Americans watched anxiously as the pandemic crept toward them, spreading with seeming inevitability from its origin in Asia to Europe and then, crossing the Atlantic, to the United States. When the disease arrived, it brought the country to a halt: Ports closed, storefronts shuttered, and once-bustling downtowns emptied. Churches shut their doors. An eerie quiet fell on American cities.

This describes the scene in the early 1830s, as Americans faced the arrival of cholera—a deadly disease endemic to the Ganges Delta that swept across the globe with devastating effects several times during the 19th century.

Yet the description also fits the first months of 2020. Like antebellum Americans, we fretted about when the disease might arrive on our shores. Like them, we raced to understand the disease—its cause, its cure, and how it might be prevented. Like them, we undertook belated public health interventions even as we worried about the economic consequences of those interventions. And now, just as in the 1830s, American Christians are confronting the pandemic within frameworks provided by their beliefs.

Given these parallels, despite all that has changed in medicine and religion in the intervening 190 years, can Christians learn anything from their antebellum forebearers?

We see in their responses to cholera a common impulse to provide moral meaning to the pandemic. But they varied widely in their approaches to those who suffered the most. Christians with socioeconomic and cultural power were blinded to the plight of the vulnerable by their visions of a disciplined, hard-working Protestant nation. It took Christians on the margins to speak on behalf of the sick, the poor, and the immigrant.

What hindsight enables us to see clearly in the 19th century may serve as a challenge to us today. Pandemics are profound social stressors that reveal fault lines of power and prejudice while also serving as opportunities for selfless love. As the coronavirus raises questions about morality, racism, and economic prosperity, we would do well to ask whether we find ourselves on the side of the suffering.

In his masterful bookThe Cholera Years, historian Charles E. Rosenberg describes a theological spectrum of Christian responses to cholera. Some Christians interpreted cholera as a divine judgment on the United States, especially on its more profligate citizens. This was in keeping with tradition: Since the arrival of Puritans in the early 17th century, American Protestants had discerned a connection between sin and sickness. Collective illness suggested collective sin, just as personal illness suggested personal sin. Pandemics had thus long prompted fast days dedicated to repentance and prayer.

Antebellum Christians carried on this tradition. When cholera began spreading along the Eastern Seaboard in the 1830s, clergy such as Congregationalist minister Orville Dewey examined what God intended in such a crisis. Taking his cue from contemporary doctors who believed that drinking too much alcohol rendered people vulnerable to the disease, Dewey saw cholera as divine support for the temperance movement. By superintending a pandemic that struck hard drinkers the hardest, surely God blessed the anti-alcohol crusade. Indeed, Dewey was prepared to consider the fatal public health crisis a “beneficent visitation” if it succeeded in impressing upon Americans the perils of strong drink.

Other Christians also perceived God working in cholera, albeit one step removed. To more liberal believers, the disease arose not from miraculous divine judgment but from the normal operation of the laws of nature. Yet, even if it were explicable in scientific terms, cholera still contained a moral lesson. By all accounts, the disease did its worst damage among the poorest residents of American cities. Because many Americans believed poverty arose from personal moral failures, they assumed these sufferers were also the most reprobate. As Thomas Bradford Jr., a lawyer working in Philadelphia at the time, observed, cholera strikes “among the lower classes of people, the intemperate, the licentious, & and the wretched.” To many Protestants, this was no coincidence. The fact that those who lived fast and loose suffered disproportionally from disease simply illustrated the harmony of God’s moral and natural laws. This etiology thus contained an ethic: Live rightly or face the necessary consequences. As cholera dealt death to impoverished Philadelphians, Bradford wrote this of the pandemic: “The city is not moved by it. … They know they can avoid it by prudence in living and care of their persons & families.” The disease could be staved off “by those who have the means and are careful.”

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Many of the poor and ostensibly immoral sufferers of cholera had another strike against them: They were Irish Catholic immigrants. This demographic reality—evident during the 1830s and even more pronounced when cholera returned in the late 1840s—only rendered more certain the old association between contagion and foreigner. Even though most doctors in the 1830s did not yet believe cholera was contagious, many Americans could not shake the intuition that the disease spread from person to person. They therefore shut their homes and their hearts to the immigrants just then arriving from Ireland. In the coming decades, the link between cholera and the Irish only fueled the Protestant nativist movement and its anti-Catholic, anti-immigrant animus.

