Dr. Howard Markel studies the history of medicine at the University of Michigan and is one of the scientists who came up with the idea of social distancing. I wanted to talk to Markel because it seems like his big idea for squashing a pandemic is coming to a dramatic end as states are reopening and thousands and thousands of protesters are filling the streets. Markel supports the protests against police brutality triggered by George Floyd’s death and respects the centrality of this cause. He calls racism and police violence a pandemic, as sinister as any virus. But he worries about these crowds.
On Monday’s episode of What Next, I spoke with Markel about what these protests could mean for the pandemic and what history can tell us about what might come next. Our conversation has been edited and condensed for clarity.
Mary Harris: How was it originally envisioned when you made these recommendations of how to implement social distancing? How was it originally envisioned that social distancing would end?
Howard Markel: This was just to be one lane of a multilane expressway that was run by the federal government. You would also have training of people to contact trace or take care of these patients. You would have a hospital lane, so they were well stocked to prepare to see these patients. You would have a vaccine production lane. An antiviral lane. All these lanes. And the federal government would hopefully coordinate that because they have the resources. Today, really, it’s just been social distancing, and we hope those labs that are making vaccines will be successful and quick about it.
In Minnesota, where the protests began, they had their highest COVID death toll just a week or two ago. Looking back at the 1918 pandemic, is there a historical precedent that gives you special pause here?
People love to talk about Philadelphia, which was the second worst city in terms of cases and deaths during the 1918–19 flu pandemic. There was a liberty bond parade there, and there’s a great picture in the National Archives of all sorts of people lining up to see floats and wish their young men going off to war. But there were liberty bond parades in many cities that year.
Philadelphia got hard hit for a lot of reasons. The parade itself didn’t help, to be sure. St. Louis canceled its parade, and that was probably the wise choice to make. But in Philadelphia there was great dissent between the mayor and the health commissioner. The school board didn’t agree with either one of them. And they also fought with the governor. All of this infighting and internecine battling, inconsistent messaging, not rolling out these social distancing measures quickly enough, and not using them long enough. It all contributed. It was a multifactorial, epic fail for Philadelphia.
I feel like we’re all living in Philadelphia now.
You don’t have to be a professor or a rocket scientist to say that these crowds are not a good idea in terms of the COVID virus. They are a very good idea in terms of registering your complaint with how [George Floyd] was treated and others are treated every day.
In the past week, a number of doctors have signed a letter where they’ve said that they endorse these protests even though they know the risks involved. I’m wondering if you’ve read that letter.
It’s very interesting, particularly some of the statistics that have been presented. The odds of a young African American man getting severely hurt or killed by a police officer—the percentages are actually very high and risky, and they are almost comparable to the risk of a young man dying of COVID. So, in a way, you pick your pandemic.
What is worse for my community? What is more deadly? And everyone has the right to weigh those risks and benefits and react accordingly.
Some protesters have been quoted saying they were aware of a COVID risk, but they were making this choice. I wonder how you think people’s understanding of COVID risk might be affected by their virtuous intentions? The idea that I’m doing something good and so it’s probably going to be fine.
That’s the wrong calculus. It should be: I’m doing something good, but I am risking getting sick.
You have to understand, if you participate in those very noble exercises, you are increasing your risk. By how much? I can’t tell you. I’m not a mathematical modeler. But I know it’s greater than the risk I have sitting in my study and talking to you on a computer.
Something else that stood out to me about your research into 1918 is that once social distancing was lifted, it was very difficult to clamp down again. The politicians worried they just didn’t have the political will. It seems like right now we opened back up quite quickly and we’re experiencing all these protests. If we need to close down again, are we going to do it?
Even in 1918—which was a very different time and place; it was a smaller country, federal government was very small, local and state governments had first dibs on public health, and people were very patriotic and a lot of the social distancing was commingled with their patriotic duty to support the war—it was very hard in many cities to reinstitute a shutdown because they had already experienced it.
If there is no spike in a couple of weeks, folks will be mad because they’ll feel lied to. “Social distancing wasn’t a thing. We didn’t need to do it.” And then if there is a spike, people will blame the protesters, saying you brought this on us.
It’s a no-win situation. Someone will blame the protesters or someone will blame the police or—there’s lots of blame to go around, and that doesn’t help cooperation.
If we do see a spike, will you point at a particular group of people?
No, I won’t. A lot of my work has been about disenfranchised groups that have been stigmatized and blamed for epidemics. I cut my medical teeth during the beginning of the AIDS epidemic and treated a lot of AIDS patients when we had no real treatments and they frequently died. And that’s where I got interested in epidemics and the concept of quarantine. And then I began studying it—how these measures were inappropriately applied to immigrants, so-called dirty, unkempt immigrants that nobody liked or wanted in our country. I’ve studied that not just among East European Jewish immigrants but among Mexican workers, among AIDS patients, gay men, intravenous drug users, lots of stigmatized groups. And I ended one of my books by saying blaming is a pointless thing. The burden of the disease is enough for that individual. Epidemics and pandemics are large, social, living laboratories, and you don’t know what the results are going to be once it is unleashed. But blaming people doesn’t help. This is a huge enough problem without that.