History need not repeat itself when we write the journal of our plague year
The year is 1665 and the plague is in London. A man riding through Essex finds “all the way people, citizens, walking to and again to enquire how the plague is in the city this week”. He dutifully tells one person after another there have been 2,020 new plague deaths.
Flash forward to 2020 and Covid-19 is everywhere. People are once again clamoring for numbers – confirmed cases, hospitalizations, deaths and positivity rates – and for exactly the same reason.
Like the people of early modern London, we see the numbers as a way to understand the severity of the pandemic and the current danger we face. We worry about the accuracy of the numbers. When the numbers rise, we consider steps to protect ourselves and our families. When the numbers fall, we think hopefully about resuming our former lifestyles. And when the numbers rise again, we wonder how long we can go on like this?
Covid-19 is not the plague, but many of our experiences today would have been familiar to anyone who survived one of the plague epidemics that routinely swept through early modern Europe. Plague was generally understood to be contagious, either through touching infected objects – mainly cloth – or through breathing infected air. People’s symptoms could vary widely and there were no real treatments. But at least there were some reliable preventive measures: quarantines, contact-tracing and self-isolation. And while it wasn’t a widely embraced practice, in later epidemics some doctors also wore the infamous plague masks.
In early modern epidemics, we see some of the same confusion, denial and posturing that has marked the Covid-19 pandemic. In April 1599, a physician warned the city government of Valladolid, Spain, that he had treated a patient who died of plague. They refused to believe him, declaring the city’s diseases could be “easily cured” as they were only “common and light illnesses”. They were not unique. Later in that same epidemic, the cities of San Sebastián and Bilbao denied the presence of plague among their residents to avoid shutting down their economies. Others spread false rumors and the city of Estella pursued legal action against those who (allegedly) slandered its healthiness.
Then, as now, people with the means to do so fled as soon as it became evident that plague had reached their city, town or village. Often, as was the case in 1625 when the English parliament removed itself from plague-stricken London to a series of nearby towns and cities, these travelers carried the plague with them, spreading the epidemic even further.
Similarly, those left behind struggled to contain the outbreak and suffered from the economic consequences of those containment measures. During the 1630 outbreak in Florence, Italy, soldiers were sent to a nearby village to enforce quarantines, contact-trace and supply food to those self-isolating after exposure, but food and medicine were in short supply. Those doctors who ans
wered the call to tend to plague-stricken overworked themselves and fell ill. With almost everyone quarantined or self-isolating and movement throughout the area limited, unemployment rates soared (and taxes plummeted). The government housed beggars, expelled poor foreigners and gave a loaf of bread a day to some of its worstoff residents, but people still starved to death.
Just as we see today, public health guidelines were not always followed and not without controversy. People failed to report plague cases to avoid being forced to self-isolate, afraid of the economic, interpersonal or reputational consequences. They broke quarantine out of boredom, out of carelessness, out of arrogance, out of fear, out of familial duty and out of the desire to commemorate traditional life milestones like weddings and funerals. Some people refused to stay at home in order to survive, going to work and risking both their lives and those of their neighbors because they had no real choice. Some people might have stayed home if they hadn’t been deemed essential to food supply lines or the functioning of government. They worried that measures taken to contain the plague would kill more than the disease itself.
Above all, hundreds and thousands of small decisions – both sensible and selfish – added up to make the difference in how deadly and economically devastating each epidemic would be.
The past does not determine the future. Humans have free will and can make their own decisions. But we can combine our scientific advances in understanding how diseases work with our study of how historical people acted in similar situations. History can help us see how others’ decisions – even ones that seem strange or irresponsible to us – are similar to the ways people have acted in the past. And it can help us guess at what the future might have in store for us, given what we know today.
The year is 1666 and plague has been in London for 19 months. Eager to finally return to normal – and to reopen the theatres – the authorities officially declare the epidemic is over. But the numbers tell a different tale: “Lord! how the towne do say that it is hastened before the plague is quite over, there dying some people still.”
The year is 2021 and there is a Covid-19 vaccine. Eager to finally return to normal – and to reopen the economy – the authorities officially declare the pandemic is over. But the numbers will have the final say. And in however many months it will take for the vaccine to be distributed widely enough to lessen the severity of the disease or achieve herd immunity, there will die some people still.
History can help us see how others’ decisions are similar to the ways people have acted in the past