In December 1899, five people of Chinese ancestry died of bubonic plague in Honolulu. The Honolulu Board of Health reacted by deploying the U.S. military to lock down a fourteen-block neighborhood containing 10,000 people, predominantly Chinese and Japanese. Authorities then attempted to systematically burn down buildings in the quarantined zone to purge the plague. But as officials tried to set controlled burns, the wind picked up and set all of Honolulu’s Chinatown aflame. The fire raged for seventeen days. It ultimately demolished 38 acres, destroying 4,000 homes and leaving 4,500 people homeless. It also spread the plague: a U.S. Public Health Service (PHS) official concluded that rats driven out by the fire had carried the disease into the rest of the city.

Blaming China and Chinese people during a global pandemic is deeply unoriginal.

As Nayan Shah argues in Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (2001), the Honolulu fire was far from the only time in U.S. history that racism worsened a public health crisis, victimizing minorities and harming the population as a whole. We are living through such a moment now, as President Donald Trump elects to prioritize xenophobia, partisan politics, and fearmongering over the public’s health. It isn’t just Trump, though. The entire public discourse about the novel coronavirus has been shot through with anti-Asian rhetoric. Conservative commentators have floated the idea that COVID-19 is “a biothreat from China” and have gleefully taken up Trump’s moniker for it, “the Chinese virus,” while conservative politicians have blamed Chinese “culture” and diet for the disease.

But racialized discourse about the outbreak can be found on the left as well. The liberal news site Vox, for example, published a video purporting to explain “Why New Diseases Keep Appearing in China” in which it posited that China is home to such outbreaks because people there consume wildlife—as though plenty of Americans don’t also hunt and eat game. The video itself points out that live wildlife markets exist around the world, meaning that public health concerns should be about such markets, not just about Chinese markets. The very premise of the video was already a flawed way to frame the issue: with approximately one fifth of the world’s population—over 1.4 billion human beings for evolving viruses and bacteria to attack—it’s unsurprising that diseases emerge from China. It’s crucial, of course, for epidemiologists and health policy planners to study what particular social and economic conditions generate disease and to make recommendations to remedy those conditions. But framing the conversation, especially in less technical publications, as a question about why China adds more than its “fair share” of global disease unnecessarily moralizes the issue and smuggles in invidious assumptions about race and culture.

Assessing our government’s myriad failures in response to COVID-19 consequently requires both criticizing the racism that has consistently been the backbone of Trump’s approach to governing while also recognizing that Trump is not alone—indeed, that there is a deep history of the United States responding to plague times with racist panic and blame. The COVID-19 pandemic therefore calls for a renewed commitment to building a racially and economically egalitarian welfare state. That means both funding a robust federal government with the power to take action for the public good and strengthening and enforcing anti-discrimination laws. But it also calls for robust public dialogue and education about the need for a society that treats all of its members with equal concern and respect. History is an invaluable guide as we work toward that end.

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Assessing our government’s failures in response to COVID-19 requires both criticizing Trump’s racism and recognizing that he is not alone.

Blaming China and Chinese people during a global pandemic is deeply unoriginal. During the cholera epidemic in New York City in 1832, for example, the Board of Health asked the city’s leading doctors to gather all information “on the subject of the Oriental Cholera.” When the epidemic arrived in New York, those New Yorkers who could afford to flee the city embarked on a mass exodus, leaving the poor to suffer in cheap, crowded living spaces that formed a perfect environment to transmit the disease. Commentators quickly moralized the epidemic, arguing, as one put it, that cholera was “almost exclusively confined to the lower classes of intemperate dissolute and filthy people huddled together like swine.” Not everyone, fortunately, agreed. A Quaker critic saw the outbreak as a reason to contest the inequality of an industrializing and urbanizing society. “Was man made for this,” he asked, “or is he not able to raise himself out of this unequal degraded state? If not, better [to] be a stone destitute of sensibility.”

Anti-Asian hostility intensified in the second half of the nineteenth century, as the U.S. passed a suite of immigration laws that restricted and eventually banned Chinese immigration. Cities and states on the West Coast employed a mix of statutes, ordinances, arbitrary policing, social pressure, and mob violence to exclude and oppress people of Chinese descent. This racist rhetoric and policy continued well into the twentieth century, with explicit racial restrictions built into immigration laws until 1952 and quotas on immigration from Asia until 1965. Set against the backdrop of this period, Shah’s Contagious Divides narrates many moments of anti-Chinese panic during epidemics in the United States, well beyond the Honolulu fire of 1899.

The PHS tracked a bubonic plague outbreak in China in 1894, for example, and Shah explains that U.S. public health authorities anticipated the arrival of plague from that point onward. They “predict[ed] that one of the Pacific Coast’s ‘Chinatowns’ would be the most likely site of the epidemic’s first strike.” “PHS officers based in China and in North American ‘Chinatowns,’” Shah writes, “feared that the ‘filth’ and ‘overcrowding’” that they believed was “characteristic of all Chinese living environments incubated bubonic plague.” Driven by these racist stereotypes about China and Chinese immigrants, San Francisco targeted its Chinese population repeatedly from 1900 to 1907 amid a series of bubonic plague scares. The city locked down predominantly Chinese neighborhoods and sent in squads to inspect and fumigate houses, it restricted travel by any Chinese persons who were not vaccinated, and it attempted to forcibly vaccinate the Chinese population. Vaccination at the time was still an infant science and it could be physically horrific. Forcibly vaccinating the city’s Chinese population would be, in effect, to use them as test subjects. Meanwhile, the selective shutdown of immigrant neighborhoods further concentrated all of the economic suffering caused by the epidemic on a subordinated racial minority.

