Authors: Prof. Dr. Tedo Dundua, Dr. Apolon Tabuashvili, Dr. Emil Avdaliani
As the world continues to experience deep effects (death rate, economic downturn, slowdown of globalization) of the novel Coronavirus, it is interesting to look at all the pandemics from a historical point of view. Below are several famous epidemics that affected the world and Georgia in Medieval or Modern and Contemporary periods, and which showed the countries making similar coordinated steps to stop them.
In general, after the appearance of very mobile Mongols in Georgia, we often find the facts of the spread of incurable diseases in the historical sources. According to the Georgian chronicler, king David Ulugh fell ill at the fortified frontier during the war between the Golden Horde and the Ilkhanate troops (Kartlis Tskhovreba /History of Georgia/. Editor-in-Chief R. Metreveli. Tb. 2008, p. 607). King David Ulugh and his son Giorgi died from the same disease in 1270 (Kartlis Tskhovreba /History of Georgia/. Editor-in-Chief R. Metreveli, p. 608). According to the opinion established in historiography, David Ulugh’s disease should have been typhus (Studies in History of Georgia /in Georg./. v. III. Tb. 1979, p. 576). King Vakhtang II of Eastern Georgia died from the same disease in 1292 (Kartlis Tskhovreba /History of Georgia/. Editor-in-Chief R. Metreveli, p. 651).
The Black Death
Information about the appearance of a new epidemic, which later became known as the “Black Death”, came to Europe in 1346 when a plague was reported in the East (V. J. Derbes. De Mussis and the Great Plague of 1348. The Journal of the American Medical Association (JAMA). 196(1). Chicago. 1966, pp. 59-62). The name “Black Death” originated from the specifics of the disease itself as the infection usually turned the skin into black colour with such symptoms such as fever and joint pains.
A year later, in 1347, first signs of the plague appeared in the Crimean Peninsula and the disease was most likely brought by the Tatar (Mongol) armies of Khan Janibeg, ruler of the Golden Hoard, when the latter besieged Caffa (nowadays Feodosya), a town which served as an important commercial Genoese city. According to the account of the contemporary, Gabriele de’ Mussi, the infection spread among the Mongol troops from man to man or from rats to humans (M. Wheelis. Biological Warfare at the 1346 Siege of Caffa. Historical Review. Vol. 8, No. 9. Atlanta. 2002, pp. 971-975). It is believed that the Mongols catapulted the corpses of the infected over the city walls, infecting those inside and poisoning wells (V. J. Derbes. De Mussis and the Great Plague of 1348. JAMA, pp. 59-62).
Caffa’s trade relations with the Mediterranean conditioned a quick spread of the disease to Europe via Italy. It is believed that the infection was carried by rats on Genoese commercial vessels sailing from Caffa to Italy.
In the wake of the Black Death, socio-economic relations across much of Europe and Middle East drastically changed. A major reason was a near obliteration of 1/3 of the population (some think about as mush as ½ of the entire populace) of Europe (N. Johnson. M. Koyama. Negative Shocks and Mass Persecutions: Evidence from the Black Death. Journal of Economic Growth. vol. 24(4). Heidelberg. 2019, pp. 345-395). Cities and entire villages turned empty – the process which impacted the existing economic relations between cities and the village. On a positive side though, the Black Death pandemic helped to develop early stages for modern medicine paving the way for hospital-like management.
Because of Caffa’s trade relations with Sebastopolis/Sokhumi in Georgia, simultaneously with the mass spread of the Black Death plague in Europe, the pandemic reached Georgia during the reign of David IX (1346-1360). The spread of the Black Death in the country is confirmed by one note of 1348 – in the country with great hardship, there was also “great death” (Ф. Д. Жордания. Описание рукописей Тифлисского церковного музея карталино-кахетинского духовенства. II. Тифлис. 1902. № 575), which, most likely, means the spread of the Black Death. And great hardship means that agriculture and commerce were depleted, and the state borders were closed. The deadly pandemic spread in Georgia in the 1340s and lasted for a long time. According to Georgian historian prince Vakhushti, the epidemic was widespread during the early reign of David IX’s successor, Bagrat V (1360-1393), and its scale was so wide that even the queen died along with many others (Kartlis Tskhovreba /History of Georgia/. v. IV. Editor S. Kaukhchishvili. Tb. 1973, p. 262).
