When researchers examined plague burials at a 17th century hospital in Switzerland, they found that a majority of victims were young labourers, likely of lower social status. According to a new study, the burials demonstrate how socioeconomic conditions can impact mortality during an infectious disease outbreak. “The ability to recover normal physiological functioning following overexertion or illness is not the same for every individual and this ability is heavily influenced by social status,” the study explained. “If a person cannot ensure their basic needs are met without working constantly, healing or recovery is often foregone.” For the study, researchers investigated human burials at a monastery-turned-hospital in Basel, Switzerland that was linked to the country’s last recorded plague outbreak, which occurred between 1665 and 1670. “The COVID-19 pandemic raised many questions about social inequality,” lead researcher and University of Basel osteoarchaeologist Laura Rindlisbacher said in a news release. “We wanted to explore these same questions for our Early Modern sample.” Osteoarchaeologists analyze skeletal remains to better understand past lives. In Switzerland, DNA analysis confirmed the presence of the plague-causing bacteria Yersinia pestis in several of the remains and on a clay pipe found at the site. The 15 individuals that were studied had an average age of 17.7 years at death and many of their skeletons displayed signs of physically demanding work, such as wear and tear of the spine and shoulders, indicating they were of lower social status. “Work strain was of particular interest for us, as this represents one of the most important factors for vulnerability during a pandemic,” Rindlisbacher said. “If somebody can’t forego work to survive, even the danger of contracting a deadly disease cannot stop these persons from working.” From plague to COVID The researchers draw clear parallels to the COVID-19 pandemic, which also demonstrated how socioeconomic status can impact vulnerability, as some had to continue working for essential income, despite risking infection by being around others. “It was striking to observe the extent to which young lives were cut short by the plague, especially the lives of disadvantaged lower-class youths already subject to hard and frequent labour,” Rindlisbacher said. “We were also surprised by how clearly some of the social determinants of well-being and survival observed during the COVID-19 pandemic also emerged for the Early Modern period.” Published in Antiquity, a peer-reviewed archeology journal, the study also points to other related factors that can play a role in surviving a disease outbreak, such as how citizenship status and the existence of social support networks can impact the likelihood that someone receives the medical attention they need. “During a crisis or epidemic, social status has a decisive influence on mortality, with access to essential goods or institutions and overall social cohesion determining the probability with which groups of people fall ill, need care or die,” the study stated. “The recent COVID-19 pandemic demonstrated how deeply socioeconomic status influences the vulnerability of specific social groups, but this is not a new phenomenon.”