Signs of the Times Summer 2020May 31, 2020
Plagues and Statistics: A reply to Martyn Percy from Anthony WoollardJune 4, 2020
On August 15th 1665, the weekly statistics on deaths in London were published. Bills of Mortality had been continuously published since 1603 by the Worshipful Company of Parish Clerks. By 1665 London had 130 parishes, and these Bills of Mortality provide a fascinating insight into how people viewed health, safety and mortality. August 15th 1665 records that eight people died of “excessive winde”, one person from “lethargie”, one from being “frighted” (more were recorded in previous weeks), another from “meagrome”, over one hundred from “teeth”, just fifteen from “wormes”, six from “thrush” – and over six-and-a-half thousand from something called “plague”. The register adds that same week there were one-hundred and sixty-eight Christenings.
London’s plague of 1665-6 recorded almost 70,000 deaths, although the true figure is probably over 100,000. Charles II and his court left London during this pandemic, and retreated to Oxford. (In fact Charles II lived in the Deanery at Christ Church, as his father had done before in the English Civil War – a conflict that spread virally to the rest of Britain and Ireland, and claimed almost 15% of the population over a ten-year period). To say that the plague of London – the Great Plague, as it became known – was devastating, is to understate the matter. In just eighteen months, almost a quarter of Londoners died from bubonic plague.
We have tended to view this tragic pandemic of seventeenth century London through rather rose-tinted spectacles. Our present political leaders have, to a large extent, paid little attention to similarities in the dynamics that made London a no-go area in 1665-6, and Covid-19 today. Frank Snowden’s Epidemics and Society: From the Black Death to the Present (Yale, 2019) highlights how the massive increase in urbanisation and intercontinental travel has exposed us, globally, to new pandemics. The warning signs were already here: HIV/AIDS, Avian Flu’, Zika, Sars, Ebola – to name but a few. We assumed that the teleology of our highly-developed societies gave us immunities to relatively recent afflictions, such as polio, tuberculosis, and Spanish flu’. In fact, some of these older diseases and pandemics – typhus, cholera, smallpox, consumption – have been surfacing again in the twenty-first century. Poverty, and cramped, poor, unhealthy social conditions, act as breeding grounds for new viruses and bacteria. Malaria always thrives in environments where there is polluted, still water. It still kills five million children a year under the age of two.
The thrust of Snowden’s book argues that pandemics have always re-ordered society. They invariably result in a “new normal” emerging. Out of the hysteria, superstition, tragedy and loss, comes a realism that re-boots society. This in turn prompts some fundamental political impetus for re-ordering society.
Our ancient forbears had a phrase we should remember: “salus populi, suprema lex esto” (“public health is the highest law, and all else follows from it”). So the marketization of health, welfare and other forms of basic care runs enormous risks for both the Developed World and the Developing World. Healthcare, rather like education, is an inherently not-for-profit enterprise.
Why? Because everyone matters. And everyone eventually picks up the bill for the deprivation of education and healthcare in other places, because it will always directly or indirectly affect the whole of society. Politicians and people can try and evade their official and civic duties and responsibilities; but cannot avoid the consequences of such neglect. What we sow, we reap.
Snowden’s book confirms what we know from other more popular studies of medieval England’s health. Jack Hartnell (Medieval Bodies: Life, Death and the Arts in the Middle Ages, 2018), John Hatcher (The Black Death, 2008) and Ian Mortimer (The Time Traveller’s Guide to Medieval England, 2009) all give interesting insights into how the plague-pandemic of the time re-ordered society – politically, financially and socially. For example, people born to serfdom might suddenly find that they were beneficiaries and heirs. Pandemics redistributed power and money; they challenged authorities and prevailing social constructions of reality; they promoted new consciousness, and reordered priorities.
The common denominator across these studies is that there is not much one can do to escape pandemics and their social and economic consequences. Plagues come and go. We are seldom ready for them. When confronted by their reality, we often go into denial. The numbers that are published now on Covid-19 have as much impact as the Bills of Mortality in 1665. Inside, most people say to themselves, as they have done in previous centuries, “it won’t happen to me”. Maybe.
