Cartographies of COVID-19: Our Unclear Path Forward

35. If Italy offered an example of the maps of COVID-19 infections by province of contraction and site of diagnosis–

–the nation was a terrifying case not only of a heightened proportion of aging population who are a coterie most sensitive to the infection’s ravages and spread, but the spread of the pathogen in the health care facilities the patients were first diagnosed, and the death of doctors and medical care givers as the pathogen seems to have been released in the ambient atmosphere, with little protective gear to ward off its spread, as it is likely to have dispersed in air ducts, emergency rooms, and medical consultations or crowded waiting lines for health care. The topography of the nation is one where the memory of the plague and infections are cemented into the cultural memories of the nation–from Boccaccio to the first Italian novel of Alessandro Manzoni, whose historical ethnography of collective panic before the disease created a cultural memories of some of the sites in which the pathogen first spread in Piedmont, and to the Veneto from Milan.

At a century and a half of distant, it is striking that the novel if not a script for COVID-19 has provided a set of archetypes for reacting to the disease’s spread, and indeed a reality of interacting with disease more acute and compelling than the filmic narratives of apocalyptic viruses as “Pathogen.” The human narrative has helped. As Pope Francis cited models of public comportment available to all Italians by urging them not to be the servile “don Abbondio of the situation”– the priest who hides from the infection he praises as a “broomstick” in clearing the peninsula of some, and cow-tows to elites, rather than those who take active attention to curing: the novel became a cultural resource and widely-quoted repository of understanding the current pestilence of COVID-19–and offered a sense of a conclusion able to be managed by human actors. The detection of the seats of illness and clues for reactions to widespread infections on a human level has been almost a cultural repository of survival.

The striking account of the different maps for confronting disease seem thematized in Alessandro Manzon’s account of the 1630 Milan plague ing I Promessi sposi, as his hero, Renzo, must combat accusations of spreading the plague, as cartographies of fear grip the city, the cartographies of piety that church officials offer in hopes to purify the city from the plague, and the refuge he takes by mounting the carriages of corpses taken to the cordoned-off area of the “lazaretto” where the ill and dying are kept; Renzo mounts the carriage, able to survive by his immunity, in a city gripped by fears of miasmatic transmission to come to terms with the dying of “symptoms unknown to the greater part of those who were then alive”–and to come to terms with the outbreak of a new–if not zoonotic–disease across the region.. The maps of piety, noble prerogatives, and fear of the spreaders of plague all overlap in the story, against the routes of the pall-bearers, as the existence of a plague spread by contact and association was recognized by those who had doubted the early theories of contagion that the supervising physician, Ludivico Settala, proposed, after the ravages of a terrifying mortality rate of 46%. Reluctance to declare an emergency until after the plague entered Milan in 1630 contributed to the lack of orientation in startlingly similar ways to today–as foreigners dispensing ointments that spread the disease from Spain were described as the bearers of disease: the city “went frantic” as strangers like Renzo were attacked by residents.

The collective literary memory of Manzoni’s hero, Renzo, navigating the topography of the diseased city streets strewn with corpses, and a desperate psychic landscape of delusion, frenetic paranoia, may have provided an enduring resource. For the figure of moving through city gates past carriages carrying corpses, after targeted for spreading the plague by one Milanese, moves between notions of infection by miasma and contagion, as he searches among confined sick and dying were confined for the betrothed from whom he was unjustly separated,–even boarding an improvised cart carry heaps of corpses,”for the most part naked, some miserably clad in tattered sheets,” past boarded up doors and windows of deserted houses, others marked by charcoal crosses to alert officials to collect corpses. While not in danger of infection, having recovered from the plague and protected from relapse, Renzo resourcefully navigates the dystopian scene of a city where elites unknowingly spread the illness by not cancelling public celebrations, the church continues to promise purification by smoke, and false cures and rumors multiply before the unknown illness unable to be mapped–much as Hindu groups organized public occasions of sharing drinks of gaumutra (cow urine), promoted as a panacea and cure for cancer by Prime Minister Narenda Modi’s All Hindu Nationalist Union–or just following rumors dispersed online in viral posts, advocating drinking alcohol, gargling regularly, or drinking water regularly.

