Topic Subtopic

History Medieval History

The Black Death

New Lessons from Recent Research
Course Guidebook
Dorsey Armstrong
LEADERSHIP
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Dorsey Armstrong
Dorsey Armstrong is a Professor of English and Medieval Literature at Purdue
University, where she is also the head of the Department of English. She
received her PhD in Medieval Literature from Duke University. She is the
executive editor of the academic journal Arthuriana, which publishes cutting-
edge research on the legend of King Arthur, from its medieval origins to its
modern enactments. She is a recipient of the Charles B. Murphy Outstanding
Undergraduate Teaching Award, Purdue’s top undergraduate teaching
honor. Her other Great Courses include The Black Death: The World’s Most
Devastating Plague and The Medieval World.

i
 Table of Contents

1.
About Dorsey Armstrong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i

2.
Reassessing the Black Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

3.
A Deeper Dive into Rat and Flea Behavior . . . . . . . . . . . . . . . . . . . . . . . 6

4.
Human-to-Human Plague Transmission . . . . . . . . . . . . . . . . . . . . . . . 14

5.
Plague, Grain, and the Mongols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

6.
The Big Bang of the Black Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

7.
The Fate of the Plague’s Survivors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
The Old World Falls Away . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

ii
Reassessing the 1
Black Death
TABLE OF
CONTENTS

This lecture shares new information about recent

scientific discoveries that shed more light on that 14th-
century pandemic known as the Black Death (or the
Great Mortality). It also discusses what the world’s
struggles with COVID-19 have so far revealed about
pandemics.

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 1. Reassessing the Black Death

Devastating, Global, and Better Understood

“ The Black Death had a severe impact: Depending on the area, it could
wipe out 60% to 70% of the population. Though much scholarship has
focused on the Black Death as a European phenomenon, it was a global
pandemic, extending into Africa and the Middle East and circulating
through Asia. Additionally, new research suggests that it was circulating
in some places at least a century before the European wave that burned
through the population of that continent from 1346 to 1353.

“ One reason that these cases of plague beyond the medieval European world
have seemed largely invisible until recently is that there have been very few
scholars who have the skills to understand letters, legal documents, and
diplomatic reports from both medieval Western sources and Mongolian or
Muslim sources. This has started to change, and scholars such as Nükhet
Varlik, Hannah Barker, and Monica Green have been able to gain access
and share information regarding different communities and languages.

“ Additionally, in early 2021, notable plague scholar Ole Benedictow released

a massively comprehensive new edition of his 2004 book The Black Death:
The Complete History. In this enormously expanded version, Benedictow
addresses and includes the new research and discoveries that have occurred
since the appearance of the earlier edition of his masterwork.

“ In addition to these new discoveries and interpretations of primary source

materials, our understanding of the Black Death has been greatly advanced
by new scientific discoveries concerning the genetic makeup of Yersinia
pestis. Innovations in medicine and science have made it possible for
scientists to look at the DNA of bodies recovered from plague pits (what
scientists call aDNA, or ancient DNA).

2
 1. Reassessing the Black Death

Plague Pit

“ It’s possible to perform comparisons to determine if what was causing

death throughout the medieval European world was the same disease
every place we can test for it. The answer turns out to be yes. (One very
important article that discusses how scientific advances have been used
to great result by scholars in the humanities working on plague is entitled
“Historians in Lab Coats.”)

3
 1. Reassessing the Black Death

Moving Forward
“ In many cases, we can now see that we must take many of the claims from
primary documents with a grain of salt. Humans then and humans now
are prone to hyperbole and exaggeration.

“ But at the same time, the general picture we get from these sources has been
confirmed. The Black Death was, indeed, the world’s most devastating
plague, and the death, trauma, and suffering endured by those who lived
through it still almost exceeds our ability to grasp it.

“ A notable point of comparison is the 2016 Great Course The Black Death:
The World’s Most Devastating Plague, which, like this one, had Dorsey
Armstrong as its expert. Between that lecture series’ release and the
production of this one, we have learned much about plague. Upcoming
lectures dive into new discoveries.

An Apt Topic
“ Plague remains a real threat in the modern world, not least of all because
it is considered by the US government to be a disease that could be
weaponized. The US government is concerned enough about plague
and its potential weaponization to have websites dedicated to answering
questions about it.

“ The Black Death also seems particularly apt for discussion in a world
affected by COVID-19. One thing that has become clearer as we compare
the effects of COVID with those of the Black Death is that during and after
a pandemic of this scale, society will experience serious upheaval. Social,
political, economic, religious, and cultural unrest are bound to emerge.

4
 1. Reassessing the Black Death

“ However, the outbreak of a true pandemic simply reveals flaws that people
already, on some level, knew were present in society. Pandemics then
exacerbate those flaws to such an extent that it may feel like the whole
world has come unmoored from its foundations.

“ After a significant adjustment period, a large majority of the people who

survived the Black Death were better off than they had been before.
Humanity underwent several improvements and advancements.

“ But there was a significant human cost attached to those advances and
improvements. Starting around 1353, it may be true that there was
plenty of land for the taking, there was increased upward social mobility,
and the general population was better nourished and better educated.
However, those well-fed, newly literate, suddenly land-rich people had also
experienced an unbelievably traumatic event.

5
A Deeper Dive 2
into Rat and
Flea Behavior
TABLE OF
CONTENTS

The Black Death was the second of three pandemics

caused by the same bacterium, Yersinia pestis. This lecture
looks at the bacterium’s origins, spread, and carriers.

6
 2. A Deeper Dive into Rat and Flea Behavior

Early Studies
“ In the 1890s, there was a series of plague outbreaks in the Yunnan province
in southwestern China and in India. Estimates suggest that somewhere
between 50,000 and 125,000 people were infected, and 80% of those
who contracted plague would die from it. Scientists working in Hong
Kong managed to isolate the cause of plague in the laboratory after careful
examination of tissue samples from those infected.

“ A few years after isolating and identifying the bacillus, scientists were
able to identify rats as the prime carrier of the disease, and in 1898, a
scientist named Paul-Louis Simond argued conclusively that the disease
is transmitted to humans when fleas jump from a rat to a human and bite
that human.

“ This means that plague is zoonotic: Like smallpox and some other diseases,
it originates in animals and then somehow jumps from animals and
infects the human population. Continuing to work backward, all research
indicated that the bacterium that had caused the outbreak in India and
China in the late 19th and early 20th centuries was the same bacterium
that had caused the Black Death in the 14th century and the so-called
plague of Justinian in the 6th century.

