Epidemics, like famines, wars, economic crises and revolutions, are ‘big events’, and are often related geographically and temporally, affecting and affected by the social metabolism, the human mediation of the universal metabolism of nature, and which require transdisciplinary analysis at multiple levels of abstraction. In ‘I Know Who Caused COVID-19’, the authors look at ‘how accusations of all sorts about causing or transmitting or controlling the pandemic created communities […] all of them intended to deal with the anxiety inherent in such a global pandemic’ (8). They seek to provide a ‘narrative about blame and retribution’ based on their ‘experience of disease as historians’ that there ‘is a substantial psychological component, both to the individual and collective processing of the fear generated by the diseases and to our social responses to the stresses generated’ (9). Their focus is on the COVID-19 pandemic and the rhetorical functions of psychological phenomena, such as anxiety and displacement, and not on how COVID-19 emerged and by what processes. The individual-level focus is of course established by the book’s title which addresses who caused COVID-19 rather than what caused it or how. Their analysis largely stays at the levels of individual and social psychology, generally abstracted from the historical and economic contexts in which individual and group psychologies arise, are enacted and subject to forces including manipulation by elites.
The book’s preface, first and concluding chapters frame the overarching theses, and the central chapters offer case studies of xenophobic reactions related to COVID-19 among four key populations: Chinese (and other Asians) within China and elsewhere; orthodox Jewish communities in the U.S., UK and Israel; African American, Black, Asian, and minority ethic communities in the U.S. and UK; and what the authors refer to as ‘Trump as Symbol: Anger within and against “White” Communities.’
Chapter one begins with the following statement: ‘In times of stress such as during epidemics, ancient prejudices and primeval fear, always beneath the surface, can be brought to life to haunt us’ (11). The authors cite Thucydides on the 430 BC plague of Athens in which he is said to have ‘blamed the Ethiopians for causing the epidemic’ (11, 157), which is said to have led to ‘moral disorder’ (11). Yet while Thucydides described the plague as originating in Ethiopia, he also wrote that Athenians supposed that the Peloponnesians, with whom the Athenians were at war (and not the Ethiopians) had poisoned reservoirs and hence caused the plague. Thucydides, who himself had and survived this plague, declines to attribute a cause or specific blame (Thucydides 1972: 151-156).
The authors equate and naturalize these ‘ancient prejudices and primeval fear’ as permanent states endowed with supernatural powers to ‘haunt us’ (11) in ways that of necessity lead to, and indeed require, the xenophobic blaming of others ‘to deal with the anxiety inherent’ (8) in responding to an epidemic. This leads to the authors’ main thesis and sweeping conclusion, that ‘from this first account of a pandemic in the West, the fear of the Other has become a permanent feature of all epidemics’ (11); this is consistent with a body of literature to which the authors have previously contributed. Yet at a minimum, the book does not engage with important scholarship demonstrating that responses to epidemics have ranged from blaming of various others, to blaming or struggling against elites, as well as within and across group solidarity responses. That an epidemic might contribute to solidarity and struggle in response to contexts and processes which both oppress individuals and groups, and which may underlie the emergence of epidemics, is not entertained.
The authors’ reference to ‘moral disorder’ as a pathologized social response to epidemics initially relies on Thucydides report that the epidemic led to departures from then prevalent social norms (Thucydides 1972: 155f). Notably, the authors cite Thucydides rather than the more materialist Lucretius who directly implicates poverty in driving people’s responses to the same epidemic (Lucretius 1972: 238). Thucydides owned large estates and leased gold mines which were worked by slaves; his interpretation of events should be understood as an elite one in which violation of social and political norms, such as those regarding property and its inheritance, is made to appear as an abstracted ‘moral disorder’ rather than as a response to poverty and oppression.
The assumptions of an inherent, permanent natural human tendency to blame others, and the labeling of departures from ‘social norms’ as an ahistorical, class-abstracted and pathologized ‘moral disorder’, position the authors’ analysis throughout as a largely individualistic one, in which blaming is treated as a ‘needed’ aspect of an individual’s response to fear and anxiety, calling up ‘symbolic registers’ and ‘known symbols of defining oneself’ (19)—following Lacan—in ‘imagined communities’—following Benedict Anderson—inspiring ‘a false sense of protection through the creation of an implied boundary between one community and another’ (27). That human responses to epidemics may be potently affected by history and current inequitable conditions is briefly acknowledged and then returned to the realm of the symbolic:
Not only is placing blame in times of stress triggered by social inequalities, as argued by Marxist and functionalist historians alike, but, as we learn over and over again, while public health measures, from building sanitary cordons and enforcing maritime quarantine to locking down cities and closing borders, may be necessary to prevent epidemics, they also build psychological obstructions and reinforce existing barriers. They may indeed save lives, but what kind of lives? And whose? And what are the meanings that any community projects onto these lives in their symbolic world? (27-28)
The authors engage with the issue of who constitutes a ‘population’ or community, recognizing the term as endeavoring to convey ‘seeming scientific neutrality’ (15). Yet while they do ‘layer’ in meanings masked by the term, including ‘flag, leader, language, race or, indeed, health and illness’, so that a symbolic register ‘come[s] to be the focus of the newly constituted community’ (16), explicitly absent is class, ignoring both Marx, who wrote that ‘population is an abstraction if I leave out, for example, the classes of which it is composed’ (Marx 1973: 100) and more contemporary scholarship regarding who or what is a population.
