Out on a Limb

by Andrew Sullivan

  Paradoxically, the Black Death also reshaped and rebuilt the rural economy to benefit the poor. With half the population suddenly wiped out by bubonic plague, food became plentiful and cheap as soon as the harvests returned, because there were so many fewer mouths to feed, and the price of labor soared because so many workers had perished. Day laborers suddenly had some leverage over the owners of land and exploited it. A manpower shortage also led to innovations. With fewer people on higher wages, for example, the cost of making a book became prohibitive—because it required plenty of scribes and copiers. And so the incentive to invent the printing press was created. Industries like fishing (new methods of curing), shipping (new kinds of ships both bigger and requiring less manpower), and mining (new water pumps) innovated to do more with fewer people. The historian David Herlihy puts it this way: “Plague… broke the Malthusian deadlock… which threatened to hold Europe in its traditional ways for the indefinite future.”

  In these two bookends of European plague, in the sixth and then the fourteenth century, you see two ways in which epidemic disease changed society and culture. In one, the disruption and dislocation of mass disease sent the world into a long de-civilizing process; Roman society was gutted and its empire dissolved into various fiefdoms. In the other, a mass-death event triggered a revival, economic and spiritual, in a kind of cleansing process that restarted European society. They were caused by the same disease. In one case, it brought collapse; in the other, rebirth.

  Most accounts of the American Revolution focus, understandably, on military and political developments. What most don’t account for is the role that smallpox played in almost losing the war for the Americans. The virus had never gone away on this continent since the fifteenth century, had devastated generation after generation of Native Americans, and was a constant threat to the colonies themselves. In the late-eighteenth century, it was still at large—and continued to be spread by troop movements of both the British and the colonists. The British, however, had a clear advantage. Most of their troops had experienced some form of smallpox as children and developed immunity. The Americans—black, native, and colonizers—were in contrast largely vulnerable.

  As Elizabeth A. Fenn writes in her recent study Pox Americana: The Great Smallpox Epidemic of 1775–82, in 1776, in an early skirmish in the Revolutionary War in Canada, a few thousand American troops were besieged simultaneously by the virus and the British. In a sudden, chaotic retreat, the Americans sought refuge on a swampy island, Île aux Noix, and met a worse enemy. “Oh the groans of the sick,” an observer reported. “Scarcely a tent upon this Isle but what contains one or more in distress and continually groaning, & calling for relief, but in vain!” Reported another, having witnessed a barn full of men covered in vermin: “One nay two had large maggots, an inch long, Crawl out of their ears.” Still another exclaimed, “My eyes never before beheld such a seen [sic]… nor do I ever desire to see such another—the Lice and Maggots seem to vie with each other, were creeping in Millions over the Victims; the Doctors themselves sick or out of Medicine.” No wonder that in 1776 John Adams was despairing, “The small pox! The small pox! What shall We do with it?”

  It was close to impossible for the American troops to gather in large numbers without smallpox running rampant. Quarantining had some impact, but in military retreats or advances it was impractical. George Washington was worried: “Should it spread,” he wrote to the Massachusetts House of Representatives in late 1775, smallpox would be “very disastrous & fatal to our army and the Country around it.” Washington’s brother worried about the effect on recruitment: “I know the dainger [sic] of the small pox and camp fever is more alarming to many than the dainger they apprehend from the arms of the enemy.” Washington, who had had smallpox as a young man and was immune, eventually decided to oversee an unprecedented campaign to inoculate the entire revolutionary army by inserting small amounts of the virus into the skin to create a much milder illness. After a period of sickness, most recovered and could rejoin the battle with immunity to the plague.

  It was arguably the most important military decision Washington ever made, evening the score with the relatively immune British, whose African American allies, never inoculated, suffered terrible losses. Enslaved black people were particularly vulnerable. Jefferson would later guess that of the 30,000 enslaved black Virginians who had joined the British, “about 27,000 died of the small pox and camp fever.”

