Research studies

Herd immunity and Theories of explaining the disease in middle Ages, Lessons of Societal Resilience to Covid-19

 

Prepared by the researcher  :  Prof. Dr. Galal Zanaty  – Strategic Planing Consultant for attorney general KSA – Department of Social Science – Alexandria University- Egypt

Democratic Arabic Center

Journal of Strategic and Military Studies : Thirteenth Issue – December 2021

A Periodical International Journal published by the “Democratic Arabic Center” Germany – Berlin.

Nationales ISSN-Zentrum für Deutschland
 ISSN  2626-093X
Journal of Strategic and Military Studies

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Abstract

This study deals with herd immunity and theories of explaining the disease during the Middle Ages, the lessons of societal response to the Corona virus. The interpretation of the disease historically did not differ in the Middle Ages until the present time, as the theories were confined to a religious interpretation that links the disease and the wrath of God as it was prevalent in the Middle Ages, and the interpretation of the disease in that it is a conspiracy that summarizes the political conflict between the East and the West and finally the link between the theory of the interpretation of the disease as being It expresses the misdeeds of human beings between them and each other,Which did not differ much during the emergence of the Corona pandemic and until now the case with regard to the societal response in dealing with the disease was limited, as it was prevalent in the Middle Ages, to not taking precautions or following precautionary measures according to the prevailing theory of interpretation of the disease, which is related to faith. Therefore, the study recommended taking into account the historical aspect. In dealing with diseases and epidemics and the pattern of their historical interpretation to develop appropriate solutions that are compatible with the societal response.

Introduction

What Is Herd Immunity during middle Ages till Now? , With the rising number of cases of  Covid  -19 around the world, health officials continue to work to find the best way to protect the public from the disease. You may have heard health officials mention herd immunity as a possible way to contain the spread of Covid-19.Here’s what you need to know about herd immunity and how it may help slow the spread of the coronavirus. Herd immunity, or community immunity, is when a large part of the population of an area is immune to a specific disease. But it was different concept during middle ages, If enough people are resistant to the cause of a disease, such as a virus or bacteria, it has nowhere to go.While not every single individual may be immune, the group as a whole has protection. This is because there are fewer high-risk people overall.

The infection rates drop and the disease peters out. Herd immunity protects at-risk populations. Methodology of this research is a comparative analytical study that uses Historical Methodology and the descriptive method and trying to Answer a Research questions: What are the concept of Herd Immunity during middle ages? ,For that the different understanding for this reasons and for the study approach I used in the study is based really on contemporary events, sources close timetable of events and time – delayed sources, while reference is relied upon in the case of thought or idea.

Recently, we note the spread of manifestations of extreme fear and tension among a large group of people around the world, in response to the global outbreak of the “Corona” epidemic (Covid-19). In conjunction with the tendency of many countries to implement forced quarantine, and the media’s great focus on this epidemic; we notice clear repercussions on the psychological aspect of man. But the serious issue is that many of them give in to tension and fear without realizing that by doing so they expose themselves to a double risk of infection with the Corona virus, if we go back to Ibn Sina, especially in his famous book “The Healing”, we note that he is one of the first to focus on the importance of the psychological aspect and its relationship to the aspect Human physiology, which was later proven by Western studies experimentally. The World Health Organization defined the emerging corona virus (Covid 19) as: a group of viruses that can cause diseases such as the common cold, severe acute respiratory infection (SARS) and the Middle East Respiratory Syndrome (MERS), and a new type of corona virus was discovered after it was identified as a cause The outbreak of a disease that began in China in 2019, and the virus is now known as severe acute respiratory syndrome coronavirus 2 (SARS-Cove 2). The resulting disease is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization announced that it had classified coronavirus disease 2019 (COVID-19) as a pandemic. .The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019. It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus that causes severe acute respiratory syndrome (SARS). As in two preceding instances of emergence of coronavirus disease in the past 18 years — SARS (2002 and 2003) and Middle East respiratory syndrome (MERS) (2012 to the present) — the Covid-19 outbreak has posed critical challenges for the public health, research, and medical communities ([2])

Concepts of Study

How Do You Achieve Herd Immunity? , There are two ways this can happen.You can develop resistance naturally. When your body is exposed to a virus or bacteria, it makes antibodies to fight off the infection. When you recover, your body keeps these antibodies. Your body will defend against another infection. This is what stopped the Zika virus outbreak in Brazil. Two years after the outbreak began, 63% of the population had had exposure to the virus. Researchers think the community reached the right level for herd immunity,. It also means 50% to 67% of the population would need to be resistant before herd immunity kicks in and the infection rates start to go down. Psychological immunity is also the first line of defense against illness and behavioral impairment, and it is a subjective starting point.The soul is mighty whenever it prepares and prepares what it can of strength and toughness of confrontation, and it is the same collapsed if it fails to repel circumstances and falls into the arms of frustration and fails to stop the influences ([3])

The soul possesses great hidden powers that you just need to search for. Every person has faculties, every age has wills, and every stage has fuel that must be invested to be strong and solid lines of defense that issue orders to the mind and heart to find a mass to prevent the occurrence of disease and a strength to get out of the scourge of sorrows and a methodology to recover from the worst pains  Psychological immunity is based on the basis that the mind and body are inseparable and that the brain affects all physiological and psychological processes in the individual, which requires the individual to strive to increase the efficiency of his psychological immunity, by developing his abilities to endurance and withstand crises, and to resist negative thoughts and feelings that lead to the path of anxiety, despair and failure ([4]) Dubey & Shahi ([5])  asserts that the individual has a psychological immune system and it is like a container that collects psychological resources that work to protect him from negative feelings that result from stress, anxiety, tension, intolerance, exhaustion and other crises and psychological disorders that he may face in his life.

Barbanell ([6]) refers to the biological immune system that works without guidance from the individual to attack foreign bodies. The person has a psychological immune system, and it is the main factor that helps the individual to psychological recovery, and works to protect us from psychological attacks from the environment by adapting to emotional stress.

