Cholera vs COVID-19

In the book by Hamlin, Cholera; The Biography, the author notes:

In 1948 the eminent medical historian Erwin Ackerknecht noted that two distinct styles of  government response to epidemics, grounded in antithetical theories, prevailed during the years 1821 to 1867. Absolutist states such as Russia, Prussia, and Austria conceived of epidemic disease as an invasion of contagious enemy agents who, having gained a foothold, would pervert the state’s subjects to their own ends. Their response was to tighten the borders against potentially contagious persons and things, but also to clamp down on the minimal freedoms they allowed, of movement, assembly, choice of medical care, and religious consolation. That way disease could be locked up. In liberal states, like Britain and France, anticontagionism held sway. Epidemics were transitory states  of atmosphere, local, global, or both, which intersected with states of society. Cleaning and  strengthening the population might help, but repression gained nothing. Halting trade simply harmed those in vulnerable positions— like the dock worker whose daily wages translated into physiological resistance to the epidemic. Here I focus on the political side of Ackerknecht’s thesis, leaving theory for the next chapter. In broadest terms, the thesis has held up. It works less well for cholera. There it explains initial tendencies, but not persistent policies. It overlooks vacillation. It also oversimplifies and misrepresents the problem cholera posed. Theory did not translate to practice in any unambiguous way. Efforts to prevent contagion by quarantine were not inherently anti-commercial; in the Mediterranean they were more likely to be seen as intrinsic to a well-regulated system of  commerce in which trading partners could be confident in the safety of trade. The very assumption of a descent from ideology to practice via theory fixes what was often fluid, and reconstructs a cholera policy that would have made sense had principles been clearly articulated. Yet cholera was not  merely a technical problem. It was a problem of institutional ambiguity. Whose job was it to fight cholera? It was a political problem of calibrating expectations to performances. No approach to cholera control was a signal success; it was not clear how much could be hoped for.

 This is an interesting book that one should reflect upon. It is an interesting observation. In fact the book should be mandatory for anyone in charge.