Is Coronavirus unprecedented?

A brief history of the medicalisation of life

David Martin Jones and Emma Webb, July 2020

The coronavirus that had been declared a pandemic by the World Health Organisation (WHO) in March 2020 has frequently been viewed in society as unique, exceptional and unprecedented. In this report, David Martin Jones and Emma Webb suggest there is nothing particularly novel about disease in the human experience – and cautions that we are desperately in need of some historical perspective.

This historical recounting of past pandemics and their interpretation both at the time and by historians – from the Athenian epidemic of 430 BC to the Black Death and the Spanish influenza outbreak of 1918 – tries to set Covid-19 in context. It also reveals the extent to which the recent exaggerated pursuit of national health has resulted in a dangerous condition of ‘cultural iatrogenesis’. The authors discuss iatrogenesis as occurring when societies capitulate to professionally organised medicine that has come to function as a domineering moral enterprise and which advertise their bureaucratic expansion as a war against all suffering.

Although most would agree that such suffering should be avoided, societies are in danger of coming under the control of total healthcare regimes and suffer in ways they no longer have the authority or will to manage. Jones and Webb argue that this is the predicament that post-Covid-19 democracies will have to confront.

Despite individuals now being healthier and living longer, there is an exaggerated sense of our general well-being being under constant threat from the air we breathe to the food in our shops. The age of infectious disease has given way to the era of chronic disorder. Longer life means prolonged time in care homes and medicine becomes more open to criticism. National health, in one sense, is in danger of becoming a hollow achievement.

Having viewed the outbreak as unprecedented and unique, many leading authorities embraced the epidemiological prediction of death rates of 1 per cent of the West’s population unless they locked down the economy, quarantined households and suspended all non-essential activity. The authors argue this overreaction, rather than the virus itself, captures, the way in which modern life has become ‘medicalised’. It is that development over the course of the twentieth century – which came to treat the population as subject to an increasingly all-knowing public health regime – that is one of the defining features of our contemporary condition.