Psychological Immunity

Kamal Ibrahim Morsi ([7]) defines psychological immunity as: “a hypothetical concept, which means a person’s ability to face crises and distress, bear difficulties and calamities, and resist the thoughts and feelings of anger, ridicule, hostility and revenge, feelings of despair, helplessness, defeatism and pessimism. Kagan ([8]) believes that there are three main tributaries from which the concept of psychological immunity is derived: the first tributary: the psychology of health, the second stream: neuropsychological immunology and the third tributary is the interaction between the brain and the immune system.

According this study, there is more than one concept like, An Epidemic is a disease that affects a large number of people within a community, population, or region.A Pandemic is an epidemic that’s spread over multiple countries or continents. Endemic is something that belongs to a particular people or country.An outbreak is a greater-than-anticipated increase in the number of endemic cases. It can also be a single case in a new area. If it’s not quickly controlled, an outbreak can become an epidemic.Epidemic vs. Pandemic, A simple way to know the difference between an epidemic and a pandemic is to remember the “P” in pandemic, which means a pandemic, has a passport. A pandemic is an epidemic that travels.Epidemic vs. Endemic, But what’s the difference between epidemic and endemic? An epidemic is actively spreading; new cases of the disease substantially exceed what is expected. More broadly, it’s used to describe any problem that’s out of control, such as “the opioid epidemic.” An epidemic is often localized to a region, but the number of those infected in that region is significantly higher than normal. For example, when Covid-19 was limited to Wuhan, China, it was an epidemic. The geographical spread turned it into a pandemic.Endemics, on the other hand, are a constant presence in a specific location. Malaria is endemic to parts of Africa. Ice is endemic to Antarctica.Endemic vs. Outbreak, Going one step farther, an endemic can lead to an outbreak, and an outbreak can happen anywhere. Last summer’s dengue fever outbreak in Hawaii is as an example. Dengue fever is endemic to certain regions of Africa, Central and South America, and the Caribbean. Mosquitoes in these areas carry dengue fever and transmit it from person to person. But in 2019 there was an outbreak of dengue fever in Hawaii, where the disease is not endemic. It’s believed an infected person visited the Big Island and was bitten by mosquitoes there. The insects then transferred the disease to other individuals they bit, which created an outbreak.You can see why it’s so easy to confuse these terms. But “Illness”, “disease” and “sickness” are interchanged a great deal.  However, there is actually some specific difference, especially when used by physicians or any health organization an illness is a general term that people will use to describe themselves when they do not feel well.  They may or may not have been diagnosed by a doctor.A disease is more specific and is determined by a physician or health worker The term sickness is usually applied if people miss work or cannot function normally in society, In general, “illness” is more general then “disease”, which in turn is more general than “sickness”. What is an epidemic? An epidemic is an occurrence of disease that is temporarily of high prevalence and that is confined to one region or one part of the world, such as a single country.What is a pandemic? A pandemic can be defined as an outbreak of infectious disease that occurs over a wide geographical area and that is of high prevalence, generally affecting a significant proportion of the world’s population, usually over the course of several months .(Foundations of Societal Resilience – Talma Lecture 2016, René Bekkers1,January 8, 2016.).Societal resilience refers to the response of systems to adversity that promotes the well-being of its units. In the definition of the Rockefeller Foundation, resilience is the capacity of individuals communities and systems to survive, adapt, and grow in the face of stress and shocks, and even transform when conditions require it.2 I define resilience as the mobilization of resources for the improvement of welfare in the face of adversity An example may be helpful in thinking about resilience. The stream of refugees arriving at the gates of Europe poses new challenges to Europe, in many areas: humanitarian assistance, citizenship, poverty, inclusion, access to education, and jobs.

The stream of refugees also raises important questions for philanthropy. How will Europe deal with these challenges? How resilient is Europe.. The concept of resilience has involved stepwise from its initial emphasis on the general persistence of ecological system functions in a world that is subject to ongoing change, through an orientation towards coupled social-ecological systems and questions of the adaptation of humans in nature, to its most recent readjustment, in taking up the more critical question of social transformation in the face of global change This particular genealogy – we suggest – is indicative of the underlying principles that constitute the resilience concept, i.e. persistability, adaptability, and transformability. This contribution explicitly focuses on literature referring to the concept of social resilience and is not intended to give an overview of the resilience literature in general. The literature on different types of resilience has grown rapidly (e.g. urban resilience, organizational resilience, and community resilience regional resilience) and cannot be adequately covered and discussed in a single review. All definitions of social resilience concern social entities – be they individuals, organizations or communities.  and their abilities or capacities to tolerate absorb, cope with and adjust to environmental and social threats of various kinds. ([9]) Also Endemics, Epidemics and pandemics’ pandemic arises from an epidemic, Infectious diseases are spread by either  bacterial or viral agents and are ever-present in society. Usually infected cases are present in numbers below an expected threshold but every once in a while there may be an outbreak, a new strain or a new disease that has a significant impact at either a local or global level. The spread and rate of new cases can be classified. ([10])

