Legions Of Pestilence – Snippet 16
Not Doubting that the Most High Will Grant His Grace and Provide Suitable Means
“…nit zweyflende, der AllerhÃ¶chste werde seine gnade verleihen undt ergebige mittel weisen…”
Hyppolitus Guarinonius looked at Kamala Dunn. “You are preaching to the converted,” he said. “That was a very favorite statement of young Matt Trelli during our stay in Kronach, when he thought we were telling him something he already knew.”
“You certainly are,” Kamala admitted. “And you, and you.” She waved toward Christoph Gatterer and Paul Weinhart. “Perhaps I am just rehearsing for when I speak to those who still aren’t persuaded. They don’t want to hear the message that the up-timers cannot provide, simply do not have the resources to provide, some kind of miracle cure for a major plague epidemic. They will have to listen to you. They will have to apply–and as rigorously as possible–the methods you already have in place.”
Guarinonius leaned his elbows on the table, steepling his fingers. “Out of curiosity… That is, we did not, generally, find the up-timers in Bamberg, when the regent first sent us to assist at Kronach, to be quite so certain that we could make a positive contribution. Yet they were lay people–not, that is, medical professionals. I truly expected… Well, all three of us truly expected, before you arrived, that you would have nothing but scorn for the measures we had spent two months trying to put in place here in Burgundy.”
“I rather noticed that you were dubious. But–let me start over. The biggest epidemic there had been in the twentieth century happened a long time back, toward the end of World War I, in 1917 and 1918. It was not just nationwide, in America. It was world-wide.”
Kamala stopped suddenly. “Just be glad we’re not expecting flu. We can’t provide a miracle plague cure for the whole continent of Europe, but at least the plague is bacterial and chloramphenicol works on it. Influenza is a virus. Whole different story. Anyway.”
“You were saying,” Paul Weinhart prompted. Of the three physicians, he was the only one who had noticed that the up-time woman, although much of her learning was more advanced than theirs, was nonetheless sometimes hesitant about speaking her mind to physicians. He suspected it had something to do with the up-time modes of training. The journals coming out of Jena made it clear that the system instituted by the gentle-lady Beulah McDonald, herself a “nurse” rather than a physician, was intended to introduce major changes to the system that had existed before the Ring of Fire.
So the up-timers–some of them, at least–were fully aware that their culture had not achieved perfection. That was good to know.
“Oh. The 1918 flu epidemic. The American Medical Association published a study of the way various cities in our country handled it, from the loosest practices in regard to ‘quarantine and closing down the schools and public meetings’ in Philadelphia to the tightest ones in St. Louis, there was a real differenceâ€“even with no medical cure. Those methods are pretty much the ones you’re planning to use here. They won’t prevent an epidemic, but they will…” She paused and searched her mind for the right word. “They will ameliorate an epidemic. The grand duke’s representatives, when they hired me, told me what would be coming up, so I had time to do some reading. Philadelphia had an ‘excess mortality per 100,000’ of eight hundred seven people.”
She looked at them. “You understand the concept of ‘excess mortality’?”
Gatterer nodded “More deaths than would usually occur in a year. I have seen church registers that record, in a town which usually had fifty to sixty deaths within a year, ten times that many during the plague of 1625.”
“Good. One more thing I was afraid I would have to explain, but don’t. St. Louis, with the strictest quarantines and closures, only had an ‘excess mortality per 100,000’of three hundred fifty-eight. That’s a significant saving of lives. The same thing showed up, according to the AMA study, when applied to all of the forty-three major metro areas they included.”
Weinhart nodded. “This is like that survey of the prevalence of childhood diseases that the Leahy Medical Center has published for the Thuringian villages around Grantville. Fascinating.”
Dr. Weinhart, Kamala knew, was doing a great deal of pro bono work for the BesanÃ§on orphanage. His two wives had presented him with sixteen children of his own. He had served as personal physician to the archducal children in Tyrol. He was a great believer in religious instruction and handed out dozens of stuffed toy lambs with little crucifixes around their necks along with his advocacy for cleanliness, fresh air, proper nutrition, and plenty of exercise. That was fine as long as all the orphaned children were Catholic to start, but might be a problem later on.
Not her problem, though. She belonged to the Disciples of Christ. The Lutherans and Catholics could sort out their differences without her personal participation. Grand Duke Bernhard’s problem.
“So, the truth of the matter is that the measures available and known now, in the 1630s, if rigorously applied, even without modern medicine, can make a really big difference in the severity of an epidemic.” Kamala stood up and turned to the easel hung with oversized sheets of paper. “And if I have anything to do with it, they will. So let’s get to work on the directive for Burgundy.”
â— Close the borders, whenever and wherever possible.
â— Place restraints on movement from place to place.
“Remember,” Weinhart said, farmers and retailers of farm produce, such as animal hides, are in constant danger of contracting the plague. It is a normal consequence of the work they do. During a plague epidemic, their constant involvement with flea-bearing animals can be deadly. Still, we cannot forbid the transport of food. If we do, people will avoid plague only to starve. It is very important to define the restraints. No unnecessary movement from place to place.”
Guarinonius sighed. “Generals tend to regard troop movements as necessary. And, of course, we are scarcely in a position to forbid the grand duke to move his military units. Which means baggage trains and camp followers. Not only in the direct theater of action, but on the way to the direct theater of action. That is the worst. They leave behind stragglers. They leave behind the sick. Sources of infection for previously untouched towns and villages.”
â— Close all places of entertainment.
“That means no kirmesses, no village fairs, no touring troupes of actors.” Gatterer nodded his head decisively.
“On penalty of what, in case of violations?” she asked.
“Hanging,” Weinhart answered.
Kamala swallowed and moved to the next item on the list.
â— Forbid other types of public assembly.
“What about political assemblies?” Kamala asked.
“Wherever possible, postpone them,” Guarinonius said. “Close down the courts, so people won’t be coming for trials. Don’t convene the Estates.”
â— Establish pest houses outside of the uninfected walled towns.
“They are useful in two ways,” Guarinonius said. “There should be two buildings. In one, the authorities can place and isolate any travelers suspected of illness. In the other, they can quarantine those who appear to be healthy long enough to be sure of it. The buildings should be some distance apart, of course.”
“That means hiring extra guards,” Weinhart pointed out. “Nobody should get as far as the regular city gate guards without an authentic certificate of health.”
“What if the infection does get into a town?” Kamala asked.
That’s the next item.
“We identify each house where there is a case of the plague. We seal the infected person and all family members inside the house. No one is allowed to leave; no one to enter. We have the house locked and bolted from the outside. For those inside, the disease has to run its course–whether they die or they recover. Watchmen guard the houses. Many do not have enough provisions to last through a quarantine. The inmates may lower a basket from an upstairs window. The watchmen will place food in it. When enough time has passed, we open the house. If there are survivors, we provide them with certificates of health.”