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What If the Black Death Happened Again?

VO: Noah Baum WRITTEN BY: Nathan Sharp
It was one of the worst disasters in human history. A sweeping epidemic, that wiped out up to 200 million people, and 60% of Europe. But, what if the Black Death happened again? What if the Plague ravaged Earth once more? Could modern medicine cope? Or would the damage, death and devastation be just as bad in the twenty-first century?
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What If the Black Death Happened Again?


The Black Death is still seen as the benchmark for devastating pandemics, more than six hundred years after it first swept across Europe and Asia in the 14th century. Also ominously referred to as the ‘Great Plague’ and the ‘Black Plague’, it was at its most potent and perilous between 1347 and 1351, killing upwards of 200 million people and wiping out up to 60% of the European population.

It began with an organism called Yersinia pestis, which jumps to humans on the oriental rat flea. However, it wasn’t the first time that this organism had triggered untold trouble. Way back in the 6th century it caused the Plague of Justinian, which decimated the Byzantine Empire and prompted the deaths of 13% of the entire global population at the time – the equivalent of roughly 940 million deaths in 2018. Yersinia pestis also caused the ‘Third Pandemic’, which started in China in the mid-19th century and killed upwards of 12 million people – including around 10 million in India. In fact, this particular pandemic was so catastrophic that it was considered “active” by the World Health Organization until 1960, roughly one hundred years after it began.

And the scary thing is that the plague still poses a very real threat. Between 2010 and 2015, there were over 3,200 reported cases of it around the world, resulting in nearly 600 deaths. Luckily, preventative measures and modern medicine have kept the disease from spreading on a scale as seen throughout history. The simplest measures include informing citizens when the plague is present in their region, taking extra care when treating flea bites, and refusing to handle animal carcasses. We also know today to quarantine those stricken with the plague, and to avoid potentially infected bodily fluids like pus and blood– knowledge that was either ignored or didn’t exist back in the 1300s. If it’s caught early enough, death only occurs in about 10% of those afflicted.

There also exists various antibiotics to treat the plague today, although most of them have seen only limited results in clinical tests and barely any of them are widely available. While some treatments are accessible in America, most are either not approved by the FDA or extremely rare. That said, the World Health Organization is expertly trained to identify, safely treat and hopefully remove all traces of the plague from patients. In the contemporary world, we’ve managed to keep the spread of the disease under control. But for how long? What if one contagious case managed to slip past the authorities? How would our modern civilization handle another outbreak of the Black Death?

According to multiple reports, and unfortunately for us, the planet is horribly under-prepared for most pandemics, let alone a ruthless outbreak of the bubonic plague. The alleged lack of resources and medicines on a global scale is perhaps the primary concern. In the event of a truly spectacular spread of disease, we’d run out of hospital space and treatments long before we contained the problem. Melissa Harvey, the Head of National Health Care Preparedness at the US Department of Health and Human Services has actually gone on record to explain the potential dangers in America alone, telling Time Magazine that; “In a situation like the 1918 pandemic” [a reference to the Spanish flu], it’s expected that resources “are not going to be there for everyone”. It’s a sobering and slightly scary thought.

Additionally, as the threat level is low at the moment, the W.H.O. doesn’t recommend plague vaccines as standard. Which makes sense, but in a hypothetical future when the Black Death happens again, it’d mean that anyone and everyone would be susceptible to it. And while those in developing countries with poorer sanitation would be at an especially high risk, the plague could be (and already has been) present in any nation, anywhere in the world. In 2008, a Nebraska family’s pet cat was found to have the bubonic plague after visiting the local vet. The authorities were swiftly alerted, and the case was managed – but the potential for a repeat is always there.

There’s also the matter of government spending strategies. The American government – in line with many others – simply doesn’t see outbreak prevention as a top priority. As such, disease outbreaks are typically handled on a case-by-case basis. For example, Time also reports that the US allocated $5 billion in emergency spending during the recent Ebola outbreak, but only after five months had passed. Similarly, it was nine months before over $1 billion was pledged to fight Zika, and by that point the disease had already spread throughout the country. In most cases we’re reacting to the issue, rather than planning towards it.

Problems arise though, when we consider how quickly the plague could spread, to infect entire populations within a matter of weeks. Say an infected flea from that Nebraskan family’s cat had bitten one of the cat’s owners. Or a neighbour. Or the vet that treated it. What if it had passed fleas onto multiple animals while at the veterinary clinic? The American government would quickly have a large-scale outbreak on its hands, with little hope of tracing or tackling it.

The tricky thing about the plague – particularly the pneumonic variety – is that it’s extremely transmittable via bodily fluids. One cough or sneeze in a crowded space could be enough to upend an entire community, city, country, etc. Flu symptoms typically occur up to one week after initial infection… But, without the proper treatment, a sufferer could be dead after just a few days more. Within a month, tens, hundreds or thousands of people could’ve suffered a similar fate.

The frightening statistics could certainly sky-rocket in this day and age. Our homes and cities are more congested and densely populated than ever before, leading to easily-transmitted pathogens and diseases. While it’s perhaps relatively simple to contain even a fast-moving outbreak in a secluded settlement, stemming an epidemic within a 21st century metropolis could prove almost impossible. From New York to Shanghai, London to Cairo, we’re talking millions of people potentially at risk. Throw in the fact that air travel not only exists now but is also becoming more and more frequent and affordable, a modern-world plague could feasibly travel to every continent within a matter of days – perhaps before its initial victims have even been identified.

The prospect provides inspiration for movies like “Contagion” and video games like “Pandemic”. But for all the Hollywood hoo-hah these storylines deliver, some aspects of them could yet prove accurate. Our modern lifestyles and cities are simply too chaotic and crowded to realistically contain a serious outbreak. And for all the obvious advances in healthcare we’ve made since the Middle Ages, the much higher global population means that there isn’t likely to be enough medicine or resources to go around – even in the world’s richest countries.

It’s obvious, then, that hundreds of millions of lives would inevitably be lost. Not only that, but the entire world economy would completely collapse. Estimates from the World Bank have already suggested that a severe flu epidemic could cost upwards of $4 trillion. And that’s just the regular flu. The figure required to even begin to battle the plague is impossible to guess. Countless companies would go bankrupt due to the deaths of their employees and clients. Without a reliable customer, massive industries would collapse. Power stations would fail to function, resulting in a huge loss of energy. This would hamper communication methods, make most technologies obsolete, and turn hospitals into risky and particularly unsanitary environments. Food production would stall; deliveries would halt; international shipping would probably be illegal – or else extremely regulated. All of which would result in massive food shortages. If the disease itself didn’t directly affect you, the damage it’d undoubtedly inflict onto society certainly would.

Small groups of survivors would likely band together in remote areas and on islands, but there could erupt massive suspicion between strangers – with neither willing to risk rubbing shoulders with anyone who’s potentially infected. If the Black Death really did spread to every continent, the world would probably become a pretty unfriendly place – which would only add to the overriding bleakness. The cities would turn into complete no-go zones, as the final resting spot for thousands of plague victims – but also as a hot-bed for Yersinia pestis, the germ that started the whole thing off.

While instances of the plague can be contained, and there’s no reason to overly worry that it will ever return on a large-scale, all it theoretically takes is one cat from Nebraska to slip through the cracks to provoke unparalleled disaster. From clean, contemporary living to a modern day dark ages in one fell swoop. It’s crazy what one little organism can do.
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