  Most Americans today have little, if any, awareness of the role the epidemic played in the war. And this is another curious fact about some plagues but not others: some seem to shift society profoundly, while others, however intense, are almost instantly forgotten. This is especially true when an epidemic coincides with war—as it often does.

  If the 1918 flu pandemic were to occur today, one 2013 study found, it would kill between 188,000 and 337,000 Americans. The reason the death toll would be so much lower than the 675,000 Americans who actually died is that medicine has improved. Many of those who died endured bacterial coinfections, which are now far more treatable with antibiotics. Globally, somewhere around 100 million human beings perished.

  The flu’s symptoms were horrifying. In her book Pandemic 1918, Catharine Arnold notes that “victims collapsed in the streets, hemorrhaging from lungs and nose. Their skin turned dark blue with the characteristic ‘heliotrope cyanosis’ caused by oxygen failure as the lungs filled with pus, and they gasped for breath from ‘air-hunger’ like landed fish.” The nosebleeds were projectile, covering the surroundings with blood. “When their lungs collapsed,” one witness recounted, “air was trapped beneath their skin. As we rolled the dead in winding sheets, their bodies crackled—an awful crackling noise which sounded like Rice Crispies [sic] when you pour milk over them.”

  But as the summer of 1918 began in the United States, relief spread. Maybe it was over. And then, in the fall, confident that a vaccine was imminent, several cities, notably Philadelphia, hosted war-bond parades, with large crowds thronging the streets, as with the massive Black Lives Matter marches today (albeit with fewer masks). In the coming weeks, the city morgue was piling bodies on top of bodies, stacked three deep in the corridors, with no ice and no embalming. The stench was rank. City authorities were reduced to asking people to put their dead loved ones out on the street for collection. The second wave of the flu had arrived, brought in large part by troops returning from Europe.

  The Army camps were a circle of hell: In Camp Devens, north of Boston, one young doctor arrived to see sixty-three young men die on his first day. The 1918 flu took aim at the younger generation, leaving some older people untouched. “The husky male either made a speedy and rather abrupt recovery or was likely to die,” that Camp Devens doctor, helpless in the face of this, reported. The average death toll in the camp was a hundred young men a day, and in the fall morgues were completely overwhelmed. People stole other people’s caskets, or gravediggers simply emptied corpses out of them into a pit in order to bury others.

  A survivor remembered, “From the moment I got up in the morning to when I went to bed at night, I felt a constant sense of fear. We wore gauze masks. We were afraid to kiss each other, to eat with each other, to have contact of any kind. We had no family life, no school life, no church life, no community life. Fear tore people apart.” How on Earth, one wonders, has this been forgotten? The truth is the memory was repressed, but, as after the Black Death, people sublimated the internal stress into the pleasure of the moment. The Roaring Twenties didn’t come out of nowhere. In the 1919 Carnival in Rio, the acting out was particularly intense. In her history of the epidemic, Pale Rider, Laura Spinney notes how one Rio reveler recalled, “Carnival began and overnight, customs and modesty became old, obsolete, spectral.… Folk started to do things, think things, feel unheard-of and even demonic things.”

  And as in Rome, and in revolutionary America, there was a direct military consequence. In 1918, the flu may have hit the malnourished German troops a little harder t
han the Allies, stymieing what they thought might be a critical advance in the conflict. A few historians suggest the flu was a factor in Germany’s defeat and postwar desolation. President Woodrow Wilson’s possible bout of the same flu in Paris forced him to sit out the peace conference for several days. Upon his return, by some accounts, he appeared weakened, and he ultimately failed to prevent the ruinously exorbitant reparations Germany was obliged to pay.

  Wilson himself was apparently so intent on winning the war that he never mentioned the influenza in public. Even when he came down with what might have been the illness himself, he kept mum. This is an American pattern. Wilson seemed to ignore the flu entirely; Reagan ignored AIDS in the early years of its devastation; Trump denied that COVID-19 was a threat until he couldn’t—and even now he is minimizing it to advance a sputtering economic recovery. But the public was hardly defying them. They, too, preferred denial. Americans focused on victory in Europe and consigned the domestic horror to historical oblivion. Similarly, if you ask young gay men in 2020 about the history of AIDS, a plague that occurred in their own lifetime, you are likely to get platitudes or a blank stare. Some things we simply want to forget.

