Today, May 7 2023, I am planning to make some updates to this piece for historical accuracy. As part of this update, I’m including some citations and commentary in this comment.
I feel torn writing about some of these, because it’s attempting to summarize and quantify an incomprehensible quantity of suffering and death. The numbers are important, to recognize what was lost, to honor the fallen as best we can, and to emphasize the importance of killing Smallpox. But quantifying that loss, for me at least, requires temporarily embracing a detached attitude, especially when the clues are many and uncertainty is abundant. So that is how I will be describing citations and numbers for the remainder of this comment—and then, when I’ve collected as many citations and clarified as many estimations as I can, I will grapple with them as a human.
“[A] thousand Europeans every day in the 18th century” is from the Wikipedia page. Specifically, “400,000“ annual deaths.
[Update] The text originally said that Smallpox killed “more than fifty million Native Americans”. I cannot find any source I might have originally used for this claim. When attempting to research this more recently, I came across the 2019 paper “Earth system impacts of the European arrival and Great Dying in the Americas after 1492”, which estimates 55 million all-cause deaths from European contact across the Americas between 1492 and 1600. “Counting the Dead: Estimating the Loss of Life in the Indigenous Holocaust, 1492-Present” is part of a body of literature exploring the interplay between disease and intentional violence, which further complicates things. Lots of things can make people vulnerable to disease. If a family is forced to relocate, goes hungry, and subsequently are weaker when they fall ill, it seems incorrect to say that the illness alone killed them. All told, disease is widely agreed to be the most significant contributor to the great dying of the Indigenous Peoples of the Americas, and of the diseases Smallpox was probably the most significant killer. Given the complexities and uncertainties here, when I finish writing this comment, I intend to update the text to “over ten million Native Americans” as a lower bound that I feel 80% confident about. I think I could refine this further with more research—this is still extremely ad hoc—but this is as much time as I can afford at the moment.
[Update] “In China, in the 10th century, humanity began to fight back.” I believe I originally got this figure from Our World In Data, but now believe it to be inaccurate. There are “references” that say the tradition dates back to the tenth century, but the evidence is sparse. Going by Wikipedia’s article on Variolation, I’m updating this to “the 15th century”.
Edward Jenner, 1796: Wikipedia. I’m choosing the day of the first inoculation (James Phipps) on May 14, 1796 rather than the publication date of the resulting paper, Inquiry into the Variolae vaccinae known as the Cow Pox, in 1798.
From here on most of the narrative can be traced through the Eradication section of Wikipedia’s article on Smallpox: - “On August 26, 1807, Bavaria became the first country in the world to introduce compulsory vaccinations.” —“In Northern Europe a number of countries had eliminated smallpox by 1900”. - “In 1958 Professor Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox.” —“In 1966 an international team, the Smallpox Eradication Unit, was formed under the leadership of an American, Donald Henderson.[127] In 1967, the World Health Organization intensified the global smallpox eradication by contributing $2.4 million annually to the effort, and adopted the new disease surveillance method promoted by Czech epidemiologist Karel Raška.” —“To eradicate smallpox, each outbreak had to be stopped from spreading, by isolation of cases and vaccination of everyone who lived close by.[129] This process is known as “ring vaccination”.” —“The WHO established a network of consultants who assisted countries in setting up surveillance and containment activities.” —“donations of vaccine were provided primarily by the Soviet Union and the United States” —“The last naturally occurring case of indigenous smallpox (variola minor) was diagnosed in Ali Maow Maalin, a hospital cook in Merca, Somalia, on 26 October 1977” —“The global eradication of smallpox was certified, based on intense verification activities, by a commission of eminent scientists on 9 December 1979 and subsequently endorsed by the World Health Assembly on 8 May 1980.”
Today, May 7 2023, I am planning to make some updates to this piece for historical accuracy. As part of this update, I’m including some citations and commentary in this comment.