Endemic – describes a disease that is present permanently in a region or population, Epidemic – is an outbreak that affects many people at one time and can spread through one or several communities, Pandemic – is the term used to describe an epidemic when the spread is global. Endemic, Endemic is derived from Greek en meaning in and demos meaning people. It is used to describe a disease that is present at an approximately constant level within a society or country. Each country may have a disease that is unique, for example, Caribbean Dengue is still present due to a failure to eradicate the Aedes aegypti mosquito (see image R). Dengue first appeared in the Americas and the Caribbean and with the assistance of the Pan American Health Organization (PAHO) in the 1950s and 1960s the Americas were largely able to eradicate the presence of the Aedes Aegypti virtually eliminating the occurrence of Dengue. However, failure to eradicate its presence in the Caribbean resulted in the continued transmission throughout the region and more recently it has found its way back into the Americas causing several epidemics.( Brandling-Bennett AD, Penheiro F. Infectious diseases in Latin America and the Caribbean: are they really emerging and increasing?. Emerging infectious diseases  1996 Jan;2(1):59.) Varicella, more commonly known as chickenpox in the UK. It is more common in children under the age of 10, who often only experience mild symptoms and after exposure develop a natural immunity to the virus. Although there is a vaccine available it is only offered to those who are seen as vulnerable. ([11]) Malaria is another infectious disease that is endemic to Africa; through education and implementing countrywide strategies the cases of Malaria are now falling. ([12])  Epidemic, An epidemic is derived from Greek epi meaning upon or above and demos meaning people and is the term used to describe a situation where a disease spreads rapidly to a large number of people in a given population over a short time period. The term epidemic is not just used with infectious diseases. It is also used with any scenario that leads to a detrimental rise of health risks within a society. eg.The rise in obesity globally (often described as an “obesity epidemic”)., for example moving from animals to humans (zoonotic diseases) (Engering A, Hogerwerf L, Slingenbergh J. Pathogen–host–environment interplay and disease emergence. Emerging microbes & infections. 2013 Jan 1;2(1):1-7).A genetic change (mutation) in the infectious agent, e.g. bacteria, virus, fungi or parasite,Introduction of new pathogens to a host population.. ([13])Epidemics can follow predictable patterns and these trends are often used to monitor, predict and control the spread of the infection. A typical example of this is seasonal flu (Epidemics, Outbreaks and Pandemics. Accessed,15 March 2020).Pandemic, A pandemic is derived from Greek pan meaning all and demos meaning people and is the term used to describe the rapid spread of a transmissible infectious/communicable disease over several continents or worldwide. Once an epidemic becomes global and affects a large percent of the population it becomes known as a pandemic. The terms pandemic and epidemic are used to describe the rate and distance of the spread of the disease and not the severity of the disease. Significant features of a pandemic are listed below: Affects a wider geographical area, often global, Infects a very large number of people, Often caused by a new virus or a new strain of a virus that has been dormant for many years., Spreads quickly in humans as there is little to no existing immunity, Can cause a high number of deaths, Because of the need to control the spread of the disease, there is often social disruption, unrest and economic loss, Escalation of an Epidemic to a Pandemic. The World Health Organization (WHO) will declare a Pandemic when a disease has shown exponential growth – dramatically increasing rate of growth, each day showing many more cases than the previous day. A current example of this is the Coronavirus Disease (COVID-19). On 31 December 2019, a cluster of cases of pneumonia of unknown cause, in the city of Wuhan, Hubei province in China, was reported to the WHO. This was subsequently identified as a new virus in January 2020 and over the following months, the number of cases continued to rise but were not contained to China and showed exponential growth worldwide. Due to the rapid global rise in cases, this was declared a pandemic on 11 March (declares the coronavirus outbreak a pandemic. STAT News. Accessed 15 March 2020.)and globally, as of 4:22pm CET, 9 December 2020, there have been 67,780,361 confirmed cases of COVID-19, including 1,551,214 deaths, reported to WHO. (Coronavirus Disease (Covid-19) Dashboard Available from: https://Covid19.who.int/ (last accessed 10.12.2020)) Stages of a Pandemic ,The WHO has identified six phases that it follows before declaring a pandemic. (World Health Organization. Pandemic influenza preparedness and response: a WHO guidance document. Geneva: World Health Organization; 2009.), There are several measures that have proven effective in the control and containment of viruses ([14])The greater the stress on the healthcare system the higher the likely mortality rate, as resources are unable to meet the demand and healthcare workers themselves exceed their capacity to provide care. Flattening the curve also extends the time scale of the epidemic so that any potential vaccine can at some future point be used to rapidly increase immunity within the population ([15])

Pandemic during middle Ages

When an epidemic spreads beyond a country’s borders, that’s when the disease officially becomes a pandemic. Communicable diseases existed during humankind’s hunter-gatherer days, but the shift to agrarian life 10,000 years ago created communities that made epidemics more possible. Malaria, tuberculosis, leprosy, influenza, smallpox and others first appeared during this period. The more civilized humans became, building cities and forging trade routes to connect with other cities, and waging wars with them, the more likely pandemics became. See a timeline below of pandemics that, in ravaging human populations, changed history. The earliest recorded pandemic happened during the Peloponnesian War. After the disease passed through Libya, Ethiopia and Egypt, it crossed the Athenian walls as the Spartans laid siege. As much as two-thirds of the population died. The symptoms included fever, thirst, bloody throat and tongue, red skin and lesions. The disease, suspected to have been typhoid fever, weakened the Athenians significantly and was a significant factor in their defeat by the Spartans. The  antonine  plague was possibly an early appearance of smallpox that began with the Huns. The Huns then infected the Germans, who passed it to the Romans and then returning troops spread it throughout the Roman Empire. Symptoms included fever, sore throat, and diarrhea and, if the patient lived long enough, pus-filled sores. This plague continued until about 180 A.D., claiming Emperor Marcus Aurelius as one of its victims. Named after the first known victim, the Christian bishop of Carthage, the Cyprian plague entailed diarrhea, vomiting, throat ulcers, fever and gangrenous hands and feet. City dwellers fled to the country to escape infection but instead spread the disease further. Possibly starting in Ethiopia, it passed through Northern Africa, into Rome, then onto Egypt and northward. There were recurring outbreaks over the next three centuries. In 444 A.D., it hit Britain and obstructed defense efforts against the Picts and the Scots, causing the British to seek help from the Saxons, who would soon control the island. First appearing in Egypt, the Justinian plague spread through Palestine and the Byzantine Empire, and then throughout the Mediterranean. The plague changed the course of the empire, squelching Emperor Justinian’s plans to bring the Roman Empire back together and causing massive economic struggle. It is also credited with creating an apocalyptic atmosphere that spurred the rapid spread of Christianity. Recurrences over the next two centuries eventually killed about 50 million people, 26 percent of the world population. It is believed to be the first significant appearance of the bubonic plague, which features enlarged lymphatic gland and is carried by rats and spread by fleas. Though it had been around for ages, leprosy grew into a pandemic in Europe in the Middle Ages, ([16])  resulting in the building of numerous leprosy-focused hospitals to accommodate the vast number of victims. A slow-developing bacterial disease that causes sores and deformities, leprosy was believed to be a punishment from God that ran in families. This belief led to moral judgments and ostracization of victims. Now known as Hansen’s disease, it still afflicts tens of thousands of people a year and can be fatal if not treated with antibiotics. Responsible for the death of one-third of the world population, this second large outbreak of the bubonic plague possibly started in Asia and moved west in caravans. Entering through Sicily in 1347 A.D. when plague sufferers arrived in the port of Messina, it spread throughout Europe rapidly. Dead bodies became so prevalent that many remained rotting on the ground and created a constant stench in cities. England and France were so incapacitated by the plague that the countries called a truce to their war. The British feudal system collapsed when the plague changed economic circumstances and demographics. Ravaging populations in Greenland, Vikings lost the strength to wage battle against native populations, and their exploration of North America halted. Following the arrival of the Spanish in the Caribbean, diseases such as smallpox, measles and bubonic plague were passed along to the native populations by the Europeans. With no previous exposure, these diseases devastated indigenous people, with as many as 90 percent dying throughout the north and south continents. Upon arrival on the island of Hispaniola, Christopher Columbus encountered the Taino people, population 60,000. By 1548, the population stood at less than 500. ([17])  By The Philosophy of Saint Augustine during Middle Ages diseases is a Punishment from god to human because mistakes.([18])