“ To confirm this, however, additional research was needed. It wasn’t

until quite recently that science had advanced to a point where we could
conclusively say that all three of these pandemics had the same cause.
Leaps in science have allowed us to determine that it was the same strain
of Y. pestis.

7
 2. A Deeper Dive into Rat and Flea Behavior

Updating a Theory
“ In the decades leading up to recent times, it had been long been accepted
by most scholars that the source of the second pandemic had its origins
somewhere in China—probably the Hubei province—where a climatic
event drove rat colonies into contact with human populations sometime in
the 1330s. After that, went the prevailing thinking, plague moved westward
at a frightening pace, transmitted by caravans traveling the Silk Road.

“ However, we now know that the genesis of the outbreak that struck the
medieval European world starting in 1347 didn’t come from China.
Rather, its origins were probably somewhere just east of the Caspian Sea
and/or in the Volga River basin.

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 2. A Deeper Dive into Rat and Flea Behavior

“ In the middle of the 14th century, plague became epidemic in this area,
meaning there was a large breakout in a geographically distinct region.
From there it moved both eastward into China and westward into the
medieval European world, where it became pandemic—causing large
breakouts in many disparate locations.

“ The case wasn’t that the plague moved incredibly quickly from China.
Rather, it moved to China at the same time it was heading into the
medieval European world, which is why outbreaks so geographically far
apart were so close in terms of time.

The Role of Rats

“ For the plague to reach pandemic status, it first had to establish itself in a
rat colony. Once in the colony, it needed to reach enzootic status, meaning
that it was widespread among that rat colony.

“ After that, it needed to go zoonotic, jumping to human hosts. If it spread

through enough of the population, then it had become epidemic. When it
spread over great distances, covering, for instance, Europe and Asia from
the British Isles to eastern China, it was then pandemic.

“ To better illustrate this process, it’s worth discussing black rat colonies.
These colonies produce new offspring with great rapidity and constancy.
Rats will happily resort to cannibalism, and black rat fleas would really
prefer not to bite humans if there’s another alternative.

“ This is how plague might be present in a rat colony living right in the
basement or rafters of a group of humans for years without ever affecting
them. Certain conditions have to line up for black rat fleas to be willing to
bite and thus infect humans.

9
 2. A Deeper Dive into Rat and Flea Behavior

“ While fleas will jump to a human host if they must to survive, they would
really prefer not to. For the jump to humans to happen, the rats in a
particular rat colony would need to start to die off. When that happened,
the rats that were still alive would cannibalize the dead rats.

“ The fleas that had been on a rat that had died would, when it was finally
necessary, jump to another rat host. If there happened to be another rat
community nearby, that different community would move in to cannibalize
the other dead rats, and the fleas would have a new host, and so on.

“ It’s possible to have plague-infected rats and fleas living near humans for
a substantial number of days or even weeks before the jump to humans
might happen. That jump would happen only when all the rats were dead.
Even then, science seems to have established that rat fleas would rather
starve for a while in the hopes that some new rats or other vermin would
show up before reluctantly choosing to jump to a human host.

“ Ole Benedictow and others have calculated that it takes about 23 days for
a rat colony to be infected and fully die off, then for the
starving fleas to jump to a human host. This time lag
explains how sailors on a ship that had an infected
rat colony on board might not become ill or
infected until the very last member of
that rat colony had died off, the
fleas were starving, and then,
all of sudden, the crew might
become infected roughly
simultaneously.

10
 2. A Deeper Dive into Rat and Flea Behavior

“ The same holds true in communities on land. Rat colonies could have
endemic plague, meaning plague is present at a stable level for a substantial
amount of time. Thus, the colony could function as a plague reservoir
until some factor causes a population shift. Then the plague could become
epizootic, or widespread throughout the rat colony.

“ When plague does jump from animals to humans, the disease has become
zoonotic. Some other examples of this include things like West Nile
virus, Lyme disease, and rabies. Regarding COVID-19, there has been
speculation that the initial jump may have come from bats to humans.

The Role of the Seasons

“ Plague outbreaks usually occurred in summer and then tended to die down
in the winter. In contrast, wintertime, when people are crowded together
indoors, is the time when flu and COVID are at their most dangerous and
transmissible.

“ The main reason for this difference is that bubonic plague is bacterial,
while the flu and COVID are viral. This means that flu and COVID are
very easily transmitted by sharing space with infected people who might
be coughing, sneezing, blowing their noses, and so on. Viruses tend to
be smaller and lighter than bacteria, so they travel farther and easier in
smaller droplets.

“ With the plague, the bacteria must be directly introduced into the body for
infection to occur. Additionally, for plague infection to occur via droplets
that contain the Y. pestis bacterium, a member of the household would
need to have the pneumonic form of plague, when the disease has moved
into the respiratory system, before they could infect anyone else this way.

11
 2. A Deeper Dive into Rat and Flea Behavior

“ With COVID, by contrast, research indicates that the virus is very easily
transmitted if an infected person is within a few feet of another person.
In the case of the Black Death, studies have suggested that it is difficult
for the bacteria to travel much more than a foot or so when a pneumonic-
infected person coughs or sneezes.

“ Plague tends to recede in winter because there are simply fewer flea bites.
When it’s cold, the rate at which fleas lay new flea eggs declines. At the
same time, those eggs that are laid are less likely to complete gestation, so
in winter, the flea population tends to decrease dramatically.

The Role of Fleas

“ Another factor is that below 50°F, the blood of plague-inflected rats is less
lethal. The way that fleas transmit plague has to do with the structure of
their digestive system, which has a proventriculus—a pre-stomach before
the actual stomach.

“ When fleas are feeding on plague-infected blood, that blood gets stuck
in the proventriculus and prevents nourishment from getting past the
blockage and into the flea’s actual digestive system. Plague-infected
blood seems to create a film that gradually blocks the entrance from the
proventriculus into the flea’s digestive system.

“ Therefore, while the flea is technically full of blood, it’s also starving, so it
feeds more and more until finally, the proventriculus becomes so full that
the flea has to regurgitate its contents back into the host it is feeding off
of. Sometimes, that host is unfortunately a human. Thus, infection with
bubonic plague occurs.

12
 2. A Deeper Dive into Rat and Flea Behavior

“ But while fleas may be sucking away on plague-carrying rats just as merrily
in winter as they are in summer, the amount of plague in rat blood in
cooler temperatures is less than in warmer temperatures. This means that
the blockage of the proventriculus of the flea
will take longer to happen, as
some nourishment will still
get through to the flea’s main
digestive system.

