Foss podcast: The History of American Epidemics

podcastlogoFor this bonus episode of the Journalism History podcast, host Nick Hirshon spoke with Katie Foss about how shifts in journalism and medicine influenced the coverage, preservation, and fictionalization of different disease outbreaks over the course of American history.

Katie Foss is a professor in the College of Media and Entertainment at Middle Tennessee State University, where she focuses on health communication, gender, and cultural approaches to media. Her book Constructing the Outbreak: Epidemics in Media and Collective Memory will be published in September.

This episode is sponsored by Taylor & Francis, the publisher of our academic journal, Journalism History.


Katie Foss:  Well, what strikes me so much about the current pandemic is this tremendous division between people who believe that it’s a serious health crisis that’s killing thousands of people, and people who either seem to think that it’s over or who think that it’s a hoax or exaggerated by media. I mean, there’s such a fragmentation and a division between the two groups in a way that I’ve never seen in historical epidemics.

Nick Hirshon:  Welcome to Journalism History, a podcast that rips out the pages of your history books to reexamine the stories you thought you knew and the ones you were never told.

Teri Finneman: I’m Teri Finneman, and I research media coverage of women in politics.

Nick Hirshon: And I’m Nick Hirshon, and I research the history of New York sports.

Ken Ward: And I’m Ken Ward –


and I research the journalism history of the Great Plains and Rocky Mountains.

Nick Hirshon: And together, we are professional media historians guiding you through our own drafts of history. This episode is sponsored by Taylor & Francis, the publisher of our academic journal, Journalism History. Transcripts of the show are available online at

Smallpox, typhoid, yellow fever. Long before the coronavirus, these were the diseases that ravaged America from the 18th century through to the 20th. Journalists covered the outbreaks as they themselves suffered the impact, and their reporting revealed the political and religious beliefs of the time. They helped construct heroes and villains. They brought attention to the need for infrastructure improvements. And they fueled campaigns that led to healthier habits. In this timely episode –


of the Journalism History podcast, you’ll hear from Katie Foss, a professor of journalism and strategic media at Middle Tennessee State University and the author of the upcoming book, Constructing the Outbreak: Epidemics in Media and Collective Memory.

So welcome, Katie, to the Journalism History podcast.

Katie Foss: Ah, thank you for having me.

Nick Hirshon: Of course. We’re here today to discuss some of your perspectives on the ongoing pandemic, based on the research that you did for your book that’s coming out in September 2020, Constructing the Outbreak: Epidemics in Media and Collective Memory. And your book describes how the news media is central to how an outbreak is framed and understood, and that’s more than just information about pathogens, as you describe. It’s shaped through prejudices, political agendas, and religious beliefs. So if I can ask, just to start off, what drew you to this topic?

Katie Foss: Actually it was a work of fiction that inspired my book. I was reading Laurie Halse Anderson’s –


Fever 1793, which is actually young adult fiction, with my daughter at the time. And she did such a fantastic job telling this fictional story, using primary documents from the actual yellow fever epidemic of 1793 that it really got me interested in how primary documents can really tell us at least what the public was finding out during epidemics of different moments, thus inspiring my book.

Nick Hirshon: You’ve referenced the yellow fever epidemic in 1793, which happened in Philadelphia. I know your book also covers another epidemic in the 18th century in Boston. Can you give us a sense of what happened in those cities during those epidemics?

Katie Foss: Sure. So, the Boston epidemic was in 1721, and that was actually smallpox, that really took over the town. What was really interesting to me about the smallpox epidemic, not only is it one of the first epidemics that’s really been documented in colonial America, but it’s also –


an epidemic that spurred a new newspaper. James’s Courant‘s newspaper came about because he was looking for a way, for an outlet in order to really fight inoculation, the practice of deliberately infecting yourself with smallpox so that you don’t get a more serious case of smallpox. And he was so against the practice that he started, the New England Courant that and, and then used his newspaper throughout the epidemic to write against this practice. So I thought that was really interesting, which is — a different epidemic than 1793 was yellow fever, and yellow fever is really interesting because it was so well documented. In fact, I think it’s one of the best-documented epidemics in history, even though it was more than 200 years ago. So I was really interested in how this story was told both through the one newspaper that continued throughout, the Federal Gazette, as well as diary entries of several townspeople of the time –


covered in pamphlets at the time and then afterwards. so we have a lot of different perspectives of this epidemic, even though it was so long ago.

