Connie Nugent MLS
Corresponding author: Connie Nugent
Contact Information: [email protected]
DOI: 10.12746/swrccc.v8i34.685
Tis now the very witching time of night, when churchyards
yawn and hell itself breathes out Contagion to this world.
Hamlet, Act IV, Scene III
It started in Chinese “wet” markets. A novel coronavirus leaped from bats to pangolins to humans, and within a few months the COVID-19 pandemic brought the world to its knees. It’s not the first global pandemic, nor will it be the last, but human suffering is the same regardless. Plagues and pestilence occur in the Bible, the Quran, and the Talmud; displeasing or disobeying God wrought havoc among the faithless.
The Book of Exodus records several plagues visited upon Pharaoh’s people, including a blizzard of locusts,
They shall cover the surface of the land, so that no one will be able to see the land. They shall devour the last remnant left you after the hail, and they shall devour every tree of yours that grows in the field. They shall fill your houses …”1
The Bible does not describe how this affected ordinary people, but Laura Ingalls Wilder recalls a plague of locusts that befell Minnesota in the 1870s. Looking out of the window, the Ingalls family sees a cloud approaching, but it is like no cloud they had ever seen.
The cloud was hailing grasshoppers. The cloud was grasshoppers. Their bodies hid the sun and made darkness. Their thin, large wings gleamed and glittered. The rasping whirring of their wings filled the whole air and they hit the ground and the house with the noise of a hailstorm.
Laura tried to beat them off. Their claws clung to her skin and her dress … Mary ran screaming into the house. Grasshoppers covered the ground … they smashed squirming and slimy under [Laura’s] feet … the roof went on sounding like a roof in a hailstorm.2
When Laura scurries to the barn to milk the cow, “grasshoppers were thick under her petticoats and on her dress and shawl. She kept striking them off her face and hands.” And the grasshoppers are voracious, “Day after day the grasshoppers kept on eating. They ate all the wheat and the oats. They ate every green thing—all the garden and all the prairie grass …” Laura’s father fought the good fight to save the wheat, but for naught. And yet, Pa does not lose hope, “Don’t worry … We did all we could, and we’ll pull through somehow.”2 Even now, changing weather patterns due to climate change have unleashed a plague of locusts that is decimating swaths of East Africa, devouring crops and grasslands. National Geographic writer Madeline Stone remarked, “… [it] sounds like something out of the Book of Exodus.”3
In a Wall Street Journal article, Michelle Slatalla points out that reading fiction about crises such as pandemics and natural disasters can allow us to identify with others who have similar experiences. In social isolation due to COVID-19, she depends on her books to help her understand the scope of this coronavirus, “So at a time when I’m spending the least amount of time around strangers, I might actually be learning the most about them.”4
The most highly destructive pandemic in human history was the bubonic plague in 14th century Eurasia. Rats harboring the bacterium Yersinia pestis traveled on ships, bringing the Black Death from East Asia in 1331 to Europe and North Africa, reaching England in 1348. In August of that year, the Bishop of Bath and Wells, Ralph of Shrewsbury, warned his diocese of the “pestilence which had come from the East into the neighboring kingdom.”5 Ships from that neighboring kingdom of Calais, France, brought the plague into England through the southwest port of Weymouth, “sweeping over the southern districts destroy[ing] numberless people.”5
Connie Willis’s award-winning science fiction novel Doomsday Book features Kivrin Engle, an undergraduate historian at Oxford University in 2054, who is scheduled to travel into the past to observe medieval life in 1320. She is inoculated against a variety of infectious diseases, including the bubonic plague, and is augmented with an interpreter to allow her to understand and speak Middle English. (Movies in which characters travel to the past and are immediately able to converse in the current language are inaccurate. Not happening.)
