This article is an adapted form of an essay that will appear in Themelios 45.1 (April 2020).
So thou, sick world, mistak’st thy self to be
Well, when alas! thou’rt in a lethargy. . . .
There is no health; physicians say that we,
At best, enjoy but a neutrality.
And can there be worse sickness than to know
That we are never well, nor can be so?
—John Donne, “An Anatomy of the World”
Once again, the terrifying term “pandemic” has been headline news. On December 31, 2019, Chinese health officials reported cases of serious respiratory sickness in people associated with a large market in Wuhan, China. This outbreak was soon linked to a “novel coronavirus” (later given the innocuous name “COVID-19”), and the World Health Organization declared “a global public health emergency” due to the deadly virus. On March 11, 2020, the World Health Organization characterized COVID-19 as “a pandemic,” with confirmed cases of the virus in well over 100 countries, thousands of confirmed deaths—and thousands of new cases being reported each day. The Center for Disease Control ominously warns that there is “no vaccine to protect against COVID-19” and “no specific antiviral treatment for COVID-19.” Despite the stunning scientific advances in our modern age, medical providers and researchers weren’t prepared to counter this coronavirus when it burst on the scene. Without vaccine or cure, the Chinese government turned to containment, imposing residential lockdowns that impacted over half the country’s population. The global spread of the coronavirus prompted nation-wide lockdowns in Italy, and other countries, severe travel restrictions, closures to schools and businesses, and cancellations of various major sporting events. The president of France even declared “war” on the invisible enemy. Churches on multiple continents have even been forced to cancel or modify corporate worship services.
The coronavirus pandemic is the latest in a long line of disease outbreaks that have wreaked havoc on humanity over the centuries, and it will very likely not be the last. This article offers theological, historical, and pastoral reflections on disease and sickness.
Disease in Biblical Perspective
Disease and death have indelibly marked the human experience east of Eden. In the beginning, there were no rogue parasites or harmful germs—everything was “very good” (Gen. 1:31). Then everything changed when sin entered the world and “death through sin,” and creation itself “was subjected to futility” (Rom. 5:12; 8:20). Though the Old Testament (OT) does not explicate this point, the realities of sickness and disease accompany the “thorns and thistles” of creation’s curse and humanity’s “dust . . . to dust” sentence. Without sin, human beings would experience neither death nor illness, which serves as “death’s prelude.”
Disease and death have indelibly marked the human experience east of Eden.
The OT emphasizes that Yahweh alone has the ultimate authority to “wound” and to “heal” (Deut. 32:39; cf. Job 5:18). Yahweh strikes Egypt with various “diseases” yet promises to heal and protect his people if they heed his voice (Ex. 15:26; Deut. 7:15). Likewise, when the Philistines capture the ark, Yahweh afflicted them with tumors and caused “a deathly panic” (1 Sam. 5:6–12). “Pestilence” is also one of Yahweh’s four dreadful judgments against Israel, along with war, famine, and wild beasts (Ezek. 14:21; cf. Deut. 32:24–26; Rev. 6:8). On several occasions in the OT, Yahweh afflicts his people with pestilence because of their unfaithfulness. For example, in response to David’s sinful census, Yahweh strikes the land with his “sword” of pestilence, and 70,000 men of Israel perished (1 Chron. 21:12–14). Because Jehoram “walked in the way of the kings of Israel” and led Judah into spiritual harlotry, the Lord brings “a great plague” on the people and strikes the wicked king with a severe, incurable disease in his bowels, “and he died in great agony” (2 Chron. 21:12–19).
However, the Scriptures do not always connect sickness to specific personal or corporate transgressions. For example, the great prophet Elisha who raised the Shunammite’s son and healed Naaman of leprosy himself fell sick with a terminal illness (2 Kings 13:14). In the New Testament (NT), Jesus corrects his disciples’ neat-and-tidy cause-and-effect reasoning that ties physical sufferings to personal sins (Luke 13:1–5; John 9:1–3).
