The most obvious parallel is the reluctance of business elite and their political lackeys to take public health concerns seriously for fear of a reduction in profits. For years, San Francisco oligarchs used their influence with city and state officials and media to obstruct the work of public health officials. Only the threat of losing authorization to host a large United States naval fleet persuaded these authorities to address the threat of bubonic plague with the seriousness and resources public health officials had long sought.
Another obvious parallel is the readiness of white supremacist society to discount public health recommendations when the victims are non-whites and other marginalized groups. Most of the victims in the first few years were Chinese in San Francisco's Chinatown, and many decision-makers believed or claimed that "Asiatics" were uniquely susceptible to the disease. During this pandemic, as soon as it became evident that most of the deaths are among the aged, disabled, medically weak, detained and essential workers in worksites which typically don't protect their workers, and in the United States all of this reads members of First Nations, African-Americans and other ethnic minorities, many politicians called for an end to public health measures which were squeezing the profits of their capitalist masters.
A major stop forward occurred when the federal health officials gained the trust and cooperation of residents of Chinatown because the threats of quarantine, indiscriminate demolition and forced relocation were removed.
Real estate interests sought to use the plague as an excuse to demolish Chinatown and relocate its inhabitants to less lucrative locations, and white supremacists used it to promote their anti-Asian immigration policies.
Finally, limitations on scientific knowledge hampered treatment of the stricken and the development of effective public health measures. The public health officials, after years of failure to contain the epidemic, eventually hit on the correct measure: elimination of the rodents from whose infected corpses fleas were transmitting the bacteria to humans. Early on in our pandemic, there remain many unknowns, and the denialists use these gaps in knowledge to obstruct public health measures.
Naomi Oreskes & Erik Conway documented how business interests manufactured doubt to slow government environmental and public health regulation. In Chase's book, we read how newspapers spread conspiracy theories and published the views of contrarian "experts" to obstruct the efforts of the public health officials:
The [daily newspaper The San Francisco] Chronicle and the Wasp[, a popular journal of satire and political commentary,] continued to print acid attacks on the plague campaign. Chronicle publisher Micheal de Young changed the tenor of his campaign in the Chronicle. Now, instead of flatly branding the plague a fake, he refined his editorials, affecting a new tone of scientific skepticism about the link between plague and rat fleas. He ran guest columns by contrarian physicians who lent an air of authority to de Young's plague denial. [Federal public health official Rupert] Blue warned Washington that de Young's pseudoscientific articles threatened to erode support of the public and of City Hall at a critical moment. pp. 183-4Chase notes in the epilogue:
Today, as other epidemics strike, stricken countries must sometimes learn all over again that the politics of denial, commercial protectionism, and discrimination too often trump science and sound medical judgment. p. 213Another note: Rupert Blue, whose mostly successful efforts at containing the plague led to his appointment as Surgeon General later in his career, was an advocate of national health insurance:
Good health is a right, Blue insisted. Promoting it was, in his view, the surest way to enhance the moral stature and happiness of a people. Moreover, he argued, it was a good investment, and every dollar spent on public health would be returned a hundredfold. "Public health is a public utility," he said in a speech before a 1913 convention of life insurance executives. "It is the great glory of the period in which we live that we have recognized our responsibility as our brothers' keeper." p. 202Finally, it is likely the United States avoided the more serious outbreaks of plagues which swept India and China at that time because the dominant species of flea in San Francisco didn't spread the plague to humans as effectively as the dominant species of flea elsewhere:
In San Francisco, the prevalent flea species was not the Oriental or Indian rat flea, Pulex cheopis. While there were a few of those in the city, the main flea species on the Golden Gate was the northern European rat flea, Ceratophyllus fasciatus. ... The plague flea's key trait wasn't its armor or its stiletto, but its gut. ...[S]cientists now know that the Asian flea cheopis grows a basket of spines in its belly. Inside that basket, a clot of blood collects, forming a potent ball of plague germs. The clot also blocks new blood meals from reaching the flea's stomach, so it begins to starve. That makes the ravenous flea attack more aggressively, biting any warm-blooded animal that crosses its path. Finally, its frenzied sucking dislodges the ball of germ-laden blood. It is, in effect, this flea heartburn that delivers a lethal dose of plague into its hapless human host. Fasciatus, the Frisco flea, has a foregut without that spiny basket. So while it is capable of transmitting plague, each injection delivers a less potent--that is, less infectious--does of the germs. pp. 190-1Believers in American Exceptionalism might consider this God's favor upon His chosen people. I just say that perhaps the next key link in a pandemic might not go our way.
