The promise and peril of anti-pandemic technology

Mask-wearing women hold stretchers near ambulances during the Spanish Flu pandemic in St. Louis, Missouri, in October 1918.

In the aftermath of the 1918-1920 flu pandemic, there was good reason to believe that new technologies and systems of communication might make another such outbreak of disease all but impossible. Despite attempts to exchange information dating back to cholera outbreaks in the mid-nineteenth century, states had failed to create meaningful international cooperation during the flu pandemic. Information collection and collation were so poor that we will never know how many millions actually died. Wireless telegraphy promised to change that: By disseminating information about the spread of disease before actual cases arrived, public health officials hoped to prevent another pandemic.

While that effort to improve the dissemination of epidemiological information improved public-health responses, it was far from enough to halt another pandemic. What had been seen as a transformational technology was something else entirely: a marginal improvement to communications systems that required good governance in order to have a public health impact. Indeed, in the first months of the COVID-19 pandemic, technological solutions like contract tracing apps seemed to offer an exit route from our pandemic purgatory. Yet, it has not worked out that way. The history of wireless epidemiology suggests that such apps may have a part to play, particularly in preventing panic. But they were never going to matter as much as political will and smart governance.

Post-pandemic wireless telegraphy

In the aftermath of the 1918 pandemic, the newly created League of Nations Health Organization founded the first major international epidemiological information system that spanned two-thirds of the globe. Coordinated epidemiological information emerged in the 1920s because the League took advantage of a new communications technology—wireless telegraphy. Although this system has now faded into obscurity, it can deliver vital lessons for today about how international cooperation can coalesce around new technologies and why technology alone cannot present a panacea.

The embrace of wireless telegraphy dovetailed with the priorities of the new head of the League of Nations Health Organization, Ludwik Rajchman. A Polish bacteriologist, Rajchman had spearheaded Poland’s response to the typhus epidemic that ravaged Eastern Europe simultaneously to the far more famous flu pandemic of 1918-20. Rajchman had come to believe that information could prevent future pandemics. He thought that if states could create comparable statistics on infectious diseases, the League of Nations would disseminate those statistics promptly around the world. This, he hoped, would enable officials to prevent pandemics because they could swiftly enact quarantines or other public health measures.

Wireless telegraphy was key to Rajchman’s plans. This technology was particularly revolutionary at a time before commercial airplanes, because goods and people travelled by sea. Wireless was the first technology that allowed moving ships on the sea to communicate with land. Because states worried about how disease would affect maritime trade, wireless offered a new and unique opportunity to control the oceans. Wireless also became a point-to-many technology: One wireless tower could send messages to multiple recipients simultaneously over long distances. This technology would enable information about cases to arrive before the cases themselves. Using this new technology could effectively shut down a disease in its tracks with the right public health measures.

Rajchman and League officials cooperated with governments around the world to make their new system work. The League owned no wireless towers so it relied upon governments to provide the infrastructure. During the 1920s, officials enlisted cooperation from multiple empires and nation-states. The British and French empires, for example, agreed to use wireless towers in their colonies in South East Asia to distribute weekly epidemiological information. Even non-members of the League participated: Nazi Germany distributed health bulletins over wireless until 1939, even though the country had left the League in October 1933. The system only ceased to function when World War II broke out in Europe and then Asia, although many of the same officials would create the World Health Organization’s information system after 1945.

The lessons of anti-pandemic technology

Although contemporary society has long since moved on to newer, more advanced communication technologies, there are important reasons why we should care about this seemingly obscure history of a mostly forgotten communications technology.

First, the use of wireless telegraphy in epidemiology specifically and as a communication tool broadly shows how politics undergird every seemingly neutral technological system. Countries like Japan participated eagerly in the League’s network. But Japan did so not for benign reasons, but because it was a cheap way to garner military intelligence on disease. This information fed into Japanese plans to invade China in the 1930s. Disease surveillance has long intertwined with military motives. It is no surprise that firms like Palantir, who provide data analytics tools to governments and militaries, have become involved in COVID-19 data management in the United Kingdom and elsewhere. But the history raises deeper questions about the long-term effects of such ties: Mobility data may initially be used to stem the spread of COVID-19, but thereafter used to restrict other rights or underpin bellicose invasion strategies. These are not abstract concerns. Freedom House has already warned that authoritarian-leaning leaders are instrumentalizing COVID-19 to expand their powers.

Second, and more hopefully, when used effectively such systems could prevent rumors and panic. In the early months of COVID-19, the historian Robert Peckham argued that governments needed strategies to manage panic during a pandemic, whether in financial markets or about the supply of toilet paper in supermarkets. Panic, Peckham argued, is a particularly modern phenomenon, spurred by new communications technologies like telegraphy that spread news so swiftly from the mid-nineteenth century onwards.

But there is a flip side to Peckham’s fears—a world where communications technologies could be a panic preventative. The media sociologist, Herbert Gans, coined the term “panic preventative” to describe how journalism could function. We often think of news as negative. An item about an earthquake in Japan might make us fear an earthquake at home in Vancouver. Gans argued that actually, when we see disasters happening in other places, we might feel safe because we know that no disaster has occurred at home. Otherwise, that disaster at home would dominate the news. News, Gans thought, could function “as an early warning system, as a reassurance system, and as a panic preventative.”

While Gans did not mention health, League officials certainly thought that way. They hoped that swift data exchanges would prevent media panics and stop governments from restricting travel, because they would have more transparent evidence on infectious diseases around the world.

So too, governments today could think of apps and social media as panic preventatives. In Taiwan, digital minister Audrey Tang built apps with “mask maps” to show supplies in pharmacies to prevent panic buying. A big-data study of online behaviour in twelve countries during the early months of COVID-19 found that when governments released official guidelines swiftly, citizens bought fewer unproven remedies. And COVID-19 contact tracing apps, if they overcome technical and adoption hurdles, might alleviate some of the anxiety around exposure.

Finally, though political decisions ultimately mattered more than a new communications technology, League officials were convinced that their wireless bulletins had reduced the spread of infectious diseases like smallpox and cholera. They believed that they had informed authorities about infected ships in advance, enabling officials to institute swifter quarantine measures. These wireless bulletins also reached many ships on the sea, enabling them theoretically to change course if they were heading for a port city reported as rife with infection.

At the same time, League officials never gained the political power either to declare an epidemic or to recommend particular public health measures. They hoped that the swift provision of information would suffice, but were often frustrated that officials on the ground did not react as they might have liked. The League could not even declare when a disease outbreak had become an epidemic because public health officials in different countries and cities held that power. In 1938, one League official noted that “arbitrary standards are adopted in various countries and individual ports, and it is obvious that no single numerical standard can be applied universally.” The League could disseminate numbers, but could not determine what public health officials did with them. While international health regulations have changed considerably and the World Health Organization can now declare pandemics, the same fundamental problem of coordinating public health policies remains.

So too today, no app or flashy system can succeed without the political will to enact public health guidelines. In the case of COVID-19, public-health authorities learned of the disease’s emergence in China within weeks and months of it spreading there. Scientists and public-health officials quickly became aware of its danger through medical pre-prints, specialized email distribution systems for news of infectious diseases (ProMED), and World Health Organization warnings. But this wealth of information—spread around the world via the internet at speeds greater than the inventors of wireless telegraphy could ever have imagined—was not enough to prevent the disease’s spread without politicians being able and willing to enact the public-health responses necessary.

Heidi Tworek is an associate professor at the University of British Columbia and a non-resident fellow at the German Marshall Fund of the United States.