KW: These moments of epidemic or pandemic light up some of these things that go unnoticed. It takes me to my next question about how these moments of isolation—or, in this case, social distancing—are making us hyper-aware of how we’ve always been interconnected. As you noted in Contagious, epidemics have the potential to tear apart social order, or maybe they can evoke a profound sense of social interconnection. A phrase that you have used to describe this is “communicability configuring community.” I’m wondering if there are ways that you see COVID-19 configuring community.2
PW: Yeah, in two different senses. Definitely in the social sense, as people are making a real effort to help their neighbors and to be aware of who has particular needs. We were asked to be aware of ourselves as social beings and the need to take care of each other—having groceries delivered and running errands and doing things for people who can’t get out. But also in the sense of being careful of the people who are at more risk. Not going into certain places because you’re going to expose people who are at greater risk from the disease than you may be.
Contagion is the best metaphor for community there is because we need each other and we’re interconnected, and that’s what contagion shows us, it shows us that we’re a community. It shows us our needs for each other, which I think social distancing has made us hyper-aware of. But at the same time contagion can also be contagion of ideas, right? And those ideas can be inclusive or stigmatizing; it can expand community or contract it. It also shows us the ways that other people are also a danger in a variety of ways—that any community has the paradox of being necessary and positive and also dangerous for any individual.
KW: You also talk about this kind of community formation as a way of enforcing national belonging in Contagious. I’m wondering what role the nation plays in the midst of a global pandemic. Are you seeing similar arguments about national belonging in the response to this epidemic?
PW: Yes, and so if a disease knows no borders, a nation has a responsibility for the health of its population. That nation tries to reinforce the borders that the disease is trying to cross. That’s where the anti-immigrant metaphor of the illicit border-crosser really comes out. Nonetheless, quarantines are really important, whether they’re local or national or whatever. A nation does have that responsibility to try to protect its population. That’s the function of the nation. During a pandemic, on the one hand we see the globalization; on the other hand there’s a resurgence of the importance of the nation as the thing that’s going to protect people, that’s going to enforce a quarantine, that’s going to get the development of the vaccine going and the pharmaceuticals and it’s going to fund these things. All of that is a national responsibility and reminds us that we are in a nation.
[But] the other thing that happens, as I said before, is the us/them. Nationalism is all about an us/them. Every us/them gets exacerbated during a crisis of any kind and especially one like this. The [antagonism toward] other nations, [the language of] the “Chinese virus,” the “close this border,” the “militarize the Canadian border,” all of that gets pronounced. Even though militarizing the Canadian border made no sense at all. There was also talk early on of protecting the Mexican border even though [the virus] was in the US. Mexico should have been protecting the border, not the US. Again, it shows us how the political picks up on the medical.
KW: Then who counts as belonging to the nation? Who is protected or supported by, say, the stimulus package? There are so many holes for folks who haven’t filed taxes in recent years or undocumented immigrants living within the United States who aren’t considered citizens.
PW: Absolutely right. There’s a term historian Alan Kraut coined, “medicalized nativism.” Medicalized nativism is the use of medical threat to make nativism palatable or to enhance the arguments of nativism: “They are bringing in diseases. They’re a threat to the population. We owe it to the population to keep them out.” This goes back to the turn of the century to the stuff that I was interested in in my first book and how I came across Typhoid Mary.3
KW: So far, we’ve been talking about national responses to epidemic disease—in the form of medical nativism and border protection—but I’m wondering how this plays out on a regional level. Does the outbreak narrative lead us to believe that we need to close not only our nation’s borders but also close off towns from surrounding areas? Are there impacts of inconsistent regional responses to COVID-19 that inspire the same kind of xenophobic thinking as medical nativism? Or can a strengthened sense of regional belonging also be a positive thing, fomenting a sense of shared experience and mutual accountability?
PW: There’s a refrain that runs through a lot of the global health literature: “microbes know no borders.” That’s part of the double message that contagion carries: that we’re all connected, all interdependent, and that we are threats to one another. That’s how contagion paradoxically reinforces a sense of unity and an exacerbation of “us/them” thinking. From a public health standpoint, it certainly makes sense in the midst of an outbreak to establish a containment zone. Depending on who’s in the zone and who is surrounding it, that can certainly feed into xenophobic thinking. If regions are distinctive racially, ethnically, culturally, it is more likely to exacerbate stigmas and blame. In the case of COVID-19, we are also seeing how politics can affect public health decisions in really dangerous ways, with blame being cast on local politicians and public health officials who are trying to protect the health of their constituents. Since microbes don’t conform to town, city, or regional borders, it can become increasingly difficult to protect a population if responses aren’t coordinated.
The problem with “us/them” thinking is that having a “them” characteristically strengthens an “us.” The fellow feeling that comes from the “us” is important to human beings, but if we depend on having a “them,” we reinforce the stigma and bias. The slogan “we’re all in this together” that has emerged is an effort to form an “us” that includes humanity. I think that’s part of the unconscious—or maybe conscious—rationale of demonizing the virus. As I’ve said, that has its dangers too—we don’t want to create a viral enemy that allows us not to see how we humans have created the conditions for disease emergence and to think about how we have to change our way of being in the world collectively. But the more inclusive our thinking is, the more we can work together productively to do so. And let’s not forget, we also have plenty of examples from history in which crises of all kinds brought out the best in people, heightening fellow feeling and eliciting a communal response. The more each of us can imagine what it would feel like to live in others’ lives, the better, I think. And the more inclusively we can all think, the more we can collectively begin to work for a world that is more just, more equitable, and in every sense healthier for all. If this crisis gets us thinking in those terms, perhaps we can salvage something worthwhile out of this calamity.
There’s a refrain that runs through a lot of the global health literature: “microbes know no borders.” That’s part of the double message that contagion carries: that we’re all connected, all interdependent, and that we are threats to one another.