Pandemics End When We Stop Caring About Their Victims

Jim Downs: The epidemics America got wrong

The smallpox outbreak in the 1860s had an unequal impact. White people had the support of religious communities, municipal relief organizations, charities, friends, and families to protect them from the virus, so their rate of infection was lower. The federal government, focused on the smallpox epidemic’s denouement, neglected to address a series of outbreaks mostly among poor Black people that lasted for decades.

From the point when smallpox first appeared among formerly enslaved people in an abandoned lot in Washington, D.C., in 1862, not far from where President Abraham Lincoln drafted the Emancipation Proclamation, the course of the outbreak depended on how those in power decided to narrate it. The refusal of the federal government to acknowledge the smallpox epidemic rendered it virtually nonexistent. The Medical Society of the District of Columbia condemned the government’s neglect. “It is generally admitted that small-pox is one of the diseases due to domiciliary circumstances, and is at all times a preventable disease,” the physicians argued. “It has been stated over and over again by eminent authorities, that there need not be a single case of small-pox in any city; if the authorities will but take the proper steps to check it.”

As more formerly enslaved people liberated themselves from farms, homes, and plantations in Maryland and Virginia and sought refuge in the nation’s capital, the infection rate increased.

Smallpox victims burned up with fever, collapsed with fatigue, and became covered with red spots that morphed into pus-filled blisters.  Witnessing the arrival of formerly enslaved people to Washington amid these circumstances, Elizabeth Keckley, who served as a seamstress for the first lady, Mary Lincoln, noted, “Poor dusky children of slavery, men and women of my own race—the transition from slavery to freedom was too sudden for you! The bright dreams were too rudely dispelled; you were not prepared for the new life that opened before you.”

While Keckley observed the impact of the outbreak, Lincoln ignored it. He made no provisions in the Emancipation Proclamation for how formerly enslaved people were to find food, shelter, clothing, or, most urgently, protection from smallpox. He framed the proclamation as an outgrowth of military necessity, to deplete the southern economy and labor force. With no quarantine restrictions, the virus seeped out of Washington and infected the rest of the South. In South Carolina, close to 800 freedpeople succumbed to the virus in one week during the summer of 1865.  

Read: The last smallpox patient on earth

When the war ended in April 1865, newspaper headlines roared with the announcement of Union victory. These boasts of triumph dwarfed any references to smallpox. But for many in the postwar South, smallpox was hard to ignore. James E. Yeatman, the president of the Sanitary Commission, a civilian corps that responded to the poor health conditions in Army camps, called for the federal government to acknowledge the epidemic: “Small-pox has had its appearance at several posts and in one of our hospitals; every precaution has been taken to prevent it from spreading, but, in order to arrest and mitigate the horrors of this dreaded disease it is necessary that some obligatory order be issued to colonels of regiments, holding them responsible for the prompt execution of the same.”