“ Along with the increased

dying off of fleas and flea
larvae in the winter, that
means fewer opportunities
for them to infect humans.
However, this doesn’t mean
that the spread of plague stops
altogether. There will still be some
fleas who have made a safe nest for
themselves on a mammalian host who
has managed to find shelter with some degree of
warmth, and there will still be the occasional leap
to humans.

13
Human-to-Human 3
Plague Transmission
TABLE OF
CONTENTS

This lecture examines the types of plague infection. It

also looks at why certain areas might experience outbreaks
over a series of consecutive years, while others might
experience single outbreaks several years apart.

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 3. Human-to-Human Plague Transmission

Types of Plague
“ There are three main types of plague: bubonic, pneumonic, and
septicemic. The bubonic form was the only form from which anyone had
any chance of recovering; survival rates of those infected with the bubonic
form hovered at about 18% to 20%.

“ The pneumonic form was the most miserable way to go. A person might
spend some days coughing up blood until they essentially drowned in their
own blood. The septicemic form was always fatal, and it was the quickest
way to go.

“ There is a critical difference among these types of plague depending on

whether they can be considered primary infections or secondary infections.
The primary vector of plague transmission was flea bites. This type of
transmission occurred when a flea fed on a plague-infected rat, jumped
to a human host, and bit that host. That sequence was the main way this
disease spread.

“ Next, a person would show signs of the bubonic form of plague, which
could include large buboes at the lymph nodes, neck, armpits, and groin.
With some luck, some people might survive this form.

“ More often, a person with the bubonic form would progress from that
illness to the pneumonic and/or septicemic form of the disease. If the
victim neither recovered nor died from the bubonic form in about five to
seven days, then the disease could move into their lungs, so most often, the
pneumonic form was secondary to the bubonic.

“ The same goes for septicemic plague: A person with the bubonic form
might have the disease move into their bloodstream. At this stage, mottled
blue-black patches might appear all over the body, indicating massive
internal hemorrhaging.

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 3. Human-to-Human Plague Transmission

“ Here’s one possible chain of events: A person could have a primary

bubonic infection, which could progress to a secondary pneumonic form,
which in turn, after a few days coughing up blood, could progress again
to the septicemic form if the patient hadn’t already succumbed. It also
seems likely that in many cases, the bubonic form might progress directly
to a secondary septicemic infection and skip over the pneumonic form.

“ Additionally, it was possible—but much more rare—for someone to

become ill via primary pneumonic or primary septicemic transmission
of plague.

 This means that if a person shared a household with someone who

was ill with the pneumonic form, but somehow avoided contact with
any infected and infective fleas, that person could still get plague by
inhaling the airborne droplets coughed out by the housemate initially
infected through pneumonic means. This would be called primary
pneumonic infection, though it was rather difficult for someone to
transmit plague this way. Because the plague bacterium is larger and
heavier than a virus, when someone coughs or sneezes, it can’t travel
very far.

 By the same token, if someone had progressed to the septicemic form

of plague, and somehow the blood of that infected person was passed
to a heretofore uninfected person via an open wound or scrape, then
that would be considered primary septicemic infection. This means
of transmission seems to have been the rarest because it requires
blood-to-blood contact.

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 3. Human-to-Human Plague Transmission

Digestive Plague
“ Bubonic, pneumonic, and septicemic are the three main types of plague,
but it’s worth touching on a fourth category: digestive plague. This is
plague that is contracted by eating the meat of an infected animal. This
kind of transmission happened when other mammalian animals had
happened to be infected, with two examples being rabbits and marmots.

“ Digestive plague is certainly harder to diagnose, as medieval people

often became ill after eating something that didn’t agree with them.
Archaeological excavations of medieval latrines and the scientific study of
fecal matter have shown that medieval people were almost always infected
with a certain number of parasites, and we know from numerous historical
accounts that people died of dysentery on a regular basis.

“ Therefore, it would be hard to separate out deaths from digestive plague

from other deaths that started out with stomach issues. However, it now
seems likely that this did happen, at least from time to time.

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 3. Human-to-Human Plague Transmission

The Role of Population Density

“ Outbreaks occurred seasonally, especially during the first devastating wave
of plague from 1346 to 1353. Once the first wave was over, outbreaks of
plague tended to recur roughly every 12 to 15 years or so, but they were
no longer the synchronous, simultaneous events that they mostly had been
during the first wave.

“ An important factor here is differences in population density in various

places. As Ole Benedictow describes it, “high population density facilitates
spread but prolongs the epidemiological processes and expands the time
horizon of the pandemic.”

“ If there were more people, it was easier for plague to spread. But in less
populous regions and cities, the plague during the first wave would tend
to burn itself out more quickly, while it tended to keep coming back year
after year in more populous locations.

An Example Village
“ As an example, imagine that plague is transported into a good-sized
village in winter of 1348. It infects a particular rat colony living under
the household of the local baker and another rat colony living under the
household of the local brewer.

“ Then, plague smolders for some months, followed by an outbreak in spring

of 1349, starting with these two households. (Benedictow is particularly
fond of the word smolder for describing plague behavior.)

“ What happens after the death of a neighbor or important member of the

community in medieval Europe? People come to pay their respects to the
family and gather together in the household of the dead.

18
 3. Human-to-Human Plague Transmission

“ At this time, when everyone is together and sharing memories of the

deceased, other things might be shared as well. For instance, pieces of the
deceased’s clothing might be passed on to other family members, given
away to friends, or even sold to neighbors for a modest fee.

“ When people return to their homes, they might do so with both their
new belongings and plenty of rat fleas. If one person in the deceased’s
household had become infected from a flea bite, that meant that the rat
colony living under or near that household had already had a plague die-
off, and the fleas, after a typical three-day period of starvation, would have
jumped to humans.

“ The members of the deceased’s family are also probably soon to show signs
of infection, and when all these other people from outside the household
show up, fleas could jump from one human to another. The most
important jump—from animals to humans—had already happened.

“ When the neighbors go home, any uninfected rat colonies living near or
under their homes become seeded with plague by the infected and infective
fleas that have come home with the family members. The process repeats.

“ If it’s a relatively small community and the first death occurs early enough
in spring, then there are plenty of warm months still ahead for subsequent
rat die-offs and fleas leaping to humans, followed by an epidemic breaking
out and then becoming a pandemic. In a small village, all the households
and buildings might complete this process over the course of one spring
and summer.

“ This would mean that this location has now been blanketed with plague.
For instance, in such a place, after the terrible year of 1349, there might
be no outbreak in 1350, especially if the community is relatively isolated
and rural.

