Tag Archives: Medical Condition

A World Of Pandemics: Part IV

How Humanity’s Response To Epidemic Disease Has Stayed The Same Throughout History

For millennia, societies have faced destructive epidemics that caused a major loss of life. Although the germs that cause epidemics change over time, and people may pretend humanity has too, responses to epidemics show startling similarities across centuries. During Justinian’s Plague, 40% of Constantinople’s population perished. When the plague of Athens struck, it took out up to 30% of the city. And when the Black Death swept Europe in the 14th century, it ended the lives of millions, with population losses of over 50% in some areas. Even epidemics with lower mortality rates cause major disruptions, like the Spanish flu of 1918. But regardless of era or disease, people have shown many of the same responses: flee from the source of the danger, look for a scapegoat, propagate pseudoscientific cures, and question scientific authority.  

In a time of crisis all bets are off; we fall into the most primal fears and patterns. And though people will do what they can to save themselves, not all behaviors are bad. Some may even better prepare humanity for future epidemics and crises.

People Try To Find A Scapegoat, Leading To Instances Of Extreme Prejudice And Racism

Photo: Michel Wolgemut and Wilhelm Pleydenwurff/Wikimedia Commons/Public Domain

When epidemics spread, communities often look for a scapegoat. During the Black Death, Europeans blamed Jewish communities for spreading the disease. One chronicle reported, “Death went from one end of the earth to the other, on that side and this side of the sea . . . In some lands everyone died so that no one was left.”

In Strasbourg, the plague took out thousands, and Christians blamed the city’s Jewish population. “On Saturday – that was St. Valentine’s Day – they burnt the Jews on a wooden platform,” the chronicle recorded. “There were about 2,000 people.” The same happened in other cities. “In some towns they burnt the Jews after a trial, in others, without a trial.”

Just as the Jews became scapegoats during the plague, racism against Chinese people increased during the 2003 SARS epidemic and the 2020 coronavirus epidemic because they both originated in China. In New York City, during the 2020 epidemic, tourists have even avoided Chinese restaurants for fear of catching the virus despite there being no evidence to suggest people of East Asian origin are more likely to spread the disease.

These are not the only cases in modern history, however, and people of East Asian origin are not the only targets of prejudice. During the Ebola outbreak of 2015, people from West Africa were targets of xenophobia; while the LGBTQ+ community was stigamatized during the AIDS crisis of the 1980s. 

People Peddle Pseudoscientific Cures And Spread Disinformation

Photo: Pluto Water Company/Wikimedia Commons/Public Doma

In 1900, the bubonic plague reached the shores of America. An outbreak in San Francisco threatened to spread the disease. Doctors warned that bacteria spread the plague, but government officials undermined their efforts by questioning the science.

In California, Governor Henry Gage was skeptical about germ theory. He couldn’t personally see the bacteria that caused plague, and thus denied its existence. As the plague swept through Chinatown, white San Franciscans claimed they were immune from the disease, blaming its spread on poor hygiene. But they, too, soon faced a plague epidemic, regardless of their scientific skepticism and denial. 

Similarly, during Justinian’s Plague in the sixth century, people turned to cures with no basis in science. Some claimed taking cold baths protected people from plague, while others sold magic amulets. 

Similar pseudoscientific claims continue into the 21st. During the 2015 Zika virus epidemic a rash of conspiracy theories made their way through social media platforms. One such claim blamed one of the viruses symptoms, microcephaly, a condition which causes babies’ heads and brains to develop abnormally, on MMR and DTAP vaccines in an effort for pharmaceutical companies to profit off of Zika vaccines. 

Psedoscientific claims can cause adverse effects to individual and societal health. In the case of the Zika virus, doctors and scholars looking to limit the disease’s reach claimed the disinformation threatened the legitimacy of healthcare institutions, potentially exposing more people to the disease as people refused to trust healthcare professionals. In other cases, the pseudoscientific claims and cures, like drinking bleach, have caused more direct health issues.

Due To Extreme Population Loss, Affected States Experience A Loss In Military And Political Strength

Photo: Edward A. “Doc” Rogers/Wikimedia Commons/Public Domain

In the sixth century, the Byzantine Empire experienced a horrific plague that caused a massive drop in population. Under the Emperor Justinian, the Byzantines had expanded their borders and fought to regain parts of the western Roman Empire. But Justinian’s Plague threatened to destroy the empire.

Thanks to population loss, the Byzantines could no longer defend their overseas territories. In addition to the military losses, the Byzantines also endured economic and administrative problems that decreased the empire’s political power. Though the empire survived the plague, it never again achieved the reach it had under Justinian.

Justinian’s Plague was not the only Ancient historical case. In the fifth century BCE, the Greek city-states of Athens and Sparta faced each other through a nearly 30-year war. During the second year of the war, however, while Sparta had laid siege on the Athens, the defending city was swept by an unknown epidemic disease, which ended a third of its entire population including the states leader, Pericles. 

