Even If It’s Not Ebola… (continued)

Could a plague change our history? John Marr in Egypt c. 1998 to film a documentary on the ten Biblical plagues.

Could a plague change our history? John Marr in Egypt c. 1998 to film a documentary on the ten Biblical plagues.

Decades earlier, it seemed to be a much simpler germy world. In 1976, when I was Director and Principal Epidemiologist for the Bureau of Preventable Diseases for the New York City Department of Health, the specter of a worst case scenario was on my mind – a visitation by some sort of terrible communicable disease that might strike the city. Six years later HIV did arrive, but in the 70’s if one had imagined a sexually transmitted virus that destroyed the immune systems of its victims and then spread worldwide, it would have been dismissed as a far-fetched fantasy.

I began to consider the possibilities. Among other candidates, smallpox remained a remote but potential threat; swine flu had been a near miss. True, a new, deadly virus had just been identified in Africa — Ebola. But hemorrhagic diseases like Ebola were unlikely importations.

If and when morphed into what then?”

So when I began to think of what might happen if and when some highly fatal, rapidly spreading, air-borne disease was introduced into the city, my speculations centered on pneumonic plague. It had a 100% mortality rate and short incubation period. Plague was endemic in the southwest U.S.; it had an epidemic precedent (1900 San Francisco), and was a universally feared agent a.k.a. the Black Death since the fourteenth century. The if and when morphed into a what then? What might happen if everything went wrong and the disease spread?

I shared my concern with colleagues, friends, and eventually a literary agent, all of whom suggested that these speculations might be worthy of novelization. The agent said that a co-author might expedite the process — I had a full-time job and an outbreak of typhoid fever was unfolding. I agreed, and The Black Death (with Gwyneth Cravens as co-author) was published a year later. By then the multi-state typhoid fever had been traced to a midtown restaurant favored by tourists. The alleged carrier (a dishwasher) escaped to Venezuela. No one died. The restaurant, sadly, went out of business.

In 1980 my wife and I moved to Greenwich, Connecticut, and after a series of interesting administrative and clinical jobs I returned to public health as an epidemiologist for the New York State Health Department in 1993. Back in the city, I had the opportunity to reflect on newer communicable diseases that had been identified, as well as some very old ones. I stumbled across a reference to the Biblical ten plagues. For the next three years it became an intellectual candy – exploring possible scientific explanations for each, as well as offering an original domino theory that explained how each plague built on the preceding catastrophes. These ruminations led to a scientific article, media attention and a classy 1998 one-hour documentary.

It also became the basis of my second novel, The Eleventh Plague – about a Teddy (Harvard ’62) Kaczynsky-like terrorist who updated Yahweh’s arsenal of afflictions. My co-author, John Baldwin, was local Greenwich resident and we were featured in the local newspapers. One morning I got a call from Greenwich Magazine. The magazine asked if I would write a freestanding article of my choice that might be of particular interest to its residents. I agreed to write an account about a what if that involved the town. They agreed. A week later I sent the “essay” to the magazine. The short piece was not exactly what they expected. I never got a follow up call.

“A long caravan became thrombosed on the Tappan Zee Bridge.”

In that scenario I imagined that an infectious agent of some sort (not unlike Ebola) was purposely released in Grand Central Station. The 24/7 TV informed viewers of the threat. The mayor, Health Commissioner, and various talking heads were immediately interviewed and attempted to calm viewers.

However, many Connecticut, New Jersey and Long Island commuters who realized what might ensue made it out of the borough before most citizens became were aware of the attack. Later, an exodus of frightened Manhattan residents packed subways and highways leading out of the city. The bridges to Brooklyn, Queens and Staten Island became clogged. People in northern Manhattan tried crossing into the Bronx over a half dozen bridges, while Bronx residents piled into automobiles, trucks and buses and fled north into lower Westchester. A long caravan became thrombosed on the Tappan Zee Bridge; other lines of traffic tried to escape north on Hutchinson River Parkway, but large trucks jammed into a low overhead bridge in both directions on the Merritt Parkway at the King Street exit in Port Chester.

Many other vehicles found alternative routes into Connecticut, but they eventually became overheated, stalled or out of gas. The worst pileup was at Exit 3 in Greenwich. The I-95 Cos Cob overpass leading to Stamford had become blocked and a terrified crowd abandoned cars and poured onto the Post Road. Astonished town residents and merchants witnessed waves of frightened people streaming through the streets looking for water, food and a route away from the city. The local police abandoned the town and joined the emigration. The chaos spread.

I fully understood why the magazine rejected this submission!

