This Indigenous Peoples’ Day, it feels fitting to talk about infectious diseases as tools of colonization, and how colonialism continues to shape the conditions that make infectious diseases more likely to emerge, spread rapidly, and cause unequal harm. Indigenous Peoples’ Day, though not a federal holiday, is now nationally celebrated on what used to be observed as Columbus Day. Columbus Day, recognized on the second Monday of October each year, is a federal holiday that celebrates Christopher Columbus’s arrival to the Americas in 1492 and more insidiously, celebrates the death, displacement, and subjugation of Indigenous peoples. Whether or not he was the first to bring infectious diseases here is debated and beside the point. What matters is that, as one of the original colonizers, he set in motion systems of violence, exploitation, and disease that reshaped entire continents.
While it might seem that history moves in cycles, repeating itself endlessly, often due to a lack of historical analysis and action, we do not believe that public health has to contribute to the repetition forever. We can accept that infectious diseases have been used as a tool of colonization and, because we live in a settler-colonial society, we must take care to not replicate settler logics of disease spread.
Yet, half a decade later and the United States is once again experiencing a major surge, with national wastewater surveillance systems showing high to very high levels across most states. That might surprise some people, and it should alarm all of us, especially given how our government, public health institutions, and media have persuaded much of the country and world that the pandemic is over. Even many trusted community-based organizations and healthcare providers—often the ones most connected to the communities hardest hit by COVID-19—have abandoned masking, testing, isolation, and air-quality measures. Language like “during the pandemic” and “post-pandemic”—reminiscent of “post-colonial”—reinforces this shared illusion that we have moved past any COVID-19-related hardship and returned to “normal.” In the U.S. there is a tendency to associate “pandemic” with “severe.” Because COVID-19 is no longer treated as severe and because the public health emergency has been declared over, there is a common belief that the pandemic is over as well. However, data from what is left of our defunded surveillance systems continues to demonstrate widespread COVID-19 infection, hospitalization, and death rates well over what can—and should—be expected as normal.
Just as there was no “normal” to return to in the wake of ongoing settler colonialism, there is no going back from an ever-present disease. We have been permanently changed by COVID-19 which continues to mutate, spread, and disproportionately harm and kill Black, Brown, disabled, homeless, incarcerated, elderly, and young people alike. Long COVID ensures that this crisis impacts everyone in between.
In many ways, the unmitigated spread of COVID-19 reflects colonial logic: the prioritization of profit, convenience, comfort, and the illusion of control over collective responsibility and care. And as its carriers, we too risk reflecting the colonizer’s mindset, even if we mean well.
Public health professionals study the social, structural, and political determinants of health, and more recently, the settler colonial determinants of health: the ways in which colonization continues to produce health inequities through displacement, extraction and domination. In the realm of infectious disease, colonialism has long created the perfect conditions for outbreaks: unsafe working conditions, overcrowding, malnutrition, disrupted ecosystems, and forced movement of people and animals to name a few. But disease has not just been an unfortunate byproduct of colonization; in many cases, it has been a tool of it.
Below are a few examples that illustrate how disease has served the colonial agenda and how colonialism created the conditions for mass death by infectious diseases regardless of intentionality. Each deserves much further investigation and understanding.
West Africa (15th – 19th centuries):
Before Portuguese colonization, smallpox was already present throughout West Africa, where local communities had developed and practiced inoculation techniques to strengthen resistance and improve their survival. When the Portuguese began colonizing parts of the region and enslaving Africans for the transatlantic slave trade, they carried with them the smallpox virus and the Indigenous knowledge of inoculation. European colonists later appropriated these practices through violent means, conducting brutal infection experiments on infant, elderly, and pregnant enslaved people to refine their techniques before offering inoculation to white clientele. What had begun as a deeply rooted practice of communal protection was transformed into an instrument of subjugation and exploitation.
North America (15th – 19th centuries):
European colonizers introduced smallpox, typhoid, measles, and other diseases that decimated Indigenous nations, clearing the way for territorial expansion, settlement, and genocide. While most of the disease spread is thought to be accidental, there are specific cases of infectious disease being used as biological warfare against Indigenous peoples because of how deadly even accidental spread was. The most well-known case of this was at Fort Pitt in 1763 when William Trent gave blankets from the smallpox hospital to the Delaware tribe with the intention of infecting them. Other lesser known cases include smallpox outbreaks among Incas and the Ottawa tribe after receiving “gifts” from the Spanish and French respectively. The health disparities and inequities that persist in Indigenous communities today are not historical accidents, but the ongoing legacy of that devastation.
