From Black Death to fatal flu, past pandemics show why people on the margins suffer most
By Lizzie Wade
This story was first published in Science Magazine on May 14, 2020.
When the Black Death arrived in London by January 1349, the city had been waiting with dread for months. Londoners had heard reports of devastation from cities such as Florence, where 60% of people had died of plague the year before. In the summer of 1348, the disease had reached English ports from continental Europe and begun to ravage its way toward the capital. The plague caused painful and frightening symptoms, including fever, vomiting, coughing up blood, black pustules on the skin, and swollen lymph nodes. Death usually came within 3 days. The city prepared the best way it knew how: Officials built a massive cemetery, called East Smithfield, to bury as many victims as possible in consecrated ground, which the faithful believed would allow God to identify the dead as Christians on Judgment Day. Unable to save lives, the city tried to save souls.
The impact was as dreadful as feared: In 1349, the Black Death killed about half of all Londoners; from 1347 to 1351, it killed between 30% and 60% of all Europeans. For those who lived through that awful time, it seemed no one was safe. In France, which also lost about half its population, chronicler Gilles Li Muisis wrote, “neither the rich, the middling sort, nor the pauper was secure; each had to await God’s will.”
But careful archaeological and historical work at East Smithfield and elsewhere has revealed that intersecting social and economic inequalities shaped the course of the Black Death and other epidemics. “Bioarchaeology and other social sciences have repeatedly demonstrated that these kinds of crises play out along the preexisting fault lines of each society,” says Gwen Robbins Schug, a bioarchaeologist at Appalachian State University who studies health and inequality in ancient societies. The people at greatest risk were often those already marginalized — the poor and minorities who faced discrimination in ways that damaged their health or limited their access to medical care even in prepandemic times. In turn, the pandemics themselves affected societal inequality, by either undermining or reinforcing existing power structures.
Lizzie Wade is a contributing correspondent for Science. She covers archaeology and Latin America for the magazine from her home in Mexico City. After graduating from Barnard College in 2008 with a degree in comparative literature, she studied translation theory at the National Autonomous University of Mexico as a Fulbright scholar. Along the way, she stumbled into an internship in the Fermilab communications office and discovered a passion for science writing. After returning from the Fulbright, Lizzie was a fellow at Wired and an intern at Science. She headed back to Mexico as a correspondent in 2013. Her work has also appeared in Wired, Aeon, Slate, and the California Sunday Magazine, among others.