For a historian with an interest in the intersection of factors that propel an epidemic, 2020 offered a living case study. Edna Bonhomme, a historian of science with a PhD from Princeton, was living at the time in shared housing in Berlin, one of 11.7 million foreigners in Germany. As a person of Haitian descent, she is acutely aware of the complexities of Black life in a country where racism has its own face, similar but also different from anti-Black racism in the U.S. 

She began speaking to Black women with different experiences from hers: a kink-positive sex worker from the U.K., an asylum seeker, a cancer survivor, exploring the strange ways that the COVID-19 pandemic and resulting lockdowns interacted with a wide variety of privileges and privations, histories of oppression and struggle against it. 

From Berlin, she watched the Black Lives Matter demonstrations after the murder of George Floyd, and she read Virginia Woolf, and histories of plagues: on plantations in the U.S. south; in Liberia, where a crisis of resources for public health exacerbated a 2014 outbreak of what turned out to be Ebola; in German-colonized East Africa. "From Berlin," she wrote, "I was afforded the space to write, breathe, and be debt free." And to write "A History of the World in Six Plagues," a new book which traces human history through our relationship with illness.

Delving into childhood memories and the history of her family, migrants to Miami from Haiti, literature of all kinds, and historical accounts of plague, Bonhomme's account is indeed structured around six historical and modern plagues, but in each section she follows where the subject takes her. This approach results in nuanced, grounded examinations of the actual, material conditions in which the epidemics of sleeping sickness, cholera, influenza, HIV, Ebola and COVID-19 she describes took (or continue to take) place. Not leaning on any one interpretive framework that might exclude relevant factors, Bonhomme considers the highly intersecting and variable impact of colonialism, racialization, gender roles and attitudes towards the human body, and, most strikingly perhaps, class, specifically in its intersection with race.

Bonhomme weaves in engaging and poignant personal experiences as well. Her traumatic experience of quarantine in an extended hospital stay in Miami as a four-year-old with typhoid fever becomes a motif as she addresses the infection-limiting benefits of isolation and confinement — and the loneliness, dislocation and even chaos to which confinement can lead. Connecting forced and chosen quarantines with experiences of incarceration, she explores also the solidarity that can arise in situations of the greatest difficulty and oppression. Also woven through the text is that surreal experience of living through the early pandemic years in Berlin, of leaving shared housing to live more traditionally with her partner (a kind of chosen quarantine at the time), of being Black in Berlin (a different kind of isolation), of choosing to get married — an impulsive and rebellious choice, at a time when isolation was the rule — and of experiencing a miscarriage minutes before they were expected at Copenhagen City Hall, where they'd absconded to wed.  

This interview has been edited for clarity and length.

How did you settle on the six examples of illnesses you chose? 

I decided to focus on epidemics that were also tied to important historical events and institutions. And so I started off with the plantation as a site that, on the one hand, I would describe as a torture camp, a site in which people were forced to work, and it was quite difficult, and it was also profitable for some people, but it was also a site that made people sick [with cholera.] Various scholars have looked at that and unpacked [questions like] what was happening to Black lives on plantations, and how do we make sense of people's ability to survive? 

Part of the reason that I wanted to think about sleeping sickness is because it was considered a massive epidemic, and specifically because it interfered with, or at least Europeans thought that the disease interfered with, labor. The other diseases — the flu, HIV, Ebola and COVID — are ones that we live with today. With each of the epidemics that I chose, it wasn't just a case of thinking about what was the most popular, or perhaps even what had the most impact, but rather, how did people who were tied to these various institutions, in which confinement was very much part of perpetuating some form of oppression at different times… how do people figure out ways to survive in spite of those various forms of oppression and those various institutions?

You talk about the labor impact of sleeping sickness. That immediately made me think of the intersecting issues with COVID of frontline workers who would typically be racialized, and often women who have had to assume higher levels of risk, and often without a lot of clarity or ability to confront the fact that they're at higher risk for a whole other range of structural reasons. So I wonder if you could could address those parallels.