East Asia (20th century):
During World War II, Japanese military doctors deliberately infected fleas with the bubonic plague—the very disease that had wiped out a third of Europe’s population six centuries earlier—and released them over rice fields in China’s Hunan and Zhejiang provinces. Their aim was to spread the plague widely enough to break Chinese resistance against Japan’s invasion and occupation, collapse the military arm, and clear the way for Japan’s colonial ambitions. These biological attacks unleashed deadly epidemics that tore through rural communities, killing thousands.
South Africa (20th century):
While malaria was historically present in Swaziland, the local population had developed immunity due to repeated exposure. This naturally derived balance was disrupted under colonial rule. European land policies and economic interventions forced Swazis into mosquito-dense lowlands, while imposed labor systems brought famine and widespread displacement. Many Swazis were forced to travel long distances in search of work and food, and in doing so, lost the immunity their communities had once built over centuries. Colonial disruption created the perfect conditions for malaria’s fatal resurgence, leaving a population of Swazis newly vulnerable to a disease that had once been survivable.
Palestine (present day):
The newest variant of COVID-19 has been detected in Gaza since August 2025, where colonization, military blockade, and bombardment have dismantled public health infrastructure, made disease prevention and mitigation impossible, and severely exacerbated the severity of illness. With limited access to clean water, shelter, healthcare, or vaccines—and with residents trapped inside the confines of the Gaza strip—the conditions mirror the logic of containment and neglect that have always defined colonial control. The virus spreads easily in these conditions, introduced to the Palestinian population by occupying soldiers and settlers, much like how early COVID-19 outbreaks spread in U.S. prisons through guards and staff.
It is tempting to distance ourselves from these histories and ongoing acts of violence, to insist that we in public health are different, more enlightened, more humane. But in every one of these examples, infectious diseases spread because some lives were treated as more valuable than others. The justifications have changed, but the underlying logic remains eerily familiar: “Natives are weaker” becomes “only the elderly, children, and disabled are at risk.”
When individuals and institutions choose to abandon proven mitigation strategies for COVID-19, when masking and ventilation become optional or even criminalized, and when the collective is sacrificed for personal convenience and comfort, we are reproducing the same colonial calculus. The idea that some people are expendable for the profit and comfort of others is not new. It is eugenics repackaged as a falsely benevolent social darwinism.
Disease has always been both a symptom and a tool of colonization. COVID-19 is no exception. Nor are the many other illnesses circulating the air we share; for example, respiratory infections were estimated to cause at least one million hospitalizations and 70,000 deaths in the U.S. this past year alone. Acknowledging these truths does not have to be about despair, it can be about reclaiming what public health is supposed to stand for. We can still choose differently. We can still think and act collectively. This Indigenous Peoples’ Day, and every day after, we at Public Health is Political encourage us all to reject the colonizer’s logic and commit to a public health that protects everyone.
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PSAs because yes, COVID-19 is still here and you deserve to be safe:
- COVID-19 is airborne. It moves like smoke and lingers in the air for hours. You can become infected indoors, even if you’re alone, especially in spaces without ventilation or filtration. Depending on crowd size and your surroundings (example: being in between two buildings), you can become infected outdoors too.
“Transmission of COVID-19 from inhalation of virus in the air can occur at distances greater than six feet. Particles from an infected person can move throughout an entire room or indoor space. The particles can also linger in the air after a person has left the room – they can remain airborne for hours in some cases.” U.S. EPA - Handwashing and physical distancing are important public health measures, but they aren’t enough on their own. Airborne transmission requires airborne precautions: high-quality masks, air filtration, and fresh air. KN95s and N95s offer the best protection. Just remember, wearing them below the nose or removing them to talk undermines their effectiveness. Explore this guide to find a mask that fits comfortably and offers reliable protection.
- You can have COVID-19 without symptoms. Often by the time people show symptoms, they would have already exposed people they shared space with to COVID-19. That’s why regular masking protects everyone, not just you.
- Vaccines still matter. Even though the COVID-19 vaccine does not provide full immunity, it greatly reduces the severity of infection and the subsequent long-term risks.
- Repeat infections matter. Emerging research links more than one COVID-19 infection to heart disease, strokes, memory loss, and dementia. Protecting yourself now protects your future.
Authored by Deionna Vigil and Shivani Nishar
Co Editors of Public Health is Political
