The Byzantine flu is the name of a disease that was a global pandemic that began in 2010 and hit its peak in 2012. It received its name because it was most prominent in the Byzantine Empire, especially the city of Nicomedia, where it played a role in the eventual downfall of Emperor John Comnenus. It also directly affected numerous other events, such as the near total collapse of the entertainment industry in many places around the world ("The Day The Music Died"), the cancellation of the 2012 Cricket World Cup (which was to take place in Mumbai) and other events of social unrest that became known as the "nororiots".
At its peak, the flu was estimated to have infected almost 7.5 billion people worldwide and was responsible for over one billion deaths, making it the deadliest pandemic in human history. Despite its name, the Byzantine flu is caused by a strain of the norovirus, NoV GIII.2-Byz12, which was a novel strain at the time. Its origins are unknown, although since it was the first norovirus strain from cattle that infected humans, researchers strongly suspect it emerged from the consumption of unprepared beef.
No universally accepted treatment or vaccine exists for the Byzantine flu, with most countries solely resorting to containment and isolation measures to stop its spread. This means that outbreaks- especially devastating ones- still occur from time to time. Roman researchers have asserted they have developed vaccines, medicines and other therapeutic options for the disease (all of which have been approved by Roman authorities for use in their territories), but the Virtue Federation has rejected these findings. In Casara, the government has approved certain treatment options, but no vaccine has been approved there.
Like many other strains of the norovirus, the Byzantine flu spreads mostly through fecal-to-oral contact, with the primary route of spread being contaminated food and surfaces, particularly in dining rooms, kitchens and restrooms. The disease can aerosolize, doing so usually after an infected person vomits or if the toilet is uncovered after it is flushed. This means that the Byzantine flu could infect hundreds, if not thousands, of people in a single area almost instantaneously. Closed quarters are more ideal for the spread, as outdoors the disease dissipates more rapidly.
A major cause for debate among researchers is the incidence of asymptomatic transmission. Some researchers conclude that, even after someone has recovered from the disease, they can still spread the disease for up to 20 days, as the body "sheds" the disease and forces the disease to find a new host. Other researchers contend that someone who has recovered can still be infectious for as little as five days or as long as 127 days after infection, depending on the body's ability to shed the disease. Roman researchers have debunked the idea of asymptomatic transmission as have the Casarans, though Virtue authorities maintain it still happens and recommend anyone diagnosed with the Byzantine flu to quarantine themselves for 10 days after recovering from the disease.
A peculiarity of the disease is that there have been widespread reports of the Byzantine flu spreading via the respiratory and sexual routes, especially in the exchange of fluids. This has been speculated as the reason why the flu has managed to spread rapidly and become more deadly than other forms of the norovirus. Roman researchers have concluded the vast majority of these reports are conflations of sensationalized media stories, as the reports simply describe instances of when one's vomit gets into the respiratory tract and/or when sexual organs have not been properly cleaned. Though a few scientists outside of Roman lands have agreed with the Roman assessment, the consensus among health officials in both Virtue and Casara is to dismiss the Roman findings outright, calling them "faulty".
The majority of Byzantine flu cases are mild, with the disease abating after 1-3 days. Onset of symptoms usually begins within 12-48 hours after initial infection, as the Byzantine flu is processed by the body during its digestive process. Mild cases typically see the development of nausea, vomiting, diarrhea and abdominal pain, which usually also causes general weakness, lethargy, muscle aches and pains, headaches and low-grade fevers. Migraines and a loss of taste have also been reported in mild cases.
More severe cases can lead to malabsorption, encopresis (the involuntary release of fecal matter), intestinal inflammation and other damages to the intestinal tract, which can require hospitalization to resolve. In the most critical of cases, sepsis, jaundice, kidney damage and pancreatitis can occur. The skin can also thicken, making intravenous tubes difficult if not impossible to insert. This means that, in order to facilitate the absorption of nutrients by the body, invasive enemas are needed in the patient. If the treatments fail, death results from multiple organ failure due to sepsis and the failure of the body to absorb nutrients.
The fatality rate of the Byzantine flu is disputed. The observed case fatality rate is around 6%, but Roman researchers believe that, if proper hygiene practices are followed, the real fatality rate is roughly the same as other, less dangerous forms of the norovirus (0.002-0.003%). Casaran researchers agree somewhat with Roman findings, believing that proper hygiene does reduce the Byzantine flu's mortality rate, but only to 0.25%, or a similar mortality rate to the actual flu.
However, a comprehensive review of various studies commissioned by the Love organ of the Virtue Federation claims that the fatality rate of the Byzantine flu is actually around 10-12%, suggesting that "pure luck" was the reason why the case fatality rate was lower. The findings by Love have been disputed by several scientists, particularly Roman ones, claiming they are tainted by methodological flaws as well as "confirmation bias".
