The Pestilence

The disease causing so much upheaval in the world of our campaign is called the Pestilence, and it first appeared in the nation of Lefwyne three years prior to the beginning of the campaign. Its exact point of origin is unknown, but it is widely purported to have begun to spread among Lefwynian nobility in the western part of the country, and was therefore not properly termed a *plague* until cases began to appear in working-class individuals. The high rate of contagion went undetected for several months after the first outbreaks, by which point trade between Lefwyne and the neighboring nations had already ensured the spread of infection. Initially, the disease spread along trade routes, particularly rivers and sea ports; from there, it entered major cities and military garrisons, which enabled it to move into the countryside.

Responses to the Pestilence on a local and national scale have varied. Lefwyne, the country most severely affected thus far, has instituted a system of hospitals and plague houses where the sick can be brought, and formed a large force of healers and clerics. These were overwhelmed within the first year, however, and there is little public confidence in their efficacy given the high death toll in every strata of society. Orphanages and workhouses are also overwhelmed with bereaved and displaced persons who could no longer support themselves following the loss of families or carers.

The rapid appearance and spread of the Pestilence in Lefwyne rendered public policy changes moot, and the inefficiency of and lack of options for large-scale government intervention has resulted in a general attitude of despair and resignation in many parts of the country. Individuals and households have been left to manufacture their own means for avoiding infection; these range from the use of masks containing mustard and other bitter aromatics, to decampment from urban centers into the countryside, to the isolation and exile of exposed or infected persons. As of the time of the campaign, around one in every ten Lefwynians has been exposed to or contracted the Pestilence, with a roughly thirty-five percent mortality rate in the event of infection; the current death toll stands in the several tens of thousands – a devastating loss for a nation of only a few million.

Though less vulnerable than Lefwyne, Corrisgaul has also been hit hard by the plague due to its high population density, comprising a single vast city with little or no space between dwellings. The vital role played by magic and technology, and the cultural emphasis on neatness, has aided in quarantine efforts, lowering the overall infection rate; but the overall death toll has been proportionately higher than that of Lefwyne at around fifty percent mortality. The reasons for this are not yet fully understood, but are likely related to the fact that in such a populous city, outbreaks are massively consolidated around small geographical points – a thousand may sicken in a radius of a quarter mile. The economy of Corrisgaul, so profoundly dependent on the importation of crops, is itself a victim of the plague due to the closure of shipping and trade routes; the nation is currently in the throes of a famine and subject to severe food rationing.

The Peleth Islands, with their bustling sea ports and numerous canals, have proven to be danger zones for infection. Over the three years of the Pestilence’s reign, several of the islands have made efforts to shut down sea trade, but these attempts quickly gave way to panic as Pelethian citizens went into open revolt over what they viewed as the loss of their professions. The resulting social upheaval, in conjunction with a number of deaths among the most powerful members of the ruling families, have resulted in a power vacuum and a long season of intensified conflicts between the governing bodies of the Islands – creating the perfect atmosphere for a flourishing piratical class. Amonderre Sev’rene, a country whose governing systems are disjointed and fractious at the best of times, has become insular and cautious in the face of the plague, leaning heavily on its acres of arable land and livestock and suffering enormous losses to its peasant classes.

On the other hand, nations with smaller populations and fewer urban centers, such as Fallstaff and the Meadows of Clarity, have had lower rates of illness and death; the greatest challenge to these countries has been preventing cross-border travel and dealing with the economic crash. The Meadows of Clarity have exported a number of healers to the most affected countries, but their rulers are unwilling to accept many refugees, due to the ancestral sanctity of their lands and the many historic attempts at conquest they’ve weathered. Fallstaff, whose ten-year nations summit was held in the second year of the Pestilence’s reign, suffered a number of outbreaks in the Lorena river delta, following which representatives put out a scattering call. The land’s many disparate peoples spread out across the country in a bid to avoid infection via crowds, and several important leaders have not been heard from since.

Demor Lant was the only nation in the Circle of Seven to close its shipping routes and canals while opening its national borders to refugees. It is also the only nation in the Circle whose citizens have not yet been strongly affected. The black dragon Tefyrthana – known to be immune to the Pestilence – has made it her mission to relocate orphans and displaced populations of other nations to her own safer shores, following an extensive screening process. There are two major processing grounds for refugees, where the ships of Tefyrthana’s charitable fleet land and launch from – Nereth on the southwestern coast, and the Bay of Furness to the north. Demor Lant’s medical facilities and personnel, not being overwhelmed with patients to the level of other countries, are generally thought to be more effective than elsewhere; many major cities have opened large hospitals or Wellness Centers for the care of patients. People in other lands have begun to look to Demor Lant as the last bastion of safety from the disease, and with each year the number of people applying for passage aboard Tefyrthana’s ships grows.

After three years of steady spread, there is currently no known cure or fully effective treatment for the Pestilence. Once an individual is exposed and infected, symptoms take around five-to-seven days to appear. The initial stage usually involves a high fever accompanied by dehydration, vomiting, and weeping sores in the mouth and throat—this is the stage that is most often partially or fully recovered from, if the patient receives rigorous medical attention quickly. Hemoptysis, or bloody sputum, appears in the second stage, which most often occurs two days into the illness and is the most consistently lethal stage due to blood loss and lack of oxygen. Gangrene of the extremities is observed in the final stage if the illness enters the blood, which the patient may or may not survive. Given the lack of effective address, the best course of action is usually to treat the individual symptoms of the illness; a well-equipped hospital will try to provide patients with anti-emetics and electrolytes in an effort to reduce dehydration, with anti-inflammatories to bring down fever and close sores. Keeping the airway free is generally more difficult, and may require minor intervention through the mouth to clear the throat of membranes or major surgery. Procedures involving the removal of lung or throat tissue have had a higher rate of recovery for severely ill patients in the second or third stage, but are considered extremely dangerous and difficult, requiring equipment and magic which most hospitals do not have access to. Across the Circle of Seven, roughly twenty-five percent of patients die of the Pestilence following the appearance of symptoms, though the rate varies with location and availability of medical resources. Another forty percent of patients experience less severe but prolonged symptoms following recovery, including coughing and recurring sores, which require long-term care and may result in chronic pain.