In the short prescient novel by Albert Camus – The Plague (French: La Peste, 1947) – we encounter a story that narrates a plague sweeping the French Algerian city of Oran. Initially, just a few die; then some more; then even more. Panic grips the streets as the epidemic enfolds the population. No-one was ready for this, and few thought any plague could draw near to them. The citizens of Oran live in a state of perpetual denial. Even when, like London in 1665-6, a quarter of the city is dying, they reason it will not be them. These folk are, after all, living in modern times. The have newspapers, cars, aeroplanes and telephones. The people of Oran cannot, surely, perish like the poor wretches of 17th-century London or 18th-century Canton?
The hero of the book is Doctor Rieux, and his resilient humanism is profoundly moving. He does not buy into the religious interpretations of the plague offered by a local priest, or of the abrogation of reason by the citizenry. As the death-toll peaks at 500 per-week, Doctor Rieux reflects on a child he has tended, but who has died. He reasons that suffering is unevenly and randomly distributed. For all the theodicy in the world, suffering simply makes no sense. It is absurd – and that is the kindest thing one can say of it.
How does Doctor Rieux respond to what is going on around him? He works tirelessly to lessen the suffering of those in his care. But he is no hero. As he later remarks that “[this] may seem a ridiculous idea, but the only way to fight the plague is with decency.” Another character enquires of him as to what decency is. “[Just] doing my job,” replies Doctor Rieux. In other words, duty and vocation come first. He is committed to caring for others in need. Little more need be said.
Should this, or any plague, panic us? Camus’ novels suggests not, because panic is an immediate reflex response to a dangerous, but essentially short-term condition from which we can flee and perhaps find safety. But in life, there is no guaranteed security. From Camus, through Doctor Rieux, we learn the following lesson. That we need to love our fellow humans (whether we like them or not, and no matter how long they live for, or how much time they take to die), and work with courage and hope for the relief of suffering. Life is ultimately a hospice, not a hospital. We are here to provide some salve in the midst of desolation and despair.
As the novel closes, Doctor Rieux opines that “this chronicle could not be a story of definitive victory,” because the plague never dies; it “waits patiently in bedrooms, cellars, trunks, handkerchiefs and old papers” for the day when it will arise again. One might think this is a depressing note to end this novel on. Yet I do not think so. It is profoundly humanitarian. In selecting this adjective ‘humanitarian’, I choose the word with care.
Because to be humanitarian is to have a binding duty and concern for helping to improve the welfare of people, and this pulse can spring from moral and religious roots. To be a humanitarian can be religious and humanist (and neither party will mind which), because it is about valuing people as inherently precious. Or, as God would value them. The result is the same. It is the lesson of the Good Samaritan (Luke 10). Or the Ten Lepers (Luke 17). Goodness for goodness’ sake: not for gratitude. Or for converts. Mercy matters.
Correspondingly, there is nothing explicitly ‘Christian’ about Dame Cicely Saunders and her founding the modern hospice movement. Committed to the alleviation of suffering, she wrote to her patients: “You matter because you are you, and you matter to the end of your life…we will do all we can not only to help you die peacefully, but also to live until you die.” Similarly, Chad Varah, a Curate from Lincoln, founded the Samaritans to help the suicidal and the depressed. All it took was the suicide of a young teenage girl, traumatised by her commencing menstruation, to restart Varah’s vocation.
Both these examples are profoundly humanitarian, and the religious pulses within them are lively, if implicit. Sometimes it is only the shock and despair at the manner of people’s deaths that leads us to review actual lives of others, and how to respond. Think Live Aid. Think Christian Aid. “We believe in life before death”.
Like many people, I have been perplexed by the hijacking and hexing that has been going on in daily government briefings on Covid-19. Facts are true, and statistics are numbers you usually can’t argue with. But presented in a disingenuous way, numbers and statistics can seriously mislead. There is one simple fact here: our figures for Covid-19-related casualties are stubbornly rooted in densely-populated, poverty-challenged urban areas.