Antibodies developed by the body after recovery give the average person immunity for six months. Because of this, Rome (the only nation that has approved a vaccine) advises its citizens to get vaccinated twice a year to gain maximum protection against the Byzantine flu.
No universally accepted treatment options for the Byzantine flu exists. Various countries- mostly those outside of Virtue territory- have approved treatment options of their own, including medicines and even vaccines, though none have gained widespread acceptance. The Virtue Love organ maintains that it has found "no credible, universal therapeutic for the Byzantine flu", telling doctors that their only treatment option is symptom management "to the best of your abilities".
In the Roman Empire, several provincial health centres and universities developed medicines of their own, with some developing vaccines. Early on, Roman authorities believed multiple options were needed to quickly quell the disease, and this strategy turned out to be successful. Of these therapeutics, the most successful have been the University of Rome's drug Ventrexat, developed early in Rome's epidemic, and the vaccine developed by the University at Buffalo, the Byznov Bullseye (so named because "Bullseye" refers to any vaccine developed by UB, while "Byznov" is short for "Byzantine Norovirus"). Those two are now the first choice among health officials across the Empire, though the other products developed for the Byzantine flu are used if patients need them. A vaccine is not required in Rome, although those with compromised immune systems as well as those who work in the food and hospitality industry are encouraged to get vaccinated.
In Casara, researchers at the University of Tepitilan developed their own drug, Comaset, which turned out to be effective in containing their own epidemic. Since then, the Casarans have also taken to importing Ventrexat, which they also use for treatment. The Casarans have yet to approve a vaccine for treatment against the Byzantine flu, although clinical trials for the Byznov Bullseye began in 2018 and are ongoing.
The Byzantine flu was first discovered in 2012, although anecdotal evidence suggests that the disease had been spreading in rural areas of the Duchy of Muscovy and the Novgorod Republic as early as January 2010. Because the strain originated in cattle, it is suspected that the first case came from consuming contaminated beef. The first confirmed cases of the Byzantine flu were diagnosed on January 8, 2012, when over 114 members of a Byzantine Christian missionary group were admitted to the hospital at the Constantine The Great International Airport in Constantinople. Each member complained of stomach problems at the hospital, reporting the onset of symptoms either during or shortly after their flight which had originated in Moscow. 25 of the patients in that initial group died, though all were over the age of 80 and had other underlying medical conditions.
Spread in Byzantium
The hospital and eventually the airport became the epicentre for the spread of the illness, with caseloads ballooning into the thousands in merely a couple of days. Byzantine Emperor John Comnenus ordered the airport shut down and redirected air traffic to nearby Adrianople, though this failed to stop the spread. By February 1, some 1,067 cases had been reported in the Byzantine Empire with 195 deaths, forcing John to place the entire country on lockdown beginning on February 5. John ordered all businesses across Byzantium to close with their assets officially seized by the Byzantine government, with only workers working in utility services (such as water and electricity), banking and healthcare (including researchers) to continue their jobs. The Byzantine Army then handled all other matters, including the delivery of essential goods to the citizens. To help with demand, an Internet application for both personal computers and smartphones was developed for citizens to request items, such as groceries, that they needed, and the Army hired some 500,000 civilians to facilitate these new tasks. Byzantine citizens were initially ordered to stay completely inside their homes, although this was later amended to allow for walks and exercise with a 2km radius of their home, but only within urban areas.
Despite the draconian measures (with some research even suggesting because of it), the spread of the Byzantine flu continued unabated. In the days leading up to Easter, the cumulative case total would surpass 400,000 and the death total would surpass 200,000, giving the disease a staggering 50.92% case fatality rate. John announced "there would be additional measures implemented" during his Easter Address, but did not specify what they were. Whatever measures they were seemed marginally effective at best, as the case fatality rate dropped below 40% but total cases surged past two million and total deaths passed the one million mark in early May. On May 2, the first of what would be later dubbed the "nororiots" occurred in Constantinople, where protesters- demanding answers from John- successfully smashed the gates at the Hippodrome and filled the arena for the first time in months. The Army spent days trying to disperse the crowd, eventually doing so on May 6 (when the virus' death total would officially surpass the one million mark), but it did little to ease tensions in the Byzantine Empire.
The Virtue Federation recorded its first cases when a cluster of cases were discovered in London, England on January 10, 2012. The cases were connected to tourists who had just returned from Constantinople, and it was found that the toilet on the plane they were on tested positive for the disease. This initial batch of cases all completely recovered, with none of them receiving hospitalization. Because of this, English officials did not worry much about the virus, taking no action to stop its spread.
