The Plague is Not a Big Deal Actually

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Guys, I don’t know if you’ve heard this but…the plague is back.

No, not the plague that we are all currently dealing with, which is not actually a plague but I know a lot of people, myself included, have been referring to it like that. And I should probably stop doing that! Because while it’s kind of funny and gets across the idea that this is a very fucked up thing that’s happening, it’s scientifically inaccurate, because COVID-19 is caused by a coronavirus, and a virus is rather different from a bacterium, which is what causes the plague.

Got that? COVID-19 is not the plague. So, now do I have your attention? THE PLAGUE IS BACK! A HERDER IN CHINA CAUGHT THE PLAGUE! OH NO! THIS IS A VERY BIG DEAL BECAUSE…well, because it’s hot right now to blame China for being a disease-incubator. Ah, racism. The plague is not actually a big deal. Here’s why.

The plague is caused by a bacterium known as Yersinia pestis (from the same Latin root that gives us pestilence), which infects rats, humans, and many other mammals. Fleas, which enjoy chomping on both rats and humans, are carriers of Y. pestis. To relate it back to COVID-19, they’re like the asymptomatic carriers that aren’t bothered by the plague but can spread it. The plague can take three different forms: septicemic, which is the rarest type and is a blood infection; pneumonic, which is spread to and from the lungs; and bubonic, which is the one you’ve most likely heard of — that’s where it infects your lymph nodes, causing them to swell and burst and become necrotic. It’s…pretty disgusting.

Allow me to take a brief aside. A few years back I was looking for a new audiobook to listen to on walks. I stumbled across Connie Willis’s To Say Nothing of the Dog, which is a delightful romp concerning time traveling historians who accidentally screw up history and need to put it back to normal in the Victorian era. I loved it. A short time later, a friend asked me to recommend a fun, breezy sci-fi read and I told her she definitely needed to read To Say Nothing of the Dog. She texted me back saying she looked it up and it’s actually a sequel, and she wanted to know if she should read the first in the series before that. I was shocked and said I had no idea it was a sequel. So my friend got the first book in the series, Doomsday Book.

Within a few days, my friend contacted me, absolutely furious. Doomsday Book was, as the title may suggest to you, not a delightful romp. While it is in the same universe and features time-traveling historians, it is, essentially, the story of a woman who travels back to the Middle Ages and accidentally ends up in a village that is just about to be hit with the Black Death, at which point all she can do is basically watch while the people around her die horrible, painful deaths.

Obviously there’s more to the story and I still highly recommend you give it a read if for some reason you too are currently interested in the spread of deadly epidemics, but just know before you go in that it is most definitely not, in fact, a delightful romp. But it does give a really great, really disgusting up-close, personal look at what it’s like to contract and die from the bubonic plague, and it’s terrifying.

Essentially it starts out feeling like you have a cold, with aches, nausea, malaise, and vomiting. Within a week the bacteria flare up your lymph nodes into what’s known as “buboes”, big pus-filled globes that appear in your armpits, groin, and neck. Back in the 14th century it killed about 80% of everyone who contracted it. And that was just for the bubonic form — you could get any of the three forms from any of the other forms, so a bubonic patient could spread it to someone else as the pneumonic version, which had a mortality rate of 90 to 95%, or as septicemic, at which point you’re just straight up 100% dead.

No one knows exactly how many people have died from the plague, but numbers range from 25 to 200 million people just for the “Black Death” version in the 14th century. There were also another 25 to 100 million people killed in an earlier outbreak known as the Justinian plague of the 6th century.

So that’s all pretty fucking serious, right? Up to 200 million deaths is nothing to sneeze at, especially at a time when the world population was only, like, twice that. Imagine if nearly 4 billion people died this year. Terrifying!

And now you’ve learned that we never actually got rid of the plague. Y. pestis is still around, infecting humans, like the poor herder in Mongolia.

But here’s why you don’t actually have to be scared of the plague, unless you happen to be a time-traveling historian: a little thing called antibiotics. That’s right, Y. pestis is a bacterium, which means that unlike a virus, we actually have a weapon that can kill it outright. If caught early, like within 24 hours of the first symptoms appearing, a treatment of antibiotics reduces mortality to 1-15%.

We know all this because this isn’t actually a newsworthy event. Thousands of people get the plague every year, including here in the United States where people contract it from infected rodents, usually in the Southwest. Two people near Denver, Colorado died from it in 2015 thanks to infected prairie dogs. On average, 7 Americans contract the bubonic plague every year. A handful of countries have persistent outbreaks of the plague, including the Democratic Republic of the Congo, Peru, and, if you can believe it, Madagascar. That’s right, the country that is infamous to players of a game called “Plague, Inc” for being nearly impossible to infect with the plague, actually has the plague all the time.

It’s still serious! If you are in a farflung part of the world where there’s a risk of you contracting bubonic plague, like, say, Denver, Colorado, you should absolutely be aware of the symptoms and seek treatment immediately, even if you’re in a country with poor access to affordable healthcare, like Denver, Colorado. If untreated, the mortality rate is currently about 50%. Better than the Middle Ages but still not worth betting your life on a coin flip.

But do not be concerned upon hearing that a herder in Mongolia contracted bubonic plague from a marmot. He’s being treated, the locals know what symptoms to watch for, and you are much, much more likely to contract, spread, or die from COVID-19, so please stay home or wear a mask if you have to go out.

Rebecca Watson

Rebecca is a writer, speaker, YouTube personality, and unrepentant science nerd. In addition to founding and continuing to run Skepchick, she hosts Quiz-o-Tron, a monthly science-themed quiz show and podcast that pits comedians against nerds. There is an asteroid named in her honor. Twitter @rebeccawatson Mastodon Instagram @actuallyrebeccawatson TikTok @actuallyrebeccawatson YouTube @rebeccawatson BlueSky

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One Comment

  1. We refer to our state, New Mexico, as “Land of the Flea and Home of the Plague”, for good reason!

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