How Governments Respond to Pandemics Like the Coronavirus

The Hamburg harbour in 1892
Hamburg, Germany, experienced a large-scale cholera epidemic in 1892, at a time when the disease had largely vanished from most of Europe.Source Illustration by J. Schonberg / Illustrated London News / Shutterstock

Sir Richard J. Evans, the provost of Gresham College, in London, is one the preëminent scholars of the Third Reich and modern Germany. Best known for his trilogy about Hitler and the Second World War, Evans has also extended his scholarship to numerous other areas, including pandemics. In 1987, he published “Death in Hamburg: Society and Politics in the Cholera Years (1830-1910).” More recently, he gave a series of lectures at Gresham College titled “The Great Plagues: Epidemics in History from the Middle Ages to the Present Day.”

I recently spoke by phone with Evans in the hope of bringing some historical perspective to the coronavirus pandemic—in particular, to understand how leaders throughout history, including those with authoritarian leanings, have reacted to health emergencies. During our conversation, which has been edited for length and clarity, we discussed how new technologies, from the railways to modern medicine, have shaped outbreaks, the different ways in which the United Kingdom and the United States have responded to the coronavirus, and why, even under different forms of government, “it’s the epidemic that’s calling the shots.”

What is your biggest takeaway when you consider how epidemics have shaped human history?

Human society has always been subject to major epidemics, and has dealt with them in quite similar ways over the centuries, even over the millennia. Of course, human society itself has also changed the way in which epidemics work. William H. McNeill, the great world historian, wrote a book called “Plagues and Peoples,” where he made a powerful argument for the impact of plagues upon human society. Take the Black Death, for example, in 1349, which killed maybe half the population in Europe. The economic effects were absolutely profound, when you think of the labor shortage, for example—too few people to work the fields—and the change in social relations and social structures.

But I think it’s also a two-way process. For example, in the Middle Ages or even in the late Roman Empire, plague spread fairly slowly, and you could deal with it by quarantine, unless societies weren’t well organized enough to do that. Then you got a big acceleration in the nineteenth century that comes with the railways. Cholera was a disease that hadn’t been known outside northeast India, but the British Empire, conquering North India, opened up trade routes. Railways spread the cholera very rapidly when it got to Europe. Steamships across the Atlantic, and of course, industrialization, with massive overcrowding and poverty, made it much easier to spread it in cities and towns. It is a two-way process. That’s first thing that occurs to me.

What was it about Hamburg that made you want to study that city, and why did you think that case study was so interesting or important?

Well, it’s the only city in western Central Europe that had a large-scale cholera epidemic in 1892. It’s more or less vanished from most of Europe, apart from tsarist Russia, long before that stage. There isn’t an epidemic in Great Britain, for example, after 1866, and so I wanted to know why this one occurred so late, and why is it so bad—I mean, ten thousand deaths in about six weeks. That’s what really made me look at it.

Also, I hesitate to do this, but let me quote Lenin, who says that there are certain events that open like a flash of lightning across a landscape. They make you see all kinds of things that you wouldn’t otherwise see. Everybody who lived through the cholera epidemic in 1892 in Hamburg and wrote letters or diaries or newspapers or whatever—they all wrote about it. The source material is fantastic. It can enable you to see the whole structure of the city and the nature of politics and society. Then it’s just in the statistical age, so you’ve got a lot of very good statistics that you can use to look at things like social distribution of disease, for example.

Then there’s a bigger question, which is that Hamburg, of course, was the second city in Germany. It was a major seaport, one of the biggest in the world. It was an autonomous city-state within the German Empire, and it ran its own affairs. It was run by merchants, who suppressed the news of the arrival of the disease from Russia, because they thought that quarantines would be imposed and that would damage trade.

I think we can see some parallels there in the present day. The coronavirus began in China, and initially China’s authorities tried to suppress the news. When it got out and they couldn’t contain it anymore, then they changed their course. You can look at the way in which society interacts with epidemic diseases and you can see certain similarities across the centuries.