This critical inaction allowed the Byzantine flu to spread across the entire Federation essentially unabated. By January 22, the Love organ reported 19,116 cases across the Federation with 2,367 deaths. By early February, the disease's totals rose to over 100,000 cumulative cases and 10,000 cumulative deaths, leading to Love urging the same drastic measures that the Byzantines had imposed. The vast majority of Virtue's members followed suit by Valentine's Day, meaning that some 80% of the world's population at the time (12 billion out of 15 billion) were under some form of lockdown intended to contain the spread.
The first cases in Casara happened on January 22, 2012, when some 145 cases came from returning home from an Odyssey Tour cruise in the Mediterranean. The tour originated in Corinth where some Byzantine passengers were picked up- it is suspected that the virus infested the tour at this point. The cruise itself managed to escape major damage, as only 300 of the cruise's 7,000 passengers fell ill to the virus, but it was found that the team responsible for cleaning the cruise's third floor did an inadequate job, which proved to be the source for many of the cruise's cases.
Once on Casaran soil the Byzantine flu proved difficult to contain. A major factor in the Casarans' inability to handle the Byzantine flu stemmed from the fact that the vast majority of Casarans live in dormitory-style buildings provided for them by the government, as few Casarans- as is their custom- actually own their own home. This meant that lockdowns were inadequate as a containment measure, since the average Casaran lived amongst a large gathering to begin with. This meant that, despite Casaran authorities doing their best to improve sanitary conditions in the housing complexes, Casara still saw rapid rises in case totals, reaching over 1,000 cases and 200 deaths by mid-February. There were fears then that the Byzantine flu would wreck havoc on Casara to an even greater extent than it did in Byzantium, but Casara's overall healthier population and more advanced sanitation conditions and practices than the Byzantines (and Virtue as a whole) meant the reality was not that bad. Still, the worries sparked massive research projects into the disease, meaning Casaran researchers were the first worldwide to start developing medical interventions aimed at battling the disease.
The first Roman cases- 45 in total- stemmed from that same Odyssey Tour that produced the first Casaran cases. Of those 45, ten needed hospitalization, and two of them died.
Like the English- and some say, because of their rivalry, because of the English- the initial Roman response was one of inaction. This also allowed the virus to spread unabated across the Empire, and do so widely, with cases reaching 225 on February 11. Concerns did get raised, as an outbreak at a nursing home in Alexandria caused death totals to spike considerably, worryingly raising the case fatality rate in the Roman Empire to 58.52%, 8% higher than in Byzantium.
However, Roman Emperor Valerius IV ignored calls for lockdowns, as did numerous health and government officials across the Empire. The Romans took a more evidence-based approach, treating the Byzantine flu like other noroviruses, meaning they focused their efforts on improving sanitation conditions- already the best in the world- as a means of mitigation. This meant the virus' spread and potency were greatly reduced across the Empire as time wore on. However, in Egypt, where the Romans only had a protectorate and thus couldn't devote as many resources as they could elsewhere, the virus still proved to be a source of some difficulty. By March, Egypt wound up accounting for 70-75% of all Roman cases, as well 95% of their deaths. This spurred research efforts across the Empire for medical interventions, with Valerius pouring some
x1 trillion into those efforts.
By April, all major governments were in agreement that the Byzantine flu was a global pandemic, the first since the so-called Spanish flu of 1918-19. Over the next few months, the virus spread rapidly and exponentially worldwide.
In Byzantium, the disease hit its peaks at the end of April, but numbers remained steady well into May and into June. Elsewhere, within the rest of the Virtue Federation, the Roman Empire and Casara, the pandemic hit its peak in mid-June, with numerous hotspots emerging. In addition to Byzantium, Virtue experienced hotspots in Germany, Scandinavia, Persia, Peru, Ireland, Australia, and the Niger River Federation, although every nation in the Federation experienced difficulty. Within Roman territory, Egypt was a particular sore spot, as the Byzantine flu rose rapidly there and accounted for 99% of the Empire's total deaths after April 15. In Casara, the capital, Tepitlian, was particularly hard hit owing to its density, but border areas with the NRF also experienced problems.
For the main article and a complete listing of Byzantine flu protests, see Nororiots.
With the disease spiraling out of control, numerous protests emerged that eventually came to be known as the "nororiots". The first known incident of the word came in the Glasgow Times on April 12, 2012, when writer Marsha McKinley weighed in on the Byzantine situation. In her piece, she believed that if Byzantine Emperor John Comnenus didn't get a handle on the disease soon, he would be faced with "nororiots very soon". McKinley claims she did not actually create the term, but is coy with where it actually originated from.