Yeah, so I think they are two very different diseases. COVID is a highly infectious airborne disease that was quite novel to us in terms of when it emerged in 2019 and it's something that we're still living with and still learning from. With long COVID, there are the studies suggesting that [sufferers are] more likely to have cognitive difficulties and so forth. So COVID is still fresh. It's still new. It was quite global in terms of its impact. 

By contrast, something like sleeping sickness is spread through a fly, the tsetse fly. And it was quite regional in the sense that it has mostly been something that has impacted people in sub-Saharan Africa. I wanted to differentiate the two in terms of not just the biology and the modes of transmission, as well as the regions they come from, but also to point out that the vulnerability and the risk are fundamentally different. 

Ultimately, for people who are marginalized in some capacity, those who are frontline workers, essential workers, those who don't have the ability to have paid rest and time off, or to be able to self-isolate for whatever reason, and have the freedom both to move and to be still, a disease can be more formidable than for those who do have the privilege to have a safer space to rest.

So I was also thinking about policy. The decision to confine people in the case of sleeping sickness, and with COVID-19, the decision to move people back to work in high-risk situations, knowing that it's only certain people who actually had to do that. In other policy-making relating to pandemics, is that a common theme? One of the things I really appreciated in this book is the combination of class, which is something that is so rarely frankly discussed in North American discourse, with racialization and gender issues. So I'm just curious about how often that question of whether people of people as productive labor plays a role through the other examples that you saw.

Absolutely. In fact, the slavery question is a question of labor, and it's a question of racialization of a particular form, a set of laborers who didn't have much of a choice or agency outside of escaping or attempting to escape, or in some cases, inflicting physical harm to the body and the self, or suicide. Being sick and not having the care that was needed to recover, is essential to the question around how we think about epidemics. 

Beyond that, particularly with the slavery chapter on cholera, there's also this: for some plantation owners and enslavers, it was kind of acceptable for there to be a poor quality of life, so long as there wasn't a major threat to the enslaved subjects, because all they needed is to make the market profit margins. And so the question around workers having to move through their labor even when they're sick, whether it's something as mild as the common cold, the flu, or as major as COVID, is a major issue.

Beyond infectious diseases, one of the major issues in the U.S. context … What does it mean that, especially in the U.S., where there's not a universal health care system, if the person, even if they have health care through their job — what does it mean for them to have to continue working while receiving chemotherapy, and how does that impact their ability to survive post-treatment, post-chemotherapy? 

Unfortunately, I know how that impacts someone quite well. Someone in my family was diagnosed with cancer in the early stages of the pandemic, had to continue working in order to maintain their insurance and at one point passed out and had a brain aneurysm while working, and that really made it difficult. And then a couple of years later, they died. So that's America, ultimately. And that is something that we have to think about, like how forced labor, or even just like forced labor through what Marx would call wage slavery, continues and does a number on and damages the body's ability to heal. 

Speaking of public health, we're right now witnessing this massive attack on it in the U.S. You've discussed private communities of care, there's the Black Panthers, there are COVID-cautious groups, there was mutual aid through the HIV/AIDS crisis, and it sort of relates to the other question: to what extent can these be an adequate alternative to public health?

These mutual aid networks, in which people are providing direct action, direct services, direct resources, even just circulating funds and redistributing it within a social network, can be quite vital for a community, and such an important indication of how people are ultimately good and want to help each other. Like, I don't want to discount the power and beauty of communities coming together, especially during crisis. We've seen this with the Los Angeles fires and how people have been helping with that. Nevertheless, obviously, I would say there's a limitation to what people, especially with their heavy hearts, can provide, and that there's a limit to also the money and the resources that can be distributed. 

To an extent it can be a lot more effective for governments to do that work of distributing resources and so forth because of the infrastructure that governments have. Nevertheless, we're currently witnessing the temerity of the U.S. Department of Health and Human Services, which is not an opinion that is unique to me, but it's something that we're seeing in real time, with one of the most prime examples of that recklessness — the measles outbreak — which, as we know, is a very contagious disease, extremely preventable, there's a vaccine that's highly effective, and yet what we're seeing is that vaccine skepticism is becoming normalized, and the number of cases has exacerbated. 