The real, underlying figures, show that we are, as a nation, endemically unequal. Our epidemiologists find themselves unintentionally plagiarising our social and political geographers mapping unemployment, disadvantage and other indices of poverty. Pandemics have patterns (i.e., follow the money). What was it Einstein once said? “Not everything that counts can be counted; and not everything that can be counted, counts”.
So I am deeply mistrustful of these rather specious government targets and numbers blurted out in daily dosage: “two metres apart, no less”; “100,000 tests a day”; “no, make that 250,000”; “more beds, Personal Protection Equipment (PPE) and ventilators are on their way”; “we are pumping another half-a-billion into our hospitals”; and “more nurses are coming soon”. Throw in a weekly clap for the NHS too, just to give those numbers some ritual substance. One suspects that this “numbers theatre” from Downing Street is there to distract us from more troubling numbers. One round trip of 30 miles, and another journey north of 260 miles, and then back again. But here we can only speculate.
Einstein was right. For what can measure the loss of trust by so many, when it only concerned the actions of a few? We need to be mindful of what we count; and always question the value attributed to any numbers we are invited to note (and those we are asked to ignore). Everyone matters. No-one is expendable. There is no number or statistic in this pandemic that can be countenanced or justified. For all the talk of “spikes”, “flattening curves” and “keeping the number below R1”, there are going to be over 50,000 preventable deaths. Which means at least 500,000 (perhaps a million) preventable bereavements.
One the most heart-rending BBC interviews I have seen over the past months was with a woman in New York City, who had lost her job. As have over thirty million other Americans. Like many who have found themselves unemployed, she lost her health insurance too. Most Americans have their health insurance tied to their employer. This woman was halfway through her cancer treatment, and awaiting more chemotherapy. That is no longer possible, because she has no job, and personally cannot afford it. And even if she could buy healthcare, she would be bidding for slots that have already been block-booked and purchased by prioritised health insurers. She probably won’t die of Covid-19, as she currently lives in perpetual self-isolation. As she remarked, testing for the virus is free in the USA. Treatment, however, is not. In time, she reflected, she is destined to become another number – but probably a statistic that won’t be counted in this pandemic.
Sometime last month I took a funeral for a friend, whose mother had died in a Care Home. Our funeral followed the protocols of the time. One son present, with his partner, the Funeral Director, and me. It was not the funeral he would have planned for his mother. Many more could have come, and would have come, were it not for restrictions on travel and the demands of social distancing. Yet we commended her to God’s gracious care and keeping, and I thought of the words of comfort Jesus offers: “where two or three are gathered, I am in the midst of them” (Matthew 18). I thought of times when Jesus sat with the bereaved (Luke 8, John 11). I was reminded of these words from Thomas Lynch:
“I remember the priest I called to bury one of our town’s indigents – a man without family or friends or finances. He, the grave-diggers, and I carried the casket to the grave. The priest incensed the body, blessed it with holy water, and read from the liturgy for twenty minutes, then sang In Paradisum – that gorgeous Latin for ‘May the Angels Lead you into Paradise’ – as we lowered the poor man’s body into the ground…
When I asked him why he’d gone to such trouble, he said that these are the most important funerals – even if only God is watching – because it affirms the agreement between ‘all God’s children that we will witness and remember and take care of each other’.” (Thomas Lynch, ‘Good Grief’, from Christian Century, July 26 2003; and The Undertaking: Life Studies from the Dismal Trade, New York: Penguin, 1998).
This vignette, as if we needed reminding, expresses something of Christ’s own divine humanitarianism for those who were marginalised, isolated and needy. The life and ministry of Jesus teaches us that to God, each and every one is precious. The detail of caring matters. As Luke 12: 7 has it, “the very hairs of your head are all numbered…so do not be afraid, for you are worth more than many sparrows”. Put another way, to God, no-one is expendable. We all matter. We are asked to live as God sees this world: everyone matters.
Social distance between God and humanity is abolished in the incarnation. God is with us. “Do not be afraid” and “do not fear” are phrases Jesus repeats a great deal in the gospels. More than seventy times, in fact. We would be wise to remember that “perfect love casts out fear” (1 John 4: 18). Yet also remember that the reverse is also true: “perfect fear drives out love”. Our calling as Christ’s followers is not to be fretful and fearful, but rather to become an extension of God’s courageous, endlessly-expended love for this world.