19
 3. Human-to-Human Plague Transmission

20
 3. Human-to-Human Plague Transmission

Densely Populated Examples

“ By contrast, consider two of the most densely populated territories in the
medieval world, which today are called Italy and France. The invasion of
plague began in Italy in 1347, and every region of Italy had seen outbreaks
of plague by the end of 1348, but plague kept returning to Italy over the
summers until 1350. There was no “one and done” as in the case of our
hypothetical village.

“ The same goes for France. This country had the largest population in
medieval Europe, and plague showed up around September 1347. It kept
coming back annually until 1351 and perhaps even 1352.

“ In these densely populated locations, there were many more households

and buildings, and thus there were many more individual and distinct rat
colonies. As Benedictow points out,

In each of these houses, the Black Death would trigger a

rat epizootic that must have run its course before the rat
fleas, for lack of rat hosts, turned on human beings in
their immediate vicinity.

“ Rat fleas would literally jump at the chance to get off a human and get
back on a rat. That would potentially restart the process of the rat colony
becoming epizootic and dying off, causing the fleas to starve and turn to
human members of the household.

“ In densely populated areas, winter might arrive before every household had
been infected. Then, an infected rat colony could smolder over the colder
months, followed by an outbreak in the spring. Yet even then, there could
still be other households whose rat colonies avoided infection until the
arrival of another winter.

21
 3. Human-to-Human Plague Transmission

“ This helps illustrate how, after 1352 or 1353, years could pass between
outbreaks. An area could be blanketed with plague, then see its rats die off
and experience the plague working its way through the human population.
After the end of that cycle, it would appear that the pandemic, at least for
this community, was over.

“ However, over time, the rat population could come back. They might stay
free of the plague for a while, but eventually, newly arriving fleas from a
plague-affected area could seed the colony once more.

“ This means that the Black Death came into the medieval European world
one time, around 1346 or 1347. All the subsequent outbreaks in the
European world, which lasted until the final outbreak struck Marseille
in 1720, were all recurrences of the original seeding of medieval Europe
between 1347 and 1353.

22
Plague, Grain, 4
and the Mongols
TABLE OF
CONTENTS

The main way that black rats and their fleas moved
around the medieval world was through the grain trade.
Thanks to the work of scholars like Monica Green
and Hannah Barker, we have a clear understanding of
this. This lecture looks at why the grain trade was so
important and some of the information illuminated by
Green and Barker.

23
 4. Plague, Grain, and the Mongols

A Changing Society
“ The reason that there was a significant grain trade in the 14th century has
to do with a dramatic demographic shift from about 1000 to 1300. This
period is sometimes called the little optimum and was a period of mild but
significant global warming.

“ One of the effects of this medieval warm period was an increase in the
growing season. With a more reliable supply of food and even some
surplus, there was a population increase over those 300 years. Some
scholars estimate that the population of medieval Europe doubled at this
time, going from an estimated 75 million people to 150 million.

“ Suddenly, there was a huge demand for land but not enough to go around.
By the 14th century, virtually every piece of arable land had been brought
under the plow, and people were starting to have to try and figure out
how to survive on land that wasn’t great for growing crops. For instance,
in mountainous regions of Europe where land was ill suited for crops, one
place where people focused their energy was animal husbandry.

“ In turn, people who did live on or near good farmland perhaps worried less
about keeping cows, chickens, and pigs and more about producing grain.
Their animal-raising neighbors might trade animal protein for their high-
quality grain.

“ As trade networks—not just for grain, but for other goods as well—
began to proliferate, there was increased momentum for other kinds of
specialization, especially in trades like blacksmithing, weaving, tanning,
and simply importing and exporting goods and selling them. This was
when the merchant class started to rise.

“ Additionally, this specialization and trade meant that, for the first time
since the collapse of the Roman Empire, there was a serious increase in
urbanization. Cities like London and Paris quickly grew in population and
in density.

24
 4. Plague, Grain, and the Mongols

“ Education expanded beyond the nobility, too. The children of prosperous

merchants, craftspeople, and some well-off peasants were now able to
attend school on a regular basis. This might sound like a huge leap
forward, but it was also setting medieval Europe up for a devastating fall
once plague arrived.

Hitching a Ride
“ When plague spread out centrifugally from its 13th-century point of
origin, it did so by hitching a ride on grain that was harvested and then
shipped after the warmer months were over. Much of this grain would have
arrived at its intended destination—with rats and their fleas in tow—in
the late autumn or early winter.

“ Plague continues to exist in rodent populations over the winter, but

there’s much less chance of fleas choosing to jump to human hosts. One
reason is that in winter, black rats have less bacteria moving through their
bloodstreams.

25
 4. Plague, Grain, and the Mongols

“ Additionally, black rat fleas tend to feed more slowly in winter, which
means that it would take longer for those fleas to reach the point where
there is enough plague in their systems to block them from getting
nourishment. Overall, the result is less transmission of plague to humans.

“ Come spring, however, the pace of infection in rats and feeding of fleas
picks up, becoming an incipient epidemic. Port cities were hit first and
hardest. The cities where an outbreak occurred in 1347—places like
Genoa, Venice, Mallorca, Marseille, Sicily, and Cyprus—had probably all
received shipments of grain in autumn 1346 that had contained within
them infected rats and/or fleas.

“ Thus, several months had passed before the sudden, almost simultaneous
outbreaks. These would become epidemics, then a pandemic as spring
turned into summer.

26
 4. Plague, Grain, and the Mongols

“ The rat colonies in these locations may have been seeded with plague at
very different times over the autumn and winter of 1346 to 1347, but the
first outbreaks among the human populations would have all occurred at
roughly the same time. And the originating event would be so far in the
past that no one was likely to make the connection.

“ Then, with the cooler months, plague would again abate, and the pattern
would repeat. The great trade centers now had rat colonies where plague
was endemic. They would ship goods from their cities throughout medieval
Europe, in some cases possibly even waiting to begin shipping until after the
outbreak of plague among the local populace had largely ended for the year.

“ The idea here was that if there were no more sick people, it would be
safe for sailors and tradespeople to start moving their wares around the
medieval world again. However, along with those goods would travel the
rats and their fleas.

“ The shipments from the locations that had been seeded with plague would
be unloaded and distributed at their new destination, and the rats and fleas
that had tagged along would then infect the local rat community. Once
again, the disease would smolder over the winter until the warmer months
came again, and then new outbreaks would emerge in these cities.