The prophets also anticipate the day when Yahweh will gather his scattered, afflicted people to bind up their wounds and heal them—not just from their physical afflictions but from “their apostasy” (Hos. 14:4; cf. Isa. 30:26; Jer. 30:17; 33:6). The scourge of suffering and the hope of restoration move God’s people to heed Hosea’s call, “Come, let us return to Yahweh; for he has torn us, that he may heal us; he has struck us down, and he will bind us up (Hos. 6:1).
Jesus declares that he “came to seek and save the lost” (Luke 19:10), in contrast to Israel’s self-serving leaders who failed to strengthen the weak, heal the sick, bind up the injured, and seek the lost (Ezek. 34:4). He shows compassion to the harassed and helpless (Matt. 9:36) and heals the sick and the oppressed (Acts 10:38). Christ’s healings authenticate his ministry as truly from God, signal the dawn of the age of restoration, and also point to the deeper healing that he accomplishes through his atoning death for sins (1 Pet. 2:24; cf. Isa. 53:3–4; Matt. 8:16–17).
Thus, the Scriptures do not present disease as morally neutral or “indifferent” like the philosophers. Rather, disease and other causes of pain and suffering are part of this broken world infected with sin, and these terrors have no place in the new creation, when God will roll back the curse, wipe away every tear, and make all things new (Rev. 21:1–4; 22:3; cf. Isa. 25:8).
Disease Is a Parable
The secular prophets warn that global pandemics are among the greatest threats facing humanity, but the biblical prophets present disease as a parable for humanity’s greatest malady—sin.
The whole head is sick, and the whole heart faint. (Isa. 1:5)
The heart is deceitful above all things, and desperately sick; who can understand it? (Jer. 17:9)
How sick is your heart, declares the Lord GOD, because you did all these things, the deeds of a brazen prostitute. (Ezek. 16:30)
When Ephraim saw his sickness, and Judah his wound, then Ephraim went to Assyria, and sent to the great king. But he is not able to cure you or heal your wound. (Hos. 5:13)
Sin is the ultimate pandemic, infecting every son of Adam and daughter of Eve (cf. Rom. 5:12). Iain Campbell writes, “a deep, universal and fatal illness . . . . Its working is lethal and toxic, and we all carry the germ.” Calvin puts it this way:
Innumerable are the evils that beset human life; innumerable, too, the deaths that threaten it. We need not go beyond ourselves: since our body is the receptacle of a thousand diseases—in fact holds within itself and fosters the causes of diseases—a man cannot go about unburdened by many forms of his own destruction.
Sin is the ultimate pandemic, infecting every son of Adam and daughter of Eve.
There is no political solution, scientific remedy, or educational program that can cure or contain the pandemic of human sin. Yet many, if not most, people do not recognize their cancerous condition or grasp its deadly diagnosis.
Disease Is Iconoclastic
Disease is iconoclastic—it shows and smashes our most cherished cultural idols. Devotees of ancient religions sacrificed to the gods to secure temporal benefits such as prosperity, long life, and fertility while asking to be spared from “disease, dearth, sterility, premature death.” People in modern secular societies want more or less the same provisions and protections yet “live in a way that takes no account of the transcendent.” Consider how this recent outbreak of illness illuminates and challenges the contemporary idols of security, prosperity, and wellness.
Disease Smashes the Idol of Security
People around the world long for security—freedom from threats or dangers—and lack of security is among our deepest fears. We must pass through security checks at airports and government buildings to reduce the threat of terrorism. We lock our doors or install home security systems to deter burglary. We install antivirus software and use secure passwords online to protect our devices and personal data to avoid malware and identity theft. Governments such as the United States and China invest hundreds of billions of dollars per year on internal and external security, yet even the most formidable military forces and sophisticated surveillance systems cannot detect, detain, or disarm the invisible threat of viruses like COVID-19.
