How the bubonic plague changed drinking habits

Engraving of a man drinking plague water during the 1665 London outbreak.
Wellcome Collection, CC BY-NC-SA

James Brown, University of SheffieldAlcohol deaths in England and Wales in 2020 were the highest for 20 years. The Office for National Statistics recorded 7,423 deaths from alcohol misuse, a 19.6% increase compared with 2019. Although this is likely to have many complex causes, data from Public Health England suggests that the COVID-19 pandemic and its resulting lockdowns are at least partly responsible for the increase. Largely, the disruption of work and social routines have led to a surge of hazardous drinking within the home (with some fairly harrowing personal stories).

The Intoxicating Spaces project, of which I’m part, has been exploring how pandemics also influenced the use of intoxicants, including patterns of alcohol consumption, in the past. As part of this work, we’ve looked at how the successive bubonic plague outbreaks that gripped England, especially London, in the 17th century (1603, 1625, 1636 and 1665) wrought similar changes in people’s drinking habits.

Like today, these sudden and frightening outbreaks of disease restricted access to inns, taverns, alehouses and other public drinking places – the cornerstones of early-modern sociability. While never subject to wholesale closure, these environments were targeted by the equivalent of social distancing legislation. A 1665 London plague order, for example, identified “tippling in taverns, alehouses, coffee-houses, and cellars” as “the greatest occasion of dispersing the plague”, and imposed a 9pm curfew.

The extent to which these regulations altered 17th-century people’s relationship with alcohol is difficult to determine based on surviving information. However, anecdotal evidence suggests there might have been a comparable shift towards drinking at home.

In his classic 1722 meditation on the 1665 London outbreak Due Preparations for the Plague, Daniel Defoe told the story of a London grocer who voluntarily quarantined himself and his family in their home for the duration of the pandemic. Among the provisions he assembled were 12 hogsheads of beer; casks and rundlets containing four varieties of wine (canary, malmsey, sack and tent; 16 gallons of brandy; and “many sorts of distill’d waters” (spirits).

A painting of a quarantined house during the 1665 London plague outbreak, with the signboards of public houses visible in the background.
Wellcome Collection, CC BY-SA

According to Defoe, this impressive stockpile was not gratuitous but “necessary supplies”. This is because, surprisingly from the perspective of today’s public health messaging, in this period alcohol was thought to have had medicinal value and its moderate consumption during plague outbreaks was actively encouraged.

Doctor’s orders

Contemporary doctors and medical writers believed alcohol worked as a plague preventatives, in two main ways.

First, the consumption of beers, wines and spirits was believed to strengthen the body’s key defensive organs of the brain, heart and liver. They were especially beneficial when taken first thing in the morning, with many commentators recommending fortifying liquid plague breakfasts.

In his 1665 plague treatise, Medela Pestilentiae, minister and medical writer Richard Kephale claimed that it’s good “to drink a pint of maligo [Malaga wine or port] in the morning against the infection”. (He was also effusive on “the inexpressible virtues of tobacco”.) Many recipes for the popular “preventative” and “cure” plague water invariably contain wine and spirits, as well as pharmaceutical herbs.

Second, and perhaps more significantly, moderate drinking was believed to ward off those fearful mental states that induced melancholy (early modern terminology for depression), which was thought to make people more vulnerable to contracting the plague.

As Defoe put it, the grocer’s liquor hoard was not for his and his family’s “mirth or plentiful drinking”, but rather “so as not to suffer their spirits to sink or be dejected, as on such melancholy occasions they might be supposed to do”. Likewise, in his 1665 plague treatise, Zenexton Ante-Pestilentiale, physician William Simpson advocated the “drinking of good wholesome well-spirited liquor” to “make the heart merry” and “cause cheerfulness”. This would banish “many enormous ideas of fear, hatred, anxiousness, sorrow, and other perplexing thoughts”, and thereby “fortify the balsam of life against all infectious breaths”.

Engraving of the 1665 London outbreak.
Wellcome Collection., CC BY-NC-SA

The key thing for all of these writers was alcohol “moderately taken”. Excessive drinking to the point of drunkenness was still cautioned against, and “living with temperance upon a good generous diet” (in the words of one author) remained the baseline for most plague medicine.