The epidemic of plague appeared from time to time in Georgia in later periods too and had devastating consequences for the population, e.g., the epidemic spread in the capital Tbilisi in 1770, caused the death of the fifth of the population.
This fact is described in detail by the German traveler Johann Anton Güldenstädt, who notes that churches and cemeteries in Tbilisi occupy a large place in the already small area for the 20000 inhabitants. Overpopulated and downhill location on the clay soil of the city, which is completely swallowed up during the rain, and has no drainage, existence of the cemeteries, poor police, which allows the streets to be covered with garbage, and so on, – [All this] poisons the air, so dysentery, malignant fever and epidemics, as well as plague, are not uncommon. In 1770 the latter killed 4000 inhabitants. Great mortality would have increased even more if the houses had not been ventilated because of bad doors, paper windows, fireplaces, and so on. There is always air circulation. In 1770 during the plague the sick were mostly taken to the streets, and it was observed that there were relatively more of them left alive than those lying in the house (Johannes Gueldenstaedtius. Peregrinatio Georgica. Tomus Prior. Textum Germanicum cum Conversione Georgica Edidit Commentariisque Instruxit G. Gelašvili. Tb. 1962, p. 89).
The fact of the 1770 epidemic is mentioned by one of the Baratashvilis who notes that the king left the city, he himself took his sick son to the village, where the latter recovered by virtue of the healthy air (Materials for History of Georgia and the Caucasus /in Georg./. Part 28. Tb. 1950, p. 57).
As we can see, Georgians with a plague were moved to the streets. At the same time, they were taken away from the city to the countryside because there was more chance of healing them in the fresh air. People with the disease were given certain medicines too. And the main way to protect healthy population from an epidemic was to stay away from the place where disease was spread.
The disease spread in Tbilisi at the end of the 18th century, but its scale was not large. As prince Alexander reported from Tbilisi on November 21, 1797, to his mother, queen Darejan, the disease was in Ganja and Karabakh, while in Tbilisi only one person died (Antiquities of Georgia /in Georg./. v. III. Editor E. Takaishvili. Tb. 1910, p. 226). Despite its small spread, the plague was there in the country until the spring of 1798 (Platon Ioseliani. Life of Giorgi XIII. Editor A. Gatserelia. Tb. 1978, p. 51), and that is why the pompously planned funeral ceremony of Erekle II, king of Eastern Georgia, was held in a rather modest way.
In the early 19th century, quarantine was introduced in three places (Garetubani, Ortachala and Avlabari) around Tbilisi to prevent the spread of the disease (Data for the Early 19th Century History of Georgia: Joseph Shagubatov – Description of the Internal Situation of East Georgia and Imereti. The Georgian Translation of the Russian Text, Research, Commentaries, Indices and Facsimiles are Presented for Publishing by A. Tabuashvili and G. Zhuzhunasvili. Tb. 2015, p. 25). Nevertheless, the plague epidemic hit Georgia in 1804, killing 1570 people (J. Samushia. Sergei Tuchkov’s References About Georgia /in Georg. with Engl. summary/. Proceedings of Institute of Georgian History, Faculty of Humanities, Ivane Javakhishvili Tbilisi State University. XI. Tb. 2016, p. 200).
Particularly devastating was the plague of 1811 in Western Georgia, which was brought to the country by Russian soldiers fighting the Ottomans. More than 30000 people died in Western Georgia alone as a result of the epidemic. The disease also spread to Eastern Georgia, killing several thousand people there (Studies in History of Georgia /in Georg./. v. IV. Tb. 1973, p. 921).
