SINGAPORE — When it arrived in the unforgiving industrial towns of central Mexico, the sand-swept sprawl of northern Nigeria and the mazes of metal shanties in India’s commercial capital, Mumbai, COVID-19 went by another name.
People called it a “rich man’s disease.”
Pandemics throughout history have been associated with the underprivileged, but in many developing countries the coronavirus was a high-class import — carried in by travelers returning from business trips in China, studies in Europe, ski vacations in the Rockies.
As infections initially concentrated in better neighborhoods, many poor and working-class people believed the disease wouldn’t touch them, as if something terrible but rarefied. The misperception was fed by elites, including the governor of Mexico’s Puebla state, Luis Miguel Barbosa, who said in March: “If you’re rich, you’re at risk, but if you’re poor, you’re not. The poor, we’re immune.”
By now it is clear that COVID-19 spares no one and disproportionately harms the hungry, the forgotten and those with preexisting illnesses and substandard healthcare.
But historians say it may be remembered as the first pandemic that spread, to a significant extent, from the affluent to the lowly — agitating class grievances in some of the world’s most unequal societies and adding a dark twist to a pandemic that has killed more than 270,000 people.
“At the very, very early stages it could be considered a rich man’s disease,” said Joshua Loomis, an assistant professor of biology at East Stroudsburg University in Pennsylvania and author of a history of epidemics. “But as we know, it didn’t take long to become entrenched among the poor, and that is where most pandemics gravitate.”
The rich have long erected barriers to insulate themselves — whether walls to hide slums in India or the gated communities and private jets favored among the wealthy in the United States. The well-off have been refining social distancing for years, and when contagion appears, societies’ first instinct has often been to target and sequester the poor.
During the cholera epidemic of the early 19th century, harsh quarantines of lower-class neighborhoods sparked riots in the Russian city of St. Petersburg that were suppressed only when Tsar Nicholas I sent in the army. In the 1930s, the Nazis used typhus prevention as a pretext to confine Jews to ghettos that accelerated the disease’s spread, ensuring it killed as many as possible.
But when a pandemic begins with the rich, the poor have nowhere to hide.
“Throughout history, the rich would wall in the poor to let disease wipe them out,” Loomis said. “There are not many examples of the poor having the power or the means to do that.”
The 1918 influenza outbreak was also propelled by transcontinental travel, but it is widely believed that American soldiers — not leisure travelers — brought the disease to Europe when they fought the closing battles of World War I. Tuberculosis, for a time in the 19th century, was associated with the elite because it killed a series of Romantic writers and artists. But it has always spread most ferociously among slum-dwellers and factory workers.
Since the first infections were reported in Wuhan, China, late last year, COVID-19 has been different.
The disease hopscotched around the world aboard commercial jets, quickly appearing in Japan, South Korea, Thailand and the U.S. The first case in India was detected in late January in a middle-class medical student who had flown home from studying in Wuhan.
Only Indians with travel histories were tested in the early weeks. Most of daily life ground on as normal; the maids and drivers who are the backbone of India’s cities left their crowded neighborhoods every morning to come to work in middle- and upper-class households, returning home after dark on train cars jammed with commuters.
In mid-March the first case was found in a poor person: a 68-year-old housekeeper in Mumbai. Doctors said she was likely infected by her employer, who had tested positive after returning from the U.S.
The government soon imposed a nationwide lockdown. But as infections continue to soar, Harjit Singh Bhatti, a physician and activist, said the government should have closed the international airports in New Delhi and Mumbai in early March and isolated arriving passengers more strictly.
“Those returning from abroad are obviously not poor,” Bhatti said. “If we had quarantined them in the beginning, India would be in a better position today.”