What does 1 Samuel 5:11 mean?
For the second time in this chapter, a meeting is called of the five rulers of the five major cities of the nation of the Philistines. At the first meeting, they decided to move the ark of the Lord from Dagon's temple in Ashdod to the city of Gath, hoping that would put a stop to the plague of tumors that had erupted (1 Samuel 5:6–8). Instead, the tumors and the panic started up all over again in Gath (1 Samuel 5:9).The leader of Gath sent the ark to Ekron, and the people there seem to have panicked before the outbreak of tumors even began. Now the leaders of the five cities assemble once more, and the people of Ekron plead with them to send the ark of the Lord back to the Israelites before it kills everyone.
Apparently, some people had already been killed by the deathly panic itself (1 Samuel 5:12). It's unclear what this entailed. However, history has shown numerous examples of populations reacting in fear over disease, often in self-destructive ways. The deaths caused in this case might have been accidents as people scrambled to get away from the ark. It might have included violence as people tried to avoid those they thought were infected. It's even possible the arrival of the ark led to heart attacks or strokes as men died of pure fear.
Few details are given. What's crucial to understand is that the Philistines recognized the important lesson: the Lord's judgment was against them because they were disrespecting His ark.