David Randall’s Black Death at the Golden Gate Review
Aka how public health officials and rat killing squads saved early 20th Century San Francisco
I think a lot these days about Hurricane Katrina. Not just because I am more nostalgic of the before times, it has been ten years since I moved away from the city, 15 years since Katrina hit. I miss being twenty-two and having the idealism that an Americorps volunteer can help rebuild a neighborhood. I miss walking into bars and hearing the best live music for the cost of a Miller High Life.
Katrina also puts into context how bad our country can bungle a disaster response.
It was a powerful Hurricane, but it did not hit Louisiana at Category 5 winds. The storm seemed to pass without devastating results for New Orleans, but then the levees broke, and the city flooded. Our country failed to invest in its upkeep over the years. Environmental engineers warned us, and disaster training was supposed to prepare us for the worst. We ignored their warnings. As New Orleanians waded in the rising water, our entire system broke down. The private and public sectors abandoned citizens of New Orleans only to be quite literally saved and fed by religious and non-profit groups. It was also another example of how the response, or lack of it, shines a light on the great racial and economic inequities that exist. Remember people, the before times were not all great either.
Covid-19 was hard to predict, but some version of contagion was going to run rabid through America, it was only a matter of time. But our response has been lackluster at best, criminal at worst.
Maybe there is comfort in knowing that at another time when a highly contagious pathogen spread through America, we did not listen to the public health officials at first, or second, or third, or maybe seven-years. Still, when finally we did heed their warnings, they saved us. And when I say listen, we followed their recommendations. Wearing a mask is much easier than hunting rats, as the author writes, turned teenagers into rat-killing death squads, which is another way of saying, here is the segue to my next book choice.
I know, I know, I am back to reading about highly contagious viruses. Read something else, you say! But our life is consumed by Covid-19, and I want to keep learning our history. This newsletter might just always be about this, buckle up.
David Randall, in his third book, Black Death at the Golden Gate (a link to a radio interview with the author), writes about a time that is often overlooked, where we faced the potential of an awful pandemic, and through the diligence of public health officials, were able to stop it. Stop me if it sounds familiar, just wish we were at the stop it part of our current crisis.
A few cases start appearing in Chinatown around 1900 in San Francisco. The media and the politicians first denied it was Bubonic plague, despite the mounting evidence that it was indeed, Plague. A quarantine was finally implemented, but only in Chinatown. When the Marine Hospital Service (now the CDC) made dire predictions, they were labeled as public health worrywarts. The virus is a hoax, city officials, and the major news outlets’ publishers told residents. At the time, the Governor continued to fight the public release of any information about community-spread, saying it was just a conspiracy to stifle the economy of the Pacific. But if you have been paying attention to the news in 2020, you know it is impossible to spin the virus to make the picture rosier. The disease only exploits lies and continues to expand. As John Barry wrote, the virus has one goal, to repeat itself. It will never disappear “like a miracle”, as our current President told us.
While reading the book, I tried to highlight every part familiar to America’s 2020 response to COVID-19. By the end, my kindle notes were almost as long as the actual book. David Randall’s book is thrilling. I know the city of San Francisco survives, I was there in the 21st Century, but at specific points of the book, I doubted myself. For the first quarter of the book, I truly believed the city would ignore all the experts, and try to lie their way out of a public health crisis, and perish.
The first member of the Marine Hospital Service to identify the Bubonic Plague was a man named Dr. Joseph Kinyoun. He was the Lebron James of the early 20th Century infectious disease lab, with the tact of Dennis Rodman. There was nobody better to study and correctly identify a virus under a microscope. Yet, he had none of the interpersonal skills to convince people they should listen to everything he said. When the time came to follow Kinyoun, the city leaders ignored him. He wrote to the Surgeon General, who was not much of a fan of his personality either, “It appears that the ‘commercial interests’ of San Francisco are more dear to the inhabitants than the preservation of human life.”
Even physicians on the Board of Health did not want to heed his warnings, “fearful that any acknowledgment of the disease would narrow their city’s future.”
Eventually, he was run out of town by the Governor of California and the media, but he was not wrong. I am learning the battle against lethal pathogens is like facing an enemy with multiple fronts- a war against the virus and a war against the establishment that wants to preserve the economy. But you can not boost the economy without solving the public health crises first. See for example, the year 2020.
Kinyoun was relieved by Rupert Blue. Turns out, he was the perfect fit. He massaged egos and made political inroads. He built relationships with the Chinese community to understand the virus better and how it was spreading.
The Marine Health Service would plaster tens of thousands of rats to the walls of their labs and test for plague in order to keep the positivity rate below 2%. Credit: The National Library of Medicine/Centers for Disease Control
Spoiler alert; it was the fleas on rats that were spreading the virus. If rats scurried to a neighborhood, the fleas followed, and victims would appear days later. Unfortunately, there was no silver bullet to stop the spread in its tracks, or a vaccine to make it all go away.
As I start to read more about deadly viruses that jump from animals to humans, there is a recurring theme that I wholeheartedly enjoy — the importance of experimentation. Like entrepreneurship, you start in one place and then experiment until you find the market fit, and epidemiologists are constantly testing assumptions. If they find something that works, they quickly put more resources behind it.
“Blue’s willingness to try new ideas-even when those notions clashed with the entrenched beliefs of his superiors in the Marine Hospital Service- had long been his greatest skill, and he leaned heavily on that openness at the time of his greatest need.
Blue implemented city-wide public health measures that helped cities improve their sanitation for the next hundred years, i.e throwing your food trash into a sealed bin so the rats would not scavenge, and many others. These came from trial and error and then telling people to follow guidelines throughout the city. And one of them was a very simple instruction-kill rats, as many as you can.
Chandler wrote the rats as almost supernatural villains- one rat couple can produce nearly 15,000 baby rats, and their skeletons are retractable. But with the elected officials and media outlets cooperation, the city was able to beat back the virus, kill tens of thousands of rats, and create a more public health-friendly city. More than a decade later, Blue also helped New Orleans rid itself of a potential plague outbreak. He did not play a positive role in the 1918 Pandemic. It is hard to be a hero twice, but he redeemed himself in New Orleans.
I can not recommend this book highly enough.
