Disease has contributed to the reshuffling of the regional and global orders throughout history. Strangely, this variable has been neglected vis-a-vis Great Power Competition (GPC), creating a "plague gap" in the literature on international relations and transitions of power. In general, historians and political scientists connect power shifts to military clashes, diplomacy, or economic developments. Investigating the emergence and spread of novel diseases throughout time offers a new variable to the discussion. My findings explore how disease has factored into the decline of some empires (the Athenian, Roman, Byzantine, and Mongol empires) and the expansion of others (Spain and Great Britain). In GPC disease can be used as an instrument of conquest or as a collaborative tool of governance. Disease can weaken states' abilities to compete economically and militarily with rivals. The ongoing GPC with the People's Republic of China (PRC) and the 2019 Novel Coronavirus Disease (COVID-19) pandemic provides yet another example of this pattern. My research suggests the possibility that COVID-19 will accelerate Chinese superiority and reshape the international order in the PRCs favor. Consideration must be given to the inclusion of disease in determining national policy in GPC.