This scenario repeated itself throughout the Americas. In 1520, the Aztec Empire was destroyed by a smallpox infection. The disease killed many of its victims and incapacitated others. It weakened the population so they were unable to resist Spanish colonizers and left farmers unable to produce needed crops. Research in 2019 even concluded that the deaths of some 56 million Native Americans in the 16th and 17th centuries, largely through disease, may have altered Earth’s climate as vegetation growth on previously tilled land drew more CO2 from the atmosphere and caused a cooling event. A graph showing the huge increase in deaths during the Great Plague of London in 1665 and 1666. The solid line shows all deaths and the broken line deaths attributed to plague. In another devastating appearance, the bubonic plague led to the deaths of 20 percent of London’s population. As human death tolls mounted and mass graves appeared, hundreds of thousands of cats and dogs were slaughtered as the possible cause and the disease spread through ports along the Thames. The worst of the outbreak tapered off in the fall of 1666, around the same time as another destructive event—the Great Fire of London, The first of seven cholera pandemics over the next 150 years, this wave of the small intestine infection originated in Russia, where one million people died. Spreading through feces-infected water and food, the bacterium was passed along to British soldiers who brought it to India where millions more died. The reach of the British Empire and its navy spread cholera to Spain, Africa, Indonesia, China, Japan, Italy, Germany and America, where it killed 150,000 people. A vaccine was created in 1885, but pandemics continued. Starting in China and moving to India and Hong Kong, the bubonic plague claimed 15 million victims. Initially spread by fleas during a mining boom in Yunnan, the plague is considered a factor in the Parthay rebellion and the Taiping rebellion. India faced the most substantial casualties, and the epidemic was used as an excuse for repressive policies that sparked some revolt against the British. The pandemic was considered active until 1960 when cases dropped below a couple hundred. After Fiji ceded to the British Empire, a royal party visited Australia as a gift from Queen Victoria. ([19]) Arriving during a measles outbreak, the royal party brought the disease back to their island, and it was spread further by the tribal heads and police who met with them upon their return. Spreading quickly, the island was littered with corpses that were scavenged by wild animals, and entire villages died and were burned down, sometimes with the sick trapped inside the fires. One-third of Fiji’s population, a total of 40,000 people, died. The first significant flu pandemic started in Siberia and Kazakhstan, traveled to Moscow, and made its way into Finland and then Poland, where it moved into the rest of Europe. By the following year, it had crossed the ocean into North America and Africa. By the end of 1890, 360,000 had died. The avian-borne flu that resulted in 50 million deaths worldwide, the 1918 flu was first observed in Europe, the United States and parts of Asia before swiftly spreading around the world. At the time, there were no effective drugs or vaccines to treat this killer flu strain. Wire service reports of a flu outbreak in Madrid in the spring of 1918 led to the pandemic being called the “Spanish flu. By October, hundreds of thousands of Americans died and body storage scarcity hit crisis level. But the flu threat disappeared in the summer of 1919 when most of the infected had either developed immunities or died. Starting in Hong Kong and spreading throughout China and then into the United States, the Asian flu became widespread in England where, over six months, 14,000 people died. A second wave followed in early 1958, causing an estimated total of about 1.1 million deaths globally, with 116,000 deaths in the United States alone. A vaccine was developed, effectively containing the pandemic. First identified in 1981, AIDS destroys a person’s immune system, resulting in eventual death by diseases that the body would usually fight off. Those infected by the HIV virus encounter fever, headache, and enlarged lymph nodes upon infection. When symptoms subside, carriers become highly infectious through blood and genital fluid, and the disease destroys t-cells, AIDS was first observed in American gay communities but is believed to have developed from a chimpanzee virus from West Africa in the 1920s.. ([20])  The disease, which spreads through certain body fluids, moved to Haiti in the 1960s, and then New York and San Francisco in the 1970s.Treatments have been developed to slow the progress of the disease, but 35 million people worldwide have died of AIDS since its discovery, and a cure is yet to be found. First identified in 2003 after several months of cases, Severe Acute Respiratory Syndrome is believed to have possibly started with bats, spread to cats and then to humans in China, followed by 26 other countries, infecting 8,096 people, with 774 deaths, SARS is characterized by respiratory problems, dry cough, fever and head and body aches and is spread through respiratory droplets from coughs and sneezes, Quarantine efforts proved effective and by July, the virus was contained and hasn’t reappeared since. China was criticized for trying to suppress information about the virus at the beginning of the outbreak, SARS was seen by global health professionals as a wake-up call to improve outbreak responses, and lessons from the pandemic were used to keep diseases like H1N1, Ebola and Zika under control. ([21])