Do you see differences across the centuries, too? Do you think people have gotten smarter about these things, or is human nature just what it is?

There are differences. First of all, medical science has got a lot better at identifying disease and a lot better at developing preventive measures. We are confidently expecting, in eighteen months or so, a vaccine for the coronavirus. Well, in the nineteenth century and before, medical science had very little idea of what caused disease, and for a very long time it was thought, for example, that cholera was caused by a miasma or a kind of invisible gas, rising from the ground and poisoning people.

It was only the development of germ theory by Pasteur and Koch, in the late nineteenth century, that made people realize that it was spread by a bacillus. Because of the development of the microscope, you could see these different organisms. It’s different from a virus, and in some ways you combat it by acid and disinfection, but, in particular, by clean water. Cholera is carried in water, and so if you can get clean water, filtrated water, purified water, then people can use that and will not get infected. Also, hygienic measures are somewhat similar to today. Again, washing your hands, particularly after you go to the bathroom, was a very big way of preventing the transmission of cholera, because it’s a disease of the digestive tract.

One difference is that, in the nineteenth century, people had all kinds of theories about how diseases spread, but it’s only in our own time that the science has become sophisticated and precise enough to pin it down and to develop, in an astonishingly short time, a preventive measure. There was no known cure for cholera or bubonic plague or any major disease, really, for a very, very long time, not really till the twentieth century. The second major difference is very striking. It’s what some have called the medicalization of society. If you look at cholera in the nineteenth century, whether it’s in Britain in 1832 or in Naples in 1884 or in many other countries when it arrived, the authorities tried to impose quarantines, isolation, and, later on in the nineteenth century, disinfection and so on. There were riots because people objected to the state interfering this way. Now we’re clamoring for preventive measures, so we’re clamoring for the state to intervene to try and control the disease. We accept medical science in a way that it was not accepted at a popular level in the nineteenth century. I think that’s very good, that we do now listen to the medics more than people did in the nineteenth century. Then, of course, in the nineteenth century, medicine, as I said, was not very effective at killing disease, and there was a lot of confusion about what caused it.


What about the ways in which pandemics have tended to impact politics and political structures? Do you think that there are common themes there?

There most certainly are, yes. On political structures, epidemics do undermine the legitimacy of governance and administration if it does too little to deal with a disease, or if it tries to suppress it in particular. I think inevitably it causes a crisis in government. A large part of that is economic. Major epidemics bring economies to a halt, and you can see that. I already mentioned the Black Death. If you look at cholera, particularly in Hamburg in 1892, essentially, because the merchant administration of the city tried to suppress the disease and suppress news of the disease, and failed to deal with it adequately, the government in Berlin just sent in Robert Koch, the bacteriologist, with a team, and they essentially took over the administration of the city. I think you can see that that led to really quite major changes in the way the city was run after that. It can cause a major crisis. Of course, in terms of the economy, it led to huge deficits in government revenues, and also caused severe damage to trade for several months before it recovered.

What about governments trying to use crises to accomplish their own ends, or political leaders trying to do so? Is that something that you’ve seen or noticed throughout history?

Well, it’s interesting. When cholera reached Prussia, in the eighteen-thirties, I came across in the archives a wonderful notice printed by the Prussian state, where it basically told people that what you had to do is trust in the authorities and obey what the authorities say. You’re not supposed to question government measures, and then trust in God. I think also there’s a major difference in terms of religion. I mean, Europe, at any rate, right up until the late nineteenth century, is a religious society, so people reacted by praying, not really doing any good in the short term.

Governments using disease, well, it’s more actually popular reactions to disease, popular protest. There’s a very good example very recently in Haiti, where cholera broke out in this series of disasters just a few years ago, an earthquake, a hurricane, and then cholera. The state was extremely weak, and people blamed cholera on the Nepalese United Nations troops who’d arrived there, and blamed them quite correctly. There were riots against the United Nations troops and, of course, protests against the government. I think it’s less common for governments to use epidemics for their own purposes. They’re reacting all the time, rather than acting.

