AIDS, like any disease, is an individual experience, but AIDS as a cultural phenomenon was seen by many as a global judgement. It marked what I regard as the integral logic of apocalypse: the local and particular projected upon the total; our individual mortality iterated as the death of everybody and everything. In the words of Susan Sontag, ‘the AIDS crisis is evidence of a world in which nothing important is regional, local, limited; in which everything that can circulate does, and every problem is, or is destined to become, worldwide’.*
HIV/AIDS is still a threat, although it is a less present global danger than used to be the case. Although there is still no cure, nowadays antiviral drugs and other therapies render it a chronic rather than a fatal infection. In 2004, the disease’s peak year, the fatality rate for sufferers was 50 per cent higher, globally, than in 2020, and that number continues to fall.
Nevertheless, AIDS continues to affect our collective imagination in a way that other plagues do not, including those that were by any objective metric much more destructive. The Spanish flu outbreak of 1918–20 killed five times as many people as AIDS has over fifty years, but after it happened it was basically forgotten – at least, until the coronavirus outbreak of 2020, which reminded us all of it once again. The Spanish flu killed off several per cent of the entire global population, more than died in the century’s two world wars, and the authorities flailed in response. Some did what they could: San Francisco, for instance, brought in draconian public health laws, restricting shaking hands and mandating face masks for citizens in public places. John Ryle notes that because of such measures ‘there were only a few thousand deaths in San Francisco during the first year of the pandemic’, but adds that ‘elsewhere, including Europe, the toll was much higher. In Alaska and Central Africa and Oceania entire communities were wiped out.’ He goes on:
In statistical terms it was the greatest natural disaster since the Black Death, yet the Great Influenza Epidemic (or Pandemic) of 1918–19 has vanished from public consciousness. Unlike the war that immediately preceded it, the flu has left scarcely a trace in modern literature; historical accounts of it are sparse. One of its few chroniclers claimed that ‘the Spanish Lady inspired no songs, no legends, no work of art’.*
Why didn’t the Spanish flu leave a greater cultural footprint? Where are all the great novels and films about that appalling global catastrophe? The answer may have to do with timing. The Great War had facilitated the spread of the disease, since it involved millions of people being moved around the globe, as troops or refugees. But the Great War also dominated the post-war imagination in a way that the Great Flu did not. War gave us heroes and antagonists, enemies with faces against which we could pit ourselves; flu gave us none of those things.
This collective amnesia ended in 2020 with the arrival of a new virus, Covid-19. In the global lockdown that followed, the long history of flu and flu-like viruses came crashing back into our lives, and the entire planet revised their knowledge of epidemiology. Our lives were entirely changed by the trauma of loved ones getting sick and dying, but also by the disruption of lockdown, which overnight completely transformed our societies.
It’s too early to say how coronavirus will factor into our ongoing general fascination with the end of the world. But it illustrates a core truth about human beings: we are our interactions with others – our friendships and sex lives, our workplace interactions and social media, our family and friends and the kindnesses we show strangers. Those who live as hermits, sealed away from human interaction, are the exceptions to the norm. Our existence is woven from a great many human intimacies – we require them to acquire empathy and social skills, to love and even to speak. That network of various intimacies defines us, but it is also what disease is: not merely the potential infections of particular germs or viruses, but the actualisation of contagion in the world.
And this is the crucial thing. Our understanding of disease, and our improved medical science, make the gloomier prognostications of science fiction doom-sayers less and less likely. No plague will kill 4,999 out of every 5,000 humans – as we’ve seen, even if the numbers are high, in terms of percentage of population it’s likely to be very low. It feels like being a hostage to fortune, writing as I am in the middle of the Covid-19 lockdown, but it is true nonetheless: disease by itself won’t bring about the end of the world. But the world that emerges, post lockdown, will surely look different, and perhaps very different, to the one we knew before. We will learn new modes of remote social interaction, distanced and masked, separated into more atomised little units. Plague may not prove the end of the world – but it might be the end of the world as we know it.
* He did so in a book called, appropriately enough, Civilization and its Discontents (1930).
* D. H. Lawrence, Women in Love (Thomas Seltzer, 1920).
* Helen Marshall, The Migration (Random House, 2019), pp. 44–45.
* The English word ‘plague’ comes from the Latin plāga, which means wound or cut, and which in Roman times had a rude slang meaning relating to female sexual organs. The English cut, via its older variant cunt, has the same double meaning.
* Susan
