How the first pandemic in history shook the Roman Empire

Recently, a viral TikTok trend had women baffled about how often men think about the Roman Empire.

“Three times a day,” answered one woman’s fiancé in a TikTok video. “There’s so much to think about,” he explained, eliciting a stunned look into the camera from his soon-to-be wife.

“They built an entire world-dominating society,” another man exclaimed.

“Actually I was just having a conversation about their aqueducts and the fact that they had concrete that could harden. … How the hell did you know that?” answered another person who said they think about ancient Rome “at least once a day.”

Why Ancient Rome Still Fascinates

Do men really ponder ancient Rome more than women? Seems like it. I honestly don’t know. But let’s face it: there are many awesome things about Rome and the empire’s legacy is undeniable. The separation of government branches — executive, legislative, judiciary — was pioneered by the Roman Republic over 2,500 years ago. While they didn’t make the first laws, the Romans introduced a number of legal innovations such as trial by jury, civil rights, personal wills, and business corporations.

As someone on TikTok quipped, Roman technology and engineering were fantastic for its day and age. Famous examples include roads, aqueducts, bridges, and breathtaking architectural feats like the Roman Pantheon upon which the U.S. Capitol building is based. Many of these technologies, like concrete, were lost to the Dark Ages only to be rediscovered over a thousand years after the empire fell. Add innovations in public office and administration, commerce, military organization, culture, and even cuisine, and it’s clear why the empire is a significant historical reference point.

At the height of the Roman Empire under Emperor Trajan during the early second century AD, the Roman Empire stretched over 5,000 km from the Atlantic coast of northern Britain, through Europe to the Black Sea, and from there to the Red Sea and across North Africa to the Atlantic coast back again westwards. A quarter of the world’s population lived within this vast territory.

This apex coincides with the so-called Pax Romana (literally “Roman Peace”), a roughly 200-year period of relative peace, order, and prosperity that began with the founding of the Empire after Julius Caesar was assassinated and ended with the reign of the infamous Emperor Commodus in 180 AD.

The Good and the Bad

But all good things must come to an end. Indeed, while we’re at TikTok trends, ask your fiancé about what exactly about Rome they’re contemplating. If I were a betting man, I’d wager that ‘why Rome fell’ would make the top three. Maybe it’s nostalgia, maybe it’s just the current zeitgeist and its post-civilization vibes, but people have been romanticizing the rise and fall of the Roman Empire for centuries.

Despite the Roman propaganda, the Pax Romana wasn’t all rainbows and unicorns. This was a dog-eat-dog society with huge disparities between the rich and the poor. Naturally, this fueled much unrest among the melting pot of dozens of different subdued cultures. Economic instability, military overreach, political corruption, and invasions by barbarian tribes gradually but surely eroded the mighty Empire.

But what may have been the straw that broke the camel’s back was something truly scary — and something all too painfully relevant despite the two millennia of separation: a pandemic.

Pox Romana: Unpacking the Plague’s Legacy

In his new book, economic and social historian Colin Elliott of Indiana University Bloomington explored how a single disease, the Antonine plague, may have brought Rome to its knees. Aptly titled “Pox Romana: The Plague that Shook The Roman World” (2024), the book skillfully dissects the social fabric prior to, during, and after the Antonine plague swept over the empire. The book paints a vivid picture of the impact of the world’s first pandemic in recorded history.

The timing of the Antonine plague — believed to be a pandemic caused by a smallpox-like virus, although not as severe as the strains that would hit Europe much later — couldn’t have been worse. Elliott argues that the tail-end of the Pax Romana was rife with disequilibrium in many sectors, which made a pandemic all the more likely and destructive. Under the veil of gold lay a very fragile system.

The author makes his case using scholarly works, archaeological evidence, and very creative proxies like “nilometers” that measured floods in Egypt that could make or break harvests. Malnutrition is festering ground for all manner of diseases because the human immune system is no longer optimal, and around the time the Antonine Plague broke out in 165 AD, famines were common.

Maybe disappointing for some, much of what is said about the Antonine Plague borders speculation and reads more like educated guesses and assumptions. How many people did the pandemic kill and what was the demographic impact? What pathogen caused the pandemic? Was it an orthopoxvirus or influenza? When did the pandemic end? You’ll find no truly satisfying statistic in the book, and I believe this is no fault of the author.

Limited but Compelling History

The paleoarchaeological and genetic evidence of the plague’s nature or impact is sorely lacking. Still, the historical records make it clear the Antonine Plague was a fact of life, lasted decades, and was bad enough to be mentioned in countless accounts, always in unflattering terms.

Elliott is working with limited information and, like a good detective, is trying to piece together the many different bits and pieces. He tries to form a cohesive picture of how the Antonine Plague may have broken Pax Romana, along with climate change, geopolitics, poor rulers, and a host of other things that converged together at the worst possible moment. The overarching theme here, it seems, is that the Empire was dry tinder and the Antonine Plague was the match. And it wasn’t just Rome. This was a pandemic, after all. For instance, Elliott is confident that the pox-like Antonine plague agent affected Asia causing instability as far east as China.

The response of Rome to the disease was pitiful but unsurprising for a society that had zero knowledge about germ theory. They doubled up on sacrifices and persecuting Christians (who were the perfect scapegoats due to their refusal to bow down to the Roman pantheon of deities). Doctors like the famous Gallen delivered their best concoctions that were borderline snake oil. Meanwhile, the elites fled to their villas away from crowded urban centers. Even the two co-emperors Marcus Aurelius and Lucius Verus, great veterans of huge wars in Parthia and Germany, became cowards. The latter is believed to have succumbed to the Antonine Plague in 169 AD.

Overall, Pox Romana is a great read, especially if you’re a Roman history buff. That’s because the work goes beyond the Antonine plague and makes a comprehensive argument about the end of Pax Romana in broader terms — sharing many nuggets of wisdom and insights about the imperial system or simply what life for the common folk was like during these trying times.