According COVID-19, Coronavirus, This photo taken on February 17, 2020 shows a man (L) who has displayed mild symptoms of the COVID-19 coronavirus using a laptop at an exhibition center converted into a hospital in Wuhan in China’s central Hubei province,On March 11, 2020, the World Health Organization announced that the COVID-19 virus was officially a pandemic after barreling through 114 countries in three months and infecting over 118,000 people. And the spread wasn’t anywhere near finished, COVID-19 is caused by a novel coronavirus—a new coronavirus strain that has not been previously found in people. Symptoms include respiratory problems, fever and cough, and can lead to pneumonia and death. Like SARS, it’s spread through droplets from sneezes, The first reported case in China appeared November 17, 2019, in the Hubei Province, but went unrecognized. Eight more cases appeared in December with researchers pointing to an unknown virus, many learned about COVID-19 when ophthalmologist Dr. Li Wenliang defied government orders and released safety information to other doctors. The following day, China informed WHO and charged Li with a crime. Li died from COVID-19 just over a month later, without a vaccine available, the virus spread beyond Chinese borders to nearly every country in the world. By December 2020, it had infected more than 75 million people and led to more than 1.6 million deaths worldwide. The number of new cases was growing faster than ever, with more than 500,000 reported each day on average.

Theories of Explaining the Diseases in middle Ages

The Black Death of 1347-1352 CE is the most infamous plague outbreak of the medieval world, unprecedented and unequaled until the 1918-1919 CE flu pandemic in the modern age. The cause of the plague was unknown and, in accordance with the general understanding of the Middle Ages, was attributed to supernatural forces and, primarily, the will or wrath of God.Accordingly, people reacted with hopeful cures and responses based on religious belief, folklore and superstition, and medical knowledge, all of which were informed by Catholic Christianity in the West and Islam in the Near East. These responses took many forms but, overall, did nothing to stop the spread of the disease or save those who had been infected.  ([22]) The recorded responses to the outbreak come from Christian and Muslim writers primarily since many works by European Jews – and many of the people themselves – were burned by Christians who blamed them for the plague and among these works, may have been treatises on the plague. ([23])  No matter how many Jews, or others, were killed, however, the plague raged on and God seemed deaf to the prayers and supplications of believers. In Europe, the perceived failure of God to answer these prayers contributed to the decline of the medieval Church’s power and the eventual splintering of a unified Christian worldview during the Protestant Reformation (1517-1648 CE). In the East, Islam remained intact, more or less, owing to its insistence on the plague as a gift which bestowed martyrdom on the victims and transported them instantly to paradise as well as the view of the disease as simply another trial to endure such as famine or flood. Although many of the religious ideas concerning the plague in West and East were similar, this one difference was significant in maintaining Islamic cohesion, even though it most likely led to a higher death toll than official records maintain. After the plague had run its course, religious response in both East and West was generally credited with appeasing God who lifted the pestilence but Europe would be radically changed while the Near East was not.The plague originated in Central Asia and spread via the Silk Road and troop movements throughout the Near East. The first recorded outbreak of bubonic plague is the Plague of Justinian (541-542 CE) which struck Constantinople in 541 CE and killed an estimated 50 million people. ([24]) this outbreak, however, was simply the furthest westerly occurrence of a disease that had been stalking the people of the Near East for years before. The historian John of Ephesus (l. c. 507 – c. 588 CE), an eyewitness to the plague, notes that the people of Constantinople were aware of the plague for two years before it came to the city but made no provision against it, believing it was not their problem.After Constantinople, the plague died down in the East only to appear again with the Djazirah Outbreak of 562 CE which killed 30,000 people in the city of Amida and even more when it returned in 599-600 CE. The disease maintained this pattern in the East, seeming to disappear only to rise again, until it picked up momentum beginning in 1218 CE, further in 1322 CE, and was raging by 1346 CE.It was around this time that the Mongol Khan Djanibek (r. 1342-1357 CE) was laying siege to the port city of Caffa (modern-day Feodosia in Crimea) which was held by the Italians of Genoa. As his troops died of plague, Djanibek ordered their corpses catapulted over Caffa’s walls, thereby spreading the disease to the defenders. The Genoese fled the city by ship and so brought the plague to Europe. From ports such as Marseilles and Valencia, it spread from city to city with every person who had had contact with anyone from the ships and there seemed no way to stop it.([25])

Christian vs. Muslim View of Plague Responses to the plague were informed by the dominant religions of West and East as well as the traditions and superstitions of the regions and presented as a narrative which explained the disease. Scholar Norman F. Cantor comments, the scientific method had not yet been invented. When faced with a problem, people in the middle Ages found the solution through diachronic (as opposed to synchronic) analysis. The diachronic is the historical narrative, horizontally developing through time: “Tell me a story”. With their fervent historical imagination, medieval people were very good at giving diachronic explanations for the outbreak of bubonic plague. Reactions, then, were based on the religious narratives created to explain the disease and fall, generally, into three beliefs about the plague held, respectively, by medieval Christianity and Islam. Even empirical observation was informed by religious belief, as in the case of whether the plague was contagious.Christian View: The plague was a punishment ([26])  ,for Example wrath on Emperor Valens because of his persecution of bishops who oppose him in religious belief ([27]). from God for humanity’s sins but could also be caused by “bad air”, witchcraft and sorcery, and individual life choices including one’s piety or lack of it.Christians – especially in the early period of the outbreak – could leave a plague-stricken region for one with better air which was not infected.The plague was contagious and could be passed between people but one could protect oneself through prayer, penitence, charms, and amulets. ([28]) Church men had an important role in mitigating the bad effects on the people, as Basil confronted the famine of 370 AD in Cappadocia, and the monk Ephrem confronted the famine of 373 AD in Edessa. ([29])This is confirmed by the narration of Socrates when he indicated that the disasters were due to God’s.Muslim View, The plague was a merciful gift from God which provided martyrdom for the faithful whose souls were instantly transported to paradise, Muslims should not enter nor should they flee from plague-stricken regions but should remain in place.