While most Americans during the antebellum era endorsed the Protestant gospel of individual responsibility, some dissenters articulated an alternative ethic. Often speaking from the religious periphery, these people acknowledged that cholera was a disease of poverty, but they interpreted this fact not as a judgment of the poor but as a damnation of the society that impoverished people and thereby made them susceptible to disease. Catholic priests, for example, for whom Irish immigrants were parishioners rather than pariahs, viewed cholera differently than Protestant clergy. Their analyses reflected both the fact that they often ministered to the working classes (and those below) rather than the well-to-do and their theological rejection of liberal individualism. Addressing the cholera pandemic of the late 1840s, Bishop John Baptist Purcell pleaded for adequate housing for the less fortunate residents of Cincinnati. If cholera represented divine reproof, Purcell argued, it was for the sins of “oppression and insensitivity to the wants and the claims of the poor.”

There was yet one more option for Christians confronting cholera: service. When the disease first arrived in American cities, those who could afford to flee did so—along with them many Protestant ministers, who left behind emptied neighborhoods and quieted church bells. Yet many Catholics who had vowed themselves to lives of service stayed to help. When fears of contagion made it difficult for city leaders to secure hospitals for cholera patients and nurses to staff those hospitals, nuns stepped into the breach. Orders such as the Sisters of Charity and the African American Oblate Sisters of Providence created and staffed cholera hospitals throughout the country. Many sisters died in this service.

Whether they gathered in churches to pray in search of the divine meaning of cholera, or, like the formerly enslaved Catholic hairdresser Pierre Toussaint, crossed quarantine barricades to care for the sick, 19th-century Christians confronted cholera with the tools of their faith.

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Rosenberg argues that as doctors improved their ability to explain and to prevent cholera—the English physician John Snow determined that the disease was waterborne in 1855, leading to improved sanitary measures—Americans looked less to God and more to public health initiatives to save them from disease. Yet, as recent history demonstrates, medical etiologies hardly preclude religious interpretations. Like their antebellum predecessors, believers today continue to turn to Christianity in the face of a global health crisis. What guidance does their faith provide?

American Protestants still search for evidence of divine reproof in widespread sickness. In a recent sermon, for example, the prominent First Baptist Dallas pastor Robert Jeffress asked whether the coronavirus might be a judgment from God. While he said it would be “presumptuous” to answer definitively, Jeffress nevertheless reminded his congregants that “God judges a nation that permits and celebrates the killing of children” through abortion. Presbyterian minister and activist Liz Theoharis, meanwhile, invoked an apparent connection between biblical plagues and wealth inequality to argue that the coronavirus calls Americans to seek economic and health care justice.

As in the 1830s, Christians are again grappling with the politics of immigration and race that trouble the American response to the pandemic. In recent weeks, President Donald Trump and other Republican politicians insisted on referring to the coronavirus as the “Chinese virus” and similar variants—with the jocular support of evangelical personality Eric Metaxas. Christian critics, meanwhile, pointed to an apparent uptick in anti-Asian racism around the world as evidence that such language is dangerously xenophobic. Korean-born evangelical minister Eugene Cho, for example, said that such language “only instigates blame, racism, and hatred against Asians.”

Christians are also carrying forward the imperative to serve the hurting. During 19th-century cholera pandemics, that service usually meant tending directly to patients. Just so, countless Christians are caring for those struck by the coronavirus through medicine and other ministries, often at great risk to themselves owing to the lack of personal protective equipment. Yet, as Anglican priest and New Testament scholar Esau McCaully argued, for most believers, neighborly love in the midst of the coronavirus might require “not our physical presence, but our absence”: dutifully observing social distancing and hygiene guidelines out of love for those at greatest risk from the disease. As questions about economic recovery begin to dominate headlines, Southern Baptist leader Russell Moore invoked “the sanctity of human life” to urge Christians to continue their public health measures, regardless of the financial consequences, for the sake of the “vulnerable.”

The epidemiology of the coronavirus differs from cholera, yet it presents the same question: How will Christians respond to their community in its time of need? The next weeks and months are likely to reveal more varied Christian responses to the pandemic, just as we saw in the 19th century. However we respond, we can hope for a Christlike legacy: healing the sick, comforting the brokenhearted, and caring for “the least of these.”

Jonathan D. Riddle, Ph.D., is an assistant professor of history at Wheaton College, where he works on the history of religion and medicine.