The David Frum Show — Episode Summary

Podcast: The David Frum Show
Host: The Atlantic
Episode: The Preventable Return of Deadly Diseases
Date: September 17, 2025
Guest: Kyle Harper, Professor of History, University of Oklahoma; author of "The Fate of Rome" and "Plagues Upon the Earth"

Overview

In this episode, David Frum interviews historian Kyle Harper to explore the disturbing resurgence of deadly diseases in the United States, focusing on the anti-vaccination movement and its consequences. The discussion traces the historical toll of infectious diseases, the revolutionary impact of vaccines and public health, and the social pathologies imperiling these achievements today. The conversation ends with a reflection on trust, societal responsibility, and the future of public health, dovetailing into Frum’s book talk on Carl Schmitt’s "The Concept of the Political" and the fragility of democratic institutions.

Key Discussion Points & Insights

1. Historical Context: Life Before Vaccines

• [12:25] Frum opens by voicing a common argument against vaccines: “We got on fine before there were vaccines…”
• Harper rebuts, emphasizing the “tax” of infectious diseases prior to modern medicine:
  • Before the late 19th century, infectious diseases were the leading cause of death globally.
  • Life expectancy was extremely low; most people died young, many in childhood.
  • Being “fine” meant enduring mass child mortality and stunted physical development, even with abundant food.
• Quote:

  “It's no kind of life that I would choose to experience...Almost everybody got [smallpox]. So it was, it was a real problem.” (Harper, 12:54; 15:39)

2. Smallpox and the Birth of Vaccination

• [15:20] Early interventions included variolation—inoculating people with live smallpox, which itself was dangerous.
• Edward Jenner's 1790s discovery of cowpox-based vaccination marked the beginning of true immunization.
• Vaccination rapidly spread, dramatically reducing smallpox deaths.
• [19:06] Frum:

  “George Washington vaccinated the continental army under command and duress. You had no choice about it.”

3. Breakthroughs and the Public Health Revolution

• [20:07] Major killers like bubonic plague, typhus, and tuberculosis were blunted through:
  • Understanding microbes (Pasteur, Koch)
  • Vaccination
  • Clean water and sanitation
  • Antibiotics and other therapies
• Frum: Criticizes contemporary public officials dismissing germ theory.
• Harper: A layered defense system—vaccines as “the linchpin.”
• [22:06]

  “Vaccines are sort of like the best bullet that we've got to really target some of the worst diseases.” (Harper)

4. Polio, Measles, and American Triumphs

• [22:26] Post-WWII developments: measles and polio vaccines.
• Polio vaccine (Jonas Salk) was revolutionary—public parades celebrated its arrival.
• [25:05] Frum recounts contemporary anti-vaccine sentiment (e.g., Walter Winchell’s misinformation on polio vaccine), drawing parallels to today.
• Harper:

  “The way in which the lack of trust in a polarized society has allowed this issue to become politicized is very dangerous.” (26:35)

5. Social Trust, Cultural Change, and Public Health

• [27:27] Daily behaviors (food wrapping, hand washing) reflect layered defenses built through science and policy.
• Harper:

  “It happened because reformers promoted knowledge...there's a government role...food safety cultures are the product of science and society, but also of smart public regulation.” (28:36)

6. The Evolution of Infectious Diseases

• [29:46] Frum: Challenges the assumption that today’s diseases have always existed.
• Harper:
  • Disease pools change as humans domesticate animals, urbanize, and travel.
  • Some diseases (like smallpox and measles) are relatively new in human history but devastating.
  • Despite advances, new threats will always emerge.
• Quote:

  “We have tripled the average human life expectancy because we've controlled infectious diseases. But we can never declare victory because they'll keep evolving.” (Harper, 32:43)

7. The Human Toll: Child Mortality and Its Emotional Legacy

• [32:43] Drastic improvement in life expectancy results mainly from reduced child mortality.

• Frum:

  "Liberating human beings from that horror where so many children died before the age of one..."