The plague was not contagious because it came directly from God to specific individuals according to God’s will. Again, these are general views held by the majority and not every cleric of Europe or the Near East agreed with them nor did every layperson. These beliefs, however, carried enough weight with believers to encourage responses which – again, generally – fall into five main reactions. ([30])

Christian Response: Penitential processions, attending mass, fasting, prayer, use of amulets and charms, The Flagellant Movement,Supposed cures and fumigation of “bad air”,Flight from infected areas, Persecution of marginalized communities, especially the Jews. Muslim Response: Prayer and supplication at mosques, processions, mass funerals, orations, fasting Increased belief in supernatural visions, signs, and wonders, Magic, amulets, and charms used as cures Flight from infected areas, No persecution of marginalized communities, respect for Jewish physicians Christian Response in Detail. Since the plague was thought to have been sent by God as a punishment, ([31]) Tthe only way to end it was admission of one’s personal sin and guilt, repentance of sin, and renewed dedication to God. To this end, processions would wind their way through cities from a given point – say the town square or a certain gate – to the church or a shrine, usually dedicated to the Virgin Mary. Participants would fast, pray, and purchase amulets or charms to keep them safe. Even after European Christians understood that the plague was contagious, these processions and gatherings continued because there seemed no other way to appease God’s wrath.([32]) These disasters had bad effects on the people of the empire, including the social effects, which were the abandonment of agricultural lands, the abandonment of business and government jobs, and the displacement of many poor people who do not have the strength to protect themselves, as well as religious effects. ([33]) Church men had an important role in mitigating the bad effects on the people, as Basil confronted the famine of 370 AD in Cappadocia, and the monk Ephrem confronted the famine of 373 AD in Edessa. ([34])This is confirmed by the narration of Socrates when he indicated that the disasters were due to God’s wrath on Emperor Valens because of his persecution of bishops who oppose him in religious belief ([35]).As the plague raged and traditional religious responses failed, however, the Flagellant Movement emerged in 1348 CE in Austria (possibly Hungary also) and spread to Germany and Flanders by 1349 CE. The flagellants were a group of zealous Christians, led by a Master, who roamed from town to city to countryside whipping themselves for their sins and the sins of humanity, falling to the ground in penitential frenzy, and leading communities in the persecution and slaughter of Jews, gypsies, and other minority groups until they were banned by Pope Clement VI (l. 1291-1352 CE) as ineffectual, disruptive, and upsetting. Cures were also often based on religious understanding, such as killing and chopping up a snake (associated with Satan) and rubbing the pieces on one’s body in the belief that the “evil” of the disease would be drawn to the “evil” of the dead serpent. Drinking a potion made of unicorn horn was also considered effective as the unicorn was associated with Christ and purity.Bad air, which was thought to be the result of planetary alignment or supernatural forces (usually demonic) was driven out of homes by incense or burning thatch and by carrying flowers or sweet-smelling herbs on one’s person (a practice referenced in the children’s rhyme “Ring Around the Rosie”). One could also fumigate one’s self by sitting near a hot fire or a pond, pool, or pit used for dumping sewage as it was thought the “bad air” in one’s body would be drawn to the bad air of the sewage. ([36])

People in the cities, almost always the wealthy upper class, fled to their villas in the countryside while poorer people and farmers often left their lands in rural areas for the city where they hoped to find better medical care and available food. Even after the plague was understood to be contagious, people still left quarantined cities or regions and spread the disease further.Persecutions of Jews by the Christian community did not start with the Black Death or end there but certainly increased in Europe between  1347-1352 CE. Scholar Samuel Cohn, notes:That the blind fury of mobs comprised of workers, artisans, and peasants was responsible for the Black Death annihilation of Jews derives from modern historians’ musings, not the medieval sources.  Even so, he concedes, “the Black Death unleashed hatred, blame, and violence on a more horrific scale than by any pandemic or epidemic in world history” (6). Although his claim regarding modern historians’ interpretation of pogroms against Jews has some validity, it does not seem to fully take into consideration the long-standing animosity felt toward Jews by Christian communities. Jews were routinely suspected of poisoning wells, murdering Christian children in secret rites, and practicing various forms of magic in order to injure or kill Christians. Scholar Joshua Trachtenberg cites one example:[The townspeople], petitioning for the expulsion of the Jews, affirmed that their danger to the community extended far beyond an occasional child murder, for they dry the blood they thus secure, grind it to a powder, and scatter it in the fields early in the morning when there is a heavy dew on the ground; then in three or four weeks a plague descends on men and cattle, within a radius of half a mile, so that Christians suffer severely while the sly Jews remain safely indoors. (144) In 1348 CE, Jews in Languedoc and Catalonia were massacred and, in Savoy, were arrested on charges of poisoning the wells. (Trachtenberg, J. The Devil and the Jews. Yale University Press, 2012 Tuchman, B.) In 1349 CE, Jews were burned en masse in Germany and France, but also elsewhere in spite of papal bulls issued by Pope Clement VI expressly forbidding these types of actions. ([37]).