I feel torn writing about some of these, because it’s attempting to summarize and quantify an incomprehensible quantity of suffering and death. The numbers are important, to recognize what was lost, to honor the fallen as best we can, and to emphasize the importance of killing Smallpox. But quantifying that loss, for me at least, requires temporarily embracing a detached attitude, especially when the clues are many and uncertainty is abundant. So that is how I will be describing citations and numbers for the remainder of this comment—and then, when I’ve collected as many citations and clarified as many estimations as I can, I will grapple with them as a human.
Much of the narrative is just from Wikipedia’s page on the History of Smallpox. This has changed a bit since 2014.
The figure “500 Million” comes from Donald Henderson by way of Our World in Data.
”Five million in India” comes from this article by Eugene D. Robin, Robert F. McCauley in the Indian Journal of Medical Ethics, 1997.
“[A] thousand Europeans every day in the 18th century” is from the Wikipedia page. Specifically, “400,000“ annual deaths.
[Update] The text originally said that Smallpox killed “more than fifty million Native Americans”. I cannot find any source I might have originally used for this claim. When attempting to research this more recently, I came across the 2019 paper “Earth system impacts of the European arrival and Great Dying in the Americas after 1492”, which estimates 55 million all-cause deaths from European contact across the Americas between 1492 and 1600. “Counting the Dead: Estimating the Loss of Life in the Indigenous Holocaust, 1492-Present” is part of a body of literature exploring the interplay between disease and intentional violence, which further complicates things. Lots of things can make people vulnerable to disease. If a family is forced to relocate, goes hungry, and subsequently are weaker when they fall ill, it seems incorrect to say that the illness alone killed them. All told, disease is widely agreed to be the most significant contributor to the great dying of the Indigenous Peoples of the Americas, and of the diseases Smallpox was probably the most significant killer. Given the complexities and uncertainties here, when I finish writing this comment, I intend to update the text to “over ten million Native Americans” as a lower bound that I feel 80% confident about. I think I could refine this further with more research—this is still extremely ad hoc—but this is as much time as I can afford at the moment.
“more soldiers and civilians than any weapon, any soldier, any army”: See Wikipedia’s “List of anthropogenic disasters by death toll”
[Update] “In China, in the 10th century, humanity began to fight back.” I believe I originally got this figure from Our World In Data, but now believe it to be inaccurate. There are “references” that say the tradition dates back to the tenth century, but the evidence is sparse. Going by Wikipedia’s article on Variolation, I’m updating this to “the 15th century”.
Edward Jenner, 1796: Wikipedia. I’m choosing the day of the first inoculation (James Phipps) on May 14, 1796 rather than the publication date of the resulting paper, Inquiry into the Variolae vaccinae known as the Cow Pox, in 1798.
From here on most of the narrative can be traced through the Eradication section of Wikipedia’s article on Smallpox:
- “On August 26, 1807, Bavaria became the first country in the world to introduce compulsory vaccinations.”
—“In Northern Europe a number of countries had eliminated smallpox by 1900”.
- “In 1958 Professor Viktor Zhdanov, Deputy Minister of Health for the USSR, called on the World Health Assembly to undertake a global initiative to eradicate smallpox.”
—“In 1966 an international team, the Smallpox Eradication Unit, was formed under the leadership of an American, Donald Henderson.[127] In 1967, the World Health Organization intensified the global smallpox eradication by contributing $2.4 million annually to the effort, and adopted the new disease surveillance method promoted by Czech epidemiologist Karel Raška.”
—“To eradicate smallpox, each outbreak had to be stopped from spreading, by isolation of cases and vaccination of everyone who lived close by.[129] This process is known as “ring vaccination”.”
—“The WHO established a network of consultants who assisted countries in setting up surveillance and containment activities.”
—“donations of vaccine were provided primarily by the Soviet Union and the United States”
—“The last naturally occurring case of indigenous smallpox (variola minor) was diagnosed in Ali Maow Maalin, a hospital cook in Merca, Somalia, on 26 October 1977”
—“The global eradication of smallpox was certified, based on intense verification activities, by a commission of eminent scientists on 9 December 1979 and subsequently endorsed by the World Health Assembly on 8 May 1980.”
Thank you.