Trump wasted an opportunity to change the narrative on Covid-19

Perhaps the best example of a leader changing health comes from 19th-century Britain, when Queen Victoria’s son and heir, Prince Albert Edward, contracted typhoid fever, one of the deadliest infectious diseases of the period.

Can the sickness of a national leader change public health? It depends. Donald Trump’s hospitalisation offered an opportunity to change the public narrative on the Covid-19 pandemic; instead, the president fuelled anti-science rhetoric. Franklin D. Roosevelt’s polio, on the other hand, galvanised the nation into public health action; in his second term, he helped create the most successful public health campaign in American history, the National Foundation for Infantile Paralysis, later known as the March of Dimes.

Perhaps the best example of a leader changing health comes from 19th-century Britain, when Queen Victoria’s son and heir, Prince Albert Edward, contracted typhoid fever, one of the deadliest infectious diseases of the period. After decades of ignoring or discounting one of the greatest health calamities of their age, a royal illness spurred British leaders, followed by the British public, to reframe the narrative around typhoid, characterising it as a serious, preventable disease—and creating the first modern public health infrastructure, a system that still influences public health efforts today. Guided responsibly, Americans’ reactions to high profile Covid cases could have a similar impact.

Typhoid, caused by a strain of the Salmonella bacterium, is passed from person-to-person when tiny amounts of infected fecal matter contaminate food and water. In the 1800s, it was a fulminating, cluster disease, erupting annually in cities, towns, and villages across Britain whose water supplies became contaminated. Typhoid killed up to 20,000 and sickened and debilitated up to 150,000 people each year. The Prince of Wales caught the illness in the fall of 1871. Bertie, as he was affectionately known, spent two months in a feverish, delirious spell at the family’s retreat in Sandringham, looked after by two royal physicians, William Jenner and William Gull. All of Britain was absorbed with daily updates on the future king’s condition. When the prince began to recover in early 1872, there was massive jubilation, including a royal procession from Buckingham Palace to St Paul’s Cathedral.

The royal sickness arrived with Britain at a political crossroads. Queen Victoria had secluded herself in private mourning for a decade after the death of her husband, Prince Albert, in 1861, leaving the monarchy in shambles. In the way that only natural disasters like epidemics can do, though, the prince’s bout with typhoid brought the nation back together. At the opening of parliament in February 1872, Queen Victoria energetically returned to the public spotlight, thanking the nation for praying for her son “during the period of anxiety and trial” while sick with typhoid. The address restored the public’s faith in the monarchy. “Never before,” noted an editorial in the leading medical journal of the time, The Lancet, “has the bearing of all classes exhibited the strength of that common band of sorrowful sympathy which we are all bound together as a nation.”

Before Bertie’s case, most Victorians believed the disease was the exclusive province of the urban-industrial poor. If the future king of England could get typhoid, so could anyone. Queen Victoria declared typhoid needed a national solution. Parliament responded swiftly, passing the first comprehensive sanitary legislation, the Public Health Act of 1872, followed by subsequent improvements in 1875.

Apart from a few scattered outbreaks in the 1920s and 1930s, typhoid largely disappeared in the West. However, typhoid remains a global health problem, striking 20 million and kills about 200,000 each year. A 2019 Lancet study called the disease an “invisible burden”, and recommended “global solutions: better data and better surveillance” — just the innovations British epidemiologists introduced 150 years ago.

— The writer is a historian at the College of Charleston. His forthcoming book The Filth Disease examines the birth of modern epidemiology during repeated outbreaks of typhoid fever.