From the Crowned Virus to the Flu of the Spaniards; How to Craft a Pandemic in Your World

The creation of a sickness or virus in your world is something that shouldn't be taken lightly. A sickness is something that changes your society, sometimes in drastic ways. Designing a disease usually isn't something that is done in the early days of your world, unless you're creating a world that was majorly shaped by the virus or disease.

This is my first article of this type, and I don't think I would have normally picked such a specific topic for my first article, but I think that this is a very timely article, especially considering the current pandemic our world is in. I feel like I should put in a disclaimer that I am in no way a medical professional. The closest thing I've gotten to healthcare was my college anatomy classes and a few months working in a hospital. In an article like this, I think the best thing to do is break it down into topics to go over, then create an example disease at the end to show how this would work. So, let's break a disease down into its most basic parts. First and foremost, you have to have a name, then symptoms, method of transmission (if there is one), mortality rate, and treatments/cure. We'll also be talking about how society could feasibly be impacted by a disease and how it could change social interactions, standards of living, etc. Let's get started, shall we?

NAME

A name is very important for a disease or sickness. It gives the disease a form of legitimacy, and allows the disease to be anchored in the dialogue of your world. When choosing a name, it's important to think of the time period that your world is in. For example, if your world is modern, you might be able to name the disease after what it looks like under a microscope (i.e. the coronavirus is named after the crown like shape it has under a microscope. "Corona" is Latin for crown). If you are in a world before microscopes or the ability to see viruses and diseases, the easiest way to name a virus is simply the location it came from (i.e. the Spanish flu was named from the fact that it was first reported in Spain. In reality, it was probably from America, but Spain was the first to report it in their newspapers.). This method of naming, of course, is reliant on the fact that your world knows what a disease is, or a virus, and has the communication ability to know where a disease first appeared. The simplest, and of course, most common method of naming a disease is based on its symptoms. The black death, which we now know as the bubonic plague, was simply called "pestilence" or "plague" or most commonly, "the death". The term "black death" wasn't seen until after the plague had passed, in the 16th century. Other common naming conventions are based on where a disease manifests itself (i.e. Foot and Mouth disease), or even the animals it came from (Chicken pox, swine flu). However, as a worldbuilder, if you wanted to name a plague in a pre-science Medieval world, you need to think about our next topic. The symptoms.

SYMPTOMS

Every disease has symptoms, no matter how small. Whether it be a sore throat, a cough, or blistering, bleeding sores, every illness will present itself in a unique way. Before lab testing, symptoms were the most reliable and common diagnostic tool. Symptoms are typically reliant on what system of the body is affected by the disease. Take, for example, the coronavirus. As an upper respiratory infection, the symptoms commonly presented by the infected are coughing, shortness of breath, and sore throats. Before getting too deep into symptoms, think broadly. Think about what system of the body you want to be affected. You could have a virus affect the respiratory system, the cardiovascular system, the nervous system, or even have a disease that eats at your bones and skeletal or muscular systems. For research, I'd recommend finding a disease that affects the same system you want your disease to affect, and look through the most common symptoms. They'll give you a good idea of how common each symptom is, and how badly it'll affect each person.

Once you've discovered a system that you want to have your disease affect, there are a few generic symptoms that you know most diseases can present with. These symptoms include fever (fever is a common immune response to a foreign body), general fatigue (if you want to be fancy you can use the term malaise), muscle aches, and chills. These symptoms are typically your body's reaction to fighting the disease. You can make your symptoms as mundane or insane as you want. For example, rabies, the disease contracted by animal bites, is commonly known as the disease which makes you angry and frothing at the mouth, but it also has some other, even more disturbing symptoms. In late stages of the disease (rabies is fatal if left untreated), victims can expect delirium, hallucinations, stiff necks, paralysis, and even an irrational fear of liquids, known as hydrophobia. In the late stages of the disease the afflicted can have a legitimate panic reaction to even a cup of water. This is due to the fact that another symptom is trouble swallowing. It's rather interesting, if I'm being honest.

