In the Yale course on the history of epidemics, the professor gives a list of ten questions by which the social and historical impact of a disease can be assessed. These clearly show why the plague was among the most feared and most influential diseases of all times.
1. What is the total mortality (number of deaths) and morbidity (number of cases)? Plague was among the most virulent of diseases in both respects, at least over a short period of time. Smallpox killed more people, and influenza infected more over the long term.
2. What is the case fatality rate? Killing 50-80% of the infected persons, plague is rivaled only by cholera among the major epidemic diseases.
3. What are the symptoms, and how painful and degrading are they? Plague, cholera and syphilis are equally excruciating and dehumanizing. In contrast, tuberculosis sufferers have been romanticized in much of the literature we read.
4. Is the disease familiar? One of the reasons there is no book on smallpox comparable to Defoe's is that it killed regularly and predictably (at least in Europe) and thus generated less panic than a disease that appeared only once a generation.
5. What is the victim's profile? Here is another reason plague was so feared and disruptive. It struck people of any age and previous state of health. No one could feel safe from it, and it often removed the breadwinner from the family, leaving helpless dependents.
6. What is the class profile of sufferers? Plague struck every social class and profession, unlike cholera which concentrates in the poorer classes, again leaving everyone feeling vulnerable.
7. What is the mode of transmission? The method of transmission of the plague (rats and their fleas) was so poorly understood that its spread could only be perceived as arbitrary, random, and unpredictable, adding to the panic it caused.
8. How quickly does the disease act? Plague and cholera can both kill within hours of exposure, in contrast to tuberculosis and AIDS which can take years.
9. How is it understood by the population? This is a key issue with plague. Given all the factors above and the medical ignorance of the time, the only plausible explanation was divine punishment.
10. What is the duration of an epidemic? As we read, plague persists for the better part of a year.
All of the above, as supported by Defoe's observations, help explain why the plague was not only one of the most feared diseases in human history, but had a considerable impact on politics, science, trade, religion and the arts.
« Back to index