Starred review from March 14, 2022
“Effective disease control is a matter not just of containing (or better yet, killing) pathogens but also of implementing effective laws and governance,” according to this incisive history of public health crises in the U.S. from the 1770s to today. Price (Judge Richard S. Arnold), a professor of law and global health at Emory University, contends that conflicts between federal, state, and local governments and America’s “deep culture of individual rights and constitutional values” have often hindered efforts to stamp out epidemics. She examines how vaccine distribution programs failed to reach high-risk populations during the 1968 “Hong Kong flu” outbreak and describes resistance to face mask laws during the 1918 Spanish flu pandemic. Analyses of smallpox, yellow fever, AIDS/HIV, and other disease outbreaks also reveal a history of racial discrimination in care and inoculation, as well as a tendency of voters and elected leaders to relax once a crisis has passed and fail to pass laws that could help prevent the next one. Turning to the Covid-19 pandemic, Price examines the public health impact of social media misinformation and tensions between Democratic governors and the Trump administration. Gripping prose and lucid analysis make this an essential study of what needs to change before the next epidemic.
April 1, 2022
Despite what the nightly news may say, there is really nothing completely new about our current pandemic. Sure, this is a new virus, but as a nation we have endured yellow fever, cholera, smallpox, typhoid, tuberculosis, polio, and AIDS, to name the most prominent. Issues with the politicization of disease and contagion have been seen before. While we no longer have the "pesthouses" of early America, nor do we have citizen-driven "shotgun quarantines" of the yellow fever days, it is still the poor, disadvantaged, and disenfranchised whose suffering is out of proportion. Economic objections to safety measures were made even before the 1918 influenza epidemic. Author Price, an academic and scholar of legal history and global health, clearly and ably lays out a timetable of disease and the legal and social response to it, from local ordinances to rulings of the Supreme Court. This is short, readable, and well documented, making it appropriate for most collections and suitable for both general readers and students with assignments.
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Starred review from March 1, 2022
A pointed study of how divisiveness and conflict undermine the nation's response to disease. Law professor and legal historian Price offers an authoritative history of America's flawed responses to epidemics. "Not only does the United States have the most fragmented public health system in the world," she writes, "but most states retain antiquated public health laws that do not serve us well." Due to poorly constructed laws and underfunded health agencies, the U.S. responds to pandemics "not as one nation, but as fifty-five smaller nations--the states, territories, and commonwealths that politically subdivide the country." Responsibility for tuberculosis control, for example, "is divided among 2,684 state, local, and tribal health departments." Price recounts waves of epidemics in the nation's early years, when there was no treatment except to isolate the ill. With the discovery of a vaccine for smallpox, local, state, and federal authorities mandated vaccination, although not without controversy. Often, citizens looked for groups to blame, including immigrants, Asians, Mexicans, or even people from other states. In response to yellow fever, "shotgun quarantines" were enforced by militias or deputized volunteers. In 1900, an outbreak of bubonic plague in San Francisco led to the quarantine of the city's entire Chinatown--a strategy struck down by a federal judge. The rollout of vaccines for Covid-19 echoes what occurred with the vaccine for polio in the 1950s. "Not only was there no patent on the vaccine but there was no plan in place to oversee or coordinate its distribution," writes Price. "America's first nationwide vaccination effort was chaotic and politically divisive, as demand for the vaccine outpaced supply." The author effectively shows how every epidemic has generated tensions about which level of government has the authority to make public health decisions. She recommends a stronger federal role in responding to pandemics, including coordination of the nation's primary health agencies and nationally funded coverage of the costs of testing and treatment. A vigorous argument for unified public health measures.
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