A history of the present: How can learning about the response to pandemics in the past help understand disease response in the contemporary period? – adapted from a talk by Alex Benham.
St John's College Access
WORKSHEET INSTRUCTIONSGrab some paper and pens to note down your answers to the questions in this worksheet as you read through! Don’t forget to take a look at the extra resources and have a go at the activity at the end. This workshop will explore how the British state has responded to pandemics past and
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This workshop will explore how the British state has responded to pandemics past and present. What is the relevance of a plague that took place over a hundred years ago to the Covid-19 pandemic that we have just faced?

In the late 19th century, a plague began in the Indian city which is now called Mumbai, but was then called Bombay. In 1896, with India being part of the British Empire, Bombay was the most important port on the West Coast of the subcontinent, a crucial exchange between India and Europe. By the late 1800s, Bombay was not only one of the largest cotton markets in the world, it also held a virtual monopoly on India’s cotton manufacturing.

Bombay was a city for the steam age, with 82 textile mills employing a total of nearly 72,000 workers. These workers were part of a general population of over 800,000 people, crammed into one of the most densely populated cities on the planet. Five or six story tenement building could house up to 600 people. Unsurprisingly, the living conditions were terrible

Bombay was a city in which people were overworked and underfed, with too much waste and too little sanitation.

Healthcare was extremely limited, if it existed at all, and life expectancy was incredibly short.

Then, on the 18th September 1886, an Indian doctor named Acacio Gabriel Viegas made a routine house call in Bhogadi, what was then the native town of Bombay. Kalpish Ratna’s book, Uncertain Life and Sure Death, describes the event:

Viegas found his patient, a middle-aged woman, moderately feverish, but she had other signs that filled him with disquiet. Speech and consciousness were impaired. She also had a large lymph node in the groin. Later that day, Dr Viegas saw a second patient with a similar illness – a young man from the port trust estate. On Sunday morning, his first patient was dead. The young man was much worse and unlikely to survive. The boy’s uncle had more alarming news. In the last month, more than fifty people had died of these very complaints in the neighbourhood, and rats were dying by the dozen. Dr Viegas did not hesitate. He told the family the boy was dying of the Bubonic Plague.’

Doctor Viegas immediately confirmed the diagnosis and communicated his findings to the authorities. His report was not the first that the municipal government had heard of the disease. In fact, the British had been hearing descriptions of suspicious swelling since at least early May, but they did not want to admit that the plague had arrived in the city.

When the municipal government eventually admitted the outbreak of the bubonic plague on the 1st of October, it sought to stress that ‘The disease was of a mild type.’

There were three main reasons for the British government’s silence:

Bombay was symbolically important to the British Empire. The British did not want to admit that they had failed to keep the plague out of this incredibly important city that represented Britain’s colonial power.

This importance wasn’t just symbolic – it was commercial. Britain depended on trade that came from Bombay to Europe, and the British did not want European countries to impose quarantine on the trade out of fear of the plague.

The third reason was much more localised. The British did not want this huge, overcrowded population to panic. They were worried that people would, quite understandably, be terrified to hear of the plague, and would then spread out across India, taking the plague with them.

The history of plague weighed heavily on the minds of the British authorities. One report said: ‘as the epidemic spread through the city, one realised the truth of many of the tales of terror handed down from the past.’ Horrified colonial officials described ‘streets deserted, whole families found dead with no records to tell them who they were. Mothers lying cold with helpless babies beside them, who no one dared pick up to take care of from fear of this new and terrible disease.’

As the plague tore through the overcrowded chawls of the native town, the authorities began frantically trying to stop it from spreading.

The authorities started cleaning buildings and flushing some three million gallons of carbolic acid and saltwater daily through Bombay’s drains and sewers. Despite their disinfection campaign, the British failed to curtail the rapidly increasing death rate in the city. All their efforts were in vain, because of the ignorance that then prevailed as to its way of spreading, and therefore of the proper measures to take to arrest its progress. In December, Bombay reported an excess mortality of 4559, a figure which spread the alarm far and wide. Recognising the terrible threat of the plague, and the failure of the colonial response, an astonishing half of the Indian population fled the city. British attempts to stop the spread of the plague focused on trying to clean things, because a lot of scientists believed that disease was spread through human excretions – either people coughing or going to the bathroom.

