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Pandemics, Superstition and Science

My Italian town, home to the Black Death of 1348, affords a perfect view of humanity’s road to reason. Let’s walk.

Frank Viviano 15 Jan

Frank Viviano, a best-selling author whose global journalism has been nominated for the Pulitzer Prize eight times, lives in Barga, Italy and is a staff writer for Barganews.

A peculiar marriage of wild celebration and tacit mourning takes place each year on Aug. 15 in Barga, the hilltop Tuscan town where I’ve lived for two decades. Its people dance in the piazzas to the music of accordions and mandolins. Outdoor markets hum with shoppers until well after midnight. Dazzling fireworks explode over its medieval cathedral and ramparts.

This is the feast of San Rocco, a centuries-old holiday dating back to the most lethal pandemic in world history. It commemorates the ardent re-embrace of life after the inconceivable horrors of the 14th century’s Black Death — in which Barga’s Serchio Valley almost certainly played a critical role. Over the brief span of four years beginning in 1348, the Plague carried off up to 60 per cent of Europe’s entire population, leaving an indelible scar in the collective memory.

As harrowing as COVID-19 may seem today, its impact doesn’t begin to compare with what transpired across the Atlantic seven centuries ago. To date, with vaccinations underway and an end to the crisis in sight, some 16,000 Canadians have perished in 2020 from the effects of the coronavirus, roughly one for every 2,400 people in a nation of 38 million. Worldwide, the toll is an estimated 1.9 million deaths in a global population of nearly eight billion, around one for every 4,000 people.

By numbing contrast, 40,000 villages and towns in Germany alone vanished forever between 1348 and 1351, abandoned by their few surviving inhabitants. The population of Florence, arguably the most prosperous city in Europe in the mid-14th century, dropped from more than 120,000 to less than 50,000. Overall, epidemiologists believe, large stretches of Italy, Spain and France may have lost three-fourths of their people.

San Rocco was its iconic victim, a 14th-century nobleman from Montpellier, France, who renounced his inherited wealth and set off on a lifelong pilgrimage that ended with his own death in northern Italy. At the height of the pandemic, Rocco worked tirelessly as an itinerant healer, tending to the dying and their families. When he too fell sick, he moved to a simple hut in an isolated forest glade. But he lived on for a year, the legend has it, sustained by a natural spring of fresh water that miraculously appeared in a nearby rock, and by a small dog who brought chunks of bread to the hut each morning.

Barga’s Chiesa di San Rocco, built on the foundations of a 14th-century chapel just beyond the town walls, recalls this legend graphically in a statue over its entrance. It features both the dog and the saint, holding his pilgrim’s staff in one hand and raising the tattered hem of his tunic with the other to bare festering sores on his thigh, emblematic symptoms of Bubonic Plague.

All of these details, most notably the church’s location, speak to a tragic distinction in Barga’s history: it was probably among the very first European communities struck by the Black Death, and a de facto transmission node. Hence the construction of a chapel dedicated to San Rocco at the town’s main gate, echoed in thousands of similar churches across Europe and meant to ward off future epidemics. Forensic historians regard the dispersion of these churches as a reliably precise “map” of the plague’s most concentrated impact and extent.

What is known, from archival evidence, is that the pandemic reached continental Europe when a Genovese galley sailing home from the eastern Mediterranean dropped anchor 30 miles south of Barga at the port of Pisa in January 1348. There is little doubt that the vessel’s hold ferried a colony of migrating rodents — all ships did in those days and many continue to do so today. The consensus view of historians is that the rats, in turn, hosted fleas infected with the bacterium Yersinia pestis, the Plague’s source.

In all likelihood, the galley’s unidentified human passengers were Silk Road merchants and devout Christians returning from the Holy Land, flea-bitten after a long, uncomfortable voyage. Their land journey homeward (which few if any must have completed), would have taken them (and Yersina pestis) along the Via Francigena, the ancient commercial and pilgrimage route through the Serchio Valley. It winds beyond the Apennines into Italy’s fertile Lombard flatlands and over the Apennines to Switzerland, Germany, France and England. The same road was featured half a century later in Geoffrey Chaucer’s Canterbury Tales.

Together, silk and pilgrims accounted for the wealth that built the ornate palazzi that still grace Barga’s historic centre. But for much of the town’s population in the terrible winter of 1348, they were harbingers of a gruesome death, spreading relentlessly north.

The ancient hilltop town of Barga was probably among the very first European communities struck by the Black Death, and a de facto transmission node for the pandemic that wiped out 60 per cent of the continent’s people. Photo: Shutterstock.