“ This pattern of spread, seeding, and infection would repeat with numerous
synchronous outbreaks throughout the medieval world during what most
scholars consider the first wave of the Black Death in Europe, from roughly
1346 to 1353. After this period, however, outbreaks tended to become more
diachronic, meaning that while plague would still follow its seasonal pattern
of spread among human populations, it wasn’t necessarily the case that
multiple locations would experience a simultaneous outbreak each spring.

27
 4. Plague, Grain, and the Mongols

The Role of the Mongols

“ In December 2020, Monica Green published a field-changing article called
“The Four Black Deaths.” Green’s research has connected the outbreak of
the Black Death to the movement of the people known as the Mongols,
an assertion that has since been supported by the work of Ole Benedictow,
Hannah Barker, and others.

“ A genetic change in Yersinia pestis, an event called a polytomy, was the

microbial big bang of the Black Death. It seems almost certain that the
point of origin of this polytomy, where one strain of Y. pestis diverged into
four, was in an area near the Tian Shan mountains, which are located in
central Asia.

28
 4. Plague, Grain, and the Mongols

“ From there, the plague spread out in a centrifugal pattern. The reason it
moved throughout the medieval European, Muslim, and Asian communities
came down to the Mongols, who were carrying it with them as they went
about the business of creating the largest empire to ever exist on earth.

“ In 2014, scholar Robert Hymes put forth the theory that groups of
Mongols may have become infected with plague by eating the meat of
marmots who were carrying the disease. Mongols also used marmots’ fur
and hides for leather. Fleas like marmots as much as they like rats.

“ Because the Mongols moved so often and so quickly, plague may not have
ravaged their individual tribal groups to any huge extent. However, their
movements probably did establish new plague reservoirs in places where
the Mongols and their plague-infected cargo and animals spent any time.
Plague reservoirs might have gone unnoticed for years or decades, until
something happened that caused the fleas to run out of an animal-based
food supply and eventually make the jump to humans.

“ As for why the Mongol connection remained unrecognized for so long,

it’s possible that there was no one to record these outbreaks. The Mongol
empire, vast and impressive as it was, came late to literacy. It’s also possible
that the outbreaks were, at the beginning, so small as to be overlooked.

“ Another possibility is that, given all the other death and carnage wrought
by the Mongols, death by plague became invisible when surrounded by
death by battle or conquest. Many chronicles from the Islamic and Persian
traditions might have made mention of something that was plague, but
until recently, no one has recognized the disease for what it is.

“ In the lead-up to the major outbreak in the 14th century, Green argues that
“the evidence of genetics suggests that, at least in the 13th century, plague
moved with sudden rapidity, only to burrow into a new host population
where its novelty, virulence, and isolation allowed it to flourish anew.”

29
 4. Plague, Grain, and the Mongols

“ The nomadic nature and structure of Mongol society meant there was
little opportunity for a plague outbreak to have turned into anything
resembling the pandemic of the Black Death. Nomadic tribes simply didn’t
live a lifestyle that would allow plague to have a major impact on a large
population. There would have been outbreaks and some deaths, and that
would have been the end of matters.

“ However, when the Mongols started to push into the European world,
outbreaks could become epidemics among the stationary populations being
colonized. This gave the plague more opportunities to spread to more
people. It could eventually travel through medieval Europe and become a
true pandemic.

The Siege of Caffa

“ For centuries, the story of how the first wave of the Black Death entered
Europe has focused on the story of the siege of Caffa. Caffa was a trading
city established by the Genoese on the Black Sea in the year 1266.

“ To maintain access to this important trade node, the Genoese had to enter
into an agreement with the ruling people of that area. These were the
Tartars, also called Mongols or the Golden Horde. This gave the Genoese
access to an extensive and profitable network, but relations between the
Mongols and the traders were often tense.

“ In the mid-1340s, the Mongols, under the command of their new leader,
Jani Beg, laid siege to the city. The fortifications on the land side were
quite significant and offered good protection and defense, and the Genoese
were still able to come and go—in a limited fashion—from the port side
of the city.

30
 4. Plague, Grain, and the Mongols

“ In 1345, the Mongol forces were ravaged by plague, which had started to
make its way west. The Mongol forces recognized that they were defeated
and that the siege was over, but before they withdrew, they loaded up the
catapults with plague corpses and launched them into the city.

“ The belief that this was the first-contact incident of plague with the
western European population derives from the first-person account of
Gabriele de’ Mussi, who wrote one of the first accounts of the plague’s
arrival in Europe. He wrote in Latin in a text that has come to be called
the Historia de Morbo, and he described the plague’s effects at Caffa. In
part, he wrote of “swellings in the armpit or groin caused by coagulating
humors, followed by a putrid fever.”

“ However, de’ Mussi was not truly an eyewitness to this event; he was
writing his history of the Black Death from his home in Piacenza, where
he was a notary. Piacenza was certainly affected by plague relatively early
on, but anything de’ Mussi relayed would have been stories that had been
passed by word of mouth, so he’s not terribly trustworthy as a witness.

“ It now seems more likely that the siege of Caffa didn’t spread the plague to
the European world; rather, it looks like that two-year siege actually delayed
the movement of plague into the Italian Peninsula. A relevant source here is
Hannah Barker’s article “Laying the Corpses to Rest,” which indicates,

Transmission of the Black Death across the Black Sea was

delayed by roughly one year because of trade embargoes
on Tana, a Golden Horde port frequented by Venetian
and Genoese merchants. [Medieval sources] also indicate
that grain exports were the principal … means by which
plague was carried onward into the Mediterranean.

“ Barker points out that if one reads the Byzantine chroniclers of the period,
they don’t connect the outbreak of plague to the siege of Caffa. Even more
importantly, the two Italian city-states with the strongest trading presence
in the area of the Black Sea were Venice and Genoa.

31
 4. Plague, Grain, and the Mongols

“ The trade network was critical for these two entities because neither
of them had access to land that was good for growing grain. Venice is
surrounded by water, and Genoa is up on a mountain.

“ A fairly conclusive finding is that the primary vector of transmission of

plague—at least initially—is via the bites of fleas (and perhaps other
vermin). This ties in with the importance of grain: Shipping containers of
grain were gathering points for plague-carrying vermin.

“ Consider this chain of events. It draws on Barker’s work and takes into
account the average length of time between when a rat population is
infected and the disease jumps to nearby human communities:

 Plague was first reported among the Golden Horde of the Mongols in
Tana in 1346.

 If all trade networks were operating normally, we would expect the

August 1346 grain shipments in the Black Sea to have reached Genoa
and Venice sometime around November of that year.