Another important aspect to symptoms is how long it takes for the symptoms to present. How long it takes to present will also play an important role in how quickly and easy it is able to spread, and how fatal it can be. Most diseases need to undergo an incubation period, which is the time between when it first enters the body to when it starts to show symptoms. During this time the disease reproduces and grows within the body. Incubation of a disease can typically take around 2-3 days, but in certain cases (much like the coronavirus) it can take up to 21 days to actually present symptoms. Or, symptoms could never present and the carriers could be asymptomatic.  You can make your disease’s symptoms as benign or as crazy as you want to. However, keep in mind that a disease that has death as a symptom probably will not spread as well as other plagues would (The black death was so fatal because it was actually a disease from cows). Symptoms can also be vital in determining your method of transmission.

Method of Transmission

There are several ways for a disease to spread from person to person. Spreading and infection is one of the vital functions of a disease. Without it, the disease would simply die out. A majority of the plagues from history were spread through either the air (via coughing) or via the water supply (i.e. Cholera). Your most infectious diseases are diseases that are spread by air. They typically are also the weakest diseases when it comes to tolerance (They usually can only survive a few minutes in the air. Diseases spread through bodily liquids last the longest, and diseases that spread through water can spread through an entire city’s sewer system before it dies out.

As a worldbuilder, you should consider what is common in your world. Does your population get their water from rivers? From sewers? Perhaps you want to be more extravagant and make your disease spread through magic if it exists in your world. Perhaps it spreads through sound and speech. It's your world. You don’t have to be scientifically accurate on everything. Or even anything!

Mortality Rate

No disease is really supposed to kill you. That’s kinda counterproductive to its end goal, which is to reproduce and spread to other hosts. A dead host does not move about, does not spread the virus to other hosts. The reason a lot of the big plagues were so deadly was because the diseases didn’t originally come from humans. They came from animals. The bubonic plague came from fleas and rats, the swine flu came from pigs, the coronavirus came from bats. The virus can’t differentiate between a pig’s body and your body, so it acts the same. However, what would just make a pig sick, would kill a human. So, in short, most diseases are fatal because of miscommunication.

As a worldbuilder you should keep in mind that, the deadlier the disease, the less likely it is to spread. A deadlier disease is also going to affect your world much more intensely than a less significant disease. If your disease has a 100% mortality rate, then it's probably pretty hopeless for your world to survive the outbreak. Most modern diseases have a mortality rate of 1-20%, with 20% being a VERY devastating disease. Imagine 1-in-5 of your family dying. It obviously would cause great unrest to your world. I personally would tone it down to somewhere around 5-10% mortality rate.

Treatments/Cures

There’s nothing more devastating than learning that you have a disease that has no cure. That’s terminal. Luckily for most people, many diseases, even if they aren’t fully curable, have treatments to help alleviate the symptoms. In most worlds, treatments are going to come from herbs and plants. Nature, while not an exact healer, is still pretty good when it comes to treating symptoms. Herbs can be used to relieve pain, break fevers, and treat inflammation. Most modern medicines are based on these herbs, utilizing similar chemical compounds to create the same effect. In your world, you could even consider a plant that cures your disease outright. Of course, in a situation such as that, there are other things to think about, like, will this plant grow naturally? Can it be farmed? What’s the risk of harvesting it? Would someone control it? How much would it cost on the market? Questions like these should be taken into consideration when creating treatments for your disease.

