The Fourth Horseman: Disease Epidemics

Biblical prophecies that warn of dangers at the end of this present age use sobering images of the four horsemen of the Apocalypse to describe terrible events that will sweep over the earth just before the return of Jesus Christ. The fourth horseman (Revelation 6:7–8) pictures the outbreak of pestilences and troubles (Matthew 24:7; Mark 13:8; Luke 21:11), including viruses and bacteria, that will ravage an entire quarter of the earth in tandem with violence, hunger, and “the beasts of the earth” (Revelation 6:8).

At the world’s current level of population, this means these calamities would kill just shy of two billion people. Even after facing the COVID-19 pandemic for the last two years, many may find it unbelievable to imagine disaster of such prophesied magnitude, especially considering advances in modern medical technology. Yet signs of conditions that would enable such devastating global catastrophes are appearing with increasing frequency—indicating that these ancient biblical prophecies are about to come alive as never before.

Communicable Disease Widespread

As our world deals with the sobering reality of more than 6 million COVID-19 deaths in a span of about two years, it may be easy to forget that other maladies continue to do great harm. The AIDS epidemic has seen the deaths of more than 35 million individuals since the mid-1980s, and even today the World Health Organization reports that more than 37 million are living with HIV/AIDS, with about 1.5 million newly acquiring the disease in 2020 alone.

Meanwhile, other diseases, though rare in the United States and developed nations, continue to cause great suffering around the globe. Though physicians in the U.S. diagnose scarcely more than 2,000 malaria infections in a typical year, 2020 saw more than 240 million cases worldwide, leading to more than 600,000 deaths—mostly children in sub-Saharan Africa. Statista.com reports that in 2019, more than 1.2 million people around the world died of tuberculosis—a number that the WHO says increased to more than 1.5 million in 2021 because of limited treatment availability due to COVID-19 quarantines and restrictions. Even more significant than the raw number is that for the first time in many years, tuberculosis deaths have been increasing year to year.

The Limits of Medicine

In the past century, the development of antibiotics—the “magic bullet” medicine of the modern era—has fostered a false sense of security in which many assume that we are no longer threatened by infectious diseases. However, the appearance of microbes resistant to powerful drugs reveals that there are limits to what antibiotics can do.

In just a few hours, thanks to international jet travel, disease carriers can come into contact with thousands of people at airports and on planes, greatly increasing the rate of exposure. The rise of mega-cities, where millions of people live in close contact, also facilitates the spread of disease. In the developing world—where millions crowd together in slums with little access to clean water, medical services, or the sanitary disposal of human wastes and garbage—these infectious diseases thrive. Social disruptions caused by war and political turmoil that plague Africa, the Middle East, and other areas of the world create fertile conditions for the spread of infectious disease. All these factors are present and growing in our world today.

The threat of biochemical terrorism—the deliberate release of toxic microbes or chemical agents in large urban centers—offers the scary scenario of large numbers of people being killed in very little time. In the last decade, our world has clearly become more vulnerable to the outbreak of global epidemics that have the potential of claiming millions of lives—which is exactly what the fourth horseman pictures.

Past Epidemics

A quick glance at history reveals the devastating effect of disease-bearing bacteria. Award-winning Canadian journalist Andrew Nikiforuk reminds us that once they “start to reproduce in exponential numbers, they can alter entire ecosystems, food chains, and water systems—and even the fate of human empires” (Pandemonium, p. xii).

Epidemics in the past arrived unexpectedly and spread death and devastation over wide areas of the world. In the Middle Ages, leprosy, tuberculosis, cholera, and typhoid thrived in the filth and crowded living conditions of medieval cities. In 1348, an epidemic of plague, the “Black Death,” killed an entire third of the population of Europe—some 30 million—in just two years. The plague spread along medieval trade routes. Columbus’ sailors brought syphilis from the Americas, and the disease spread rapidly through Europe, aided by promiscuity. Europeans brought smallpox to the Americas, where it killed 100 million Native Americans in one century because they lacked natural antibodies to the disease.

A century before COVID-19, the flu epidemic of 1918 killed 50 million people in just 18 months. By contrast, the battlefields of World War I required four years to claim 15 million lives. When disease strikes, it can devastate a population with a speed and range that exceeds mankind’s ability to destroy itself through conventional warfare. The resurgence of infectious diseases clearly indicates that the fourth horseman is no less a threat to human health than it was before modern medical advances—and that it will ride again when conditions are ripe.

Lessons of History

Around 450 BC, the Greek physician Hippocrates observed that “diseases didn’t come calling unless there had been either great changes to human health or great changes made to the health of the land”—in other words, “humans make epidemics.” German pathologist Rudolf Virchow, considered the father of pathology, concluded more than a century ago that “epidemics resemble great warnings from which a statesman… can read that a disturbance has taken place in the development of his people” (Andrew Nikiforuk, The Fourth Horseman, pp. 21–22).

Human lives and the environment today are changing in unprecedented ways. Just look at the results of the population explosion: polluted air and water in garbage-ridden and growing cities, slums where millions live in squalor, forests destroyed by economic development, and severe temperatures that affect weather patterns and economies around the globe. Add to this the appearance of drug-resistant germs, diseases spread via jet travel, and immune systems weakened by stress, promiscuous sex, intravenous drug use, and malnutrition—and you have a potent prescription for global epidemics. Many of today’s diseases are the biological consequences of promiscuity, poor hygiene, and a host of high-risk behaviors on the part of people who ignore fundamental principles of health and are not prepared to take responsibility for the damage that their actions cause, even to others.

Long ago, our Creator warned that “if you do not obey the voice of the Lord your God, to observe carefully all His commandments and His statutes… the Lord will make the plague cling to you… the Lord will strike you with consumption, with fever, with inflammation… from which you cannot be healed” (Deuteronomy 28:15–28). The Bible reveals that because of mankind’s willingness to ignore fundamental physical and moral laws, we will reap the consequences of breaking those laws, and that “every sickness and every plague… will the Lord bring upon you until you are destroyed” (Deuteronomy 28:61). Jesus Christ also warned that, before His return, global calamities would threaten the existence of the human race (Matthew 24:21–22). When the fourth horseman begins its final ride, human beings will be at fault. These sobering prophecies are coming alive and moving towards fulfillment in the years just ahead.