The likely agent would be a new, highly fatal air-borne virus”

I am not a “prepper” – a fanatic preparer for some sort of WMD-like (Weapon of Mass Destruction) disaster — although I do live in a rural area, up a one-mile dirt road, have a back-up generator, a fish-stocked pond and a few weeks of food. I do not think that the novels of James Wesley, Rawls are particularly credible. However, I do think we –- especially an urbanized America — are increasingly vulnerable to a natural or man-made disease visitation that would rupture and tear the gossamer fabric of our society. I believe that a similar Greenwich scenario could conceivably happen sometime and somewhere in the future.

The infectious agent would likely be a new, highly fatal air-borne virus like SARS or MERS-CoV. Both these coronaviruses have asymptomatic bats reservoirs (like Ebola) that transmit the virus to humans and cause highly fatal diseases. It is quite likely that many more other viruses exist in countless animal reservoirs – as most newly discovered viral agents do. To pretend to think we have discovered all the important communicable diseases is delusional. Look back to our graduation year – 1962. Fifty-plus years ago Ebola, Lassa fever, Marburg agent, Legionnairs’ disease, Lyme disease, Hantavirus, West Nile fever, and HIV were unknown. More will emerge, and some will be quite lethal.

If the event occurred in a large city and the media hyped it, the public would indeed likely panic. Inter-city transportation would fail; communications would be ruptured; public order would disappear; food would become in short supply; looters would appear; an unprepared National Guard would attempt to seal the city. Nearby city and states would attempt to restrict outward migrations. Appointing a national health “czar” would be a joke. International reactions are unknowable, but as in the recent SARS and Ebola epidemics have demonstrated, they would be too little and too late.

Survivalism is not a new phenomenon in American history. Considering and implementing an individual plan to survive a major disruption to daily routine may not be a bad idea. It would include an alternative energy source in the event the power grid became compromised – batteries, candles, and an autonomously operated generator. A source of fresh water either in bulk or available from a nearby pond/lake/river and some Clorox to make it safe (one drop per gallon); a store of non-perishable foods viz. spaghetti/pasta, jerky, canned fruits/veggies. A garden might also be nice.

“A reasonable amount of energy/water/food to last it out is inexpensive, comforting and logical.”

Prepper sites and the web are full of elaborate preparations, some quite paranoid. The above sounds as if I am a prepper, but I am not. A disasterologist, maybe. I just heard from a very reliable source that a hand-held atomic bomb launcher has the range of 10-12 miles. Our government is concerned that a Russian model could find its way into a terrorist group. Good-bye Washington DC.

Even an extreme WMD event would elicit a robust response from fed, state and city resources and Homeland Security. I am confident that they would halt the spread of an airborne disease in a few weeks. BUT, in a large city like New York the initial response would be overwhelmed. The farther away from the epicenter, the less the threat, while suburban and exurban communities might be impinged upon. The Hamptons would be quite safe, assuming they could be self-sufficient for a few weeks. To have a reasonable amount of energy/water/food to last it out is inexpensive, comforting and logical. (Mormons keep a six month supply in their households.)

I think it goes without saying that our local, state and federal governments have contingency plans. The Ebola scare might have been a blessing in disguise for our health care and emergency response organizations. All public health agencies are aware of how close we came to a SARS pandemic in 2002. The CDC also is prepared. To announce the details would only create anxiety and a host of talking heads to criticize the plans.

I am sounding like a Cassandra, but ANY attack — nuclear, cyber, economic or whatever could destabilize our fragile system, especially an urbanized area. Maybe this should be fictionalized to create more political will, but that has already been done by a number of authors.

Ed note: If you have taken any steps of your own toward the kind of individual plan he outlines at the end, please let me share your preparations with classmates by sending a brief description to chris@christophercory.com. Or comment below.

Ed. note: We are all invited to join an interesting scholarly crowdsourcing project:

John continues to write or co-author studies on the under-appreciated role of infectious diseases in history. He now invites any of us to comment on a recent paper about the role of smallpox or measles in defeating an army of 60,000 Christian Ethiopians that besieged Mecca in 570 CE, and click here to see the comments so far. John particularly hopes for reactions from a pre-Islamic historian, anyone with an interest in early Christian history, or someone who knows about the Jewish Yemenite country. You can write directly on the page (use the Edit button at the top) or send comments to the editor.

Please comment below.

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  • John S Marr March 11, 2015 at 6:19 pm

    Thanks, Henry. And YOU were thre best fullback with Rufus Day. You accounted for the low scores. My best to you. And the old soccer gang. John

  • Henry C. Childs February 22, 2015 at 9:23 am

    What a pleasure to catch up with John, after all these years, in spite of the tenor of his piece. I am reminded by his writing of the alacrity of his movements as our goalie on the freshman soccer team (allowing only two goals all year), seeing the nimbleness of mind in covering this potential catastrophe. As a long-time refugee from NYC and current resident of the southern Blue Ridge Mountains, I will be sure to stock up on supplies, even so.