About Muslim Response in Detail, Muslims also gathered in large groups at mosques for prayer, but these were prayers of supplication, requesting God lift the plague, not penitential prayers for the forgiveness of sins. Scholar Michael W. Dols notes that “there is no doctrine of original sin and man’s insuperable guilt in Islamic theology” and so religious responses to the plague took the same form as supplications for a good harvest, a healthy birth, or success in business. Dols writes: An important part of [Muslim] urban activity in response to the Black Death was the communal prayers for the lifting of the disease. During the greatest severity of the pandemic, orders were given in Cairo to assemble in the mosques and to recite the recommended prayers in common. Fasting and processions took place in the cities during the Black Death and later plague epidemics; the supplicatory processions followed the traditional form of prayer for rain. Mass funerals were conducted along the lines of traditional burial rites with the addition of an orator who would request the plague be lifted but, again, there was no mention of the sins of the deceased nor any reason given why they died and another lived; these things happened according to the will of Allah.Belief in supernatural visions and signs markedly increased. Dols cites the example of a man from Asia Minor who came to Damascus to inform a cleric of a vision he had been granted of the prophet Muhammad. In the vision, the prophet told the man to have the people recite the surah of Noah from the Quran 3,363 times while asking God to relieve them of the plague. The cleric announced the vision to the city and the people “assembled in the mosques to carry out these instructions. For a week the [people] performed this ritual, praying and slaughtering great numbers of cattle and sheep whose meat was distributed among the poor”. Another man who received a vision from Muhammad claimed the prophet had given him a prayer to recite which would lift the plague; this prayer was copied and distributed to people with the instruction to recite it daily.While the majority of Muslims believed that the plague had been sent by God, there were many who attributed it to the supernatural power of evil djinn (genies). ([38]) Ancient Persian religion – pre- and post-Zoroaster (c. 1500-1000 BCE) – attributed various events and illnesses to the work of the malevolent deity Ahriman (also known as Angra Mainyu) or to spirits who sometimes advanced his agenda, such as djinn. This belief gave rise to an increase in folk magic and the use of amulets and charms to ward off evil spirits. The charm or amulet would be inscribed with one of the divine names or epithets of God and prayers and incantations would be recited to imbue the artifact with magical protective powers.As in Europe, those who could afford to do so left infected cities for the countryside and people from rural communities came to the cities for the same reasons as their European counterparts. Since the plague was not believed to be contagious, there was no reason for one to remain in one place or another except for a proscription attributed to Muhammad who forbade people going to or fleeing from plague-stricken regions. The reason for this proscription is unknown and it seems people ignored it because, whether the plague came from Allah or a djinn, it was not within an individual’s power to escape the fate God had decreed. For the faithful Muslim, the plague was a merciful release from the world of multiplicity and change to the eternal, unchanging paradise of the afterlife; it seems only to have been considered a punishment for infidels outside the faith.Even so, there is no evidence that minority populations – whether Christians, Jews, or any other – were persecuted in the Near East during the years of the plague ([39])  Jewish physicians, in fact, were highly regarded even though they could do no more for plague victims than any others.

Conclusion

Applying the case study to our Arab reality to obtain lessons learned from history, we find that the pandemics that the Arab region was exposed to during its long history, especially in the Middle Ages, we find ethical and religious considerations that were the reason for the resilience of Arab societies from their counterparts in Europe in the Middle Ages, which considered that disease is what God plagues humans according to religious interpretations of disease and this flexibility was represented in The role of the government in dealing with citizens in terms of raising awareness as much as possible, then the role of the individual and his belief in fate in adopting the causes while believing in the reality of death in addition to not using intimidation policies were among the reasons that made these types of pathological challenges not pose a threat to the Arab region as is the case On the European continent during the Middle Ages and the modern era. Also the herd’s immunity consisted in adapting to disease and coexisting with it while taking the necessary precautions, which reduced its risk and was a reason for making the Arab world more flexible in dealing with it.

The Church had a role in negative social resilience in the middle Ages in terms of its exploitation of its religious authority over rulers and the ruled in that disease was a divine punishment for them, which made epidemics kill huge numbers of Europe in the Middle Ages, unlike the Islamic East.

As the Islamic East dealt with disease using scientific methods under the auspices of the rulers, while the rulers of Europe believed that these diseases would be a reason to reduce the pressure on them in light of the economic deterioration that prevailed in Europe under feudalism, and that in leaving the disease that kills the weak as a natural development of  humanity in what we call herd immunity.

Is stay the best Theories of explaining the disease in the middle age Socio-political religious, Through what has been presented in this study, we can define several theories to explain epidemics in the middle Ages. During the middle Ages, we find that theories were represented in the religious theory supported by the Church that disease is nothing but punishment and affliction from the Lord. As for the political theory, it was represented in the theory of the conflict between religious and civil authority in the theory of the two swords or an attempt to explain it according to the Islamic Christian conflict in that period, especially during the Crusades. As for the social theory, it held that the cause of these diseases was poor personal hygiene, which was the culture of European societies in the middle Ages, or that these diseases were transmitted through merchants and invasions that were exposed to Europe during the middle Ages. Through the pandemics that the Arab region was exposed to during its long history, especially in the Middle Ages, we find ethical and religious considerations that were the reason for the resilience of Arab societies from their counterparts in Europe in the Middle Ages, which considered that disease is what God plagues humans according to religious interpretations of disease and this flexibility was represented in The role of the government in dealing with citizens in terms of raising awareness as much as possible, then the role of the individual and his belief in fate in adopting the causes while believing in the reality of death in addition to not using intimidation policies were among the reasons that made these types of pathological challenges not pose a threat to the Arab region as is the case On the European continent during the Middle Ages and the modern era.Also, the herd’s immunity consisted in adapting to disease and coexisting with it while taking the necessary precautions, which reduced its risk and was a reason for making the Arab world more flexible in dealing with it’s the plague raged on, people in Europe and the Near East continued their religious devotions which, after it had passed, were credited with finally working to influence God to lift the plague and restore a sense of normalcy to the world. Even so, the seeming ineffectuality of the Christian response to the people of the time caused many to question the vision and message of the Church and seek a different understanding of the Christian message and walk of faith. This impetus would eventually contribute to the Protestant Reformation and the change in philosophical paradigm which epitomizes the Renaissance.

