Coronakrach: Two important books on what pandemics do to your mind
“…when a potentially dangerous outbreak appears on the horizon, we give in to those impulses again, this time at the collective, societal level. Massive anxiety or massive hysteria heralds and shrouds an actual outbreak and once the outbreak turns out to be contained and subsiding, we turn our heads away and forget about the horrors of anticipating the wave of the pandemic, having conquered our fears, wrote Sameer Khan and Damir Huremović, US-based psychiatrists, in a paper titled Psychology of the Pandemic in Psychiatry of Pandemics - A Mental Health Response to Infection Outbreak (Ed. Damir Huremović; Springer, May 2019). Did Huremović have a premonition that a mega catastrophe, propelled by the Corona virus, was six months away and that it would infect over one million people and kill over 70,000 across the world in the first two stages?
Not at all. Thinking very differently, he wrote in the first few lines of the preface: “This book could have been written a century ago – at a time when the last true pandemic was sweeping the globe and psychiatry was emerging from the confines of insanity asylums and establishing itself as a reputable medical specialty. At the time, it did not happen, and for the next hundred years or so, psychiatry would not seriously consider and address the mental health challenges accompanying massive infectious disease outbreaks and pandemics.”
Yet, he seems to have envisioned something unwittingly. In the preface he states: “Few human experiences are so profound and so terrifying, as is the fear of being stricken by a grave contagion, a process that can not only kill us, but worse – it can mutilate our body and transmogrify our soul into something no longer recognizable, no longer human. This notion is only made worse by the realization that such affliction is passed onto us by our fellow humans, even our loved ones, or that we have passed it onto them. Such realization poisons and unravels the social fabric of humanity.”
In recent memory, the world has not witnessed such catastrophe-triggered stress on preexisting psychic frictions. Disaster psychiatry seeks to “outline mental health responses that are, by default, undertaken as e mergency mental health responses to a disaster” (Introduction, p5). This clinical discipline is “applicable to organizing and providing emergency mental health response to epidemic outbreaks, there is little focus within disaster psychiatry on infectious diseases alone” The initial responses to lockdown, isolation and quarantine makes books like the one we are discussing relevant.
In an essay in Le Monde diplomatique on 11 March 2020, the day the World Health Organisation declared a pandemic, Frédéric Lordon coined the word “coronakrach” for the massive anxiety or hysteria that shrouds the condition. Huremović, foreseeing nothing like this, wrote, “an actual outbreak and once the outbreak turns out to be contained and subsiding, we turn our heads away and forget about the horrors of anticipating the wave of the pandemic, having conquered our fears”
The 13-chapter book is a good read on how “Pandemics disrupt our sense of reality and order, leading to a changed way of storing and metabolizing memories and experiences”. It also looks at the deepening existential meaning of the outbreak whose manifestation is now a reality. Contributors to the book include Christy Duan, Howard Linder, Guitelle St Victor, Saeed Ahmed, Jacqueline Levin, and Saira Hussain. These scholars have taken up subjects like a brief history of pandemics, the societal, public and epidemiological aspects, the importance of culture in managing mental health response, the neuropsychiatric complications of infectious out breaks, social distancing, quarantine and isolation, and effects on healthcare workers. In another paper on the neuropsychiatric complications of infectious outbreaks, Huremović points out social media’s lack of responsibility. Instagram posts misled readers on the Zika outbreak: “60% of the posts included misleading, incomplete, or unclear information about the virus… over 50% of the images used expressed fear and negative sentiment.”
“There is a single word that can serve as a fitting point of departure for our brief journey through the history of pandemics – that word is the plague,” he rightly says. Human history made pandemic or epidemic a synonym of the plague.
This collection reminded me of an exceptional work: Contagion: How Commerce Has Spread Disease (Yale University Press, 2012) by Mark Harrison, professor of medical history at Oxford University. He mapped seven centuries and six continents to show how business and governments handled (read mishandled) every significant outbreak of cross-border disease from the Black Death of the 1300s to more recent scares including SARS, mad cow disease and the Mexican swine flu scare of 2009. Severe Acute Respiratory Syndrome, the first pandemic of the 21st century, Harrison wrote, was no “domestic issue but a global concern. On 15 March the WHO confirmed that SARS was no ‘worldwide health threat’. With cases, spotted in Canada, Thailand and Vietnam, ‘by 19 March suspect cases had appeared in the USA, Spain, Germany, Slovenia and the United Kingdom. The speed with which the disease travelled was an unsettling reminder of how small the world had become. Inevitably, SARS soon came to be associated with the phenomenon of globalization”. SARS got woven into “networks of commerce and tourism – and in more subtle ways, as the lightning-fast transmission of information enabled by electronic media created a virtual pandemic.” Harrison presented a historical overview of the interplay between disease and commerce, politics and international diplomacy, looked at how contagion, trade and statecraft are intertwined, and unraveled ‘unstable compromises’. All these are encapsulated in the chapter, War by Other Means.
Plague, for instance, following the world’s main arteries of trade was spread by merchant traders in Europe during the 17th century. Huge yellow-fever outbreaks in the Americas in the 19th century were triggered by the slave trade. Outbreaks of respiratory diseases, including avian influenza, escalated rapidly into pandemics as a result of air travel as in Covid 19 – all are a deadly legacy of commerce imposed on humanity.
The 43 pages of plates on the history of contagion that touch on how slave markets were among the principal hubs of infectious disease in the Americas, on how yellow fever crossed the Atlantic from Africa in the 1640s, and on black death can be precious materials for power point presentations on the anastomosis between pandemics and epidemics on the one side and colonialism and imperialism on the other.
As Covid 19 threatens to turn the global order upside down, these two books help dispassionate readers understand corruption, decay, pollution, anomie, and weakness anew and see how these are interlinked to viruses threatening increasingly helpless mankind.
Sankar Ray is a writer and commentator on Left politics and history, and environmental issues. He lives in Kolkata.