Disease Smashes the Idol of Prosperity
The so-called American dream of achieving happiness and success is really a global aspiration shared (with some variation) by many societies ancient and modern. First Kings 4:25 fittingly expresses the OT vision of the good life: “And Judah and Israel lived in safety, from Dan even to Beersheba, every man under his vine and under his fig tree, all the days of Solomon.” Aristotle spoke of “happiness” as humanity’s highest good—“the pleasantest and the fairest and best of all things whatever” (Eudemian Ethics 1214a), though the philosophers cautioned that true happiness is not found in one’s circumstances, status, or stuff. President Xi Jinping’s famed “Chinese Dream” called for a march toward “common prosperity.” Yet the outbreak of COVID-19 in early 2020 has caused massive disruption to the world’s second-largest economy, shuttering schools, offices, and businesses, and dramatically disrupting trade and travel for weeks. Fear over the virus’s rapid spread beyond China sent the U.S. and global markets tumbling and forced numerous businesses to lay off or furlough workers. The financial hardship caused by this public health crisis exposes our fears of instability and loss.
Disease is iconoclastic—it shows and smashes our most cherished cultural idols.
Jesus warned, “You cannot serve both God and money” (Matt. 6:24), and Paul likened greed to “idolatry” (Col. 3:5; cf. Eph. 5:5). Brian Rosner explains, “Greed is idolatry because the greedy contravene God’s exclusive rights to human love, trust, and obedience.” He perceptively observes that “in western society in general the economy has achieved what can only be described as a status equal to that of the sacred.” As wealthy (and “middle class”) Christians worry about the bleeding red numbers on our savings and retirement account balances due to fears over the virus outbreak, we must remember that Mammon cannot save or satisfy us, nor can it offer the true security for the future that only God supplies.
Disease Smashes the Idol of Wellness
The Global Wellness Institute defines wellness as “the active pursuit of activities, choices, and lifestyles that lead to a state of holistic health.” In 2017 global wellness was a $4.2 trillion industry, including spending on beauty products, nutrition and diet, wellness tourism, fitness, spas, and more. Wellness evangelists promise health and wholeness for those who frequent this fitness club, follow that program, and use these products. Yet disease affects the fit and unfit alike, an uncomfortable reminder of our frailty and mortality. As Vanhoozer notes, “‘Get well soon’ rings hollow to the man on his deathbed.”
Disease offers us a healthy reminder of our weakness and limitations. We do not have bionic bodies. The psalmist reflects on the human life span as seventy or eighty years, which are full of “toil and trouble” (Ps. 90:10). We are not promised four-score years but should “number our days” (Ps. 90:12). Even with an optimal regimen of diet, exercise, and sleep, our bodies slow down and break down until eventually we die. Disease may rapidly accelerate this process of dying, but each one of us lives within divinely-imposed limits, even as we long for God to make all things well in the resurrection.
Responding to Sickness
How did the church respond when “a third of the world died” in 14th-century Medieval Europe due to “the Black Death”? Most explained the calamitous plague as an expression of divine punishment against human sin and sought to appease God’s wrath in various ways, including public repentance in sackcloth and ashes, self-flagellation, and violence against the Jews who were blamed for poisoning the water. Sixteenth-century evangelicals consistently interpreted the “English sweating sickness” as the divine “rod” sent to discipline the nation for its wickedness, and preachers called on believers to pray and amend their ways. During the 17th century, three bouts of bubonic plague beset England. The Protestant Church identified this disease as a divine scourge striking down sin. One London preacher likened the 1625 plague to the “flying scroll” of Zechariah 5:1–4 that travels over the land, and he called parishioners to remember this record of God’s judgment. Protestants typically responded to these trials with “an inward turn” to examine conscience and behavior in light of the Scriptures rather than with public processions and violent appeasement strategies. Others, such as John Donne, also reflected on the brevity of life and the “decay” of this sick world.
Protestants typically responded to these trials with ‘an inward turn’ to examine conscience and behavior in light of the Scriptures rather than with public processions and violent appeasement strategies.
In light of this all-too-brief biblical analysis and historical survey, we now turn to consider three ways that followers of Christ should respond to the threat of global pandemics and the trials of personal illnesses.