Nick Hirshon: Certainly. And now I know you’ve recently been called upon to probably offer your perspective, given how timely your research is. You wrote a piece that was published online April 1st for the Smithsonian magazine titled, “How Epidemics of the Past Have Changed the Ways Americans Live,” and you wrote how outbreaks such as tuberculosis, typhoid, cholera sparked health campaigns that led to infrastructure improvements and healthy behaviors, a lot of which we now see as normal today. So what were some of those infrastructure improvements and behaviors that resulted from previous outbreaks?

Katie Foss: Mm-hmm. Yeah, it’s really interesting how a crisis really can be the spark that, that creates a lot of different changes, and I would say a lot of my focus in that article was on tuberculosis because tuberculosis and cholera I would say are the two that had the most –


profound impact on, on public health, both in the timing and the realization of how they were transmitted, how the diseases were transmitted, but also in, kind of the shift from, you know, I would say the shift to embracing the germ theory. Right? So we can think about the cleanup of both the waterways as well as the cleanup of the streets as two major developments that happened because of this recognition that, you know, certain diseases are contagious and can make us sick, and there are ways that we can prevent diseases on a macro level, and not just by individuals, adopting more healthy behaviors.

Nick Hirshon: Mm. Well, and as you talk about this health campaigns, these infrastructure improvements and so forth, what is the role in the news media in propagating some of what government officials are saying about this, or how does the role of the press come involved here?

Katie Foss: So the press plays significant roles in, in several different ways. One is just informing –


  the people of these different campaigns, that these are going on, that they’re being launched, you know, paired with interviews with public health authorities of the time to really bolster the credibility of the campaigns. But they’re also very much used to persuade people to embrace new, healthy behaviors, and also to embrace what authorities were doing at the time. So we can think about, for example, with tuberculosis, the growing realization that tuberculosis was contagious launched these major health campaigns as part of this war on tuberculosis. and part of that was just getting people to kind of welcome authorities into their homes, especially unfortunately the tenements and, and other kind of lower-class dwellings, and also, you know, seek out public health authorities or, or seek out doctors when they’re feeling sick. And that was a shift, too, to just get people to less treating at home and more kind of seeking care outside of the home, especially when we talk about across –


  socioeconomic classes.

Nick Hirshon: Mm-hmm. Well, and in your piece for the Smithsonian, you begin it by describing how the New York City health department launched a campaign in the 1890s known as the War on Tuberculosis, and it discouraged cup sharing and prompted states to ban spitting in public spaces. I know you mentioned buildings and public transit. So what was the role of the media maybe in that campaign in particular?

Katie Foss: So the media had several different roles. In that campaign, like I said, first was alerting people that, ‘Hey, tuberculosis is contagious,’ because they thought it was hereditary, and that was a belief that actually lasted several decades after scientists confirmed that it was, in fact, contagious. Then also just these massive campaigns that were both textual and visual to convince people not to spit in public. That was a big one, which is pretty interesting to me since we don’t think about that, that you’d have to tell people not to spit in public or to share cups with strangers, but that very much was part of that campaign. So we saw a lot of –


 different drawings as well as text, very simply and directly telling people not to do these behaviors that would increase the spread of tuberculosis. And it wasn’t just about like news. It was also in posters. A little bit later on, Thomas Edison and, and his company was hired to create a series of films, of silent films to convince people to adopt more healthy behavior. So it’s interesting how it definitely crossed media platforms in not only informing people on how to change behavior, but persuading people that they needed to adopt more healthy behaviors.

Nick Hirshon: And in your research, I kind of am just wondering here how the journalism may have changed with time, because what we’re seeing right now, the onslaught of negative news can drive away readers, listeners and viewers. People say, “I just can’t deal with it anymore. It’s bad for my mental health.” And so this is just me wondering here, and I’d love to hear what you have to say as an expert on this –


since news is a business, and if they see that ratings are declining, newspapers are not selling as many copies, and so forth, do news organizations respond and maybe they’re tempted to offer a rosier prediction of casualties during an epidemic, for example, or they run positive features about how doctors are helping the search for a cure? How do journalists kind of respond to make sure that they are at once giving information that people need, but also, maybe keeping them as customers?

