With pandemics, sickness and death only a fraction of devastation

With pandemics, sickness and death only a fraction of devastation April 25, 2020

When deadly pandemics and epidemics hit, the immediate fear is always of catching the disease yourself — and maybe dying.

plague black death fall rome america coronavirus public health
Transporting the dead: Illustration from “Once a Week” magazine, accompanying a ballad about a medieval plague in the Elliant district of Brittany. (John Everett Millais, Wikimedia Commons, Public Domain)

At first, however, we don’t tend to worry about the collateral damage, the potential devastation not to people but to the fundamental systems that keep societies humming in normal times.

Like health-care and death-processing systems, for example.

I’m thinking about this as the coronavirus spreads out and creates trepidation and depredation across America, because a similar dynamic occurred — though in a far more extreme fashion — when the Roman Empire collapsed in antiquity and, later, in devastating plagues across Europe in the Middle Ages.

While doing research for a book I remember reading about these near-Apocalyptic historical events and how they completely overwhelmed virtually all civic services.

Keep in mind that when imperial Rome imploded in 476 AD and the jobs supported by the revenue of empire evaporated, all the most literate, capable and educated people also disappeared, heading to where jobs remained, far away. Those elites are who ran government, commerce and public services in that day. Suddenly, whomever was left were on their own. And a public health system did not then exist.

During the medieval plagues (which began in the 14th century and occasionally resurged over centuries), a similar devastation occurred but for a different reason: instead of people disappearing due to emigration, they vanished due to death. But the end result was much the same: with too few qualified, knowledgeable people to do many key jobs, they just didn’t get done — from grave digging to soul saving to food growing. Survivors were forced to innovate, or criminalize to get what they and their families needed.

Plagues generated a disturbing religious component, based on the idea that the disease was a punishment from God for mankind’s sinfulness. Supposed heretics and troublemakers were executed to atone, including many thousands of Jews in Christian Europe.

“Some upper-class men joined processions of flagellants that traveled from town to town to town and engaged in public displays of penance and punishment: They would beat themselves and one another with heavy leather straps studded with sharp pieces of metal while the townspeople looked on,” according to an article in History.com. “For 33½ days, the flagellants repeated this ritual three times a day. Then they would move on to the next town and begin the process over again.”

The current pandemic of COVID-19 is admittedly mild compared to those ancient catastrophes, but, still the virus has already killed tens of thousands worldwide, and millions have been infected. And, in the U.S. we can see the telltale effects: jobs are disappearing, public systems are straining, health-care professionals are apprehensive and overworked, (some) churches are shuttered, students shun schools, people huddle mostly at home hoping to be spared infection.

This is why public-health officials at all levels have been animated in their emphasis on social distancing, hand washing and massively reducing the size of any gathering. They know into what dark alleyways pandemics can lead. Their immediate concern with the coronavirus was that there might be so many cases that U.S. health-care facilities and systems might be overwhelmed, suddenly caught with too few hospital beds, insufficient slots in intensive-care units, a gaping lack of protective gear for health professionals treating the infected, and a worrisome deficit in testing equipment and materials to determine exactly how widespread the pandemic is in this country.

The good new is, it’s been less severe than models first projected, but it’s been plenty bad enough. Today, nearly 50,000 Americans have died of the pestilence, nearly as many as perished in the Vietnam War, and many more have been sickened. The not-good news is that the virus continues to spread, infections mount and deaths proliferate.

The reason it’s not worse, public-health experts are telling us, is because Americans have been surprisingly cooperative and disciplined in mitigation behaviors to this point: staying home, social distancing when outside and frequent hand-washing. Still, there is a lot of pressure from certain quarters to too-quickly restart the economy, opening even such close-quarters facilities as massage parlors, gyms and hair-and-nail salons.

Governors who are reacting to the pressure by leaning toward briskly reopening their economies, face a rebound of the virus, experts warn. I am guessing some governors aren’t thinking about the wholesale devastation to society if an incurable mutating virus breaks out and goes wild, as did the “Black Death” (bubonic plague) in Europe during the 14th century.

They should.

And experts are also now warning that a “second wave” of COVID-19 might wash over America in the fall or winter, and that it could be even more virulent.

Now’s the time to worry about the economy second, not first. What’s best for long-term public health should trump everything else until the pandemic confirmably recedes, including the momentarily irrelevant economic and political obsessions of President Trump.

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