As it happens, my own home bears silent testimony to that tragedy. I live in an apartment carved out of one of those grand buildings, the 1000-year-old Palazzo Salvi-Balduini. In 1348, its lower floors served as a convent. My windows look out over the grapevines and bay trees of the former cloister. Within days of the pandemic’s arrival, most Barghigiani and all of the nuns had died. Given the sudden, immense wave of fatalities, normal burials were impossible. The nuns’ remains were consigned to a common resting place: a deep well in the palazzo’s lower cantina. It remains inaccessible, sealed behind a solid oak door and enormous iron lock, 673 years later.

The ghostly shadows of 1348 haunt many communities here, mementos of a pandemic legacy that lingered on in daily life for centuries. From 1350 until well into the 1900s, many Europeans bathed as infrequently as possible, believing that water was the chief carrier of pestilential disease. Before the Black Death, “this was simply not the case,” a French historian once told me. “Early Medieval Europe inherited the Roman habit of bathing daily. The plague brought it to a complete stop.”

In addition to provoking a vast array of hygiene-related maladies, the Black Death also spawned a new industry. By 1370, royal commissions were being granted to manufacturers of perfume in France and Hungary, as Europeans sought to disguise body odours they were fearful of washing away.

Of infinitely more importance, the cataclysmic trauma of 1348 unravelled the medieval web of morbid religious fears and superstitions. In the process, it launched the Italian Renaissance, which soon began transforming Europe with its rediscovery and amplification of the secular humanism, sensual art, informed science and philosophical speculation that characterized classical Greece and Rome. The transition from mourning to living implied in the two emotional currents of the Festa di San Rocco.

The heirs of that revolution extend in an unbroken line from Leonardo da Vinci and Galileo Galilei, through Isaac Newton and Charles Darwin, to Albert Einstein and his successors. By the end of the 19th century, its medical landmarks included vaccines for smallpox and cholera, rabies and anthrax, the microscope, surgical anesthetics and antiseptics, confirmation of the role of germs in disease, the stethoscope, blood transfusions and X-rays. The intellectual framework of modern health care, the structural context of today’s multiple vaccines against COVID-19, was built in the ruins of the medieval universe.

Aug. 15 is the day Barga’s people dance and fireworks light up its medieval cathedral and ramparts. The feast of San Rocco, icon of medieval superstition, also celebrates how far humanity has progressed. Photo by Keane.

Some 25 years ago, while working on a book about my Sicilian grandparents, I happened by chance on 25 pages of German names in the 1918-19 death register of Terrasini, our ancestral hometown. “They were Austrian prisoners of war, mostly teenagers inducted near the war’s end,” the registry’s curator explained. Taken captive and sent to Sicily for internment, the young Austrians were forgotten for months after the November 1918 Armistice, left incarcerated 1,200 miles from home while Terrasini’s officials awaited instructions on what to do with them.

Albert Einstein had already formulated his theories of relativity by then, but the understanding that crowded conditions acted as viral super-spreaders was still rudimentary in 1918. The teenaged prisoners in Terrasini were crammed by the hundreds into a fetid abandoned stable when the Spanish influenza swept through. Hundreds of thousands of their fellow soldiers fell victim to the virus in the war’s trenches, hospitals and barracks, the survivors passing the virus along to millions of civilians. There was no such thing as an immunization against the flu. There was also no such thing as an antibiotic to combat the mortal effects of secondary bacterial infections that often accompanied it. The first true antibiotic would not appear until the discovery of penicillin by the London bacteriologist Alexander Fleming in 1928, after three decades of research. It is likely that such infections were responsible for a pneumonia wave that was the primary cause of flu-related deaths.

The 1918 pandemic left up to 100 million dead in a worldwide population of two billion, one in 20 of the globe’s residents — compared to COVID-19’s current toll of one in 4,000. The dead included 55,000 Canadians, almost as many as the war itself claimed, in a nation of nine million: around one of every 160 of Canada’s people, 15 times the COVID-19 death rate as of January 2021.

This is not to diminish the pain inflicted by COVID-19. To a world suspended in the suffocating vacuum of rising contagion and paralyzing lockdown, the wait for a vaccine has often seemed interminable. But the reality is that it has been phenomenally brief.

Prior to this winter, the fastest development period on record for a new vaccine was aimed at the mumps. It took four years, from 1963 to 1967, to reach implementation. On the average, 10 to 15 years of research and testing precede the release of such medications. None of the COVID-19 vaccines now in active use in the West was under study before the beginning of April. All had completed clinical trials by autumn, were approved by health authorities in Europe and North America between mid-December and the first week of January, and quickly deployed in enormous injection programs.