While the authors discuss Edward Bernays and the use of marketing and propaganda as ways to control ‘the public mind’ (170), they nonetheless posit blame as arising from endogenous individual psychological needs and from groups that ‘constituted themselves as victims’, with the result that the ‘articulation of victimhood in one sphere begins to impact on the others’ (175). This construction excludes from view any class or economic interests in reinforcing dominant ideologies through elite control of media and other mechanisms. Where an impact of misinformation, disinformation and propaganda is recognized in the book, these constructs are mystified and naturalized as a ‘fast-spreading “infodemic” (information epidemic)’ (22) abstracted from the activity of any specific actors.
The authors appropriately emphasize that words can have potent metaphorical meanings (18, 85, 181, 204) linked to potent symbolic registers, but fail to apply this understanding consistently; for example, they highlight that calling something an epidemic might add to anxiety (201-204), while failing to see that referring to something as a ‘lockdown’ (9, 27, 28, 37, 74), rather than as a public health measure or as a solidaristic protective activity, does likewise. They frequently use metaphors which soften and mystify. When discussing the early nineteenth century cholera epidemics and appropriately noting that ‘it was the non-white bodies in Asia that were blamed as the source of the disease’ rather than ‘global trade’, imperialism and colonialism are euphemistically referred to as ‘the British engagement in India (23)’ and as ‘accelerated engagement in colonies across several continents’ (45).
Chapter four addresses xenophobic responses to African American and other Black and Brown communities. While recognizing that structural racism was a barrier to COVID-19 vaccination in the U.S. and UK (153), the authors essentially reject the real role of oral history and collective memories of prior racist medicine and public health in contributing to mistrust or reasonable circumspection as too ‘often read as artefacts of the historical treatment of these communities” (113). They go on to argue that it is ‘not a community memory’ of such mistreatments but a ‘direct campaign’ (120) of their ‘constant evocation in the context of COVID-19 that creates a symbolic register defining the risk confronting communities simultaneously generating anxiety within them’, and which generates ‘a pseudo-collective memory, one which is instrumentalized by post-colonial public historians, the media, popular culture and social networks to create an image of danger to the African American Black community’ (115). This interpretation denies any ‘collective “folk memory”’ (119; emphasis added) that an oppressed group may construct and intergenerationally pass on, and instead posits that highlighting past injustices is, in Nietzsche’s sense, an abuse of history (198).
Elsewhere the authors argue that ‘Black Britons have been persuaded to never to forget the historical racism in “racist Britain”’ (143; emphasis added). They further argue that reminding people of historical oppressions, stigmatizations, and denials of dignity only or predominately creates anxiety and reinforces or even generates otherizing responses (115, 119, 126, 127, 198). This argument both ignores and dismisses the role that understanding past oppressions may have in validating and contextualizing current experiences of oppression, in potentially reducing anxiety, and that at the social level, may lead to solidarities and understandings of community not reliant on the demonization of others, or that recalling history may stimulate positive social movements. This dismissal is made further apparent by the absence of any substantive consideration of links between COVID-19 and the solidarity evidenced in the Black Lives Matter Movement (144).
The authors treat ‘ghettos’ and ‘ghettoization’ (84) as largely symbolic phenomena, in which communities ‘living within their real and symbolic space’ respond to ‘metaphoric constructions of health dangers’ (85), again ignoring class distinctions that drive inequitable housing which exacerbate COVID-19, and other health inequities without treating ‘ghettos’ as forms of internal colonization. The emphasis on symbols is so dominant that they are made to appear and are taken as essence (85, 115).
Throughout, individual and group level beliefs are abstracted from context, and, in particular, from global capitalist processes. In chapter two, the authors discuss possible links between wet food markets in Wuhan and the onset of the COVID-19 pandemic, and clearly demonstrate ways in which images of ‘exotic foods’ and ‘the Western world’s fetishistic disgust over the Chinese and indeed Asian trade in wildlife’ were mobilized to stigmatize Asians and attribute blame (40-48). Yet to then ignore that these markets are part of global circuits of industrial agricultural capitalist production and value chains financed, and with value realized, internationally (Wallace 2020: 83, 90, 104), is to remain in the realm of ideas and of putatively eternal psychological reactions, obscuring any understanding of either xenophobia or the COVID-19 pandemic.
‘I Know Who Caused COVID-19’ contains interesting discussions and points, but identifying and engaging with them requires a substantial and vigilant exercise in reading against the grain. The book inappropriately naturalizes xenophobic blaming in response to epidemics, dismisses the importance for the present of acknowledging past oppressions, erases class and the materiality of unequitable disease distribution with origins in capitalism, and dismisses the potential and actuality of solidaristic responses through mystifications such ‘moral panic’. The book neither offers, nor substantively explores, paths out of xenophobia and stigmatization. Here the conclusion is telling, since it ends by offering a (cute but unhelpful) response to the statement in the title: ‘I know who caused COVID 19. They did’ (13), leaving the reader to seek deeper critique and theorizing that may inform praxis elsewhere, perhaps from others.
David C. Perlman is a physician and researcher in New York City. He has been involved in efforts to bring health care and prevention to oppressed communities.
- 2007 The Nature of Things trans A.E. Stallings (London: Penguin Books).
- 1973 Grundrisse M. Nicolaus (London: Penguin Books).
- 1972 History of the Peloponnesian War trans. R. Warner (London: Penguin Books).
- 2020 Dead Epidemiologists: On the Origins of COVID-19 (New York, Monthly Review Press).