Songfacts®:

• "The Sick, The Dying... And The Dead!" details the Black Death plague, which blighted Europe between 1347-1353, killing a third of the European population. The cause of the plague was the bacterium Yersinia pestis, transmitted by fleas that infested migrating Asian black rats.
  
  It was the fleas on board that bit infected
  Rats got blood inside of the fleas
  
  Originating in China, the disease followed the trade routes through India into Europe, coming ashore in Sicily in October 1347.
  
  Invaders came on phantom ships
  Sailed the Black Sea West to Sicily
  
  The Black Death reached southern France in January 1348, and was first recorded in England in August 1348, after two fishing boats from France docked at Weymouth, Dorset.
• During the chorus, Dave Mustaine references the nursery rhyme "Ring Around the Rosie," which is linked to the 1665 bubonic plague that ravaged London.
  
  The sweet smell of rosies, a pocketful of posies
  You can't mask the fragrance of death in their beds
  There's typhus in the air, and ashes everywhere
  Amongst the sick, the dying, and the dead
  
  A rosy ring was a rash that would show on cheeks from the plague. People carried posies of herbs as protection and to ward off the smell of the disease.
• This is the title track of The Sick The Dying… and The Dead. Mustaine wrote the song and chose the album name before the COVID-19 outbreak. He had no qualms about releasing the album with its plague-referencing title when memories of the new plague remained fresh.
  
  "For me to let the occurrences in modern current history tell me what I'm going to do and what I'm not going to do is not going to sit well with me," the cantankerous frontman told Rolling Stone. "For me to let the occurrences in modern current history tell me what I'm going to do and what I'm not going to do is not going to sit well with me."
• Mustaine assembled the album from riffs and music he'd archived for years, some dating to his teenage years. "A lot of the riffs have been saved over time," he told American Songwriter. "A brand new song can be made up of something I wrote when I was 15 or 55. If it's a good riff, I'll save it."
• The Leo Liberti-directed video is the third installment of Megadeth's video trilogy that recounts the origin story of the band's mascot, Vic Rattlehead. It follows the visuals for "We'll Be Back" and "Night Stalkers."