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So we know that the Purelake plague is the common cold. To us this makes the term "plague" seem extreme. It seems to be a called a "plague" because of the fear it has created. I have a couple of ideas concerning diseases on Roshar that may be why the common cold has everyone so frightened. First, we know that the higher investiture on Roshar makes people generally more healthy. What does this mean for disease? From Kaladin's perspective we know that medical knowledge exists beyond surgery. There is the slave with the grinding cough in Tvlakv's wagon as an example. I think that the higher investiture/health means that what we think of as minor diseases, the things that our bodies feel beat up by but fight off routinely, just don't exist on Roshar. Or maybe they do, but the vitality provided by a higher investiture environment means they don't suffer from the symptoms. Second, I think that viruses as we know them are foreign to Roshar. There is relatively little mammalian or avian life on Roshar. Removing these two animal groups removes much of the opportunity for zoonotic transmission and mutation of viruses. Without the constant mutation and transmission between species, I believe the heightened Rosharan immune system has effectively wiped out viral diseases. So finally, our friends from the 17th Shard arrive and bring with them the common cold. A viral infection that spreads and mutates quickly between humans, and due to its viral nature, Investiture cannot simply overcome the symptoms. So you have an outbreak of people becoming visibly sick, in a world where minor diseases are foreign. I think under these circumstances, fear and some level of panic are justified. I know there is a good deal of speculation here, but I don't think it's unreasonable.