And while the current secretary for the Department of Health and Human Services has promised to support vaccines, one of the top vaccine regulators, I think it was, Dr Peter Marks, has said that he's not doing enough, and that is indicative of, I would say a callousness [toward] human life. Because ultimately, when one then says that the government is not responsible and people have to be on their own, whether or not they have the capacity to do so or not, it means that ultimately those who are the most "fit" will be able to survive, those with the most money, the resources and so forth, as opposed to ensuring that everyone has an equal opportunity to survive, to be cared for. Again, I'm always moved and impressed and content by the love and the care that people can provide within a community structure. And people should continue to do that — but it's not enough, and hopefully people can come together collectively to demand that the government should also be providing that care work.

You've also talked a lot about carceral societies and a wide variety of carceral situations. Right now we're seeing the open rise of some of things that have existed and affected some communities for years, but now are becoming blatant and very open. That is to say that a profoundly carceral and punitive society, with punishment based on class and racial lines, has always been a thing, but now we're seeing the open rise of deportation, isolation, surveillance and very strict punishment. You write in the book, "a world without prisons has become a far off possibility." You wrote that before the second Trump administration, I think. So what does this mean for plagues you've already described, like measles, and the effect there?

If I were writing another book and I wanted to expand what plague and epidemics mean, then I would actually think about non-infectious diseases as well. And I alluded to this in one of my previous answers by pointing to cancer. But of course, there are other epidemics that we are living with, particularly the opioid epidemic, which is very much an epidemic that is perpetuated by poverty, that is tied to desperation, that is tied to the ways in which communities have been devastated in a post-industrial context of jobs being gone and so forth, and that that epidemic is something that people are living with, and I would say, is something that various communities, particularly in the Appalachians and Midwest, are still struggling with.

In the book, when I talk about the prison question, it's how chronic diseases, early aging, specifically, tuberculosis, airborne diseases, are very much more likely to be present in a prison system than for a non-incarcerated population. Beyond that, if we think about this current moment in the United States, where there's an open war on migrants. Migrants who, in some cases are speaking about Palestine, students, what I would consider to be babies. These are young, idealistic, in some cases teenagers, and if anything, we should be commending them for being brave, and yet they're being hunted down by the U.S. government, or, most recently, people being taken by the U.S. government, accused of being part of gangs without any type of due process, suddenly deported to El Salvador. 

What implications does that have, not just for people's mental and physical state, but just for others who might also be fearing, "will I be next?" I think that ultimately, the question around deportations, with the question around anti-immigrant policies, is really a chaotic process that is also tearing apart, in some cases, the members of families that have multinational citizenship and/or resident statuses. And so in a sense, it's not purely about infectious diseases and epidemics per se, but rather the kind of the fear that it stokes within communities.

I think one thing that people have been writing about, and I'm also doing some research on right now, is how U.S. foreign policy is going to, especially with the cuts to USAID, impact the spread of epidemics currently in Latin America, Africa and elsewhere. What various countries of the African continent are doing, luckily, is they had realized back in 2014 with the Ebola crisis that they could not rely on the U.S., and so the formation of the African CDC since then has meant that there's far more coordination between African nations. I actually attended an online press conference that they had last week, because they do regular press conferences just to answer questions posed to the African CDC in a way that I'm like, "Oh, wow. This is great. Like, this is what should be done." 

But the reason I point this out is just to say that in the short term, and actually even medium term, it costs lives for us not to continue to fund the USAID, especially with specific programs around antiretroviral therapy. And at the same time, people are making do, particularly on the African continent, because they had already had a little taste of bigotry and exclusions more than a decade before. 

You describe how social networks play a role in survival under duress. You mentioned Palestine, which reminds me of resistance that has often emerged, specifically within the prison system in Israel. You said TB, and I think of Nelson Mandela. In some of the other examples you talk about, groups for both mutual aid and more long term resistance to oppressive systems have come from prison systems. I wonder if you could describe where it's relevant to dealing with the plague, perhaps the HIV example, how those sites of either very strict quarantine and isolation or actual formal prison systems, how those can also spawn resistance?

