Reflections | China has been plagued, and shaped, by epidemics – it has also overcome them

What a year it has been! For the greater part of 2020, the whole world has been held hostage by a microscopic pathogen that’s not even considered a living thing. As the coronavirus has rampaged, there have been times we have seemed powerless against the Covid-19 pandemic. Various reports indicate that a vaccine is finally on the cards, but medical experts continue to temper optimism for a panacea.

Epidemics have plagued China since written records began 3.5 millennia ago. Historians calculate that there were around 290 serious epidemics in China between 243BC and 1911, averaging about one every seven years. Others went further back in time and identified 700 cases of supposedly widespread infectious diseases in the 2,700 years from the 7th century BC to the end of the 20th century. Despite the alarming numbers, most records contain scant details of the diseases, if any, focusing instead on their catastrophic effects.

And how horrific those effects were! In AD312, northern and central China were devastated by a deadly contagion. In the region of present-day Shaanxi, only 1 to 2 per cent of the entire population survived. Eastern and central China were hit by an infectious disease in AD891. In Hubei, four out of every 10 people died. An extremely lethal epidemic in 1232 took 900,000 lives in just 50 days.

The toll exacted by these and many other mass infections sometimes altered the course of history. Cao Cao’s defeat and retreat in the famous Battle of the Red Cliffs, whose outcome was the splitting of China into the Three Kingdoms (AD220-280), was due in part to infectious disease breaking out among his troops. The plague that broke out in the capital Beijing in 1643, which decimated the city’s population, was the final death knell of the Ming dynasty, which fell to armed rebels the following year.

With the frequency of such outbreaks, the Chinese had much experience in mitigating their effects. Isolating the sick as a means of stopping the spread was employed as early as the Qin dynasty (221-206BC), a practice that continues. The use of medicines derived from plants and minerals helped to relieve suffering and allowed stronger patients to recover, which was all that could be done before the advent of modern pharmaceuticals.