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A lesson from history: How the yellow fever epidemic changed society

Kathryn Olivarius, assistant professor of history at Stanford University, has studied the social impacts of yellow fever in Antebellum New Orleans.

Photo by Magali Gauthier.

Asked how she was fairing during the shelter in place, Stanford University historian Kathryn Olivarius reflected on being a researcher studying early American epidemics during the COVID-19 crisis.

"I write about yellow fever by day and worry about COVID-19 at night," she said.

Olivarius, an assistant professor of history, was working on her doctoral dissertation on slavery around the time of the Louisiana Purchase in 1803 when she discovered voluminous documents on recurrent epidemics of yellow fever in New Orleans. The letters, advertisements and news articles changed her work in profound ways.

Yellow fever killed more than 150,000 people in New Orleans between the Louisiana Purchase in 1803 and the Civil War, according to Olivarius. 

"Once you see it, every single source is covered with references to yellow fever. I could not discard it as background noise. This is really important stuff in the background of this place," she said. "It put me down the path of thinking about yellow fever — and not just death — but about life and how it fundamentally shaped institutions."

She was writing a book, "Necropolis: Disease, Power and Capitalism in the Cotton Kingdom," due out next year, when the coronavirus epidemic broke out. Now she's seeing parallels between what happened in the South and her own experiences with the coronavirus pandemic.

The earlier viral disease shaped society and the economy, just as COVID-19 is shaping our own, she said. The experience of yellow fever, much like COVID-19, permeated everything.

New Orleans in the early 19th century was a hub of the cotton, sugar and slave trades, yet it was constantly besieged by yellow fever. Outbreaks roiled the city about every three years, shaping social status, slavery, government and jobs, she said. 

If the coronavirus continues to infect populations for months or years, present-day society and government will be faced with dilemmas similar to those that confronted New Orleans.

"It's possible we can't find a vaccine. How are we going to live with this disease?" she said.

What the world is experiencing now as a crisis is something people lived with perpetually in the 19th century, she said. 

Without antibiotics, antiviral drugs or even knowledge of the underlying cause of yellow fever, staying healthy was a major concern.

"You had to reconcile yourself to this precarity in the past," she said.

Yellow fever was fearsome, killing 50% of its victims. The disease started with a fever, aches and pains, a severe headache, weakness, fatigue, nausea and vomiting. Recovery took weeks or months.

After a week and a short remission of a few hours or a day, one in seven people developed severe liver disease with bleeding and jaundice. Shock, organ failure and death could ensue.

Although rare in the U.S. today due to vaccinations and mosquito control, there's still no cure and no treatment for yellow fever. Between 30% and 60% of people with severe symptoms still die, according to the U.S. Centers for Disease Control and Prevention.