In Bombay, the disease probably started with a rat that came off one of the ships in the port. Living on this rat were rat fleas, with the scientific name Xenopsylla Cheopis. Some of these were themselves infected with a tiny bacterium called Yersinia Pestis. The infection therefore travelled down a scale of size: we have the rat, the rat fleas, and the rat fleas that were infected with bacteria. These fleas bite the rat, and the rat becomes infected with the bacteria. The rat gets sick, and suddenly the fleas are confronted with a dying host which they can no longer feed off. In desperation, searching for food, the fleas jump off the rat, and onto the closest warm blooded mammal they can find – in a city, you can guess who this will most likely be. That is how humans started getting bitten by fleas, and how Yersinia Pestis started infecting human beings.

Over 90% plague cases are bubonic or septicemic and are caused by rat flea bites. Less than 10% of plague cases are pneumonic – when the bacteria enters the lungs. This much rarer form of the plague is the only way it can spread from human to human, through droplets from the infected people coughing. The plague is astonishingly deadly. Untreated, bubonic plague kills 50% of the people it infects. However, untreated septicaemic and pneumonic plague kill 100% – sometimes in the span of hours.

The problem was that the British just did not understand that the plague was spread by rat fleas. In the early months of 1897, when they massively intensified their response to the plague to try to stop it, their entire approach was centred on sanitation. The statement below is by James Lausson, one of the key British scientists in Bombay during the plague:

With regard to the Indian epidemic, many of the filthy habits of the country predispose to the rapid spread of infection by inoculation: e.g., expectoration (coughing and spitting) on floors and walls, an eradicable Oriental habit. In cases where the sputum is especially infective it will be readily seen that the room may become saturated with the poison, from which further infection by inoculation of members of the household may take place.

Lausson focuses on filth as being something particularly bad in India, because he thinks that Indians have particularly dirty habits. This is a very colonial way of thinking. The British wrongly believe that they are inherently superior to a supposedly less civilised, less sanitary native population. With this explanation in mind, let’s look at how another British scientist, Sir James MacNabb Campbell, talked about the movement of Indian people around Bombay:

In many cases, as is well known, the people proved themselves alike agents in the dissemination of the Plague, and obstructive to remedial measures. Racial characteristics and innate prejudices combined to encourage a more or less perverse attitude towards plague and plague measures which with its results can only be briefly indicated here.

In this report, Indian people are seen as inherently opposed to sensible measures to avoid the plague. It suggests that they don’t take it seriously, or obstruct measures designed to contain the disease. Campbell is explicitly racist in his writing blaming what he calls ‘racial characteristics’ for this issue.

These prejudiced ways of thinking shaped the British response to the plague in Bombay. Thinking that disease was spread by unclean habits, British authorities set about disinfecting houses to the point of destruction, hosing them with highly toxic acids, or sometimes literally tearing them down so they could not infect other people. They also set about inspecting everyone who was moving about and searching homes for plague victims who they would then remove by force to medical detention and special hospitals. This was incredibly destructive to the Indian population of Bombay, who were not only being killed in huge numbers by this horrific disease, but then had to deal with groups of soldiers invading their residences, abducting their sick relatives, and potentially even destroying their homes.

The British methods didn’t help at all. Flushing sewers and destroying buildings just flushed rats out into the open, pushing them to mix with other rats and other humans. Detaining sick people terrified the population, encouraging them to hide their sick friends and families even more and therefore preventing them from being properly isolated. Focusing on filth and movement prevented action on the real cause of the plague – the rats and the fleas, and their capacity to mix with humans.

At first we might like to think that they are very different: surely modern science would never approach a disease in such an unethical and destructive way? We certainly did not see houses being destroyed in Britain when people were infected with Covid, or sick people being forcibly removed to hospital.