Against the wishes of Mr. Dunworthy, an Oxford professor, Kivrin is sent to a small village near Oxford. She becomes mysteriously ill almost immediately and is cared for by the residents of a nearby manor. Meanwhile, in 2054, a mysterious virus sweeps through Oxford, causing a citywide quarantine. As Kivrin and Mr. Dunworthy individually are horrified to learn that she is in 1348, not 1320, the story alternates between the Black Death pandemic near Oxford and the 21st century viral pandemic in Oxford. The parallels are evident; disease overpowers those in the past and in the future and loved ones die. The city of Oxford in 1348–49 “appears to have suffered terribly … the school doors were shut, colleges and halls relinquished, and none scarce left to keep possession, or make up a competent number to bury the dead.”5
One strength of this novel lies in the human response to medical crises. Kivrin bonds with the family who tends her during her illness, specifically the children Agnes and Rosemund, and with the priest Father Roche. As the villagers succumb, and Kivrin and the priest are the primary caretakers, Kivrin plans to take Father Roche to Scotland, since she knows it will be two more years before the Black Death reaches Edinburgh.6 It’s too late; the priest is also infected, “‘Don’t do this to him,’ Kivrin murmured over and over without knowing it. ‘Please! Please! Don’t do this to him.’” But it is no use. “‘Why do you weep?’ he said. ‘You saved my life,’ she said, and her voice caught in a sob, ‘and I can’t save yours.’”7
Simultaneously, seven hundred years in the future, residents of Oxford are frantically working against time to diagnose this new virus and to devise treatments. Mr. Dunworthy, though ill himself, spares no effort in trying to retrieve Kivrin from the past. Transported to her last known location, he and a colleague search for her; he is overwhelmed by what he sees in a plague-stricken village, “No one could have lived through this, watching children and infants die like animals, piling them in pits and shoveling dirt over them … how could she have survived this?”7 Eventually Dunworthy locates Kivrin in the next village; she is the only one left, sitting alone among the graves of her friends.
The bubonic plague revisited Eurasia and England several times throughout the next few centuries. During the plague in Scotland in the 1600s, Mary King’s Close, on Edinburgh’s Royal Mile, was a section of narrow streets and tenements. Around half of its 500 residents were infected, so all were locked in their homes, the area was bricked up, and they were left to die.8 City fathers built over the close, and now it is an underground tourist attraction.
Northern Africa was not immune to the plague; Oran, Algeria, is the setting of Albert Camus’s novel The Plague. Set in the 1940s, events in the plot parallel much of the current response to COVID-19. At first the community elders dismiss the disease as unimportant, “… it was a mistake to paint too gloomy a picture.” Dr. Rieux counters, “It’s not a question of painting too black a picture. It’s a question of taking precautions.”9 The Prefect issues orders for minimal restrictions, which prove useless, and eventually is persuaded to establish a general quarantine, “the town ceased to be in touch with the rest of the world.”9
Townspeople practice social isolation, “… the first thing the plague brought to our town was exile … that sensation of a void within which never left us, that irrational longing to hark back to the past or else to speed up the march of time.”9 At first people are “alarmed, but far from desperate … they hadn’t yet reached the phase when plague would seem to them the very tissue of their existence.” As the number of deaths increase, “a mood of profound discouragement settled upon the town” as residents begin to understand the true nature of a pandemic. No one is safe. The hospital is overrun; physicians are exhausted; supplies run low, particularly for the poor. The plague finally runs its course, and citizens begin to discuss “the new order of life that would be set in.” But the town is changed, “In the memories of those who loved through them, the grim days of the plague do not stand out like vivid flames, ravenous and inextinguishable … but rather like the slow, deliberate progress of some monstrous thing crushing out all upon its path.”9
People living through plague years surely must have thought the world was ending. “Are these the last days,” Father Roche asks Kivrin in Doomsday Book, “the end of the world that God’s apostles have foretold?”7 Albrecht Durer’s iconic woodcut The Four Horsemen of the Apocalypse mirrors those desperate times as it portrays the prophecy from The Revelation of St. John 6:1–2
Then I saw the Lamb open one of the seven seals, and I heard one of the four living creatures call out, as with a voice of thunder, “Come!” I looked and there was a white horse! Its rider had a bow; a crown was given to him, and he came out conquering and to conquer.1
One method of conquering is with pestilence; the bow and arrows of the horseman on the far right represent the randomness of infection. A person shot with arrows usually does not know the location of the archer; the victim of infectious disease may never know the source of the pathogen. Other interpretations attribute pestilence to the horseman swinging the scales of famine.10 Regardless, Durer’s “four galloping figures on fearsome horses … have become universal symbols: Conquest, War, Pestilence … Death, with his mad relentless eyes, on his haggard steed.”10 No one is exempt; the horsemen “ride roughshod over popes and peasants alike,”11 much like a coronavirus.