Could Manzoni help create a powerful landscape for navigating COVID-19’s spread? The most memorable image of the episode of Manzoni’s novel is the hero, Renzo, being accused of spreading the virus, and escaping a crowd that pursued him through the narrow, desperate streets of Milan besieged by plague by jumping on the horse and carriage bringing the cadavers of the dead to the lazaretto, to be buried, jumping on one of the carts that famously collected bodies in the city that suffered a mortality of almost half its residents–a number Manzoni believed greater–as sellers of remedies haunted the streets, and he made his way to his beloved–as the clerics hold public processions in the city, and nobility insist on processions of full pomp in its open spaces. The model afforded by the priest Felice Casati, who attended those afflicted with round the clock deidication till “hid face was pale and haggard, inspiring both sorrow and encouragement, . . . like one who would spare the weaknesses of others,” provided a model response for many doctors, nurses, and care workers on whom the peninsula relied. We are less with a narrative, perhaps, to understand the morality of COVID-19, and uncertain of the fate that the prospect of “re-opening” might bring.

More than Boccaccio’s suggestion to retreat to the countryside, the hmage haunted landscape of the pestilential city Renzo navigates, unable to find assistance from its inhabitants, long read by primary school students across the country, if reluctance, stages a traumatic climax in the novel’s dramatic tension. The accumulated detail of “filthy rags and discarded bandages, infected straw, or clothes” mix with “deadly stumbling blocks with which the ground was strewn,” become the setting navigated that Manzoni reconstructed by intense study of first-hand accounts to preserve a sense of the landscape of pestilence, a cataclysm cardinals, grandees, aristocrats and hawkers of oils negotiate to battle the plague–untori. Renzo, cured from infection, inhabits, searches for his betrothed, Lucia where ill and dead are sequestered in quarantine in the city’s infected sector, oriented himself to a hellish landscape of the sick and dead bodies that seems a limit case of civilized life, akin to “bare life” Levi found was so well able to convey within the new world of the Lager.

Engravings of the ravages of victims in Monazoni’s novel had illustrated the landscape of social confusion, suffering, death, and near-abandon, in vivid tableaux of uncertain mental stability. Manzoni’s detail was appreciated by Primo Levi, known usually for the austerely clinical prose of laboratory reports he honed as a chemist, as a deeply ethical and human gesture in the context of the plague, whose layering of historical detail and dramatic tension he saw an exception for Renzo’s human gesture; the layered detail Manzoni borrowed from historical sources of Latin and Italian may have indeed provided Primo Levi terms enabling him to return in his writing to the Lager of Auschwitz, to reorient readers to the inverted world of dead bodies, so far from the time when he wrote. Was the spread of Coronavirus, even in the face of a huge quarantine over not only the northern cities of Italy where it began–

–but, within a week, the entire peninsula, not a case of a similar limit, that L’Espresso met by a hope for grace, as if in a hope for a rostral of normalcy and scripts of exemplary conduct in the face of illness, where every patient is attended to, as Christ, by medics and nurses with antiviral masks, given the continued lack of any antiviral cure, taking readers into the houses of the ill with COVID-19 and focussing on the individual drama of exemplary care.