It’s interesting that you have all these governments around the world right now that people have termed authoritarian or autocratic or autocratic-leaning. Putting aside China for a minute and just looking at the U.K. and the United States, with leaders who at least have impulses of that sort, they nevertheless seem entirely reactive rather than proactive in the measures they’re taking.

There are interesting differences in the way these various countries have dealt with this. I think the U.K.’s response is very much in the British tradition of volunteerism, liberalism, the laissez-faire state. Britain has been much slower to introduce major regulation and major intervention by the state. It’s tended more, up to now, to rely on voluntary action by people.

If you happen to look at states with a much stronger state presence in society in Continental Europe, like France and Italy or Spain, there’s much more enforcement of government measures—isolation enforced by the police, for example. I think that’s a major difference in the traditions and then the political culture of different societies.

When you were studying twentieth-century history and especially twentieth-century fascism and authoritarianism, were there examples of big health outbreaks, and how were those dealt with?

No, sorry. I don’t think there were, no.

That’s an acceptable answer.

Maybe they were lucky. I don’t know. I’m not sure that, in the end, there are big differences between authoritarian and liberal states or democratic states in the way they react to a major epidemic. It demands very major government intervention, whatever kind of government or whatever kind of state you have, whatever kind of political party is in power. In a way, it’s the epidemic that’s calling the shots. In Britain, there’s been massive public pressure for government to intervene in a more authoritarian way in society, in shaping public reactions and shaping public behavior. In the end, it may be easier for a regime like China to impose regulations and restrictions. Then if you look at some of the other societies that have been relatively successful in combating coronavirus—take South Korea. That is a democratic state, and yet that’s been successful, too.

You were talking about the differences between the U.K. and the U.S., which certainly have manifested themselves early on, but it’s very possible that, in a month’s time, everyone will be trying to be doing the same thing, putting the same Band-Aids on the same overwhelming problem.

Well, that does depend. When you get to a later stage of the epidemic, it does become very important what kind of health-care system you have. The National Health Service in the U.K. will be under tremendous strain, but I think it’s probably better equipped to cope than the health service in the U.S., such as it is.

To return to Hamburg for a minute, can you talk more about how things changed once they finally came out of this cholera epidemic? I know your book goes to about 1910, but what by the end had you seen change, and how was society different?

I think Hamburg was very unusual in imperial Germany, because it was regarded as kind of an English city. It was very Anglophile. That’s one of the things that characterized that city, that it had this very laissez-faire attitude toward administration, toward society and politics, and then that changed. It became more what you might call Prussian. It became more top-down, more authoritarian in the way they organized things.

Also, there’s a great loss of legitimacy by the city fathers. That was reflected in the growth of popularity of the Socialists in Hamburg, the Social Democrats. The city administration in some ways became less liberal, and revised the voting rights to take voting rights away from the working classes to protect its own rule. They got more integrated into imperial Germany. I think it became more German, if you like, and then that had a lot of implications. I think it’s difficult to connect that with the rise of National Socialism, which is relatively weak in Hamburg in electoral terms in the nineteen-twenties.

So to summarize some of what you are saying, you see more continuities than differences in how states respond, even though we’re in a new age with modern medicine and modern communication and we can see what’s going on so much more quickly and so on. Is that accurate?

Yeah, it is accurate. I mean, as I said, certainly common features emerge. For example, in terms of information being made available, again, there have been a lot of complaints in the U.K. that not enough information has been made available to people. That’s fairly standard across epidemics in history.


In terms of more differences, you can also look at the effects of the more intensive and faster communication across the globe. Trade has always played a role in spreading disease, and the incredible rapidity with which coronavirus has spread across the world is, in part, a reflection of the way in which we’re all bound together, in particular by air travel. You can look back then to the nineteenth century and see how the spread of the disease was sped up by the introduction of railways. Before that, you’ve got sailing ships. They move relatively slowly, but you can see how the bubonic plague was spread across the Mediterranean by shipping and merchants and so on.

Richard, thank you for this. I hear you’re coughing now, so I hope you stay inside.

I need a glass of water. It’s talking too much, Isaac.

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