Racial and class-based divisions, economic strife and extreme politics have all followed pandemics in history, as suffering populations and authorities have sought answers and scapegoats for their plight. Whatever tensions or problems existed, epidemics have found them, sharpened them and they have come into the open as the illness receded - from the Black Death in 1348 to the plague of 1665 from the 19th century cholera epidemics and the 1918 flu to HIV/AIDS. Many large-scale outbreaks of disease have resulted in scapegoating of minorities and been followed by prolonged civil unrest.

But Oxford Professor of Medical History, Mark Harrison says, ‘When there has been extremism and tensions [following an epidemic], they have already existed....Epidemics in themselves don’t cause tensions, they expose them....The lesson of history is that epidemics accentuate problems and bring them into the open.’

When there has been extremism and tensions [following an epidemic], they have already existed....Epidemics in themselves don’t cause tensions, they expose them

The effects can be dramatic, as evident in even recent years: in 1986, the Duvalier family, which had ruled Haiti for nearly three decades, was swept from power after the country's economy was brought to its knees  in the midst of the AIDs crisis. Jean-Claude ‘Baby Doc’ Duvalier, who took power after his father's death in 1971, had previously enjoyed overseas backing for his regime. But panic around the condition was widespread in the mid-1980s and the Haitians were made a 'special risk factor group'.  The impact of that decision on the Haitian population and on 'Baby Doc' was enormous. The nation's travel industry collapsed virtually overnight and with it went the precarious economy.  Haitians are perceived to have been doubly victimised: first by the import of HIV/AIDS from the US and then by the stigmatisation of Haitians.  But the link with AIDs, and the action taken of naming the nation, saw the unpopular Haitian regime driven from power after nearly 30 years in charge and 'Baby Doc' leave for exile. 


In earlier centuries, there have been a variety of responses to pandemics and epidemics - some have been extreme, even heinous, others have followed as a consequence of the illness and the loss of life. Six centuries before the Duvaliers were forced out of Haiti, the Black Death of 1348 saw anything from one third to a half of Europe's population wiped out, as plague raged across the Continent. The enormous magnitude of the crisis, saw a complete change in the social landscape and, in the aftermath, there were horrific anti-Semitic attacks across Europe. Rumours and wild accusations led to populations and their rulers looking for scapegoats - and to cancel debts and seize Jewish property - and there are records of appalling attacks on whole communities.

Scapegoating of communities or individuals, has followed in the wake of other pandemics, as people have sought answers or simply to punish those they hold responsible. But reports from 1349, also show that a penitent movement, the flagellants, developed, comprising survivors of the pandemic. They moved from country to country flogging themselves in public, to atone for their sins - which, it was feared, had caused the Black Death.

The Black Death of 1348 saw anything from one third to one half of Europe's population wiped out...and, in the aftermath of the plague, horrific anti-Semitic attacks across Europe

Long term impacts

After the initial horror, the Black Death had a long-term impact on the social fabric of Europe. With so many peasants losing their lives,  the epidemic was followed by a labour shortage and wage inflation. Since the lower classes were able to command greater rewards for their work, the days of peasants being tied to a master's land were largely gone.  It effectively proved to be the end to serfdom in England, with peasants, who were previously unable to leave their master's lands, seeking better opportunities and more money in towns. For those who survived the pandemic, it meant the possibility of mobility and a better standard of living. There was such concern among the ruling class, about the increase in wages and peasants roaming the country searching for better job opportunities, that the 1350 Statute of Labourers' Act was enacted. This made it illegal to receive higher wages than had been offered in 1346, ‘the twentieth year of our reign of King Edward III’. 

There is also evidence, says Professor Harrison and fellow medical historian Dr Claas Kirchhelle, that suffering and epidemics bring communities together, across cultural and class divides, as they combine to fight illness and prevent outbreaks.  Responses to the same pandemic have also differed in different countries, with some looking to blame while other populations reacted with cooperation. The Spanish were not held responsible for the Spanish Flu, which had not originated in the Iberian peninsula anyway. And, according to Dr Kirchhelle, 'The third plague pandemic saw different faiths and ethnicities in the cosmopolitan Egyptian city of Alexandria come together to take communal health action.'