First, public health crises force us to face our fears. Fear is a natural reaction to danger, death, and uncertain times. What shall we do with our fears? Fear leads some people to minimize the threat, while others magnify the danger as all-consuming. Some have responded to the COVID-19 outbreak by caring for the vulnerable, while others express their fears by threatening or ostracizing Chinese people in their communities. For Christians, fear can prompt us to “return to obedience and charity,” loosening our grip on the world’s toys and reminding us that our “true good is in another world” and our “only real treasure is Christ.” Many Chinese Christians in Wuhan responded to the terrifying coronavirus outbreak by calling for prayer and passing out face masks, food, and gospel tracts. Andy Crouch wisely writes, “We need to redirect social energy from anxiety and panic to love and preparation.” When we remember that “God is our refuge and strength, a very present help in trouble” (Ps. 46:1), we can overcome debilitating fears and respond to crises with courage and compassion for our neighbors in need.
Second, sickness is an occasion to seek the Lord. Consider the contrasting responses of Asa and Hezekiah to their severe sickness:
In the thirty-ninth year of his reign Asa was diseased in his feet, and his disease became severe. Yet even in his disease he did not seek Yahweh, but sought help from physicians. (2 Chron. 16:12)
In those days Hezekiah became sick and was at the point of death, and he prayed to Yahweh, and he answered him and gave him a sign. (2 Chron. 32:24)
The Chronicler’s point is not to criticize the work of physicians, but to stress the fundamental need to “seek the Lord” in sickness. While earlier in his life, Asa commendably led his people to seek God with their whole heart and soul (2 Chron. 15:12), he relies only on human experts in his time of personal need rather than prayerfully turning to his God. In contrast, Yahweh answers tearful deathbed prayer, restoring the king’s health and prolonging his life another fifteen years (2 Kings 20:1–7).
Like Hezekiah, Jehoshaphat similarly offers a model response to troubling times. Hearing news that a vast army was marching against Judah, the king “was afraid and set his face to seek Yahweh.” He proclaims a fast and assembles the people “to seek help from Yahweh” (2 Chron. 20:3–4). Jehoshaphat then prayed,
If disaster comes upon us, the sword, judgment, or pestilence, or famine, we will stand before this house and before you—for your name is in this house—and cry out to you in our affliction, and you will hear and save . . . . We do not know what to do, but our eyes are on you. (2 Chron. 20:9, 12).
Seville writes, “Jehoshaphat had a disposition of trust, regardless of danger. Even in the face of pestilence or plague, he cried to God.”
Third, sickness and other forms of suffering also test our faith and reveal our hope. Consider Peter’s words:
In this you rejoice, though now for a little while, if necessary, you have been grieved by various trials, so that the tested genuineness of your faith—more precious than gold that perishes though it is tested by fire—may be found to result in praise and glory and honor at the revelation of Jesus Christ. (1 Pet. 1:6–7)
The apostle helps believers recognize that their present sufferings and struggles—whether due to social ostracism, threats, sickness, and so on—are not random blows of Fate but a divinely designed test to prove their faith and prepare them for glory. One Wuhan pastor similarly reflected, “It is readily apparent that we are facing a test of our faith.” He reminds believers that “Christ has already given us his peace, but his peace is not to remove us from disaster and death, but rather to have peace in the midst of disaster and death, because Christ has already overcome these things.” Our present peace and future hope should move us to respond to crises like the coronavirus outbreak with Christ-exalting good works.
Our present peace and future hope should move us to respond to crises like the coronavirus outbreak with Christ-exalting good works.
Thus, global health crises prompt us to reflect on the true pandemic of human rebellion against a holy God. Sickness reveals our fears and exposes our idols and serves as an urgent invitation to seek the Lord. All people—rich and poor, young and old, religious and non-religious—are susceptible to sickness and are certain to die one day. Yet for followers of Jesus, sickness tests our faith, reveals our hope, and moves us to be zealous for good works.