The Chinese in San Francisco did push back, with some success. Street protests occasionally forced public health officials to lift the quarantine, and massive public resistance led officials to abandon their plan of forced inoculation. In Wong Wai v. Williamson (1900), federal judge William Morrow enjoined local and federal health officials from enacting a plan to prevent Chinese persons from leaving the city unless they had submitted to vaccination. This coercive vaccination regime, Morrow explained, was “boldly directed against the Asiatic or Mongolian race as a class, without regard to the previous condition, habits, exposure to disease, or residence of the individual.” It therefore violated the Fourteenth Amendment. Judge Morrow explained that although public health officials have sweeping “police power” during an epidemic—police power being the name for the general authority of sovereign governments to legislate and regulate to protect public health and welfare—that power, “however broad and extensive, is not above the Constitution.”

San Francisco locked down Chinese neighborhoods, restricted travel, and attempted to use the Chinese population to test an experimental vaccine.

Morrow’s opinion cited the famous case of Ho Ah Kow v. Nunan (1879), in which U.S. Supreme Court Justice Stephen Field, temporarily sitting as a federal circuit judge in California, struck down a San Francisco law that required all prisoners to cut their hair short. Field found that the law was merely a pretext to force Chinese men to cut their queues (long braids), and he wrote that “in our country hostile and discriminating legislation by a state against any class, sect, creed or nation . . . is forbidden by the Fourteenth Amendment.” Ho Ah Kow v. Nunan remains a crucial precedent establishing that the Equal Protection Clause of the Fourteenth Amendment blocks states from discriminating under pretextual laws. In the context of public health crises like the one we face today, Judge Morrow’s opinion in Wong Wai v. Williamson should be a similarly important precedent for the proposition that even under the police power, racial discrimination is barred by the Fourteenth Amendment.

Nevertheless, although Justice Field struck down the queue law in Ho Ah Kow v. Nunan, he still took the opportunity in his opinion to expatiate on the inferiority of Chinese immigrants. He called them a “vast horde,” and he criticized “their dissimilarity in physical characteristics, in language, manners and religion.” These differences, he said, would “prevent the possibility of their assimilation with our people.” He therefore argued that Congress should ban Chinese immigration, a point of view that was very much of a piece with the larger Chinese Exclusion movement in the period. A similar tone of contempt might very well be detected in Judge Morrow’s language in Wong Wai v. Williamson, as he paints in broad strokes about “the Asiatic or Mongolian race.” Such biased language and ideology are insidious even when they appear in judicial decisions that protect racial minorities from discrimination by the state.

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The police powers of the state and federal governments, of course, are critical for fighting disease and protecting the people’s welfare. The $2 trillion federal recovery bill passed in response to COVID-19 is a classic use of the police power, as are Medicare, Medicaid, the Affordable Care Act, and anti-poverty programs such as Social Security, unemployment insurance, and SNAP. But the police power also remains a potential tool for discrimination, a loaded gun waiting for the wrong hand to wield it. Justice Field’s suggestion to ban Chinese immigration leans on a paradigmatic instance of the police power, border control, as did Trump’s declaration of a national emergency in order to build his border wall. Congress, the public, and the courts all need to be vigilant to distinguish real emergencies that justify expansive police powers from ginned-up emergencies that let the executive act in a state of exception free from external legal control.

The COVID-19 crisis is political just as much as it is medical.

Unfortunately, our government’s use of police powers today is still frequently shaped by racial discrimination, just as it was in the late nineteenth century. Now, as then, militaristic combat metaphors are swirling together with anti-Asian racism in government rhetoric. As Trump has beefed up military funding under his isolationist, xenophobic “America First” foreign policy, he has slashed federal offices and agency funding devoted to foreign aid, global health, and disease preparedness. He has undermined diplomacy and international cooperation, which are essential in a global pandemic. And he proposed cutting funding for the Centers for Disease Control (CDC) even as his Secretary of Health and Human Services refused to divert any funds from the border wall to cover potential CDC shortfalls. These racist efforts to cut off public health funding to developing nations, to keep out Hispanic immigrants, and to means-test and generally eviscerate the domestic welfare state are directly tied, both ideologically and materially, to the stripped-down public health bureaucracy Trump has created through a toxic combination of malice and neglect—a public health bureaucracy that now lacks the capacity and nimbleness to respond fully to the coronavirus pandemic and that leaves us all more vulnerable as a result.

The COVID-19 crisis is political just as much as it is medical. Our response to the twin crises of coronavirus and Trumpism has to be both medical and political as well. Only by acting together, collectively, through government—which is to say, via democratic politics—will we be able to fight off this disease and rebuild, better, in the aftermath. Like the Quaker writer in New York in 1832 who saw the cholera epidemic as a reason to improve social and economic equality, it’s up to progressives today to demand a robust, racially egalitarian welfare state that governs in the public interest, plans ahead, treats everyone with equal concern and respect, and helps its people navigate medical catastrophe and economic collapse. Then maybe next time, we can escape the worst legacies of our past and confront the disaster, effectively, together.