Another great pandemic was smallpox. Large-scale death rates were reported in the 18th century in Europe, where in some years around 400000 people died annually of smallpox. Moreover, one-third of the survivors went blind (A. Geddes. The History of Smallpox. Clinics in Dermatology. 24. Birmingham. 2006, pp. 152-157). The recurrent smallpox epidemic also caused various attempts to combat smallpox till the discovery of inoculation as an effective vaccination.
The smallpox epidemic was spreading from time to time in Georgia too. One of the historical documents mentions the smallpox epidemic. This document is a letter of Erekle II, compiled on May 11, 1772, and addressed to commander Revaz Amilakhvari. In it, among other things, it is mentioned that the smallpox was spread in Tbilisi and the royal family had to leave the city (The Documents Issued by Erekle II. 1736-1797. Editor M. Chumburidze. Tb. 2008, p. 82).
Güldenstädt also mentions this fact and informs us about the method of preventing the spreading of smallpox: “On May 15 (1772) more than 100 children were inoculated, and I especially watched my house owner’s 6-year-old healthy boy and girl who was not even a year old… One week before the illness and during the illness children are not given meat, fish and rice, they are given only wheat bread and milk; however, breast, horse and donkey’s milk are considered the healthiest, while cow’s milk is considered the most useless. The inoculator made not deep, bloody, cross-shaped incision, 1/2 inch in size, in the groove between the thumb and forefinger with the tip of a large knife; he would lift the tip of a knife into the horn, where the smallpox serum was, clean the blood with a cotton swab, and put a poisoned knife on the wound, then he used to put cotton on a wound, and wrap it in a piece of cloth. The children usually had fresh air and recovered before May 19, with three freckles on the wound. On May 22, they became swollen and white, on May 23 they joined each other. The children were not sick, and the boy ran barefoot. On this day I went out of town and returned on the 2nd of June; I met the boy recovered and learned that he had no more freckles…” (Johannes Gueldenstaedtius. Peregrinatio Georgica. Tomus Prior, p. 63-65).
According to Güldenstädt, on May 23, 1772, he visited the king’s son, prince Yulon, who had been given a smallpox inoculation a few days earlier (Johannes Gueldenstaedtius. Peregrinatio Georgica. Tomus Prior, p. 67).
As we can see, during the spread of the smallpox epidemic in Georgia in the 18th century, the way to protect oneself was to keep a distance from the place of the epidemic. The vaccine, according to Güldenstädt, was quite effective at the time.
From 20th century pandemics to the Coronavirus
In 1918 a new flu pandemic launched worldwide. The outbreak was devastating, causing millions to die, more than the World War I casualties. During new experiments upon the old virus strain, it was proved that the 1918 pandemic was caused by an influenza A – subtype H1N1 progenitor strain (G. Tsoucalas, A. Kousoulis, M. Sgantzos. The 1918 Spanish Flu Pandemic, the Origins of the H1N1-virus Strain, a Glance in History. European Journal of Clinical and Biomedical Sciences (EJCBS). 2(4). New York. 2016, pp. 23-28).
The next major pandemic was and has remained (though under control) since then is HIV/AIDS. Most likely HIV originated in Kinshasa, Congo in the 1920s (HIV spread from chimpanzees to humans). Up until the 1980s, we do not know how many people were infected with HIV or developed AIDS. HIV was unknown and transmission was not accompanied by noticeable signs or symptoms. By 1980, HIV spread to five continents killing hundreds of thousands of people (P. Sharp, B. Hahn. Origins of HIV and the AIDS pandemic. Cold Spring Harbor Perspectives in Medicine. 1. Huntington. 2011, pp. 1-21).
In the early 21st century, there were other major epidemics too such as Ebola and H1N1 paving the way for the novel coronavirus – a major epidemic that covers the entire globe affects billions of people and stagnates the world economy (many similarities with the Medieval period).
Though the above pandemics took place in different historical periods, there are many similarities in how various world regions, whether it is Georgia, Western European states or Middle East countries, responded to the outbreaks. Nowadays, in the increasingly interconnected world, it is the World Health Organization that coordinates the work on battling/preventing global or local epidemics.
Author’s note: First published in Georgia Today