Scholar Anna Louise Des Ormeaux notes that a significant aspect of the change in the religious model was the Christian belief that God had caused the plague to punish people for their sins and so there was nothing one could do but “turn humbly to God, who never denies His aid” (14). And yet, to the people of the time, it seemed as though God had denied his aid and this led people to question the authority of the Church. No such dramatic change occurred in the Near East, however, and Islam continued on after the plague with little difference in understanding and observance than before. Dols comments:  The comparison of Christian and Muslim societies during the Black Death points to the significant disparity in their general communal responses…the Arabic sources do not attest to the “striking man­ifestations of abnormal collective psychology, of dissociation of the group mind,” which occurred in Christian Europe. Fear and trepidation of the Black Death in Europe activated what Professor Trevor-Roper has called, in a different context, a European “stereotype of fear”…Why are the corresponding phenomena not found in the Muslim reaction to the Black Death? The stereotypes did not exist. There is no evidence for the appearance of messianic movements in Muslim society at this time which might have associated the Black Death with an apocalypse. (20 A number of Christian European writers of the time, and afterwards, refer to the Black Death as “the end of the world” while Muslim scribes tend to focus on the death toll in emphasizing the magnitude of the pestilence; they do so, however, in the same way they write about deaths from floods or other natural disasters. In the aftermath of the Black Death, Europe would be radically transformed in social, political, religious, philosophical, medical, and many other areas while the Near East would not; because of a different interpretation of exactly the same phenomenon.

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([2](  Fauci, Lane & Redfield, H. C., & Redfield, R. R. (2020). Covid-19—navigating the uncharted, 2020,1.

([3](  Essam Mohamed Zidan, (2013). Psychological Immunity: Its Concept, Dimensions and Measurement, Journal of the Faculty of Education, Tanta University, 51, 811-882. 811.

([4](  Emad Muhammad Mukhaimer, 2009, Human advancement in the light of positive psychology and how to develop the positive aspects of the personality of children, Cairo: Dar Al-Kitab Al-Hadith. 8.CF, Husband, A. J. (2003). Psychoimmunology. CRC Press.p.4.

([5](  Dubey & Shahi ,2011, Psychological immunity and coping strategies: A study on medical professionals. Indian J Soc , Sci Res,  (1-2), 36-47,36.

([6](  Barbanell (2009), Breaking the Addiction to Please: Goodbye Guilt. Rowman & Littlefield, 17.

([7](  Kamal Ibrahim Morsi (2000), Happiness and Mental Health Development, Volume 1, Cairo: Universities Publishing House. 96.

([8](  Kagan (2006), The psychological immune system: A new look at protection and survival. Author House., 14.

([9](What Is Social Resilience? Lessons Learned and Ways Forward, Article in Erdkunde, March 2013, Research Gate, Markus Kick, University of Bonn & Patrik Sakdpolrak, University of Vienna, Erdkunde.

([10](  US  Department of Health and Human Services,. Principles of Epidemiology in Public Health Practice Third Edition An Introduction to Applied Epidemiology and Biostatistics. Accessed, 15  March 2020.

([11](  Chickenpox vaccine overview. NHS Website. Accessed 15 March 2020.

([12](  Global malaria progress and challenges in 2016.Accessed 15 March 2020.

([13](  National Institutes of Health. Understanding emerging and re-emerging infectious diseases. Biological sciences curriculum study. NIH Curriculum Supplement Series. National Institutes of Health, Bethesda, MD. 2007.

([14](  Wang CJ, Ng CY, Brook RH. Response to Covid-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. JAMA. 2020 Mar 3.

([15](  Tomas Peuyo, Coronavirus: Why You Must Act Now, Politicians, Community Leaders and Business Leaders: What Should You Do and When?, Medium, March 10 2020 (viewed March, 16th 2020.

([16](  Anna Louise Des Ormeaux. “The Black Death and its Effect on 14th and 15th Century Art.” Louisiana State University, N/A, pp. 1-105.

([17](   Religious Responses to the Black Death, Joshua J. Mark by Joshua J. Mark, published on 16 April 2020.

([18](  Augastine ,City of God,London,2010,PP.1-53                     .

([19](  Religious Responses to the Black Death, Joshua J. Markby Joshua J. Mark, published on 16 April 2020.

([20](  Ibid.

([21](  Ibid.

([22](  Anna Louise DesOrmeaux. “The Black Death and its Effect on 14th and 15th Century Art.” Louisiana State University, N/A, pp. 1-105.

([23](   Religious Responses to the Black Death, Joshua J. Mark by Joshua J. Mark, published on 16 April 2020.

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([26](  CF , Augastine ,City of God,London,2010,PP.1-53           .

([27](  Socrates,The Ecclesiastical History,Noted by Zeno A.C,second Series ,Vol., II,The First American Printing ,1994,IV,p.11.

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([29](  Gregory of Nyssa,Against Eunom,trans.,not.,and introd.By William Moore and Henry Austin Wilson,Second Series,Vol.5,First American Printing,1994,p.I,8.CF,Palladius,The Lausiac History,trans.,by Robert T. Meyer,London,1965,p.40.

([30](  Farrokh, K. Shadows in the Desert. Osprey Publishing,  2009.

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([32](   Religious Responses to the Black Death, Joshua J. Mark by Joshua J. Mark, published on 16 April 2020.

([33](  Camille Aziz Salib: Natural disasters and their effects in the era of Emperor Valens 364-378 AD, Professor Promotion Research, Cairo, undated, pp. 1-25.

([34](  Gregory of Nyssa,Against Eunom,trans.,not.,and introd.By William Moore and Henry Austin Wilson,Second Series,Vol.5,First American Printing,1994,p.I,8.CF,Palladius,The Lausiac History,trans.,by Robert T. Meyer,London,1965,p.40.

([35](  Socrates,The Ecclesiastical History,Noted by Zeno A.C,second Series ,Vol., II,The First American Printing ,1994,IV,p.11.

([36](  Kohn, G. C. Encyclopedia of Plague and Pestilence. Facts on File, 2007.

([37](  Michael W. Dols. “The Comparative Communal Responses to the Black Death in Muslim and Christian Societies.” Department of History, California State University, N/A, pp. 1-22.

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