Some historians and scholars have attributed this unexpected loss of life to Athens’s ultimate defeat and the eventual decline of Ancient Greece’s cultural output. Others would not go that far, citing Athens’s eventual regrowth and victories throughout the battles, but they do agree the city state did lose prestige and power due to the political aftermath of the disease.

Similarly, historians have attributed Germany’s loss at the end of WWI to the emergence of the Spanish Flu epidemic in the summer of 1918. Beginning the year with a military advantage against the Triple Entente and looking to end the war before American soldiers could be deployed, the Germans launched an offensive in hopes of breaking through enemy lines and reaching Paris. They, however, lost about half a million men due to the virus, making it impossible for the army to make that final charge.

Because They Feel A Personal Responsibility To Help, Healthcare Personnel Experience The Worst Of The Disease

Photo: Unknown/Wikimedia Commons/Public Domain

Doctors, nurses, and other healthcare workers often experience high mortality rates during epidemics. The famous plague doctor costume, developed in the 17th century as the bubonic plague continued to ravage Europe, attempted to protect doctors from miasmas, or disease-transmitting clouds. In modern epidemics, doctors wear personal protective equipment, including masks and gloves. 

Due to the close proximity and extended time healthcare personnel spend among epidemic diseases, the high mortality rate among healthcare workers is still the norm despite technological advances.

In the fifth century BCE, Athens experienced a horrific plague that took out one in three Athenians in a single summer. As the Peloponnesian War raged, Athenians battled against an unknown enemy riskier than combat. Doctors experienced an even higher mortality rate during the plague of Athens. That year, according to Thucydides, “Neither were the physicians at first of any service, ignorant as they were of the proper way to treat it, but they died themselves the most thickly, as they visited the sick most often.”

But during the 2015 Ebola epidemic in West Africa, doctors and nurses also perished at a much greater percentage the rest of the population. The World Health Organization attributed the high mortality to fairly regular problems within epidemics, including shortages of both medical supplies and staff, improper use of equipment, and longer than recommended exposure to the disease most often due to a sense of duty to help.

Societies Affected By Major Epidemics Have Resorted To Mass Burial

Photo: S. Tzortzis/Wikimedia Commons/Public Domain

When the Black Death swept across Europe, millions perished in its wake. And the disease’s mortality rate left societies with a troubling logistical problem: How should they dispose of the bodies piling up in the streets?

In Lincolnshire, England, Black Death victims were buried in a mass grave. Discovered in 2013, the grave contains the bodies of nearly 50 people. The community apparently left the grave open and filled it as people perished. According to a journal article in Antiquity, the grave was “filled over the course of several days or weeks.”

Large cities experienced an even more critical problem. According to a 14th century Florentine chronicle, bodies were thrown into deep trenches every night. “The next morning, if there were many [bodies] in the trench, they covered them over with dirt. And then more bodies were put on top of them, with a little more dirt over those; they put layer on layer just like one puts layers of cheese in a lasagna.”

Similar action was taken during the 1918 Spanish Flu epidemic. In 2015, a Pennsylvania Department of Transportation contractor looking to widen the 61 Freeway dug into a 2.25 acre field in Schuylkill County, 100 miles northwest of Philadelphia. Many of the regions residents who perished from the Spanish Flu were found to be buried without caskets. Historians and archaeologists believe there was such a high mortality rate the grave diggers and casket makers could not keep up with the demand, forcing them to unsystematically bury the victims in a large pit.

A Certain Contingent Of People Resort To Hedonism When Death Seems Inevitable

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In an era before people understood bacteria and viruses, epidemics brought even more confusion. And when succumbing to the disease seemed inevitable, some people cast off social restrictions and turned to hedonism.

Boccaccio described the response to the Black Death in Florence. Some shunned the sick and avoided any contact with them. “There were those who thought that to live temperately and avoid all excess would count for much,” Boccaccio related. These people secluded themselves from society while “eating and drinking moderately.” 

Others took the opposite tactic. They believed “that to drink freely, frequent places of public resort, and take their pleasure with song and revel, sparing to satisfy no appetite, and to laugh and mock at no event, was the sovereign remedy for so great an evil.”

These hedonists traveled from tavern to tavern, “drinking with an entire disregard of rule or measure.” 

Boccaccio reported that many of the hedonists perished – but so did those who chose to live moderately.

Similar behavior transpired during the Plague of Athens in the 430 BCE. According to Thucydides:

Men now coolly ventured on what they had formerly done in a corner, and not just as they pleased, seeing the rapid transitions produced by persons in prosperity suddenly dying and those who before had nothing succeeding to their property.

So they resolved to spend quickly and enjoy themselves, regarding their lives and riches as alike things of a day. Perseverance in what men called honor was popular with none, it was so uncertain whether they would be spared to attain the object; but it was settled that present enjoyment, and all that contributed to it, was both honorable and useful. Fear of gods or law of man there was none to restrain them.

