic language in its discussion of the disease. People and spaces that seemed natural, predictable, familiar one day could be inexplicably and uncannily rendered unnatural, unpredictable and foreign the next. In some cases, the onset of the disease occurred without warning, and, as Stowe’s account suggests, it could bring a city suddenly to its knees. Furthermore, the extreme symptoms could transform the appearance of loved ones shockingly quickly and horrifically.
In 1842, Edgar Allan Poe published “The Masque of Red Death” (1842), which was written about a fictional disease but in response to cholera. Its protagonist Prince Prospero is certain of his safety. He imagines he can shut himself and friends away from the prevailing disease in a place where “the courtiers might bid defiance to contagion. The external world could take care of itself.” From there he hosts an extravagant party for his wealthy friends. Too late, he discovers, the Red Death is already there. It kills everyone.
The story echoes early news stories about fancy parties held in defiance of social distancing recommendations that infected numerous attendees as well as more recent ones about Ivanka Trump disregarding federal guidelines to travel for Passover, Florida beaches reopening as cases continue to multiply and the virus spreading rapidly where churches and universities refused to shutter.
Like others of his time, Poe found the history of pandemics invaluable for living through one. While written in response to cholera, the “Red Death” is also a nod to the medieval plague, the Black Death. The connections between cholera and the Black Death had been drawn by the German author Justus Hecker who had written a popular book about the Black Death following cholera’s arrival in Germany. Faced with such an unprecedented global crisis, Hecker looked to history. He became convinced that although cholera and the Black Death might seem different, they shared many characteristics and were probably the same disease. What seemed so uncertain, in part because unprecedented, Hecker and Poe taught, in fact had a precedent from which nations could learn.
Uncertainty in a time of crisis is, as these sources suggest, more than simply a personal emotion. Following the first cholera pandemic in the U.S., the nation’s piety wilted as did trust in the medical profession. Indeed, Alabama, Connecticut, Delaware, Georgia, Ohio, Maine, Maryland, Massachusetts, Mississippi, New York, South Carolina and Vermont all loosened or repealed their medical licensing laws. A medium-term effect was the so-called democratization of medicine in which herbalists, alternative practitioners and quacks flourished. A long-term effect was a wholesale refiguring of medical knowledge: Whereas in the 1820s, many of America’s most prominent medical thinkers were still theorists, by the 1860s, the profession was being organized around observable, empirical facts.
The religious changes were similarly drastic. As historian Charles Rosenberg details in “The Cholera Years,” in 1832 Americans looked to God, but by the 1866 outbreak, they turned to data. The pandemic seemed to reveal that neither God nor doctors could do anything to stop the massive casualties. Nevertheless, there were benefits, too, as Rosenberg argues, by 1866, cholera so pressed the need for sanitation reform that it led to the precursors of Boards of Health.
We all hope that we are not at the precipice of the kinds of horrors the cholera pandemics unleashed on the nation and the world, but we know we are in for some truly horrific months. Covid-19 is certainly not as deadly as cholera, but it is poised possibly to kill millions and to seriously harm many more. Projected figures and scenarios have varied wildly. A Harvard epidemiologist suggested in early March that up to 70 percent of the world might be infected if no public health measures were taken. More recently, conflicting predictive models estimated 100,000 to 2.2 million fatalities (if no interventions) in the U.S. alone. Currently, the Institute for Health Metrics and Evaluation at the University of Washington predicts 60,308 American deaths by Aug. 4. Data about fatality rates has likewise continued to shift dramatically, hampered by a lack of available information about how many Americans have contracted covid-19.
The promise of a vaccine offers great hope, although it is no balm for our current emergency. If current vaccine trials prove successful, a vaccine might be available by fall 2020, but 12-18 months has long seemed a more reasonable estimate. Here, too, we must remember the cautions of history: in 1984, the U.S. government suggested a vaccine for HIV/AIDS might be available in the next two years, and although treatments have improved dramatically, we are almost 40 years later still waiting. A covid-19 vaccine should be easier, but already there have been tragic missed opportunities.
To deal with such uncertainty, we might look to writing from the cholera pandemics to make sense of our own anxieties. Our own uncertainties swell, exacerbated by our unpredictable president, hidden medical information and failures of testing. We fear the political, social, cultural and economic unknowns. But we can look to historical pandemics to learn that they are precisely that: unknowns. We capitulate to fear, or we use our shared vulnerability — and uncertainty — as a catalyst for common good.