Writing plague
From Thucydides’ account of the plague of Athens, to Camus’ La Peste, to Emily St John Mandel’s Station Eleven, pandemics ask fundamental questions about what it means to be human.
Trust is a precious commodity and nowhere more so than in a pandemic. Without trust in science, it is difficult to persuade people that viruses are real and present threats, rather than – as some people seem to believe – a conspiracy by Big Pharma.
And without trust in government, it is difficult to persuade people to accept lockdowns and other restrictions on their liberty.
How else to explain why countries with high political and social trust enjoyed lower coronavirus infection rates than those that scored low on such measures, even when adjusted for factors such as population density, gross domestic product, and previous exposure to coronaviruses.
Indeed, studies indicate that if all societies had trust levels as high as Denmark’s, the world would have seen thirteen percent fewer coronavirus infections.[1]
Prior to settled human communities, survival depended on the clan and its ability to resist or outrun predators, whether they be pathogens, animals or other people. But in modern societies, we have no choice but to trust individuals who are unknown to us and whom we may never meet.
This is especially the case at times of war, or pandemic emergency, when we need to have confidence in government and faith that citizens will act collectively for the common good. Indeed, the historiography of trust suggests that this attitude, or emotion, is a particular feature of modernity.
As the German sociologist Niklas Luhmann has remarked, without trust, most of us would struggle to get up in the morning.[2] Or as Ute Frevert, of the Max Planck Institute for Human Development, puts it: “We moderns love to trust… it makes our lives easier and nicer”.[3]
This preoccupation with trust and respect for democratic institutions can be traced to Athens and the plague that erupted there in 430 BC. The outbreak is famously described by Thucydides in book two of his History of the Peloponnesian war. Written over 2,000 years ago, it’s the first historical description of an epidemic disease erupting in a civilized environment and an account that still resonates with modern readers.
Much of its power derives from the fact that Thucydides places a high value on eyewitness testimony: we trust his account, or at least we are prepared to give it credence, because Thucydides writes about events which he tells us he himself observed and in which he was an active participant.
Highly contagious and often fatal, the plague appears to have been sparked by the influx of refugees fleeing the fighting in Attica. Camped behind the Long Walls running from Athens to Piraeus, the refugees swelled Athens’ population from 100,000 to 400,000, rendering the city crowded and unsanitary.
Although the pathogen has never been identified – candidates include smallpox, measles, influenza and anthrax – the typical symptoms were vomiting, convulsions, blisters, diarrhoea and a raging thirst.
Athenians appear to have had little or no immunity to the successive waves of disease and by 426 BCE it is estimated that between 100,000 to 150,000 were dead.
Thucydides writes: “The bodies of dying men lay one upon another, and half-dead creatures reeled about the streets and gathered round all the fountains in their longing for water.”
But perhaps the most remarkable aspect of his narrative is how the plague serves as an agent of social and moral pathology, destabilizing Athenian society and disrupting religious customs and norms of civilized conduct.
“Men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane,” he tells us. “All the burial rites before in use were entirely upset and… many had recourse to the most shameless sepulchres.”
It is no accident that Thucydides’s account follows Pericles’s famous funeral oration that is so often quoted as summing up the greatness of Periclean Athens and its democratic institutions.
“In our public life, and in our private business we are not suspicious of one another,” insists Percles. “.. a spirit of reverence pervades our public acts; we are prevented from doing wrong by respect for the authorities and for the laws… as well as those unwritten laws which bring upon the transgressor of them the reprobation of the general sentiment”.
In so doing, Thucydides presents two radically different images of Athens: in the one, a city ordered by and deriving much of its strength from generally accepted civic customs and procedures; in the other, a place of increasing self-gratification and anomie. The result is an erosion of trust and the willingness of Athenians to endure sufferings for the common good.
We will get through this together
In our world and in our own time, the coronavirus has asked similar questions about who we are and how we should comport ourselves - and exposed similar ideological and political fault lines.
When Covid first swept the globe, I assumed that the world’s advanced democracies would put the health and welfare of their populations first and that it was a measure how far we had come as civilised peoples that we were willing to suspend our freedoms and economic activity for the common good.
The country which exemplified this approach was New Zealand. Announcing some of the strictest lockdown measures in the world, New Zealand’s Prime Minister Jacinda Ardern said: “We will get through this together, but only if we stick together”.