 In turn, it would be reasonable to expect human outbreaks in those

city-states to be first recorded sometime between late November 1346
and June 1347.

“ However, events in reality were different. Barker points out that the
situation was bad in Italy. Shipments of grain were not coming in, and
there was a massive crop failure in northern Italy in 1346.

“ But because there was so much discord, disagreement, and actual military
conflict occurring among the Mongols, the Genoese, the Venetians, and
so on, everyone had a variety of trade embargoes against everyone else in
the area of the Black Sea. During the siege at Caffa, while the Genoese
could come and go by the port side of the city, they couldn’t get any grain
because of an embargo.

32
 4. Plague, Grain, and the Mongols

“ The Venetians wanted to keep the Genoese out of Tana because that was a
key trading point. Everyone was withholding whatever they could. Many
people and lots of goods were crossing the Black Sea from north to south
in 1346, but grain was not making that crossing.

“ Since grain trading was frozen, there was no reason for any of the Italian
city-state ships to even bother to stop in the ports controlled by the Golden
Horde because what they needed most—grain—would not be given to
them. Indeed, the siege of Caffa interrupted the normal flow of trade—
especially that of grain—and bought the medieval European west about a
year’s delay.

“ Eventually, though, the Venetians pressed the point and sent two new
ambassadors to negotiate with Jani Beg. Trade relations were normalized,
and the 1347 grain harvest from the Black Sea region resumed.

33
 4. Plague, Grain, and the Mongols

“ According to several historians, serious outbreaks in the Byzantine

world first occurred in the fall of 1347. Three major Byzantine cities—
Constantinople, Pera, and Trebizond—all reported simultaneous
outbreaks, which makes sense given the fact that all three would have
received their first grain shipment in a long while at around the same time.

“ The most important point to take away from this now-debunked first-
contact story is best articulated by Barker herself:

Plague’s movement across the Black Sea was certainly

not a matter of bioterrorism during the siege of Caffa.
Instead, it was an unintended consequence of peace.

34
The Big Bang 5
of the Black Death
TABLE OF
CONTENTS

Advances in medicine and science have made it possible

for us to look at the DNA of bodies recovered from
plague pits. Scientists call this aDNA, or ancient DNA.
Researchers have used this data source to reveal new
information about the Great Mortality.

35
 5. The Big Bang of the Black Death

The Polytomy
“ It seems clear that precipitating the 14th-century Black Death in medieval
Europe was an event that occurred about a century earlier. This was an
event known as a polytomy, and scientists working on the subject refer to it
as the big bang of Yersinia pestis. The polytomy occurred sometime around
the 1250s, or perhaps even earlier.

Yersinia pestis

“ As far as science can tell, the Y. pestis bacterium has been in existence for
more than 6,000 years, and while it is an animal disease, it is zoonotic,
which means it can leap to and infect humans from time to time. Over
time, the bacterium has evolved into different lineages, or strains.

“ This evolution or divergence happens when there is something called a

single nucleotide polymorphism, or SNP. There is a substitution of a single
nucleotide at a particular position in the genome. As far as we can tell, it’s
a spontaneous mutation. And once that change happens, a new strain of
plague is born. After a strain emerges, it may go on to birth new variant
strains, and so on. Strains can also die out over time.

36
 5. The Big Bang of the Black Death

“ In 2013, a group of scientists (Cui et al.) published an article documenting

that sometime in the mid-1200s, Y. pestis appears to have undergone a
polytomy, suddenly diverging into three and subsequently four distinct
lineages.

“ Some of these lineages are still in existence, and some have descendants in
existence, but a strain somewhere in the middle—the link that connects
them—has gone extinct. There are probably strains out there (both extinct
and currently in existence) that we haven’t yet identified today but which
we might at some point in the future.

Scapegoating
During the first outbreak of the Black Death in Europe, Jewish communities
became targets and scapegoats. The scholar Nükhet Varlik has used the term
epidemiological orientalism to describe the blaming of disease on a people or
community considered foreign and other. Varlik has also pointed out that this
behavior has never stopped.

An unfortunate modern example comes from COVID-19. In America,

certain people have tried to shift anxiety and anger away from inadequate
government responses and toward China, and there has been a rise in hate
crimes against Asian Americans in the wake of COVID-19.

37
 5. The Big Bang of the Black Death

Zooming In
“ To study the plague, the authors of the study were able to use the plague
strain from the third pandemic, which broke out in India and China in
the late 19th century and, as of this course’s production, has never been
declared over. The study’s authors worked backward to figure out what the
strains between that event and the big bang would have looked like.

“ The specific strain that caused the Black Death is no longer in existence;
it went extinct, presumably after it ran out of hosts. However, the Black
Death strain and the third pandemic’s strain are only different from one
another by a couple of SNPs. This is a tiny change, genetically speaking,
but it appears to have caused a radical change in the lethality of the plague.

“ We know what the Black Death strain looked like because of advances
in the sequencing of aDNA. As early as 1998, scientists began extracting
tooth pulp from victims buried in known plague pits, or mass graves, and
sequencing them.

“ The scientists concluded that the same bacterium that caused the third
pandemic also caused the second one, the Black Death. In 2000, a study
was performed on a plague pit from Marseille, and the authors of that
study indicated that they had ascertained that plague was the cause of
death there. But there was some doubt in the scientific community.

“ In 2011, scientists turned their attention to a known plague pit in

Smithfield, just outside London, and again went about extracting aDNA
from the corpses buried there. Their research firmly established that those
deaths had been caused by plague. And furthermore, several strains of
plague currently in existence in the world today are descendants of that
strain, which itself has gone extinct.

38
 5. The Big Bang of the Black Death

“ That study and subsequent ones have established, at the very least, that
the deaths in the Smithfield plague pit were caused by a strain of Y. pestis.
However, some scientists were not fully convinced that every epidemic
episode during the Black Death was a result of plague. Some felt that there
might have been other diseases circulating at the same time.

“ But now, additional plague pits throughout the European world have had
the same techniques applied to them, and the evidence seems clear: The
outbreak that killed people in Barcelona, in Marseille, in London, in Oslo,
and so on were caused by the same strain of Y. pestis.

“ It is fairly conclusive that subsequent outbreaks of plague in the centuries

that followed were not caused by another wave of plague moving east to
west out of Asia, nor were they even likely caused by people in one plague-
stricken community in medieval Europe traveling to another. Plague came
into the European world one time—in the mid-1340s—and subsequent
outbreaks over the centuries came from plague reservoirs created during
this initial seeding.