L’Espresso, April 5 2020/Fabio Buccarelli

The gesture before the advance of the 1630 plague seemed those demographic impact is unclear–did Milan suffer the death of half of its population? or was it two-thirds, as Manzoni believed?–suggest that the narrative of human resilience and deep truths were more crucial in understanding its devastation if we are able to survive it. The fist Renzo raised as he returned to the city besieged by plague that had killed two thirds of its population preserved a sense of dignity amidst the dramatic layering of historical detail of Manzoni’s tableaux of reactions as a literary recreation of human dignity, whose pages “magnificent pages” were enriched its readers, across time, by “human wisdom . . . true in all eras,” focussing on his account of the plague in which an estimated half of Milan perished, and presumably more was afflicted, as able to speak “not only in the time in which the story is set, but in Manzoni’s time and in our own,” despite his criticism of the theatrical gestures Manzoni describes his hero as adopting, lifting his fist, as if to preserve himself as he watched faces contracted in suffering from plague, as healers proliferated remedies as spiritual cardinals sought to restore they city’s peace.

G. Gallina, “Accusing the untori of spreading diseases during the great plague of 1630″
original illustration of ‘I Promessi sposi’
Welcome Institute
G. Gallina, A Monk Visiting Plague Victims in the Lazzaretto, from Manzoni, I Promessi sposi

If Winston Smith feels robbed of expression before the telescreen in 1984, the human gestures Manzoni describes provided powerful literary terms for Levi to navigate the experience of the lager in his memories, and the “human gesture” of sharing food, or of reading and reciting Dante’s Inferno, to preserve his sense of self in its inverted ethics, and to preserve ourselves in some way today.

The sense of a progressive ice age that descended on the entire peninsula in a metaphorical geography that bridged historical periods in postmodern ways in the data visualization The collective paralysis of the peninsula as a consequence of the rise of infection rates led Teralytics to use the proxy of mobility in a cunning color scheme to scale the consequential changes of the landscape of a “frozen country,” as if a new ice age of re-glacialization, to register the traumatic shock of emptying public spaces from piazze to houses of worship all suspended in time. The scale of paralysis was rendered over the course of one month, from February 23-March 27, pulling the entire peninsula into our own version of an ice age; an azimuthal projection of the peninsula maps in animated form, not indices of mortality, infection, or hospitalization–data often either incomplete or bad–but makes strange the familiar peninsula as if to suggest the entrance of a new era, by the suspension of all movement in a shocking tableaux, more embodied than an image from Tableaux.

 Teralytics, (c) Mapbox, data (c) OpenStreetMap

The spread of the novel coronavirus had plunged the peninsula into a different space and perhaps historical period, returning it to another era, removed if symbolically close in cultural memory. We don’t know why Italy was proved so acute a site of contagion–was it due to the aged population? if so, why did it not spread so virulently in Japan?–but the forced slowdown of the entire country moved almost each province to a standstill of historical proportions, tracing in the unprecedented drop of mobility–

–a brilliant condensation of the extent of its total impact on the peninsula that suggests reversion to an earlier historical epoch in just a month.

Marco Belpoliti offered the apt metaphor for the extent marked by such chromatic shifts of mobility as one of social environment, less marked by death rates and morbidity, but the return of a “little ice age” of a sort between the mid-fourteenth century, a term Matthes used to describe glacial advances and retreats as one of the deepest, undetected historical actors of change of the cooling of the northern hemisphere that created massive crop failures, famine, disease, and child mortality. Transposing a term used first for the foreign historical period of the Late Holocene, Emanuele Le Roy Ladurie invested the term with far greater torque as a historical explanation in 1971, as marking a shift in the deepest layers of the waters of historical change, inaugurating an age from the first peasant revolts and rise of charges of witchcraft to the composition of Frankenstein by Mary Shelley in the cold summer of 1816 when forced indoors beside Lake Geneva.

36. In presenting the animated map, Belpoliti accentuated the visualization’s power lies in its evocation of an enforced collective time travel to another period less defined by the frenetic mobility of cars, trains, and planes and transit webs that followed new metrics of glaciation as it moved from the freezing of movement from Lombardy and Lodi down the coast of the Adriatic, and from Milan and Venice down, past San Marino, all the way to Bari, Naples, and the islands of Sicily and Sardinia, mapping adherence to lack of mobility in Val D’Aosta of a massive decline of over 80%, just slightly less in metropolitan areas of Bologna, Modena, and Reggio Emilia (79%), Rome (71%-82%), the first municipal district of Naples (81%), if lessened mobility slightly diminishes to the south and less inhabited Apennines. If the best images that one has of the duress of medical personal may be the faces of the health workers who emerged from twelve hour shifts in ICU’s with minimal equipment, protective garb bearing its imprint on their faces as they treated those suffering from the virus, and have posted selfies that try to register what it is like to work in an epicenter of a nation shouldering over 47,000 cases return to the outdoor world, it circulated as evidence level of sacrifice and intensity of extended shifts.