Around the world, the impact of the COVID-19 pandemic has manifested in populations spontaneously coming together in song or in support of healthcare workers. In countries, such as Germany, where there was an effective initial response to the pandemic, recent opinion polls indicate a rise of trust in government parties and a decline in support for opposition parties and the far right - despite individual acts of militancy.  But, in the US, some groups have been demanding the lifting of restrictions, in the face of lockdowns, and at the same time there has been criticism of the handling of the epidemic and inequalities.  


According to Professor Harrison, much depends on how the pandemic is handled by governments and whether this is seen to be fair or furthering inequality. We are yet to see the aftermath of COVID-19 but, Professor Harrison says, there is already evidence of a ‘backlash’ with many attacks on 5G installations and online conspiracy theories receiving more-than-usual attention and support. He maintains, ’In some previous cases [in history], governments have inflamed tensions. [In other cases] it has been economic effects or class or racial/ethnic tensions.’ 

Professor Harrison adds, ‘The 5G attacks aren't simply based on conspiracy theories, but have been conducted by people who appear to see the communications infrastructure as a form of oppression and want to hinder a return to normality.’

The 5G attacks aren't simply based on conspiracy theories but have been conducted by people who appear to see the communications infrastructure as a form of oppression and want to hinder a return to normality

Throughout history, populations have sometimes responded dramatically to the problems faced by illness within their society. In London of 1665, which was riven by plague, there were riots and attacks on the authorities. People flouted restrictions on movement and deep social divisions were exposed as the wealthy classes fled, leaving poorer people in the plague-ridden capital. But, once the danger was over, people flocked back to London. According to Samuel Pepys, ‘Now the plague is abated almost to nothing… to our great joy, the town fills apace, and shops begin to be open again’.  

‘Inequality became an issue in 1665,’ says Professor Harrison. ‘And the cholera epidemics of the 19th century exacerbated tensions between the working class and governments in Paris and Moscow.’ 

But what causes huge upheaval in one country, will not necessarily be reflected in others. According to Dr Kirchhelle, the cholera pandemics also inspired significant collective action for public health. While initial British responses to cholera were unstructured, the period between the 1850s and 1890s saw different cities, local authorities, and successive national governments decide to construct large-scale affordable water, sanitation, and hygiene systems throughout Britain. Financed by cheap credit and local taxation, citizens took great pride in their collectively-built and owned health infrastructure.

Responses and reactions

Ultimately, Professor Harrison maintains, ‘Situations in different countries, lead to different outcomes....What should concern us about the present pandemic is the longer term impact, the economic impact.’  

He says, ‘Class and ethnicity can become an issue, if there is perceived to be an unequal impact of a disease and the way it is handled...If poor people are seen to be more at risk and if the lockdown is felt more by them, then it can lead to tensions.'

Key to the likely response, will be the measures brought in to deal with easing the restrictions. Sensitive ‘policing coupled with targeted aid for vulnerable communities becomes really important

While public support of collective symbols such as the National Health Service is at an all-time high, we are already seeing significant concerns about the disproportionate effects of the pandemic in poorer urban areas and British Asian and Middle Eastern communities, says Dr Kirchhelle.

‘There could also be a perception of a generational divide, (which is already there in our society) and those most likely to break measures are youths and young adults,’ Professor Harrison maintains. ‘They already resent the lockdown and the economic measures. It is a toxic mixture.’

Key to the likely response, says Professor Harrison, will be the measures brought in to deal with easing the restrictions. Sensitive ‘policing coupled with targeted aid for vulnerable communities becomes really important’. 

Rumours and theories are often rife in times of epidemics, more so now because of the easy international methods of communication. According to Professor Harrison, ‘In previous epidemics, rumours have expressed a social truth of marginalisation...and they can become a focus for action.’

He has concerns about potential for scapegoating communities, ‘There is disinformation on all sides at the moment...but in previous epidemics, countries have become concerned about other countries who were seen to be taking advantage of the situation.’

Professor Harrison says, ‘In the 1890s, the European powers imposed heavy quarantines and embargoes [because of cholera] against their competitors. But these became untenable over time. Their economies were interconnected and they had to work together....And it led to the first international sanitary agreements.’

Both academics hope for a similar response to the COVID-19 crisis, with the best way out of the current and future pandemics lying in rapid, transparent, and collective international action to coordinate public health interventions, develop effective diagnostics, vaccines, and therapeutics, and protect vulnerable communities. According to Professor Harrison, ‘This probably will come about because of shared economic interests, but it won't happen immediately in all sectors.’

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