“ One point that still puzzles scientists is the extreme lethality of the Black
Death strain of plague. When it came into initial contact with uninfected
rat colonies, it infected them so quickly and violently that die-off had
to happen with some alacrity, and the jump to humans was similarly
incredibly deadly. Science doesn’t yet have an answer to the question of
how just a variation in a couple of SNPs could have differentiated the
Black Death from the evolved form some 600 years later, which was
definitely still plague but much less lethal.

“ In any event, from roughly 1346 to 1353, the plague steadily made its
march. But after the initial outbreak, subsequent outbreaks were most
likely not new waves coming into the medieval European world from the
outside.

39
 5. The Big Bang of the Black Death

“ Instead, after 1353, it seems that there were rat colonies throughout
Europe where some equilibrium had finally been achieved. The rats were
able to live with plague, and the fleas had enough living rats to not make
the jump to humans.

“ Subsequent outbreaks would occur when that equilibrium went out of

balance. In such an event, all the rats in a particular colony succumbed to
plague and the fleas were forced to jump to human hosts. Eventually, an
equilibrium would be restored, and the plague outbreak would die down.

40
The Fate of the 6
Plague’s Survivors
TABLE OF
CONTENTS

Many historians believe that the long-term aftereffects

of the plague were generally positive. For those who
survived, life was greatly improved. The land crunch of
the late 13th and early 14th centuries ended. The rigid
hierarchy of the model of the three estates broke down,
providing greater social and economic opportunities for
those who survived. But there were great losses as well.
And people’s modern experience with COVID-19 has
revealed that while there may be future benefits in store,
the cost of those benefits can sometimes seem to be much
too high.

41
 6. The Fate of the Plague’s Survivors

Lost Knowledge, Lost People

“ In many cases, the plague caused the irretrievable loss of knowledge.
For example, certain practitioners of particular crafts died before their
knowledge could be passed on to their apprentices.

 Cathedral building in Italy stopped abruptly in many places.

 Certain pottery-making techniques in England were not passed down.

 In Siena, the Lorenzetti brothers, who were artists famous for their use
of naturalism and three-dimensionality, both died of plague before they
could pass along their secrets and skills.

“ Additionally, the experience of the pandemic was not a singular event

or occurrence. Plague recurred in Europe at least every generation or
so from the 14th century to the 18th. One recurrence seemed, oddly,
to leave the elderly and the very young—the most vulnerable—alone
and target healthy adults in their 20s and 30s. One outbreak was later
referred to as “the plague of boys” because adolescent males seemed to be
disproportionately affected.

“ People who managed to survive an outbreak would often experience great

grief and loss when future plague carried away family members, especially
their children and grandchildren. Dread of future illness likely caused
anxiety as well: No matter how far up the social and economic ladder a
person had advanced by surviving the initial outbreak from 1347 to 1353,
they likely experienced constant fear of the loss of their loved ones.

“ As of this course’s production, it has become clear that the COVID-19

pandemic shares with the Black Death the trait of being an ongoing
trauma. If there ever is a final outbreak, it might not be apparent until
years later.

42
 6. The Fate of the Plague’s Survivors

Upheavals and Revelations

“ Another apparent fact is that COVID has brought numerous upheavals
and trauma in many areas, including in politics and the labor market.
Social, political, economic, and medical systems have become completely
unmoored and overwhelmed, and violence has increased by many measures.

“ While the trauma of the pandemic certainly has contributed to some of

these problems, a catastrophic event such as a pandemic does not truly
create the conditions that lead to violence and systemic collapse. Rather, a
pandemic reveals the social, economic, and political flaws that are already
inherent in society. Examples of such flaws include food insecurity, income
disparity, a bloated medical infrastructure, political corruption, racism,
misogyny, and homophobia.

“ The COVID pandemic has not only revealed to us how severe those issues
are, but it has also seemingly removed whatever veneer of restraint was in
place that allowed us to continue living day to day in the belief that society
was generally functioning. Apparent safety nets have largely failed.

“ It could be argued that the same was true of the Black Death. It is not
so much that the Black Death caused events such as the Ciompi Revolt
in Florence, the Jacquerie in Paris, or many other episodes of violence
and revolt of the time; rather, it is more the case that in the wake of the
plague, the inherent flaws in the social order were now more plainly visible
than ever before. The status quo could no longer be accepted, ignored, or
dismissed.

“ Many scholars have made the case that without some sort of external event
putting pressure on society, like the Black Death, medieval Europe would
have kept on being medieval for centuries more than it did. It is true that in
the face of this crisis, people were forced to adapt and innovate to survive.

43
 6. The Fate of the Plague’s Survivors

“ But for America in the 21st century, it would be helpful to take a step
back. We need to shore up basic social safety nets, which is something
that certain medieval institutions seemed to do a much better job of in the
wake of the plague than we’re doing today.

 For example, shortly after the plague first blazed through Florence, the
city fathers pulled themselves together and got back to the business of
being a functioning society.

 This time saw the establishment of a board of health and the creation of
charitable organizations.

 Essential workers—for example, grave diggers—were able to command

large sums of money.

“ The story of COVID is still playing out during this course’s production,
but today, the maintenance workers, grocery store stockers, delivery
drivers, teachers, and other essential workers who are the engine of society
receive some of the lowest compensation—despite the risks posed to them
by COVID. Many people are simply refusing to return to those jobs
without significant increases in pay and benefits.

“ And plenty of people in certain fields are insisting on working remotely or

resigning. Many have decided, for example, that it is simply not worth it to
waste hours of one’s life on a daily commute.

44
The Old World 7
Falls Away
TABLE OF
CONTENTS

In terms of personal finances, people who survived the

first wave of the Black Death were usually better off
than they had been before. There was ample land and
livestock, and because of the labor shortage, workers could
demand higher wages. As of this course’s production and
release, we are seeing similar effects in our own society.
So many people have left their old jobs and moved on to
better jobs or retirement that we are experiencing a labor
shortage that is, for the first time in decades, driving up
hourly and minimum wages. This lecture looks at other
effects of the Black Death and the COVID pandemic.

45
 7. The Old World Falls Away

The Economy Shifts

“ In the aftermath of the Black Death, there was a renewed push for
efficiency in some trades and occupations because there simply weren’t
enough workers to meet demand. However, these moves were already
happening before the Black Death came on the scene.

“ Late medieval society was already innovating: An education was no longer

something reserved for the elite few, nor was it always connected to a
particular religious institution. For example, on the Italian Peninsula, as
a capitalist market economy started to come into existence in the 13th
century, banks, businesses, guilds, civic institutions, and more needed
greater numbers of workers who could read, write, perform mathematical
calculations, and so on.