Impact on Society

Even if your disease has a cure, and even if the people of your world can band together to overcome it, society as they know it will be changed from this disease, sometimes drastically. Take for instance, the black death. During the outbreaks, many people would abandon their families and lock themselves away from society, breaking up generations of families. Faith in religion decreased drastically as people saw the church was just as powerless to stop the plague as anyone else. The price of goods increased drastically, as it became downright dangerous to be out creating, moving, or selling goods. Due to a majority of the workers dying, wages increased dramatically as nobles were desperate to find people to work their lands. Wages increased so dramatically that, after the plague, wages had actually risen higher than the cost of goods, thus increasing the quality of living for many in Europe. The new power that the peasants felt with their new money caused the aristocrats to attempt to reduce the power of the peasants. This led to the French revolt in 1358, and the subsequent guild member’s revolts in 1378. Even in modern times, with the onset of the Coronavirus, the price of goods has increased as it has become dangerous to produce them (most notably beef). Retail stores have raised their starting wages in order to attract people to work. Some predict that the coronavirus will mean the end of gestures like handshakes almost entirely. Sometimes groups can be targeted specifically for how they handle the viruses. During the era of the black death, the jewish people were targeted because they didn’t get the plague nearly as much as other groups. This was because they kept themselves cleaner, but at the time it was never thought of. There will also be groups who will resist the changes that happen in the world. Those who don’t want to be told what to do might resist what the governments of the world tell them to do, and might even do the opposite, just to “stick it to the man”

In your world, there are many things to consider when a disease hits your society. The biggest factor of cultural and societal change will be how willing to adapt your people are. Not only is this going to determine how well they survive the disease, but also how much their society will be changed after. Will sanitation become of bigger importance? Will a common gesture start to be phased out? Will people’s faiths be questioned? Remember that a disease causes economic changes as well. What becomes more valuable? What becomes cheaper? Will niche markets open up? People always find a way to profit from disaster, just take a look at the mask market for the Coronavirus. A government can also be drastically changed by a disease. How an authority governs could be dramatically changed by an infection, especially if their handling of it is good or poor. Keep all these things in mind as you continue to create your post-disease world.

Example Disease

As a quick demonstration to use all these concepts in a practical sense, let's create a disease for a world. Let’s say this world is at the same level of technology that they had during the Spanish Flu outbreak of 1918. This virus, which has been contracted from a common animal there, has been called the Minotas Virus (Minotas is “mint” in one of the common dialects). The name of the virus is attributed to the strange minty smell that comes from the skin of the infected. Other symptoms include a general feeling of malaise, a horrid cough, and as the disease progresses, bouts of amnesia, disorientation, and eventually a comatose state, which can last for a few weeks until the virus has run its course. If the infected can perform magic, the virus tints any visible magic green, and severely weakens the users abilities. If a magic user contracts the disease they are more than twice as likely to die from it than a normal person. It’s most commonly spread through coughing, however magic users can spread it through the casting of certain magics, though it is unknown exactly which magics are affected. About one in every seven people die from the disease, with almost every one in three magic users dying from the disease. At the moment, there is no known cure, however scientists have begun researching into the properties of the plant Peperitus Minatus to see if it could be a viable option for curing the disease. The disease affects magic users so strongly that the government of this world has ordered a mandatory quarantine for all those who are magically inclined. They are not allowed to leave their dwellings for anything at all. Because the symptoms of the disease are much easier to detect on magic users, many people have begun to blame the magic users for the disease, some even believing that if they were to kill off the magic users, the disease would go away. A niche market for masks has opened, as people notice that it reduces the risk of infection. As more and more magic users are afflicted, commonly available magical items such as premade potions and charms are nearly impossible to obtain. The price for these items has skyrocketed, and many are willing to pay just about anything for a magic user to begin working again. The government has been praised on its efforts to handle the pandemic, and many are confident that the virus will be eradicated within the next 1-2 years.

Well, I hope you’ve enjoyed this ramble and rant of mine on viruses. I’d like to state again that I am in no way a professional. Just someone who used to work in a hospital for like 4 months and likes creating worlds in my spare time. I hope you can take a few tidbits of information and apply them to your world. Remember, at the end of the day, it's your world, do what you want with it! I’m not sure if I’ll do more of these, but I would certainly be open to it if it was enjoyed!