Katie Foss: Oh, they very much write to their particular audiences, and we can see this in a lot, in a few different ways. So we can see this if we compare local media coverage of a very localized epidemic compared to national coverage of the same epidemic. For example, diphtheria in Nome, Alaska, in 1925 was heavily covered by both local and national media because of the use of dogs to deliver the diphtheria antiserum, and if we look at the local coverage it’s much more positive –


than kind of the, what they called the outside media coverage, which painted a very dire picture of what would happen to the people of Nome if they didn’t get this antiserum. So, and, and it’s interesting because with that one, it was actually the mayor of the town who also owned and ran the newspaper. So he was writing the stories for his own town, and, and said, “Don’t worry. Help is on the way. We’ll get this antiserum,” versus the coverage in Fairbanks, Alaska, which said, “Save the people of Nome. They’re going to die unless we come to the rescue.” So it’s really interesting. We see local versus national coverage, but we also see kind of this unfolding of the epidemic that across time we see parallels in how epidemics are covered and, and even like across the course of a particular epidemic in which there’s a delay between the onset of an epidemic, the rise of cases, and the covering of the epidemic itself and, and of course reluctance to call something an epidemic. But then –


of course and as it nears its peak, the coverage becomes very dark, very much in crisis mode, which I think we’ve seen now, too. But then before it reaches peak or, or slightly after but cases are still building, we do start to see kind of this relief narrative, this promise that things are getting better, the light at the end of, end of the tunnel, even if the reality was at the moment that they hadn’t reached the peak yet. So, in various moments, I mean, it’s really interesting that some of the things that I saw in these epidemics in 1793 and in 1918 and in 1952 we’re seeing now that optimism. I think that’s as you’ve said, to, to try to keep that customer, but also just to try to, I think, offer some hope to the public in a very dark time.

Nick Hirshon: Well, and journalists are people, too, right? So they’re living, they’re experiencing this news event, and I wonder if that was part of your research, too, or just something that you kind of have pondered.


Because the same people that are covering this are having to deal with the daily repercussions of maybe they’re fearing for their own jobs. Maybe they’re getting sick or they’re losing loved ones. They’re living in cities where everything has changed. So do you have any sense of how this affected the journalists themselves, and maybe then how that colored their coverage?

Katie Foss: Oh, absolutely. They definitely had, the journalists of these different time periods definitely had a stake in what was happening to their own towns. So we can think about like, you know, obviously in 1721 people weren’t defined journalists or trained journalists in any way. Either you owned and, and wrote for your own paper, or you had different people in, kind of influential, important people in town contribute pieces. So we can think about, for example, the Reverend Cotton Mather was a very, very big, proponent of this practice of inoculation and wrote quite a few pieces, that were published in the local newspapers to oppose James Franklin’s, you know –


anti-inoculation pieces. Very much had a great stake in it. I mean he even had his own family inoculated, so as he’s writing about why we need to practice this, and using the paper to convince other people to practice inoculation. He’s also having his own children inoculated. You know, in different moments in time we also see this, where they very much, these journalists were very much also townspeople, also citizens, also participants in their own public that they’re writing for. Andrew Brown, in a similar way of writing, in 1793, you know, was facing a paper shortage. He reached a point where he had to reduce his paper, the only paper still printing, to only a couple pages because he couldn’t access paper. So it is interesting about how their lives are affecting it. Even though we don’t get a direct narrative about how that happens, you can see it in the way that the story unfolds and what the paper looks like at different moments.

Nick Hirshon: Well, and during –


the current pandemic we’ve seen a lot of first-person stories written by journalists who maybe have contracted the virus or just have described how their lives have changed. So it sounds like you’re saying maybe there wasn’t a lot of that sort of first person, in the journalism, or did you see that at all in some of these previous outbreaks?

Katie Foss: I really didn’t see that directly where they said, they went up and went, and said, “I am sick and here’s my experience.” And I wonder if some of that was just that the way that they brought this – you know, how styles have changed obviously over time. But I also wonder for some of these diseases how difficult it might have been to continue writing. For example, if you have smallpox you’re probably not gonna write. George Washington didn’t even write for three weeks when he had smallpox, or yellow fever, the same thing, just that it was so severe it would have been difficult to continue producing. Now, if we want to look at tuberculosis, that’s a different story because it’s a chronic condition, so we definitely have many people who wrote about their experiences, either directly –


  or kind of indirectly through – and we can think about the number of fiction writers who incorporated their own experiences into the stories that they told.

Nick Hirshon: Hmm, very interesting there. You were talking before about the difference between maybe the way a certain outbreak was covered in a community versus another outside community covering one in a different place. Do you get any sense of foreign coverage? Was there any international coverage that you may have looked at of how they then reflected on what was going on in the United States?

