For as long as human history has been recorded, and certainly well before that as well, we’ve been afflicted by disease; some minor, some fatal, and up until relatively recently – the past few centuries, for the most part – all largely mysterious in regard to their causes. If the diseases that afflict humans are broken into their most simple division, we can group them as communicable and non-communicable. Non-communicable diseases are those that arise in an individual due to a particular circumstance or circumstances – heart disease and stroke being two examples. While troublesome, debilitating, and sometimes deadly to those afflicted, as well as perhaps socially or economically injurious to their families, non-communicable diseases have primarily been a geographically local problem.
Communicable diseases, on the other hand, are those that can be passed between individuals. Commonly the result of viruses, bacteria, or parasites passed either directly from person to person, or indirectly through a more complex chain of transmission, communicable diseases have been the far more widespread causes of our collective historical misery. For those with which we (as a species) have become familiar – for example, the many rhinoviruses that cause what we refer to as the common cold – the suffering is widespread but largely not life-threatening nor the effects long-lasting. Others, however, when newly emerged in an immunologically naïve population, perhaps as the result of humans pushing into new geographic areas, meeting up with other human populations who have long experienced the disease and developed resistance to it, or as the result of a mutation allowing a successful jump from one animal species to another, have scythed their way through populations, leaving mountains of bodies, as well as population imbalances, economic upheavals, societal restructurings, and overturned systems of belief in their wake. When such a disease experiences a dramatic surge in a particular population or geographic area, we refer to it as an epidemic. When it surges in multiple countries, across continents, or, as the SARS-CoV-2 virus is presently doing, around the world, it is called by a different name, one we all now know all-too-well: pandemic.
But SARS-CoV-2 is not by any means our first, as the saying goes, rodeo; our history records a number of pandemics dating well back into antiquity. As Prof. Christian W. McMillen clearly, informatively, and concisely recounts in his Pandemics; A Very Short Introduction, detailed records of these widespread occurrences of communicable diseases among our species can be well documented as far back as the time of the Byzantine emperor Justinian I (they have, of course, been noted in sources from the even more distant past, but the records for such events become much more vague and the diseases themselves therefore more challenging to identify). Beginning perhaps somewhere in the interior of central Africa, or maybe Asia, the “Plague of Justinian” as it has come to be called, involved an outbreak of Yersinia pestis that made its first appearance into historical records in the Egyptian port city of Pelusium in 541 C.E., and from there spread across the Mediterranean, eventually reaching as far as Britain and Persia respectively. Writings from the period record cities being depopulated, countrysides largely devoid of people, and crops left in the fields due to a lack of anyone to tend or harvest them. For some areas, outbreaks of plague would become a somewhat regular occurrence of antiquity – every seven years for a time in Syria, for example. For others, it would wreak havoc and then seem to disappear – for a while, at least.
Of course, plague isn’t the only pandemic worthy of historical note. In Pandemics, Prof. McMillen works his way through a succession of diseases that have risen to the status of pandemic. After completing a concise but very informative explanation of the epidemiology and impacts of plague, he follows with similar examinations of smallpox, malaria, cholera, tuberculosis, influenza, and HIV/AIDS (as the book was published in 2016, SARS-CoV-2 had not yet made its presence known, if in fact it had even yet made its zoonotic jump to our species). Working methodically through the known histories of each of these diseases, Prof. McMillen makes it perfectly clear that while their respective pathologies differ significantly, many of their societal as well as sociological effects are uncomfortably similar.
From the spread of often dangerous and counter-productive rumors, to resistance of organized efforts at containment and treatment, to rises in fear-driven paranoia and xenophobia (as well as in racism and homophobia in some instances), what we read in Pandemics as having occurred during periods of pandemic disease would have served very well as a primer of what we could have recently expected in response to our our present pandemic. Of course, in the process of attempting to control and overcome pandemics, a number of other beneficial developments are also presented – for example the institution of what were effectively public health districts in the Italian states in the fifteenth century, or the implementation of quarantines in the nineteenth.
Of particular note in Pandemics is Prof. McMillen’s focus on one of his areas of historical specialty – the history of novel exposure and subsequent experience of diseases in immunologically naïve native populations to introduced diseases. While it is often mentioned in various histories that native North American peoples suffered greatly as a result of the introduction of such diseases as influenza and smallpox to the continent from Europe, the deeper socio-cultural and inter-national political effects of these disease outbreaks upon the many native nations is not one commonly encountered in any history, much less one as intentionally brief as Pandemics.
Of further significance, and worthy of commendation, is Prof. McMillen’s remarkable ability to clearly present the nuances involved in the acts of facing, treating, and preventing pandemic diseases. As he clearly points out, with the exception of smallpox, all the diseases to which he dedicates chapters in the book, other than plague (that has become more sporadic and much less widespread), are very much still with us, killing tens of thousands to even millions of people each year. For some of these diseases – for example HIV / AIDS – effective treatments have been developed (so long as they can be afforded) that have transformed them into chronic rather than fatal conditions. But for others, cholera particularly, that can effectively be treated, the conditions that underlie its pervasiveness, remain as uncorrected as they have been for decades, even centuries, resulting in not only the continuation of the disease itself but a host of other problems that make life a living hell for the millions enduring them each day.
While it is indeed very likely that, so long as Prof. McMillen and Oxford University Press are agreeable to such a thing, there will be a second edition of Pandemics; A Very Short Introduction beginning to be drafted very soon – if in fact it isn’t already being written – given the present states – fearful, confused, depressed, grieving, anxious, uncertain, and even for the fortunate minority who have been vaccinated, cautiously hopeful – in which we all to one degree or another presently find ourselves as the result of living through the present pandemic, taking the time to acquire and read a copy of this present edition will go far to cutting through the often overwhelming maelstrom of argument, ignorance, and sometimes unintelligible noise to show how such events are not new, are capable of being understood, have elicited illogical human responses in the past (anti-mask and anti-quarantine protests are by no means unique to CoVid-19) and most importantly, have been survived. Think of it as one of the shortest paths to acquiring a more clear and informed perspective in a very unclear and and very bewildering time.
Title: Pandemics; A Very Short Introduction
Author: Christian W. McMillen
Publisher: Oxford University Press
Series: Very Short Introductions
Format: Paperback
Pages: 176 pp., w. 10 illustrations
Date: December 2016
ISBN: 9780199340071
In accordance with Federal Trade Commission 16 CFR Part 255, it is disclosed that the copy of the book read in order to produce this review was provided gratis to the reviewer by the publisher.
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