“ As trade networks were expanding, clerks who could read and write
Latin and a variety of foreign languages came to be in high demand. The
medieval European world needed algebra, so Italy imported it from the
Muslim world.

“ During this time, educational practices moved more firmly away from the
religious—which they had already started to do—and toward a secular,
humanist type of education. This might have also been partly due to a
general decline in religious belief.

“ These pre-plague economic and cultural developments were already in

motion, but the plague accelerated their pace. For example, labor-saving
devices such as the water-powered sawmill had been in existence for more
than a century, but given how much labor surplus there was prior to the
outbreak of the Black Death, there hadn’t been a really compelling reason
to make extensive use of it.

“ Now, with the labor shortage after the Great Mortality, it came into
regular use. Likewise, there was a push to make machinery, production
techniques, farming implements, and so on as efficient as possible.

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 7. The Old World Falls Away

The Black Death’s Impact on Nobility

and Religious Institutions
“ Following the Black Death, the nobility and religious institutions that
owned a lot of land were not better off. Those at the very top of society, for
the first time in centuries, found themselves at a serious disadvantage.

“ The rigid three-estates model of medieval society broke archetypes of

people down into those who fight (the nobles), those who pray (the clergy),
and those who work (everyone else). This model began an accelerated
rearrangement and collapse, which had started with the development of
trade networks, specialization in trades or occupations, and the rise of a
merchant class just prior to the outbreak of the Black Death.

47
 7. The Old World Falls Away

“ In the aftermath of the Black Death, the lords had titles and lands, but
were largely cash-poor and desperate for laborers. By contrast, a newly and
increasingly wealthy merchant class had cash and goods, but no titles.

“ This was when marriages began to happen between the nobility and the
wealthier families of the merchant class. That, in turn, further undermined
traditional social structures and hierarchies.

“ In the aftermath of the plague, many nobles wanted desperately to hold

onto their status and titles. When looking for a way to do this, they settled
on the enterprise that for so long has been the domain of the nobility: war.

“ More than one scholar has suggested that the Hundred Years’ War
between France and England went on so long because this was one way
that the lords could still make some income. They could levy taxes to pay
for the war, and anything they captured or conquered they could claim as
their own.

New Networks of Support

“ One of the first and hardest-hit places—Florence, Italy—managed
to respond to the devastation of the Black Death with the creation of
social networks meant to help and protect its citizens. It established the
first board of health in the medieval world, and it created charitable
organizations to take care of widows and orphans.

“ In this and other parts of Italy, charities were formed to provide dowries
for girls of marriageable age. Almost immediately, local governments had
recognized the gravity of the depopulation problem.

“ Throughout the medieval world, in the face of so much death and

destruction, individuals and institutions stepped up to provide support
and care for those who needed it most. With every outbreak that occurred

48
 7. The Old World Falls Away

from 1353 to 1720, local governments expanded and refined the social and
health services of their communities to better combat plague and provide
relief and support.

“ This centuries-long development of government intervention to mitigate or

stop the spread of plague suggests some interesting things.

 First, it suggests that most people were not thinking of the pandemic
as a punishment from God. It had been going on so long and killing
everybody so indiscriminately that most people had accepted this
was simply a natural and very unfortunate event that repeated. While
people certainly prayed to God for deliverance or assistance, by the
16th century, most people who were running things were looking for
practical ways to combat an affliction that they believed was not a
punishment from God but just part of the world.

 Second, the ongoing crisis of the Black Death and its almost 400 years
of recurrent outbreaks cemented in the minds of many people the
belief that one of the main functions of government was to take care
of its citizens. One could argue that it is here that we see the origins
of the creation of national health services that continue to exist in the
European world and beyond today.

“ The United States, as it came into existence, did not have this threat to
contend with. Perhaps the lack of such a threat is one of myriad reasons
why US government and society has developed as it has.

Modern Times
“ Plague first arrived in the United States in the early 20th century. It
came to America via a ship that had traveled from India, where the third
pandemic was currently raging, and entered the US through the port of
San Francisco. It is this strain of plague that is currently endemic in the

49
 7. The Old World Falls Away

American Southwest. This why hikers in places like the Sierra Nevada
mountains, Arizona, and New Mexico often see signs warning people not
to touch dead rodents.

“ Every year, there are anywhere from 3 to 15 cases of plague in the US. If
diagnosed in time, these are treated relatively easily with antibiotics.

“ While a descendant of the plague that swept through the medieval world
in the 14th century is here in the United States, that strain has disappeared
in Europe.

“ Around the world, we are seeing stunningly different responses to the

COVID pandemic. On different continents, in different countries,
and even in different states, cities, and neighborhoods, responses to the
coronavirus have been wildly varied.

Port of San Francisco, 1900

50
 7. The Old World Falls Away

“ Responses, advice, guidance, and public reactions have also changed

over time. In part, that is good news: As we get new information and
understand the disease better, protocol for handling it will change.

“ Hopefully, as with the Black Death, one of COVID’s lasting lessons will
be that we need to have better safety nets in place. For instance, America’s
medical infrastructure desperately needs an overhaul. A system in which
health insurance is directly connected to employment doesn’t make any
sense when the pandemic causes many people to lose their jobs—and thus
their insurance—at exactly the moment when they need it most.

“ When a crisis like this arises and people are out of work through no fault
or choice of their own, the argument for a steady, universal basic income
starts to make more sense. That’s especially true when comparing universal
assistance to the mad scramble to figure out who needs benefits and
welfare the most at the current moment.

“ More than anything, we have learned how interlinked we all are, especially
in this truly globalized reality in which we now live. And while it may
be the case that our interconnectedness is one of the reasons COVID
spread so far and so fast, hopefully this same interconnectedness will help
humanity ultimately beat this disease, as we share information, resources,
vaccines, and medical treatments with one another.

51
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Image Credits
1: Getty Images; 3: National Library of Medicine; 6: Getty Images;
10: Wellcome Library, London/CC BY 4.0; 13: CDC/Ken Gage; 14: Getty
Images; 17: Wikimedia Commons/Public Domain; 20: Wellcome Library,
London/CC BY 4.0; 23: Getty Images; 25: New York Public Library;
33: The British Library; 35: Getty Images; 36: CDC/R. E. Weaver, MD,
PhD; 37: Michael Coghlan/flickr/CC BY-SA 2.0; 41: Getty Images;
45: Getty Images; 47: Thinkstock/Getty Images; 50: National Archives and
Records Administration

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