<https://press.princeton.edu/books/hardcover/9780691166834/th...>
That is, the Antonine, and other plauges of Rome relied on the dense urbanisation, highly-developed transportation, and long-range trading patterns, all of which served to provide the conditions in which pathogens which were either benign or simply too virulent to establish themselves in smaller, less-interconnected communities --- in such cases the epidemics would simply burn themselves out, perhaps decimating a village or small trading group of same, but not spreading further.
The fact that Yersinia pestis seems to have evolved first in rodent populations (themselves often microcosms of human civilisations with large and interconnected population clusters) seems relevant. IIRC Harper cites hamsters or gerbils as the prior host species to humans.
James Burke, of Connections fame, stated in a later interview "ReConnections* of how he'd extend the episodes of the original series that a key consequence of jet air travel would be an increased spread of global pandemics. This occurs toward the end of this video:
<https://archive.org/details/JamesBurkeReConnections_0>
More broadly, it seems to me that any network will co-evolve parasite or pathogenic entities, whether we're talking human cities (look at the long list of urban vices, online abuse, network issues, and the like). One factor contributing to the "golden age" effect is that such ages exist before the parasites / pathogens evolve. As such, the sense that "something went wrong" seems to me misled, and a better formulation would be that such golden ages were living on borrowed time in the first place.
Podcast episode of Harper addressing a similar theme from Plagues Upon the Earth: <https://traffic.megaphone.fm/NBN2511895438.mp3>.