By locking down early and maintaining social distancing, Ardern ensured that fewer New Zealanders died of Covid and other respiratory diseases than in typical non-pandemic years.
Sweden took a different but similarly successful approach. Rather than closing schools and dictating when and where Swedes could mingle, the government trusted Swedes to behave responsibly by voluntarily quarantining when sick, working from home and keeping apart whenever possible.
The result was that though Sweden’s excess mortality was worse than its Scandinavian neighbours, it was significantly lower than the Europe’s.
By contrast, in the UK, the government worried about “behavioural fatigue” setting in if it locked down too soon. Instead, it took a “herd immunity” approach by allowing the virus to spread unabated, only to have to abruptly reverse course when modelling suggested the country’s health service would be overwhelmed.
Meanwhile, in the United States, political polarisation meant that for every person who embraced the need for lockdowns and face masks, there was another who railed against the measures and rejected – or distrusted - the scientific premises on which they were based.
The result was that the US suffered 3,740 excess deaths per million of population - far more than any similarly wealthy country.
Indeed, at times Americans resembled nothing so much as the townspeople of Oran, the northern Algerian town which is setting for Camus’s 1947 novel La Peste, and where Camus observes, half the population spent their time denouncing the health authorities and looking for ways to circumvent the quarantine measures.
“In this respect our townsfolk were like everybody else, wrapped up in themselves,” he writes. “They were humanists: they disbelieved in pestilences.”
But as Camus warns us in the next sentence it is a mistake to regard plague as “a bad dream that will pass away”. It is not pestilences but “men who pass away, and the humanists first of all, because they have taken no precautions”.
It is only when the gates of Oran are bolted, cutting the inhabitants off from the outside world, that the townspeople are slowly forced to confront the reality of the plague and their exile.
Beset by feelings of fear, isolation and loss of agency, they beg to be reunited with loved ones. When the authorities refuse, some inhabitants become violent and are shot.
Eventually, however, they are forced to accept the absurdity of their situation and the pointlessness of seeing themselves as atomized individuals. The catastrophe has become collective.
“A feeling normally as individual as the ache of separation from those one loves suddenly became a feeling in which all shared alike,” Camus writes. This ache, along with fear, became “the greatest affliction of the long period of exile that lay ahead.”
In Camus’s novel, there is no possibility of a vaccine, only a serum, but the main character Dr Rieux doubts it will be of any use as he suspects the plague bacillus has already mutated.
In the case of Covid-19, however, vaccines were the surest means of ending the need for on-going restrictions. Indeed, studies have shown that countries which locked down early and maintained strict social distancing measures until vaccines became available, emerged from the pandemic with healthier populations and healthier economies too.
Even Trump, no fan of lockdowns, recognised the importance of vaccines by providing Federal funding for Operation Warp Speed. But though his initiative ensured life-saving vaccines were available in record time, many Americans hesitated to take them. This was particularly the case in Republican states, where governors questioned their efficacy.
Indeed, it was in the months after the vaccines were made available to the public that US death counts started to shoot above those of European countries, driven by high levels of vaccine hesitancy in states like Alabama, Louisiana and Georgia.
The result, according to an analysis by Bloomberg, was that the US suffered three times as many excess deaths as the UK, more than four times as many as Sweden, and 28 times as many as New Zealand.
In her book, On Immunity: An Inoculation, the writer Eula Bliss observes that few medical procedures are as misunderstood or as charged with anxiety as vaccination. This is partly because vaccination lends itself to vivid metaphors, from the “scarring” of flesh, to the “contamination” of blood, to the “violation” of what we imagine to be pristine bodily spaces.
But since the Victorian period, resistance to vaccines has also been closely tied to the expanding influence of the state and distrust of medical authority. The result is that many people no longer think of public health as something that operates in and through their bodies. Instead, they recoil from the concept of “herd” or “community immunity”.
But if Covid has taught us anything it is that we are not atomized individuals. Vaccination works by enlisting a majority in protection of a minority. To be sure, it is far from a perfect science – vaccines are sometimes associated with adverse events. But risk is part and parcel of modernity: in free societies we are obligated to balance these risks and, in the face of uncertainty, trust in scientific expertise.
And, after all, what is the alternative? In Station Eleven, Emily St. John Mandel imagines an event called “the collapse” triggered by a deadly flu epidemic that kills 99 percent of the world’s population. Inspired by the 2002 SARS epidemic, Station Eleven is a haunting portrait of a world without planes or pharmaceuticals and where a dog bite can prove fatal.