Katie Foss: Only through secondary sources. Since all of the epidemics that I studied were 1952 and earlier, I really just focused on actually the local perspective, and then a little bit of the national coverage.

Nick Hirshon: Sure. I do wonder again even right now how things are different. For example, for me, living in New York City, which has been a epicenter, right, of the pandemic compared to people living in more –


rural communities, suburban places where maybe it hasn’t hit the same. Um, we all have our own challenges, but I imagine that a lot of that coverage would vary widely, even from a big-city newspaper to a smaller weekly paper in, in some community – yeah.

Katie Foss: Oh, absolutely. Or here in Murfreesboro, Tennessee, things are covered very differently at the local and state levels than they are in the New York Times and other national coverage.

Nick Hirshon: Certainly. Well, this is kind of something that interests me a lot as I do live in New York, and we are home to Governor Andrew Cuomo, who has gotten a lot of media attention lately. So I’m curious what you kind of think here about the media darlings that emerge during pandemics or epidemics. One of the first that we had in this pandemic was Dr. Anthony Fauci, who is the infectious disease expert who appeared alongside President Trump and made multiple cable news appearances, and then women started to say, “Oh, he’s attractive,” or his confidence or his intellect is something –


that’s attractive. Now we’ve also seen people on the other side maybe cast some doubt on him and he becomes an enemy in some narratives. As I mentioned, the governor of New York, Andrew Cuomo, has had daily updates on his state’s response to the coronavirus that’s broadcast live on social media and on cable news, and he’s also won over a lot of people. And I saw this one Marie Claire story that was just posted on May 6 titled, “So, Is Andrew Cuomo Single or What?” Um, because apparently [laughs] women are kind of, interested in him, and the answer is that it seems like he is single. The governor of California, Gavin Newsom, has also gotten some attention on the West Coast and throughout the nation, and I’m sure in a lot of local markets where our listeners reside there have been mayors and council members, county executives, who have earned a lot of press attention. So what is your kind of impression about the creation of these media darlings who emerge during outbreaks?

Katie Foss: So it absolutely happens in, in every epidemic. I, although I will say that historic ones that I’ve studied –


they said nothing about the appearance or attractiveness or they, they really didn’t care if, for example, Dr. Benjamin Rush was single or not. But we absolutely see this hero narrative, and I think that’s one thing that, that gets readers and, and, consumers through is these people that they believe can lead them through this experience and, and get ’em out on the other side successfully. I mean, every outbreak, I think, has its heroes and its villains. It just kind of what the story is changes a little bit depending on where and what we’re talking about.

Nick Hirshon: Did you see with some of those villains, are there cases where maybe readers, the public, is turning against doctors who are giving information that they just don’t like, even if it may be accurate?

Katie Foss: Um, not as much because, with the epidemics that I studied, I certainly started before kind of medicine became this –


celebrated, you know, heroic profession. But in the midst of an epidemic, doctors are heroes, and even if they’re saying conflicting information, and even if later on they’re, you know, kind of discredited for what they said – for example I mentioned Benjamin Rush just because he really was the hero of the 1793 epidemic. So later on, he actually lost a lot of credibility with other physicians because he was so big on his own treatments, and now we know a lot of them were really dangerous, like excessive bloodletting. But during the epidemic, he was absolutely just championed as, you know, someone who could do no wrong, someone whose opinion that most people were completely embracing. Again, at the same time there were other physicians who were saying, the complete opposite in their advice. But in the moment, you don’t see a lot of backlash in the way that we do now.


Even if the treatments now seem absolutely crazy for the moment, that in the moment, or just, you know, we probably even knew better in the moment. For example, in 1918 a number of grocers started saying that their onions would cure influenza, and I’m guessing in 1918 they even knew that, but you didn’t have people who were writing in to oppose it or to try to boycott media because of those messages.

Nick Hirshon: Right. Um, did you see then other villains emerge? Obviously there has been some talk during this pandemic. There’s been blame spread around different countries. “China should have done something earlier. Europe did something earlier.” Did you see anything about, maybe foreign adversaries that emerged?

Katie Foss: Absolutely. In 1918, it’s really interesting because the coverage, of course, during World War I kind of clumped together both the virus and Germany, so there was a lot –


of, of different statements that reinforce “Germany is our enemy but we’re also fighting influenza, and by fighting influenza we are fighting Germany and we’ll triumph over the enemy.” So particularly during war we see kind of a clustering or an othering, I would say, of disease with kind of a hostile entity.

