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Aletta Jacobs School of Public Health

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Living with COVID: Lessons from applied history

Datum:10 juni 2021
Rina Knoeff
Rina Knoeff

‘Funfair, or no funfair?’ that was the question in cholera year 1849. The illustration shows the joys of the yearly event on the left, and the devastating consequences of celebrating during a cholera epidemic on the right. The central warning was, of course, that the fair with its exuberant dancing (‘Hosse! Hosse! Hosse!’), would eventually lead to a dance macabre and an early grave. 

Illustration: Anonymous, 'Kermis of geen Kermis?' (1849), Rijksmuseum Amsterdam
Illustration: Anonymous, 'Kermis of geen Kermis?' (1849), Rijksmuseum Amsterdam

After nearly one and a half years of COVID-19, the image is uncannily familiar. As is the reference to dancing as the ultimate representation of the dangers and challenges of epidemics. In April 2020 journalist Tomas Pueyo argued that after applying the hammer (i.e. harsh lockdown measures), we must learn how to dance with the virus – an image that was eagerly adopted by the Dutch government in explaining the strengthening and loosening of lockdown measures. Unwittingly, Pueyo’s metaphor is rooted in a long history of dances of death. 

These dances of death first appeared during the medieval plague. Initially they were painted on the walls of graveyards, churches and street corners and later appeared in newspapers and magazines. They represented the idea that although societies are plagued by inequalities, still everyone, rich or poor, man or woman, wise or ignorant, is equal in death. To quote the English poet John Donne: ‘Death comes equally to us all, and makes us equal when it comes’. As such the medieval dance of death was as much a social critique as a direct representation of the dangers of epidemics. Ultimately these dances signaled that during the extreme hardships of epidemic disease people have to pull together to survive. This is a simple, yet complicated historical lesson. We are so used to a modern micro-biological management of the disease with accompanying top-down governmental measures, that we have forgotten how to mobilize the bottom-up strength of local communities. 

Yet, ever since the Middle Ages, closely-knit communities have the best strategies – rooted in a strong sense of mutual responsibility and solidarity – for coping with epidemics. For example, in 1831 the city of Berlin was confronted with riots, killings and arrests following harsh regulations to control an outbreak of cholera. Relentless policing did nothing but increase the violence. It was only after the establishment of locally organized soup kitchens for the unemployed and better care for orphans and widows that social unrest calmed down (Cohn, 2017, 179). Unlike many other European countries, the Dutch never struggled with large-scale cholera riots. This was undoubtedly due to the efforts of locally organized cholera committees and the local improvements suggested by the hygiënisten, an influential group of community doctors, who introduced better living conditions for the poor. 

To return to the metaphor of the dance of death: Adopting a ‘historical choreography’, a series of dancing steps that put social and cultural coping mechanisms center stage, will strengthen a society’s mechanisms of coping with crisis. For more details on this, see ‘Dancing with death. A historical perspective on coping with Covid-19’, recently published together with Catrien Santing (UG), Beatrice de Graaf (UU) en Lotte Jensen (RU). The article describes how such historically embedded coping mechanisms were directed towards living with the virus. Ultimately, we argue, an approach of ‘applied history’, helps in addressing today’s pressing question of which strategies can be adopted to return to a normal life, including living with socially acceptable medical, hygienic and other pandemic-related measures. 

Rina Knoeff is medical historian and professor of health an Humanities at the RUG Faculty of Arts