What New York City’s Cholera Epidemics Can Teach Us in the Age of COVID-19

Part of the Series

Despair and Disparity: The Uneven Burdens of COVID-19

This isn’t the first time that New York City became the epicenter of a deadly disease. Consequently, this also isn’t the first time a widespread disease has been racialized and linked to the “other.” When cholera arrived on the shores of New York City in 1832, the disease had already ravaged parts of Asia and Europe. New York City officials and scientists did not understand the cause of the disease. Some saw cholera as divine retribution, only inflicted on the sinners of the city. In the 1830s, approximately 250,000 people lived in New York City. Many of them were craftsmen, canal-diggers, traders, merchants and bankers. This diverse labor force carved out socioeconomic rifts which slowed down the city’s response to impending epidemics.

When cholera hit, it caused widespread panic. Roughly 3,000 New Yorkers died, and an estimated one-third of the city’s inhabitants fled. Seventeen years later, in 1849, the second wave of cholera struck. As immigration expanded, the city’s population had grown significantly between the first and second outbreak. Yet public health policy had failed to adapt to the city’s population growth. As many as 5,000 died before the 1849 spate ran its course — and as many as 40 percent were Irish immigrants.

As the second outbreak ravaged New York City, John Snow, a prominent London anesthetist, contested the force of tradition when he published a pamphlet titled “On the Mode of Communication of Cholera.” Snow’s study argued that cholera was not miasmic (not an airborne disease) but instead spread through contaminated water. Snow’s theory was controversial and faced severe skepticism from British and American medical communities, particularly those who subscribed to the commonly held miasma theory of contagion. By 1865, however, sanitary reform advocates justified improving the city’s sanitary and public health conditions by pointing to Snow’s theory.

In 1866, cholera hit New York City for the third time. With a population of over 1.1 million that year, one-fourth of whom were immigrants, New York City’s population was starkly divided between the city’s traditional elite class (Park Avenue bankers and traders) and predominantly Irish immigrants and African Americans living in the most neglected quarters that became the main sites for contagion. Equipped with Snow’s theory on how cholera spread, the city was better prepared to meet the threat posed by the disease. Still, as many as 1,000 died due to cholera. The majority were Irish immigrants living in poverty.

Not all physicians agreed on cholera’s etiology or on a generally effective way to treat cholera. Most, however, subscribed to the notion that people inhabiting ill-ventilated tenement apartments in working-class neighborhoods like the Five Points were particularly at risk of contamination. In his seminal work, The Cholera Years, historian of medicine Charles E. Rosenburg writes, “The poor who lived in such squalor were to be removed to clean, dry, and airy houses as soon as possible.” This often proved impossible because of the city’s dense population and lack of resources. Stigmas about poor immigrants carrying the disease were common in the press. The New York Herald claims that the outbreak is owed to “the great mass of steerage passengers, or emigrants, composed of the poorest and worst European peasantry, and hapless worn down artisans of manufacturing districts, who, by some inexplicable problem, manage, from their daily earnings to save a portion to pay for their passage.”

Some news sources racialized the disease as an “Asiatic” infection. On September 1, 1865, the National Republican (a Washington, D.C., newspaper) prints, “The latest intelligence from Europe confirms the apprehension that the Asiatic cholera, in its most malignant form, is on its march, and advancing steadily westward … It … came tither, as at former periods, from India, for so many centuries its home and first starting-place.” The name “Asiatic cholera” derives from the disease’s assumed origin. In 1817, cholera spread rapidly from the Indian subcontinent to Russia via trade routes over land and sea. Soon after, the disease reached the rest of Europe, North America and the rest of the world. Early outbreaks in India are believed to have been the result of poor living conditions, which were considered ideal conditions for cholera.