Nick Hirshon: And I’d like to get your perspective on some of the news coverage you’ve seen during this pandemic now that you have that sort of expertise, but looking at the changes over the centuries, what would you say are some of the things that really were highlights to you of, wow, how stark the journalism changed maybe in how they covered these different outbreaks over the centuries? Were there certain narratives that were different, or just the way stories were written about it changed?

Katie Foss: Mm-hmm. So one thing that really struck me with 1793, and, and I talk a lot about that one because that really was a really interesting epidemic to me, and there’s so much available. So one thing that was really –


interesting to me was, were all the different opportunities for regular people to write in and contribute to the newspaper and, and write in not just with their own experiences with disease but also their own kind of ideas about treatments and ways to prevent the spread of disease. I thought that was absolutely fascinating. and that’s not something that I saw as a, as constant in the later epidemics, where you got a lot of participation from regular people at least getting to weigh in on how do we prevent and, and, and cure disease. Even though now that’s come back, right? With, with social media people say whatever they want, and which can be sometimes unfortunately taken as fact. so that was one thing that I noticed. Um, I also noticed that, again, that difference between local and national coverage, or even parts of the country affected. So with tuberculosis, the media coverage that came out of Colorado, especially Colorado Springs, was, wasn’t pro-tuberculosis –


but it definitely reflected on tuberculosis as kind of a way of life or something that you can live with and be successful with because most of the residents did have tuberculosis or they had family members with the disease. Compared if we look at New York coverage, at the same time of the same disease, was very science driven, was very much written from the perspective of a public health authority, treated people with tuberculosis in such a way that they should not be part of society, and we can think about like the sanitarium movement and how that fit in. so even at the same time, in, you know, the same time we saw different papers covering the same disease in very different ways depending on who was writing and what was going on in, in this moment.

Nick Hirshon: Well, and then as you look at that evolution continue to what we’re seeing in the current pandemic, what are some things that stand out to you and ways – maybe again those narratives are changing, the heroes and the villains. Anything else about the way –


the journalism has covered this?

Katie Foss: Well, what strikes me so much about the current pandemic is this tremendous division between people who believe that it’s a serious health crisis that’s killing thousands of people, and people who either seem to think that it’s over or who, who think that it’s a hoax or exaggerated by media. I mean, there’s such a fragmentation and a division between the two groups in a way that I’ve never seen in historical epidemics. Um, no one in 1918, I don’t think, would have written in a mainstream newspaper, would have been published saying, “Influenza is not a big deal. What are we doing?” Right?

Katie Foss: I don’t see that. And, um, certainly not from the government. I’ve never known other government officials to, at least publicly on record, in these different epidemics that I studied, to really downplay an epidemic.

Nick Hirshon: Sure. That’s something that we’re definitely seeing in stark relief right now, and –


I guess even when you’re looking at letters to the editor back then, there weren’t too many of those second-guessing the common media narrative or attacks on the media –

Katie Foss: Right.

Nick Hirshon: – the way that we see today.

Katie Foss: Mm-hmm. Well, and people didn’t question disease back then in the same way that we tend to now, since so many people have forgotten that these experiences existed that disease, you know, used to – and right now is again – shape every single part of your life and every day. I mean it wasn’t uncommon to have to take a couple weeks off of school because you came down with an infectious disease, because it happened so often.

Katie Foss: So to question disease back then would have just been absolutely absurd.

Nick Hirshon: Sure. Well, we thank you again for all of your perspective that you provided today, and before you go we always end the podcast with the same question I’d like to pose to you now. Why does journalism history matter? You can answer it in the context of the research you’ve done, or just in a broader sense. But why do you think the history of journalism matters?


Katie Foss: Well, we have to stop forgetting what happened in the past, so that we can prepare for the future. And I don’t think, anything, any bigger reminder could possibly happen rather than our moment right now. It’s telling us why journalism history matters.

Nick Hirshon: Sure. Your research shows us a kind of a path forward, and I think there’s a lot of positive things that emerge from your research as we talked about earlier, the infrastructure improvements, healthy behaviors that maybe will become more common after we pass through this. So, thank you so much, Katie, for taking the time to talk to us today on the Journalism History podcast.

Katie Foss: Yeah, thank you for having me. I appreciated our conversation.

Nick Hirshon: Thanks for tuning in to this episode of the Journalism History podcast, and additional thanks to our sponsor, Taylor & Francis. Until next time, I’m your host, Nick Hirshon, signing off with the words of Edward R. Murrow. Good night, and good luck.


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