There has been plenty of chatter about how this pandemic will change society. I don’t have any predictions worth the paper this magazine is printed on, so I decided to turn to history.
One of the podcasts I regularly listen to is Tides of History. In April, they ran an episode on the Antonine plague, named after Roman Emperor Marcus Aurelius Antoninus, which hit the Roman empire roughly from 165 AD to 180 AD (with perhaps some ripples after those dates). Most modern historians believe this epidemic was caused by smallpox. What makes this plague interesting is the fact that the Roman empire was at its peak at the time.
The podcast drew heavily upon Kyle Harper’s book, The Fate of Rome, so I downloaded the book through an app and read the chapter on the pandemic. It’s fascinating, partly because genomic sequencing and other technological advancements are reshaping some of our assumptions on disease. For example, did you know that bovine tuberculosis actually descended from the human form of the disease? You can thank genomic sequencing for that tidbit.
Science is also changing our understandings of disease history in more fundamental ways. Many thought that raising livestock was a major factor in diseases leaping from animals to humans, but Harper writes that fairly recent advancements show that farm animals are only a small part of the “biological brew” that spawns infectious disease. Most infectious diseases, even today, come from the tropics. That’s due to the sheer biodiversity in those regions, fuelled by energy from the sun, and uninterrupted by the ice ages that stopped the evolutionary clock in other regions.
“The biogeography of infectious disease, then, does not follow the spatial distribution of plant and animal domestication; rather, it obeys the deeper principles of geographical ecology,” Harper writes.
The Antonine plague, along with another pandemic that hammered Rome later, emerged from the southern reaches of the empire’s networks.
Way back in our history, a highly infectious disease with high mortality rates might have leapt from wildlife into our hunting and gathering ancestors, killed many, and then… had no place else to go, really. People mostly lived in isolated groups. Once they either had resistance or were dead, the disease burned itself out. Pathogens and parasites that didn’t kill their human hosts had the better long-term strategy.
But the Antonine plague had a large, interconnected population to work with. The incubation period lasted several days, so a person could pick it up in one part of the empire and be somewhere else entirely before the disease laid them low. Romans were also an urban people, and although they did have public toilets and fresh water via aqueducts, their general sanitation practices were far from adequate. They had an idea about “contagion” but didn’t know about germs. And although there is some evidence that they ate fairly well for the time (even the poor seemed to have access to animal protein), there’s skeletal, dental and written evidence that they suffered from many other diseases that caused fevers, diarrhea and death before the Antonine plague fell upon them.
By 166, the plague had reached the city of Rome. It moved through the army, killing an estimated 15 to 20 per cent of the soldiers, and forcing Rome to conscript gladiators, slaves and men from communities that had been exempt. Athens, Asia Minor, Germany and Gaul were all hit in waves over several years.
Harper writes that the pandemic resembled a “toxic and fissile pinball, shattering at each collision and diffusing outward in radiating streaks from each point of contact.” It would burn through a town or city, subside, then re-emerge once there were enough susceptible people for it to infect again (the new people having either been born since the last wave or recently migrated).
Some of the medical procedures, such as blood-letting, worsened people’s health. But basic nursing was crucial — in this case, that meant getting food and water into patients. The physician Galen, who chronicled the pandemic, said those who ate tended to survive, while those who couldn’t eat inevitably died.
The disease didn’t hit everyone evenly. The very young and old were most susceptible, as their immune systems weren’t able to fight it. And while the empire avoided social chaos for the most part, the Nile Delta was the exception. Whole villages in that region were depopulated. But the region was already susceptible to disruption because of hydrological changes to the river system. Western settlements were also more dispersed than Egyptian villages, which made a difference in the virus’s spread. Banditry also became a problem in the Nile region. In Egypt, coin currency lost its purchasing power during the pandemic.
The plague also affected farming and food. Galen wrote of “continuous famine for not a few years among many of the nations subject to Rome.” People from towns would travel to the country and strip the wheat fields, leaving the farmers to survive on twigs and grass. Real land values and rent prices also dropped. Harper writes the effect on wages was likely a wash, as the economic damage and labour shortage caused by the plague likely cancelled each other out.
I also read an article by Jennifer Wright, who wrote a book on historical plagues (Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them). She notes Romans scapegoated Christians during the Antonine plague (this is likely where the phrase about throwing them to the lions originated). Snake-oil salesmen conned the desperate, selling “magical” charms to repel the disease.
Death toll estimates vary wildly from two per cent to over 30 per cent of the population. The empire did ultimately survive. Marcus Aurelius proved a steady leader through the whole thing for the most part, auctioning the palace’s treasures to fund a state response and burying the poor at the state’s expense, at least in Rome. But the empire was left weakened to meet future challenges.
Much has changed since Marcus Aurelius’s time. History won’t repeat itself down to the fine details, but I think we can see some parallels. There are examples of magical thinking and scapegoating already. We’re in for a long haul economically and we might see more waves of COVID-19. In the meantime, we need to provide way better care for the most vulnerable in Canada, such as those in long-term care homes. We also need to support food production and bolster the critical stress points in our supply chains, for the sake of Canadians and others around the world who source food from us. No one wants the twig and grass diet.