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Ashes, Ashes We All Fall Down

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Burden S. Lundgren
August 5, 2022

The nursery rhyme of the title may describe the 14th century plague epidemic with the “fall down” referring to deaths. Our world is falling down too. Crime and almost every other form of social pathology is on the rise. There is political unrest. Children are returning to school with short tempers, a lack of social skills and signs of regression in learning. It’s not just children. College professors are reporting high levels of apathy and non-involvement in their students. Mass shootings are back. There seem to be rotating shortages of just about everything from baby formula to dog food—and speaking of that, pet shelters are overfull again. Whatever you can find costs a lot more. And non-COVID viruses are acting in a bizarre fashion with unexpected outbreaks in unexpected times and places.  

Epidemiologists have explained the science of the epidemic, but not its social shock effects. Thucydides provides a classical account of the effects of an epidemic on society. In the midst of the Peloponnesian War, Athens was struck by a deadly plague (actual disease unknown). Thucydides describes the utter dissolution of the society:

“… people now began openly to venture on acts of self-indulgence which before they used to keep dark… As for what is called honor, no one showed himself willing to abide by its laws, so doubtful was it whether one would survive to enjoy the name for it…No fear of god or man had a restraining influence. As for the gods, it seemed to be the same thing whether one worshipped them or not when one saw the good and the bad dying indiscriminately. As for offences against human law, no one expected to live long enough to be brought to trial and punished…”

It should be noted that the Greek word for law also includes culture and customs—the norms of a society.

Athens was no barbarian outpost. It was named for the goddess of wisdom. It was the very cradle of democracy, the home of Socrates, Plato and Aristotle, a military superpower and an exemplar of on ordered society. The disease caused not only death, but chaos.

Thanks to the strong leadership of Pericles, confidence in the government was temporarily restored.  But with norms undermined, Thucydides recounts that Pericles’ successors “each of whom aimed at occupying the first place, adopted methods of demagogy which resulted in their losing control over the actual conduct of affairs” which caused the once invincible Athenians to surrender to their foes.

There have been many epidemics of the plague labeled “the Black Death,” but the most notable is that in 14th century Europe. At least a third of the population died. The consequences were severe enough to re-order the society. Food scarcities resulted from the shortage of workers, but these same workers benefited from that shortage. Serfs, bound to the land by inherited conditions of servitude, gained enough power to break the feudal system forever. The position of women was improved at least for a time as they could now take over their dead husband’s affairs. Confidence in the church, the overriding institution of authority, was eroded as people saw the futility of rites and sacraments in fending off death. Some believe this erosion helped lead to the Reformation. The disease was hardest on the Jewish populations. Entire Jewish communities were wiped out by Christians blaming them for the epidemic.  

The so-called Spanish flu coincided with the end of World War I and caused far more deaths than the War (up to 100 million vs. 16 million), but the world hardly took notice. John M. Barry in his classic work on the epidemic pays almost no attention to aftereffects beyond medical advances, but he does offer a prescient warning:

 “There was terror afoot in 1918, real terror. The randomness of death brought that terror home. So did its speed…

The media and public officials helped create that terror—not by exaggerating the disease, but by minimizing it, by trying to reassure.

…In 1918 the lies of officials and the press never allowed the terror to condense into the concrete. The public could trust nothing and so they knew nothing… The fear, not the disease, threatened to break the society apart.”

The decades following the epidemic were times of tumult: the “roaring twenties”, gangsterism, enfranchisement of women, financial collapse, the rise of fascism, another world war. We cannot know what would have happened absent the epidemic, but it is not unreasonable to believe that the sudden absence of 100 million souls and the undermining of trust in government played a part in what actually did happen.

The history of significant epidemics strongly suggests we should not be waiting for “normal” to return. It won’t. We can expect fragility in institutions we thought were unbreakable and economic, social and political volatility for decades to come. But this very instability offers us the opportunity to re-examine the way we do things. What broke? Can we repair it, or should we replace it altogether? As a prominent political figure remarked in another context “Strap in!”        


Author: Burden S Lundgren, MPH, PhD, RN practiced as a registered nurse specializing in acute and critical care.  After leaving clinical practice, she worked as an analyst at the Centers for Medicare and Medicaid Services and later taught at Old Dominion University in Norfolk VA.  She has served as a consultant to a number of non-profit groups.  Presently, she divides her time between Virginia and Maryland. She can be reached at [email protected].

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