This does require quiet mettle, resolved courage and compassionate humanitarianism. As a calling, it is inherently costly and sacrificial in orientation. Such love does not seek its own security, or indeed reward. Our calling is to express the continual love and risk revealed in the incarnation. To become like Jesus, who is the body language of God.
The philosopher John Macmurray wrote few books in his life, but one of his most absorbing meditations is on the essence of communion between individuals, groups and societies. We are all connected. In his Persons in Relation (1970), he also noted that it was important to distinguish between real religion and fake faith. The mantra of the fake-variety, he argued, ran something like this: “fear not; trust in God; and God will see that none of the things you dread will ever happen to you.” But, said Macmurray, real religion has a different starting point: “fear not – some of the things you are most frightened of may well happen to you; but they are nothing to be afraid of.” “Do not be afraid”, says Jesus; “do not fear”. Have courage, faith, love, hope and charity. It will be enough.
Harold Kushner’s When Bad Things Happen to Good People (1978) sold millions of copies worldwide. But few recall that this best-selling book grew out of his own personal loss. Kushner was a Rabbi who dedicated to the book to the memory of his young son, Aaron, who died in his early teens from an incurable genetic disease.
So the book was written by a good man who prayed very, very hard – but who still lost his son. Like Doctor Rieux and Albert Camus, Kushner knew that real religion is not measured by how we avoid suffering and loss, but rather, how we engage with it, and abide with and care for others who have lost even more:
“…people who pray for courage, for strength to bear the unbearable, for the grace to remember what they have, instead of what they have lost, very often find their prayers answered…[because] God…doesn’t send us the problems…but God does give us the strength to cope with them (pp. 125-7).”
In Thornton Wilder’s, The Bridge of San Luis Rey (1927), we meet a Franciscan monk ruminating on the apparently pointless deaths of five people who fell from a bridge. What is the point of this, he muses? Where is God’s purpose in this tragedy? He writes in the Introduction that:
“…some say we shall never know, and that to the gods we are like flies killed on a summer day, and some say, on the contrary, that the very sparrows do not lose a feather that has not been brushed away by the finger of God…”.
Wilder’s novel is absorbed with values and virtues, and it offers a spiritual-humanitarian meditation of dwelling in the midst of senseless suffering. One character, Dona Maria, reflects on what it is that distracts people from the reality of pain and anguish:
“[she] saw that the people of this world moved about in an armour of egotism, drunk with self-gazing, athirst for compliments, hearing little of what was said to them, unmoved by the accidents that befell their closest friends, in dread of all appeals that might interrupt their long communion with their own desires.”
Yet Wilder ends his novel with an affirmation of what the gospels ultimately assure us of; namely of God’s total care and love for everyone, wherever and whoever we are:
“But soon we shall die and all memory of those five will have left the earth, and we ourselves shall be loved for a while and forgotten. But the love will have been enough; all those impulses of love return to the love that made them. Even memory is not necessary for love. There is a land of the living and a land of the dead and the bridge is love, the only survival, the only meaning.”
We are plagued by all manner of numbers and statistics in our age. But even plague-related numbers and statistics may not be looking and counting in the right way anymore. We are asked to see as God sees. Count as God would count. One stray hair, one stray sparrow (Luke 12: 7), one stray sheep (Luke 15: 3-7): all matter. Everyone matters. No-one doesn’t. Each person is made in the image of God, and precious to God’s sight and heart. What drove the humanitarian impulses of folk such as Doctor Rieux, or Cicely Saunders and Chad Varah – and many who currently work on the frontline of NHS and in challenging social care contexts, whose names will never be known – is what had Einstein hinted at. Everyone counts, equally. No numbers or statistics that any government promotes on pandemics, and that suggest it might be otherwise, have any real place in this world. Nor in the world that is yet to come.
The Very Revd Professor Martyn Percy, Dean of Christ Church, Oxford