However, the colonial British government’s racist ideas about disease have persisted in some ways. Do you remember the origin stories we were told about where Covid-19 had come from?

Here a two examples of headlines written during the beginning of the pandemic:

George Knowles for the Mail on Sunday, 28th March 2020: ‘Will they ever learn? Chinese markets are still selling bats and slaughtering rabbits on blood-soaked floors as Beijing celebrates ‘victory’ over coronavirus.’

Julie Marson and Ruth Edwards for The Times, 8th June 2020: ‘Ending wet markets around the world must be our priority.’

Articles told lurid stories about supposedly filthy wet markets and strange traditional customs in China like the alleged eating of bats. This largely apocryphal set of stories unleashed a wave of very real racism directed at East Asian people across Europe and the US, with East Asian travellers or people of East Asian descent targeted for abuse and discrimination.

Such racist narratives about Covid also enabled the British government initially to present the disease as a problem from elsewhere, as far away as China. Like the colonial authorities in Bombay, the government refused to confront the reality that Covid would arrive in the UK, and then failed to react quickly when it did.

The idea that Covid was a disease of filth and contamination shaped the early response to the pandemic. Think about how in Spring 2020 the focus in Britain was on washing hands, disinfecting every possible surface, worrying about taking takeaways from delivery drivers or erecting plastic shields around shop workers. This was all despite the fact that we increasingly knew that the disease was airborne, that it was suspended in small airborne droplets, not on surfaces.

The racist narrative about Covid initially focused on the problem of travellers from Asia carrying the disease into Britain, despite evidence that much of the initial spread was by people who were infected in European countries. In the early days of the pandemic in Britain, particular ski resorts in the Alps were important in disseminating Covid-19 through the country, This is why country specific travel bans rarely work. Members of the British government also began blaming Black and minority ethnic communities for being particularly responsible for the spread of disease in another echo of colonial Bombay. Craig Whittaker, a Conservative MP, said:

If you look at the areas where we’ve seen rises and cases, the vast majority … is the BAME communities that are not taking this seriously enough … [the] immigrant and Asian population.

Black and minority ethnic groups did suffer disproportionately from Covid-19 – more infections, more hospitalisations, more deaths. One study in an East London hospital found that Black patients were 30% and Asian patients 49% more likely to die within 30 days of hospital admission compared to patients from white backgrounds with a similar age and baseline health.

This was not due to Black and Asian people taking the disease less seriously, but rather reflected structural inequalities and socially mediated risks. The British state only made these inequalities worse by targeting Black and minority ethnic communities for disproportionate policing and punishment. From 27th March to 11th May 2020, Black, Asian and minority ethnic people in England were 54% more likely to be fined under Covid-19 regulations than White people. Black people were disproportionately targeted: although Black people made up just 12% of London’s population, they received 26% of fines and 31% of arrests for alleged breach of regulations during the Spring lockdown. Echoing the actions of colonial authorities in Bombay, the British state responded to disease amongst minorities as a problem of public order, not public health.

So what is the point of exploring all this? A French academic called Michel Foucault once said that we need to try to write what he called ‘A History of the Present.’ This means evaluating ideas or statements which may seem natural or logical at the time, like ‘we must close the borders’, ‘foreigners bring disease’ or ‘washing hands keeps us safe’. Foucault says we must take such statements and subject them to rigorous historical analysis. Instead of accepting these ideas as just common sense, a history of the present means trying to understand where they came from, and why they came to exist. This kind of thinking allows us to ask the hard questions of ‘why do we do this?’ rather than simply accepting choices as a given. The best way of understanding the present is to be ruthlessly critical of the past. The problems we face today are a product of history, but so are the solutions we often try to apply to them. Historical analysis helps us look at these issues in more nuanced ways.

Further Reading

If you are interested in learning more about the impact of the bubonic plague in Mumbai, have a look at this article on the influence of the plague on modern day Mumbai and how it has physically shaped the city. To access the article, click here.