  Katherine Anne Porter, who wrote Pale Horse, Pale Rider, a story inspired by her own experience surviving the 1918 flu, said something in an interview once that has stuck with me. The flu poleaxed Porter, then a twenty-eight-year-old chain-smoking journalist for the Rocky Mountain News, and after a near-death experience she recovered for the next six months. Her hair turned white, then fell out; hallucinations came and went; she tried to get out of bed and broke her arm; she was told that phlebitis would cripple her for the rest of her life. And yet she lived. And it changed her.

  “It just simply divided my life,” she wrote, “cut across it like that. So that everything before that was just getting ready, and after that I was in some strange way altered.… It was, I think, the fact that I had really participated in death, that I knew what death was, and had almost experienced it. I had what the Christians call the ‘beatific vision,’ and the Greeks called ‘the happy day.’… Now if you have had that, and survived it, come back from it, you are no longer like other people, and there’s no use deceiving yourself that you are.… It took me a long time to realize… that I had my own needs, and that I had to live like me.”

  I feel similarly, as a survivor of the first plague in my lifetime, HIV and AIDS. Within the gay world, AIDS was a plague quite similar in its impact to those in the past that afflicted the general population. Yes, men who have sex with men were not the only victims, but they made up a big majority of US cases in the beginning, and they still do. Around seven hundred thousand Americans have died of AIDS, a toll COVID-19 is unlikely to match, and concentrated in a far smaller population. I saw close friends die, nursed the sick, mourned ex-lovers, watched familiar faces grow old in a few months and lie dead in a few more. For more than a decade, gay men and their families were beset with the helplessness that defines a plague: the knowledge that there is no cure, that there is only prudence, luck, or death. But mainly death.

  It changed me—and many others—for good. The liberation of surviving an early brush with death is hard to describe, but like Porter, I learned that I had to live—and live like me. Regardless of the crowd, or accepted opinion, or communal loyalty, I was determined, as the plague changed me to live my life freely, to say what I think, and to do as I pleased. And this is not entirely unusual. Plagues can first depress you, force you to isolate and hunker down. But, in time, they can also prompt a kind of defiance, a very human desire to tell this virus to go to hell and to act in ways that ignore it. Gay men slowly began to try to have sex again and to celebrate the life that sex gave, even as they also always risked, to a greater or lesser extent, illness and death. Over time, as treatments improved and the illness ceased to be a death sentence, condoms, like today’s COVID masks, came to be used sporadically, then less and less, until they were largely cast aside.

  There lingered, though, the gnawing sense that those of us who survived had to do something to make the staggering number of victims mean something, to honor them and remember them in some way. It was an extraordinary act of collective will that, out of the ashes of a plague, galvanized the many gay men and lesbians who were determined to remake the world in its wake, to insist on formal civic equality and that they be treated with dignity and respect. And within just a couple of decades, we had achieved this—even the right to marry.

  It would never have happened so quickly, or at all, without AIDS and how it illuminated the unique stigma homosexuals lived under. In some ways, in fact, the gay-rights movement of the 1990s and 2000s is best understood as a subplot in the narrative of plague. It sounded crazy to talk of marriage equality in 1989, but plagues, as I’ve noted, make people crazy. The psychological strain, the fear, the anxiety: they build and build until people give themselves permission to scream, to protest, to re-create or reinvent religion, to express themselves fearlessly in public, to reorder the whole.

