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Archaeological evidence from Germany and other northern European countries indicate that the disease also spread to these regions. For a while, Northern Europe's relative isolation spared it, but this does not seem to be the case. While many towns and villages had already declined due to the collapse of the Roman Empire, other diseases, and famine, this pandemic further devastated communities.

Emperor Justinian, at the time, was busy financing the Hagia Sophia and carrying out his wars in the western Mediterranean. At that point, he was on the verge of retaking critical parts of the Western Mediterranean that would have resulted in the Byzantine Empire effectively reuniting lands from the Roman Empire.