Nicola Sgarbi, M.D./Modena, Italy (Ospedale Civile di Baggiovara)

Perhaps there is no way to visualize the extent of trauma they have faced. and the mental achievement of witnessing the suffering of patients they have attended. But the picture, taken to register a critical moment in Nicola Sgarbi’s life as he returned home, provided a sense of virtual contact for many who were sheltering in place, removed, in late March, as the ravages of COVID-19 began in the United States and in New York, the only worthwhile reaction of some, as Nicholson Baker, was to bear witness to the unimaginable intensity of their work as a form of compassion, to share on social media as much as only “liking” or “retweeting” Sgarbi’s selfie, imagining the precipice between life and death on which he had walked.

Can the spread of the novel coronavirus be measured in historical equivalents, or considered in terms of the past? As Ladurie announced his discovery of an undetected slow-moving historical actor moving of the sort that history road in these deep, unseen, hidden waves of climate and bacteria, there is readiness to believe that we had indeed come to one of those unseen turning points, which with the benefit of historical hindsight and scientific advances we were able to measure as we lived through it? The metaphorical recasting of the effects of the Coronavirus provoke reflection on the scale of its deep change and effects. If the harsh winter of 1788-89 led peasants to storm the Bastille in 1789, are there also neglected undercurrents of historical change as we try to process the true scale and proportions of the spread of COVID-19 as an episode of epidemiological history, as much as try to find a road map to the scale of its human effects?

 Teralytics, (c) Mapbox, data (c) OpenStreetMap

In a state like Italy, where concrete evidence of the spread of plagues in the past, from “houses of the plague” to shrines to the memory of plagues, inhabit the landscape, perhaps the permanence of such memories of massive death seem a barely restrained past: a cagy American historian I know once wondered that the archivists in Florence watched with stunned wonder at him licking his fingers as he fingered through registers from plague years, fearful that the bacillus was still preserved in the pages of the register, and might spring to life in his saliva.

The narrative poetics of this data visualization maintains a national category to define the impact from the first detection of confirmed cases in Italy to the cascading impact of collective responses to the disease, showing the vigilance of society, and measuring a coordinated response tot he deadly respiratory disease’s spread. In contrast, we are still searching for metrics that can condense the huge change of human geography, processing the scale of mortality, the waves of impending hospitalizations and lack of medical facilities, adjustments of undercounts of confirmed cases of infections and unemployment, or, indeed, an attempt to tabulate the tough pill to swallow of the economic recession that will accompany the disease’s spread, focussing on leisure destinations, amusement parks, gambling casinos, and energy production sites, as if the effects of the Coronavirus can be mapped economically, in known terms and criteria, rather than in a broader change of sociability.

2 Comments

Filed under data visualization, disease maps, infectious diseases, public health, US Politics

2 responses to “Cartographies of COVID-19: Our Unclear Path Forward

  1. Rachel brownstein

    It is amazing that his response is to close the borders. Has to be something weirder than denial, as you suggest. Border closing as both cause and “cure”.

    • The denial might be strategic, in part, as well as cognitive. The desire to bracket the danger of the problem suggests not only a cavalier nature to reality, and the hubris of being in control of the situation, but inability to acknowledge the responsibility of governments and the desire to be able to shift discussion to a story of personal ability. The crisis offers an opportunity to achieve an existing goal–as about American companies leaving China!–but as able to be leveraged to his own good in multiple ways.

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