  The extraordinary and near-spontaneous mass gatherings to protest police violence against black people this year, I suspect, are rooted in this same human need. Untethered from normal routines, indeed from work itself, and shut inside with almost no human contact for months, people needed to vent, to transcend the moment and be with one another. The spark, the killing of George Floyd, was not exactly plague related, but, as sometimes in history, disinhibited feelings of very different kinds can still merge into a collective spasm. And in this plague, black people have been disproportionately hit everywhere, in large part the result of the familiar burdens of entrenched poverty and discrimination. It seemed to make some kind of sense, in a world remade by plague, to tackle this injustice more squarely and radically than before.

  Plagues, in this way, always present the survivors with a choice. Do we go back to where we were, if that is even possible, or do we somehow reinvent ourselves for a new future? The conflicting desires compete in our minds: to go back to normal or to seize the opportunity to change a society temporarily in flux. We can choose to make a different world, reordering our social compact and our political institutions and our relationship to the natural environment in ways that will protect us against, or at least mitigate the damage from, future plagues. Or we can recognize what was precious in what the plague took from us and seek to restore the status quo ante.

  This plague comes, as the Roman plagues did, in a period of great climate change, and of near-peak globalization, which almost certainly means more epidemics are on their way. And it has already set precedents that imply a very different trajectory ahead. In the United States, the federal relief has been extraordinarily generous by American standards, foreshadowing, perhaps, a debt-funded universal basic income and a big redistribution of wealth in the near future. The virus has also proved itself capable of finally cracking the cult of Trump. The president’s inability even to fake interest in or competence over the epidemic may well have made his reelection impossible, and his terrible tone in response to massive protests has rattled even his closest allies. The epidemic hasn’t ended polarization and may even have intensified it. But it has empowered the opposition in ways previously unimagined. And it may have tilted the balance sufficiently, at least in the short term, that once-inconceivable political change could take place here, in what seemed until just a few months ago an impossibly divided and politically sclerotic country.

  In this respect, perhaps, COVID-19 in America may best resemble the bubonic plague outbreak in London in 1665. It devastated the city that summer, prompting an exodus of the wealthy and connected, with perhaps one hundred thousand eventually dying in a city whose population was just under half a million. Worse, it was followed the next year by the Great Fire of London, which effectively razed the heart of the city, ruining many in the merchant class. But this catastrophe was subsequently seen as a chance to rebuild and renew, and many of the greatest landmarks of London were then constructed, as streets were
widened, stone replaced wood, and the economy took off again. The pestilence and fire jump-started a revival not just in the economy and public health but also in the sciences and arts.

  Do we go back to where we were, or do we somehow reinvent ourselves for a new future?

  You can see the potential contours of a similar response today. This plague makes a strong argument for a more aggressive approach to public health, which would mean, at a minimum, extending health insurance to everyone in the country, as well as reform and renewal for the disgraced CDC and WHO. It could unleash a new wave of infrastructure spending to repair the immense damage to the economy. It could, and absolutely should, end the argument over preventing climate change—because it is so deeply connected to new viral outbreaks, as shifts to hotter weather portend a highly dangerous upheaval in the animal and microbial worlds. And while I worry that this plague could well usher in a new era in which traditional liberalism gives way to a freshly invigorated collective leftism, particularly around identity politics, it could also deeply wound the appeal of the populist right in America, which, once in government, failed the core test of preventing an open-ended, lengthy period of infection, sickness, and death.

  Some existing trends might also intensify. It’s hard to see how a policy of mass immigration or free trade will survive public scrutiny for long in a world where viruses cross borders with such surpassing ease. The US-China relationship, already tense, could deteriorate still further. Living online, with all the isolation and depression and extremism that can generate, is now an even stronger and widespread norm, as we avoid physical interaction even more than we did previously. Same with working from home: atomization of our culture, the already-increasing levels of depression, loneliness, and antisocial behavior, could deepen further. The collapse of small retail has been accelerated, and the power of the giant tech companies is ever greater. And the epidemic has not assuaged the yawning gap between rich and poor. While COVID relief has made a real, temporary impact, the stark social and economic inequality in the country looms as large as ever. Rates of suicide, drug abuse, and overdosing could climb even higher.