Corona is not the plague after all!This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
Comparisons of the current pandemic with earlier epidemics are obvious. A look at the Middle Ages shows the obvious differences between Corona and the other countries. The plague – but also similar patterns of behavior in dealing with the disease.
First came television images from faraway Wuhan. Similar to the plague in the late Middle Ages, initial indications of the outbreak of the epidemic had been suppressed there. Later, the Chinese Communist Party's ability to act should be demonstrated through massive intervention, up to and including the use of all electronic surveillance capabilities. Then worrying news arrived from northern Italy and Bavaria. Media reality suddenly became a tangible reality.
As with any epidemic, horror images from plague times are immediately activated – despite the much lower mortality with Corona. In the Italy of the 17. In the mid-nineteenth century, the plague wiped out up to a third of an entire city's population. Corona has a lethality rate of 0.37%. Four-fifths of those infected in China had a mild course of the disease. Severe courses are rare, intensive treatment the exception.
The readily avoided knowledge that it was getting serious
The motive for the attempt to conceal the outbreak of the epidemic in Wuhan may have been concerns about production and exports. In times of plague, the declaration of the disease was also delayed in Europe out of fear for trade and traffic. City councils were often merchants themselves who feared for their businesses. So it was convenient that doctors appointed for this purpose wanted to examine the first cases even more closely. In the plague campaigns starting in 1348, the symptoms that were considered decisive were not yet clear. Over time, it was learned that bumps were definite signs of disease. Experience also taught that disrupting foreign relations could protect a city.
Acting despite uncertain knowledge
Then, as now, action had to be taken before there was any certainty of knowledge. However, the field of uncertainty has changed during the last centuries. The vote of the physicians was already important for the decisions of the authorities since the first plague. However, the ideas about the origin of the disease were different from those of today – and remained so until the end of the 19th century. Century.
Since the discovery of the plague pathogen by Alexandre Yersin in 1894, the cause of the epidemic has been known. According to our understanding, which was influenced by bacteriology, an infectious disease has since been defined by the fact that the pathogen can be determined with certainty. Robert Koch was also successful because he made pathogens visible. This created comprehensibility. Credibility. This is also the case with Corona: the invisible is visualized by the virus model (Fig. 1). This is how it should become imaginable.
Three competing forms of knowledge
In order to explain the development of the disease, people in the late Middle Ages resorted to three forms of knowledge that were considered to be of equal value. This made the fight against the disease so difficult.
Scientific knowledge: Bad vapors from the soil and waste were driven out by fire, the homes of plague sufferers were fumigated, and residents were forced to clean the streets. Since ancient times, there has been the idea of infection by germs, but it has never been empirically proven.
Theological explanations: The Catholic Church interpreted the plague as a punishment from God. The reformers saw them only as a test of faith. Prayer and repentance were the order of the day. Catholic urban communities asked for deliverance from the plague with the promise to build a church later on. In Venice, Santa Maria della Salute bears witness to such a vow in 1630.
Close observation: in upper Italian cities, it was soon noticed that the first cases were reported in the poorer quarters and spread from there. Police discovered the importance of itinerant traders and beggars. Prohibitions were therefore directed primarily against these groups. So action was taken, even though not all the connections had yet been seen through.
What was more important? The personal and collective salvation or public health care? Such conflicts became concrete when the bishop proposed a petition service or procession. Since the plague could be a punishment from God, such measures were quite "rational". At the same time, doctors were closely monitoring infection patterns in the city: the search for clear symptoms – such as plague bumps – showed patterns of spread from person to person, house to house. Meetings of several people were soon regarded as sources of infection. With this new knowledge, authorities had to choose between promoting the salvation of souls. Weighing up the prevention of further infections. They tended to trust doctors more and more. The monopoly of the medical profession in the interpretation of disease is the result of a long process of medicalization.
The fact that the ban on processions and religious services was enforced can be seen as a step towards demarcating the spheres of competence of secular and ecclesiastical authorities.
Bans on religious services are now accepted by churches. But who would have imagined a papal blessing "Urbi et orbi" before 2020? without being able to imagine a hundred thousand believers in St. Peter's Square?
The current spate of fake news about the Corona crisis, for example about "miracle cures" against the disease, are circulating especially on the net. Conspiracy theories exist today as they did then: In Milan in 17. Century "plague ointment smearers, because they had allegedly contaminated church pews with germs.
A European consensus emerged on the package of measures
Since the late Middle Ages, attempts were made to extend the sealing off of cities against the plague to entire territories. The plague was brought to Italy from the east coast of the Mediterranean because it was endemic in some areas of Asia. Venice was the leading trading power in the traffic with the East. Became so the laboratory for new methods of the self-protection. Only ships with a certificate confirming that they came from an uncontaminated area or that they had already been in quarantine were allowed to enter the harbor. Otherwise, 40 days (hence the term quarantine) had to be spent anchored on an offshore island. The last plague outbreak in Western Europe also arose from the Levant trade in 1722 – in Marseille.
Italy's lead in disease control has been recognized by countries north of the Alps. Thus, southern German cities sent their doctors there for training. In 19. In the sixteenth century, Europeans were able to protect the continent from the plague, which continued to be endemic in Asia, through international agreements. Seamen and merchants, as well as Mecca pilgrims had to pass through the eye of the needle Alexandria and were obliged to quarantine there. During the plague quarantine, affected houses were marked with the plague cross – no one was allowed to leave them. Then they supplied themselves with baskets, which were pulled up to the higher floors. In the current crisis, people in Germany were still allowed to go for walks without a diagnosis.
Fear and uncertainty in times of Corona
Despite the low mortality risk, many people fear for their lives. Perhaps the rapidly rising curve of infected people is misunderstood as referring to an equally rapidly rising death rate of those tested. Disquiet was probably also caused by TV images suggesting a universal spread of danger. In the case of the plague, the nightly fires to smoke out the streets and corpse carts on their way to mass graves – these days Italian TV images of military trucks with coffins or of disinfection squads in airports and subways.
That everyone was equal before the virus is a common but false amption: viruses never spread uncontrolled, they are not actors. People have always traded – with different options. Today, part of the population can retreat to the home office, while others have to expose themselves to the risk of infection on a daily basis, because this is the only way they can perform their work. Social differences can be seen, among other things, in the small homes of the poorer and larger homes of the wealthy.
Other triggers of individual fears have also changed. In plague times, when a doctor visited a home, people feared that the doctor would diagnose the plague. Today, on the other hand, many wish to be tested. This, too, is a result of habituation to the interpretive power of the medical profession.
Corona teaches us that we must learn to deal with uncertainties and fears. However, these were much greater in earlier generations. Meeting in poorer countries many more people.