Albrecht Durer. The Four Horsemen of the Apocalypse. 1494–95.
Europeans brought smallpox, cholera, typhus, and other deadly bacteria and viruses to the New World, “causing devastation far exceeding that of even the Black Death in fourteenth century Europe” since native populations had no natural immunity.12 Although these diseases and bubonic plague are treatable since the discovery and development of antibiotics, pandemics still occur throughout the modern era. Texas playwright Horton Foote’s play 1918 takes place in a small Texas town that is ravaged by the influenza epidemic that will kill over 20 million people worldwide. In reviewing the film made from the play, critic Vincent Canby wrote, “Present, but unseen, and striking with an awful, sudden randomness that tests [the town’s] uniformly Christian faith … it’s like a medieval plague, one that breeds not in the squalor of ancient, overcrowded cities but in a well-ordered, American cleanliness that is supposed to be next to godliness.”13 The title of Katherine Anne Porter’s trilogy of short novels, Pale Horse, Pale Rider, reflects the passage in Revelations and reminds the reader of Durer’s woodcut, in which Death is the ghastly rider on a white horse. Pale Horse, Pale Rider recounts the effects of the influenza pandemic on Miranda and Adam; both are infected, but only one of them survives.14
The panic over the poliovirus frightened families during the 1950s (many remember the horrifying thought of being imprisoned in an iron lung) until Jonas Salk developed a vaccine and became a national hero. Professor David Oshinsky compares that pandemic with the current one, “Both the poliovirus and the coronavirus rely on ‘silent carriers’—those showing no immediate symptoms—to spread the disease, inciting a fearful sense of uncertainty. Both target specific, if dramatically different, age groups: COVID-19 seems especially lethal for the elderly, polio for the young.”15 Oshinsky points out that “Americans came together during the polio era to fight the disease with fewer tools than we have now but with greater purpose and determination.” The March of Dimes raised millions of dollars through public spiritedness—“the victory belonged to science and to the people.”15
In his History of the Peloponnesian War, Thucydides examined the epidemic of typhoid or typhus that raged through Athens in 430 BCE and how the practical and moral weaknesses of society allowed the disease to flourish. A lack of attention to public health and safety and poor urban planning provided conditions ripe for rapid contagion. According to Katherine Kelaidis of the National Hellenic Museum, “It is clear that, for Thucydides at least, the death and suffering of a great epidemic (just like war) test the moral health of individuals and of societies. And a people who are not morally strong, when they become afraid, quickly slip into lawlessness and sacrilege … To paraphrase Michelle Obama, pandemics don’t make your character; they reveal your character.”16 It is important, therefore, that although we are living in a time of medical uncertainty, that we face the COVID-19 pandemic with selflessness and courage, with grit and determination. As Camus’s Dr. Rieux points out, “… what we learn in a time of pestilence [is] that there are more things to admire in men than to despise.”9 And, as always, there is the human capacity for hope.
“Hope” is the thing with feathers -
That perches in the soul -
And sings the tune without the words -
And never stops – at all -17
Article citation: Nugent C. Pandemic. The Southwest Respiratory and Critical Care Chronicles 2020;8(34):68–72
From: The Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas
Submitted: 4/11/2020
Conflicts of interest: none
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.