Told through the perspective of a troupe of Shakespearian actors known as the Traveling Symphony, the novel shows us a world in which death and tragedy have stripped life to its essentials.
Holed up in an airport where all the planes have been grounded and one of the few diversions is visiting a museum containing artifacts from the time before the collapse, Kirsten, the youngest member of the troupe, is haunted by reminders of the pre-pandemic world.
Observing the meaning that Shakespeare brings to the lives of those toiling to make sense of life post-collapse, she joins the troupe and embraces the Symphony’s motto that “Survival is insufficient.” In this way, Kirsten’s story emphasizes that to move beyond mere survival, it’s crucial to live a life dedicated to connecting with and helping others.
But perhaps the character who best exemplifies the deep human need for connection is Jeevan, a paparazzo turned paramedic who becomes the town doctor in the post-pandemic world. Prior to the collapse, Jeevan’s occupation has left him feeling empty and disconnected. But as street lamps fall dark, he realises that the systems he has taken for granted depended on a vast network of people trusting one another.
“We bemoaned the impersonality of the modern world,” Mandel writes, “but that was a lie, it seemed to him; it had never been impersonal at all. There had always been a massive delicate infrastructure of people, all of them working unnoticed around us.”[4]
Collectively, Jeevan and Kirsten’s stories and the journeys of the other characters emphasize that meaning is created through service, art, love, and trust and that civilisation has always been, as one character puts it, “a little fragile”.
Until now, my focus has been trust. But while it would be marvellous if we lived in a world where everyone could be trusted, experience has taught us that the world isn’t like that and that it sometimes pays to be distrustful. My concern is when this scepticism is taken to extremes, as with anti-vaxxers for whom no amount of evidence will persuade them that vaccines are, for the most part, efficacious and safe.
This is a particular problem in modernity because we have no choice but to take most infornation on trust. But what happens when misinformation and disinformation become ubiquitous? What happens, in short, in a world where, thanks to the Internet and social media, half-truths, conspiracy theories and outright lies travel faster than any virus?
In Dostoyevsky’s Crime and Punishment, Rashkolnikov has a dream in which he imagines the world has been visited by a mysterious plague that corrodes relationships. Unlike in Thucydides, no specific physical symptoms are mentioned. Instead, the microbe attacks people’s personalities, convincing each of their moral infallibility and intellectual superiority .
Each thought that he alone had the truth and was wretched looking at the others, beat himself on the breast, wept, and wrung his hands. They did not know how to judge and could not agree what to consider evil and what good; they did not know whom to blame and whom to justify.
Rashkolinkov’s vision culminates in a conflagration that sets nation against nation, and individual against individual.
“The most ordinary trades were abandoned, because every one proposed his own ideas, his own improvements, and they could not agree… Men met in groups, agreed on something, swore to keep together, but at once began on something quite different from what they had proposed. They accused one another, fought and killed each other.”
In this world without trust, there is no possibility of community. Instead, reduced to atomized individuals, all we can do is watch as the “plague spread and moved further and further”.
This is an abridged version of a talk I gave on May 18-19, 2023, at the Center for Academic Research and Training in Anthropogeny at the Salk Institute in La Jolla, CA. The subject of the symposium was ‘The Role of Myth in Anthropogeny’. https://carta.anthropogeny.org/events/role-myth-anthropogeny.
[1] Thomas Bollyky, Olivia Angelino, Simon Wigley, Joseph L Dieleman, ‘Trust Made the Difference for democracies in Covid-19’, The Lancet, 400 (27 August 2022): 657; Jacqui Thornton, ‘Covid-19: Trust in government and other people linked with lower infection rate and higher vaccination uptake’, British Medical Journal, 376 (2 February 2022): o292.
[2] Niklas Luhmann, Trust and Power (John Wiley & Sons; Chichester, 1979), p. 4.
[3] Ute Frevert, Does trust have a history? European University Institute, Max Weber Lecture No. 2009/01, 2009. The flipside of trust, of course, is distrust. Although most of us are inclined to altruism, research suggests that around a quarter of human beings act exclusively in their own self-interest and are impervious to incentives to reciprocate.
[4] Emily St. John Mandel, Station Eleven. London: Picador, 2014, p. 178