News of cholera spreading throughout Europe and Asia generated panic among Americans on the basis of race and class. The notion that cholera was a foreign disease brought to New York City by poor immigrants stuck throughout the 19th century. Some newspapers labeled potentially sick passengers “cholera immigrants,” often conflating the problem of infection with poverty and citizenship status. One newspaper writes, “This class of immigrant is unwelcomed at any time. They are not wanted here. No one but the capitalist who want to cut down wages … has asked them to come.” Other newspapers called for the protection of “the humanity of the immigrant.” In the summer of 1866, The New York Herald writes, “To save the lives of those afflicted and to prevent the disease from spreading among others and through the country, it is necessary to have a quarantine station at which the immigrants can be landed and where they can be properly treated.” The Metropolitan Board of Health considered various locations across New York City as quarantine stations. But, out of fear and prejudice, property owners and residents in these areas rejected these plans.

Escaping famine and poverty in Europe and Asia, immigrants arrived in New York City in large numbers in the mid-19th century. They faced harsh working conditions in the railroad companies, poor living environments in the Five Points neighborhood, and prejudice from members of the working class who complained that immigrants “keep the wages of labor down to the lower notch.” Many newly arrived immigrants fell victim to padronism, a contract labor system that provided immigrants with jobs but was often exploitative.

News about cholera breaking out among Asians on board ships from China and India en route to Europe and North America fueled stereotypes about infection, exacerbating anti-immigrant sentiment. David H. Bennett, professor of history at Syracuse University, claims that immigrants “drew hostility because of their poverty; the diseases they brought with them after the perilous ocean voyage; [and] the slum housing they were forced to live in.” These hostilities were aggravated by nativist American-born Protestants who equated anti-immigrant sentiment with the protection of their “way of life.” In New York City, many immigrants were defenseless against the ramifications of prejudice and injustice. They weren’t immune to inequity and bigotry, however. Like immigrants today who face the threat of COVID-19 infection, many 19th-century immigrants protected themselves from the threat of contagion while maneuvering the challenges of learning a new language and culture far from their native homes.

The number of 19th-century cholera fatalities pales in comparison to New York City’s COVID-19 deaths. With over 190,000 cases, including more than 16,000 deaths (as of May 20), the five boroughs have become a hot zone for the novel coronavirus. While in the 19th century it was European immigrants who were hardest hit by cholera, today it is communities of color that face unprecedented risks. COVID-19 has been designated an “Asian virus” by both the president of the United States and the press. Scholar Joey S. Kim argues that the “virus was racialized from the moment ‘China’ appeared in the global lexicon of COVID-19 discourse. It can no longer be moved or morphed into a different cultural or racial/ethnic signifier due to a longer history of Orientalism that pre-dates the current.” COVID-19 has been commonly called “the China virus,” “Kung-flu” or the “Wuhan virus.” Such names, Kim points out, denote more than a reputed origin: “They reinforce rhetoric that is overused to the point of both nonsense and normalization. They place blame and hypervisibility on a type of body that cannot respond without bodily dispossession or, worse yet, bodily plunder.” To this point, anti-Asian assaults connected to coronavirus have become a regular occurrence. Across the U.S., Asian American health care workers have reported a rise in bigoted incidents.

For many who live in the city’s most underserved sectors, safety has become a privilege. Reports of tenants dying in their Section 8 apartments in East New York and of people being turned away from hospitals showcase a stark socioeconomic divide that is as old as New York City itself. Many Black and Latinx people are being harassed and arrested for not social distancing, tactics that some argue resemble the racist stop-and-frisk policing practice. The New York Times reports that “some prominent elected officials … charge that the New York Police Department is engaging in a racist double standard as it struggles to shift to a public health role in the coronavirus crisis.”

For the more than half a million undocumented immigrants in the city, the pandemic exacerbates pre-existing structures of oppression, including concentrated poverty, legal inequality and unreliable health care. These morally unjust realities provide fertile ground for COVID-19 to spread among this vulnerable community. While many New Yorkers work from home and practice social distancing, undocumented immigrants — an already disenfranchised and marginalized demographic — face unprecedented legal, health and financial risks that will linger far longer than the duration of this pandemic.

COVID-19 is the first pandemic of this decade. Yet the social structures that determine who gets sick and dies are the same as the 19th century. The cholera epidemics of the past teach us that class and race have always been central to the way New York City responds to outbreaks. Those who suffer are the ones who always suffer: the marginalized and underserved.