• Harper:

  "...They loved their kids like, we love ours... ‘Here ends my joy.’ These people were, were broken by this heartache and trauma…”

8. The Measles Paradox and Modern Anti-Vaccine Movements

• [35:12] Measles is the most contagious human disease.
• Widely believed to be benign for healthy, affluent children, but deadly for the vulnerable.
• Measles vaccine success depended on herd immunity, which requires communal participation.
• Anti-vaccine sentiment attached itself, ironically, to the vaccine closest to eradication.
• Harper:

  “We were on the path to send [measles] the way of smallpox, but now it's back…”
  “It's a vaccine that you get not only to protect yourself, but to protect the herd. And in a polarized society...that argument doesn’t have the purchase it used to.” (35:12)

9. Society, Individualism, and the Covid Parable

• [39:29] Covid-19’s social impact was shaped by who it threatened most.
• Many Americans refused to adopt public health recommendations if they primarily protected others, especially the elderly.
• Harper:

  “Our response to Covid very much was shaped by the fact that it affected different groups...These are hard questions...impossible when you're pretending bunk science is real.” (40:09)

10. Ancient Responses to Epidemics and the Temptation to Blame

• [41:14] Societies have always sought scapegoats or supernatural explanations.
• Roman arguments over religious neglect during plagues parallel modern search for blame.
• Harper:

  “These are very deep human ways of responding to disease...you look to blame something or someone.” (41:56)

11. The Institutions of Public Health and Their Vulnerability

• [42:33] Modern science and public health are deliberate achievements, built painstakingly over centuries.
• Built on Enlightenment values (empiricism, verification, neutrality).
• Massive U.S. investment in medical research has benefited the world, but these institutions are now politicized and at risk.
• The consequences of underfunding or political attacks will be paid in future crises.
• Quote:

  “Science is a human institution...Our greatest weapon is our ability to innovate, to come up with solutions and to work together...They [scientific institutions] need to be neutral ground.” (Harper, 43:27)

12. Outlook: The Next Pandemic

• [47:12] The next pandemic is inevitable. Its impact will depend on both scientific preparation and social cohesion.
• Frum:

  “This is a year in which we don't look very well prepared in either dimension. And let's hope we do better in the years ahead.”

• Harper:

  "It's a sad fact we're less prepared today than we were for COVID 19. We don't know when the next pandemic will threaten us, but we know that it will come someday.” (47:29)

Notable Quotes & Memorable Moments

• “Almost everybody got [smallpox]. So it was, it was a real problem...”
  — Harper (15:39)
• “The way in which the lack of trust in a polarized society has allowed this issue to become politicized is very dangerous.”
  — Harper (26:35)
• “It's a vaccine that you get not only to protect yourself, but to protect the herd...in a polarized society...that argument doesn’t have the purchase it used to.”
  — Harper (35:12)
• “This is the greatest accomplishment in the history of our species...We have tripled the average human life expectancy because we've controlled infectious diseases.”
  — Harper (32:43)
• “It's a sad fact we're less prepared today than we were for COVID 19.”
  — Harper (47:29)

Timestamps for Key Segments

• 00:54–11:56: Frum’s monologue on erosion of law under Trump
• 11:56–12:25: Introduction of Kyle Harper
• 12:25–14:13: Life before vaccines; the burden of infectious diseases
• 15:20–19:21: History and breakthrough of smallpox vaccination
• 20:07–22:06: Pasteur, Koch, and the microbial revolution
• 22:06–26:35: Postwar vaccine miracles and early anti-vaccine panic
• 27:27–29:46: Everyday public health practices; infrastructure
• 29:46–32:43: Disease evolution; public misunderstanding
• 32:43–34:44: Child mortality and its emotional/human impact
• 34:44–39:29: The story of measles and the anti-vaccine surge
• 39:29–41:14: Individualism and the social response to COVID-19
• 41:14–42:33: Historical scapegoating and societal blame in pandemics
• 42:33–47:29: Science as an institution; its achievements and risks
• 47:29–47:43: Preparation (or lack thereof) for the next pandemic

Tone & Language

Frum and Harper's exchange is academic, empathetic, and sometimes biting, especially when critiquing anti-science beliefs and current political trends. Both speakers reference history, personal anecdotes, and recent events to keep the discussion vivid and grounded. Harper’s tone is measured and explanatory, aiming to bridge knowledge gaps and infuse urgency. Frum interjects with pointed, sometimes sardonic observations about political failures and cultural change.

Final Takeaways

• The return of deadly diseases like measles is a preventable tragedy rooted in eroding social trust, politicization of science, and anti-vaccine sentiment.
• Vaccines represent one of humanity’s greatest — but fragile — achievements.
• Societies must recommit to collective responsibility, support scientific institutions, and resist the lure of misinformation and individualism at the expense of public health.

For More:

• Kyle Harper's books: "The Fate of Rome" and "Plagues Upon the Earth"
• Subscribe and support The Atlantic for in-depth reporting on democracy, history, and science.