The first actual nororiot occurred on May 2-6, when protesters smashed the gates of the Hippodrome and filled the stadium's seats, for the first time in months. The Byzantine Army eventually managed to disperse the crowd, who were satiated when John pledged to come up with a solution "soon", even though he did not specify what that was. On May 11, more protests broke out across Byzantium in response to cities cancelling in-person celebrations of the Byzantine New Year, commemorating the Founding of Constantinople.
On May 15, two days after a report by the Roman Free Press claimed that Byzantine soldiers were routinely ignoring sanitation practices before delivering items, John pledged to review sanitation procedures as well as the Army's compliance to them. Though John was vague when asked what changes he implemented, whatever they were, they seemed to abate the disease's spread somewhat. The effects of this have been disputed by researchers, who claim that the spread in Byzantium simply slowed because the populace had increased immunity to the disease.
On May 29, the anniversary of the Fall of Constantinople, over 30,000 protesters gathered to surround the Palace of Daphne. At first, the protesters demanded what they had always demanded of John- some kind of tangible solution to the disease- but, later in the day, calls intensified for John to resign. This happened because the protesters and the Byzantine Army got engaged in violent confrontations in an event later described as the Citizens' Sack of Constantinople, which would last until June 12. Witness reports conflict on which party began the Sack, with Army officials stating the protesters became violent and the protest organizers insisting the Army "egged them on". Whatever the case, the entire city became a battleground for weeks, with lots of looting, pillaging, burning and other acts of outright disobedience taking place.
The Sack only ended after John agreed to meet the organizer of the protests, a man from Argos who named himself Perseus, after the legendary hero. Perseus left the meetings satisfied, but after addressing his followers and outlining John's plan to contain the pandemic and end the lockdown, he was arrested and sent to the notorious prison, the Prison of Anemas, where Perseus would state he was tortured every day. More protests erupted- though they were not as violent as ones during the Sack- calling for Perseus' release, with Perseus' cause later being taken up by John's daughter, Alexia.
As the cumulative case and death tolls inched closer and closer to the one billion mark, many riots broke out elsewhere across the Virtue Federation. The most notable of these were the Summer of Tears in the Mongol Khanate, where weekly- and sometimes even daily- protests were brutally and unashamedly put down by the Mongol Army, with millions dying over the summer months. Other notable protests were the Trafalgar Square Riots in London in June and July and the Protests at Darius' Gates in Persepolis in the first two weeks of August, where millions battled local law enforcement and military units for days on end.
Overall, from April 1 to November 22, 2012, the Virtue Protectors report having engaged in 42,619 different operations across the Federation at this time, deploying some two million troops in the process. Anecdotal evidence and other research has shown that these totals are vastly under-reported, as the Protectors may have been engaged in over 100,000 different operations- many of them clandestine- with over ten million soldiers deployed. It is suggested that Virtue under-reported its operations to hide its numerous human rights abuses during this time, of which abundant evidence exists.
In Roman territory, the only significant riots occurred in Egypt, but these proved difficult to contain. Right from the outset, Egyptian activists called upon Rome to withdraw its troops and grant Egypt its independence, calls that only got louder as the disease continued to spread in the country. Caesar Valerius at first stated that "independence was off the table" on February 22, but on June 2, at a press scrum, Valerius stated he was now "thinking about it".
As the summer wore on, the Egyptian independence movement gained momentum, continuing to do so even after the Romans managed to control the pandemic in the country. Anger mounted over Valerius' mishandling of the pandemic in the country, leading to a terrorist attack at the Vatican in 2013 followed by an attempted coup by the attack's organizers, Cardinal Wilhelm Claes and Decius Tarsus. The Roman Army invaded and successfully defeated the coup attempt, but public opinion forced them to eventually recognize Egyptian independence on October 15, 2013.
While there were no violent protests in Casara concerning the pandemic, the Casarans engaged in a unique series of protests during the summer known as the Forbidden Raves. Here, in defiance of public policies prohibiting mass gatherings in Casara, thousands would gather in each city and town across the Casaran Empire, throwing massive, rave-style events that literally went day and night. They first began in the southern Fezzan outpost of Migan at the end of April before eventually spreading across the Empire by the beginning of June.
The organizer of the event in Migan, Krisa Starcos, stated she wanted to stage the events to prove to Casaran officials that these events- with proper precautions- could still take place. Starcos based her explanation on the Roman model, as she noted the Romans were successful at containing the Byzantine flu (outside of Egypt) without having to ban gatherings. She also noted that banning gatherings went against Casara's communal and friendly spirit, and she did not want the virus to change that. The Casaran Empress, Psyia Gdinuk, met with Starcos on June 12, and, days later, lifted the bans on gatherings, deciding to instead emphasize heightened sanitation measures, which changed Casara's fortunes for the better.