In The Wake Of Epidemics, Artists Focus On Macabre Themes

Photo: Schedel’s Chronicarum/Wikimedia Commons/Public Dom

Throughout history, epidemics shape culture as well as society. After living through an epidemic, artists in many eras turn to macabre themes. 

During the Black Death, artists emphasized the end of life itself. Historian Frank M. Snowden says that the plague “had a transformative effect on the iconography of European art.”

Artists drew the “dance of death,” showing skeletons reveling, and also emphasized perishing through including hourglasses in their art. Art reminded viewers that there was no escape from the inevitable.

People Change Their Personal Religious Beliefs And Practices

Photo: Elihu Vedder/Wikimedia Commons/Public Domai

A dangerous epidemic can either shake people’s faith or reinforce it. During the Black Death, Europeans worried the disease had been sent by God as a punishment for their sins. Although many flocked to church for protection, faith didn’t protect Europeans from the plague. 

In the 14th century, the plague swept through religious communities, wiping out entire monasteries and convents. The pope himself withdrew from society instead of stepping up as a religious leader. Zealots like the flagellants swept across the continent, atoning for sin by publicly whipping themselves.

During modern epidemics, backed by knowledge of germ theory, religious communities modify traditions to stop the spread of disease. Others simply stop attending church to avoid exposure to large crowds.

Societies Isolate And Quarantine Those Infected

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For centuries, people separated the sick from the healthy. The Old Testament even lists rules for isolating lepers. 

But quarantines in the modern sense began in the 14th century during the bubonic plague. Venice, a trade hub in the Mediterranean, established the first quarantine by banning ships from the city for 40 days after arriving. Our word for “quarantine” comes from the Italian word “quaranta” which means 40. 

The idea quickly spread. In the second major plague outbreak in 1374, Milan adopted a quasi-quarantine by sending plague victims to a field outside the city, where they remained until they recovered or perished. The coastal town of Ragusa on the Dalmatian coast created its own quarantine station, an idea that quickly caught on. Several islands in the Venetian lagoon were used as quarantine stations for centuries.

Quarantines continued into the 20th century. During the Spanish flu, one city protected itself from influenza by shutting down the roads and quarantining anyone who arrived by trains. In that city, Gunnison, Colorado, no one perished from influenza.

People Practice Healthier Behaviors

Photo: Rensselaer County (New York) Tuberculosis Association/Wikimedia Commons/Public Domai

Educating the public about the spread of disease has been an important tool in fighting epidemics. In the early 20th century, public health campaigns warned people not to carelessly spit, cough, or sneeze, since these helped spread infectious diseases like influenza.

In the 1980s, public education was an important tool in fighting the AIDs epidemic. To slow the spread of the disease, these campaigns focused on changing at-risk behavior. These efforts warned against sharing needles or having unprotected sex. After peaking in the early 1990s, the number of HIV cases in the US dropped in large part thanks to public education.

People Migrate En Masse To Escape The Disease

Photo: Wellcome Images/Wikimedia Commons/CC BY 4.0

During epidemics, large groups of people often migrate to avoid disease. Boccaccio’s Decameron tells the story of Italians who fled Florence during the plague. 

In 14th century Egypt, the bubonic plague destroyed villages and forced many from rural areas to migrate into Cairo. In one district in Upper Egypt, a survey counted 6,000 workers in the fields before the plague. Thanks to those perishing and migrating, only 116 laborers remained after the plague. 

Similarly, in January 2020, about 5 million people left the city of Wuhan, China, before the lockdown. According to Mayor Zhou Xianwang, millions fled days before the quarantine went into place. However, migrants fleeing an epidemic potentially spread the disease, undoing the impact of quarantines.

While Bad For The Economy In The Short Term, Epidemics Tend To Bring Positive Long-Term Economic Changes 

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In the short term, epidemics bring massive economic disruptions. During Justinian’s Plague, trade nearly came to a halt and agricultural prices soared thanks to fewer farmers. In Constantinople, where up to 40% of the population perished, the Byzantine Empire faced an economic crisis when tax revenues collapsed. 

During the Black Death, the high mortality rate meant fewer laborers in the fields. In the short term, that meant higher prices. The bubonic plague, however, brought some unexpected long-term improvements to Europe’s economy. Thanks to a labor shortage, wages rose in the decades after the plague. In England, wages roughly doubled. In Suffolk, laborers made 67% more for reaping after the Black Death. 

Increased wages for the laboring classes meant higher spending and a greater standard of living. Agricultural workers could suddenly afford “luxury” items like butter. In cities, people benefited from more disposable income. In effect, the Black Death redistributed wealth from the aristocrats to the peasants and urban workers, helping drive Europe’s economic engine for centuries.

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