Among leading industrialized nations, the most outstanding record in managing the COVID-19 pandemic belongs to Taiwan. A scant seven of its 24 million citizens have died from the effects of the coronavirus, a stupefyingly low mortality rate of 0.3 per million. Not coincidentally, the official who oversees Taipei’s most immediate policy decisions, vice-president Chen Chien-jen, has a master’s degree in public health from his country’s most prestigious university and twin doctorates in human genetics and epidemiology from Johns Hopkins, the top medical research institution in the United States.

Among populous Western countries, Germany has the lowest COVID-19 death rate at 530 per million, a far cry from Taiwan’s astonishing numbers but well under half the European average. Its leader since 2005, Chancellor Angela Merkel, is a physicist with a doctorate in quantum chemistry who spent most of her career as a research scientist in Berlin’s Academy of Sciences before entering politics in 1990.

The rise of Chen and Merkel to leadership owes a great deal to national traditions that strongly emphasize the vital importance of education and science. The contrast with COVID-19 statistics in countries led by populist movements, which tend to dismiss the significance of academic credentials and expertise in general, could not be more striking.

Total pandemic deaths in the United States under Donald Trump, its now-disgraced president, are almost certain to exceed 400,000 before his successor Joe Biden takes office on Jan. 20. At 1,160 per million people, the U.S. COVID-19 mortality rate is more than two and a half times the figure for Canada, which has an economic and demographic profile almost identical to that in the United States. In Jair Bolsonaro’s Brazil, Viktor Orbán’s Hungary, and Andrés Manuel López Obrador’s Mexico, the pandemic death rate per million hovers around 1,000, more than four times the global average.

It is not science and its medical research branch that have failed us in the pandemic of 2020-21. The rational humanism of the Renaissance and its scientific legacy have not proven to be false gods. On the contrary, the failure lies with those who reject the incontrovertible evidence that scientific research and rational thought are the bulwarks of contemporary life and civilization.

Nowhere is that failure more evident or confounding than Britain, home of a remarkable number of history’s notable scientists and medical discoveries since the Black Death.

“I think the people of this country have had enough of experts,” Michael Gove, then Lord Chancellor of the United Kingdom and a fierce critic of the European Union, proclaimed three weeks before the 2016 Brexit referendum. Governed by a populist faction of the Conservative party that pushed for departure from the EU, Britain now has a COVID-19 death rate that ranks among the worst on Earth at more than 1,250 per million. Worse than Donald Trump’s United States.

Populist rhetoric and policies continued to dominate Conservative decision-making under Prime Minister Boris Johnson through nine months of seesawing efforts to contain the pandemic. The unspoken strategy was to let the virus take its own course until the chimeric “herd immunity” was obtained — the favoured response to the pandemic by most populist regimes, despite widespread scientific doubts over its sheer possibility and the enormous risks it entailed.

Long after Italy, France and Spain had imposed severe lockdowns and travel restrictions, British officials were still publicly questioning the perils of mass gatherings and the need for masks or social distancing. To the dismay of medical professionals, coherent policy steps to meet the crisis failed to materialize even after Johnson himself contracted the virus and was hospitalized at the end of April in critical condition.

As late as Dec. 16, when opposition leader Keir Starmer pleaded with the government to implement a serious lockdown, citing predictions that festive parties during the holiday season were certain to be super-spreaders, the response was a classic populist dismissal. Johnson called Starmer “inhuman” and accused him of wanting to “cancel Christmas.”

The previous day, 18,450 new COVID-19 cases were diagnosed in the United Kingdom. By Dec. 19, the daily increase had doubled, leaving Johnson with no option but to swallow his own words: Christmas festivities were abruptly banned. By Jan. 8, cases were increasing by almost 70,000 per day, and the hospitals were so full of gravely ill coronavirus victims that Britain’s National Health Service was close to collapse.

On Dec. 19, the U.K. reported its two millionth COVID-19 case in the 10 months since mid-March. The three million mark was passed just three weeks later. By then, the turn against populism, in both rhetoric and policy, seemed complete. Faced with a full-fledged health disaster, 10 Downing Street embarked on one of the globe’s most comprehensive vaccine campaigns.

It was designed and overseen by eminent researchers from Oxford, Cambridge and the Imperial College of London. In a word, by experts. The heirs to a momentous revolution nearly seven centuries ago, set in motion after the most lethal epidemic the world has ever known brought death to San Rocco in a dark forest.  [Tyee]

Read more: Health, Coronavirus

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