So one thing I would say is that I was lucky enough to organize and learn so much from formerly incarcerated people when I used to live in New York City and being involved in reading groups for people where we discussed the New Jim Crow. And beyond that, the kind of prison literature that helped inform me, everything from Antonio Gramsci's prison letters and notes to George Jackson's letters as well, helped to show me and even beyond that, just like Malcolm X, his autobiography as someone who was incarcerated. I had a political education that allowed me to see the power, strength and intellectual prowess of people who have been incarcerated, even though I would say mainstream U.S. society would suggest that those who have been incarcerated should be disposed of. 

In thinking about the prison and that education that I had, I also wanted to see how it was connected to the HIV/AIDS epidemic and how people in prison were coping with that. When I studied public health, there was this particular way of thinking about the prison as a "vector of disease." And I put this in quotes because so often people could be perceived as just potentially highly infectious without thinking about the human stories, about who they were, their names and so forth. I think that I wanted to have a perspective and a case study in my book about survival and about women coming together in one of the most oppressed spaces to do the work of not just theorizing what the prison can do to the body and the harm it causes, but also how mutual aid is happening and how people can exercise agency even under duress. 

The case of Bedford Hills Women's Correctional Facility in upstate New York, and how they formed the AIDS Counseling and Education Program during the height of the HIV/AIDS epidemic is also, in my opinion, a continuation of freedom fighters who are incarcerated and try to make do in these spaces, people who become part of a community, in some cases, and try to ensure the survival of the collective. I would say we can often move inside and outside of various forms of marginalization, but we can also exercise our own privilege, particularly when we form collectives.

What would an anti-oppressive but also effective response to infectious plague look like?

What I thought about this question is, how do we build systems of public health and public health policy more specifically, that don't feel oppressive, that aren't just a top-down approach where people feel like they can't trust authorities? And part of what people are thinking about is participatory observation, where public health officials actually work alongside communities. They have town halls, there's active surveys and so forth, asking people what they know or don't know and that they are also part of making decisions, in a sense, and a non-oppressive public health policy would be one in which it could be a democratic perspective. 

Unfortunately, there's a lot of mistrust in the United States, and in other countries as well, when it comes to public health officials, because the government doesn't provide — it feels like the government doesn't provide — much to society. And so in order to have an anti-oppressive system, one actually has to start building trust within communities and to really make things far more democratic, so that at least people's basic needs are taken care of, but that people's questions could also be answered, and that there could be active debates, not online, but actually in person. Even beyond that, I think that basic education in biology would also be helpful.

There's a clear love of literature, of diverse sources of knowledge and thinking, that runs through the book that's really lovely. I've always had a fascination with both prison literature and plague literature, which are very intersecting, overlapping things. I wonder if you could talk about those, about literature, and how those two types of literature played out in your writing of the story.

During the early portion of the COVID-19 lockdowns, I fell in love with literature again, and I wanted an opportunity to think about how being home, turning inwards, and just taking the time to reflect on what was happening outside also meant that I was okay and reveled in being able to enter into a space of fiction, into a literary world where I could suspend everything that was happening outside these walls. Literature, especially when the prose was enlightening and also jumped from the page, I felt would inspire me. But beyond that, I also wanted to get a sense of how writers, especially those that lived through wars, crises, outbreaks, how they made sense of it, and to an extent, some of the writers that I mentioned in the book, whether it's Virginia Woolf, Susan Sontag, even W.E.B Dubois, they exercise some type of privilege by virtue of having the time, the space to sit in silence and to write and to think and to be respected, once they were celebrated. 

And so I wanted to be able to be in conversation with these people, most of whom are dead, and have a way of, of not just referencing them, but showing that their words, the philosophical purchase, matters. And hopefully, for those who read the book, they can also be inspired to pick up some of that literature and find themselves thinking, Oh, wait, this perspective on the sick bed might help me during a time when I find myself dealing with surgery and so forth. So yeah, it's the literature that is what carried me through, but it's also something that's carrying me through life right now, especially as a parent now. My book is not a COVID book per se, but it's really a book about survival and how people make sense of outbreaks no matter where they are.