However, then as now, it’s likely that the disruption of patterns of labour and leisure, along with the daily anxieties of living in a plague-stricken city, drove many to the psychological consolations of the bottle on a more dangerous and habitual basis. In A Journal of the Plague Year – Defoe’s other, more celebrated novel about the 1665 London outbreak – he tells the story of a physician who kept his “spirits always high and hot with cordials and wine”. But “could not leave them off when the infection was quite gone, and so became a sot for all his life after”.

James Brown, Research Associate & Project Manager (UK), University of Sheffield

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Worst Pandemics in History

Surviving the Black Death

Border closures, identity and political tensions: how Australia’s past pandemics shape our COVID-19 response

Susan Moloney, Griffith University and Kim Moloney, Murdoch University

Tensions over border closures are in the news again, now states are gradually lifting travel restrictions to all except Victorians.

Prime Minister Scott Morrison says singling out Victorians is an overreaction to Melbourne’s coronavirus spike, urging the states “to get some perspective”.

Federal-state tensions over border closures and other pandemic quarantine measures are not new, and not limited to the COVID-19 pandemic.

Our new research shows such measures are entwined in our history and tied to Australia’s identity as a nation. We also show how our experiences during past pandemics guide the plans we now use, and alter, to control the coronavirus.

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National and state leaders may not always agree, but this hasn’t hindered our coronavirus response

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Bubonic plague, federation and national identity

In early 1900, bubonic plague broke out just months before federation, introduced by infected rats on ships.

When a new vaccine was available, the New South Wales government planned to inoculate just front-line workers.

Journalists called for a broader inoculation campaign and the government soon faced a “melee” in which:

…men fought, women fainted and the offices [of the Board of Health] were damaged.

Patients and contacts were quarantined at the North Head Quarantine Station. Affected suburbs were quarantined and sanitation commenced.

The health board openly criticised the government for its handling of the quarantine measures, laying the groundwork for quarantine policy in the newly independent Australia.

Quarantine then became essential to a vision of Australia as an island nation where “island” stood for immunity and where non-Australians were viewed as “diseased”.

Public health is mentioned twice in the Australian constitution. Section 51(ix) gives parliament the power to quarantine, and section 69 requires states and territories to transfer quarantine services to the Commonwealth.

The Quarantine Act was later merged to form the Immigration Restriction Act, with quarantine influencing immigration policy.

Ports then became centres of immigration, trade, biopolitics and biosecurity.

Spanish flu sparked border disputes too

In 1918, at the onset of the Spanish flu, quarantine policy included border closures, quarantine camps (for people stuck at borders) and school closures. These measures initially controlled widespread outbreaks in Australia.

However, Victoria quibbled over whether NSW had accurately diagnosed this as an influenza pandemic. Queensland closed its borders, despite only the Commonwealth having the legal powers to do so.

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When World War I ended, many returning soldiers broke quarantine. Quarantine measures were not coordinated at the Commonwealth level; states and territories each went their own way.

Quarantine camps, like this one at Wallangarra in Queensland, were set up during the Spanish flu pandemic.
Aussie~mobs/Public Domain/Flickr

There were different policies about state border closures, quarantine camps, mask wearing, school closures and public gatherings. Infection spread and hospitals were overwhelmed.

The legacy? The states and territories ceded quarantine control to the Commonwealth. And in 1921, the Commonwealth created its own health department.

The 1990s brought new threats

Over the next seven decades, Australia linked quarantine surveillance to national survival. It shifted from prioritising human health to biosecurity and protection of Australia’s flora, fauna and agriculture.

In the 1990s, new human threats emerged. Avian influenza in 1997 led the federal government to recognise Australia may be ill-prepared to face a pandemic. By 1999 Australia had its first influenza pandemic plan.

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Today’s disease names are less catchy, but also less likely to cause stigma

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In 2003, severe acute respiratory syndrome (or SARS) emerged in China and Hong Kong. Australia responded by discouraging nonessential travel and started health screening incoming passengers.

The next threat, 2004 H5N1 Avian influenza, was a dry run for future responses. This resulted in the 2008 Australian Health Management Plan for Pandemic Influenza, which included border control and social isolation measures.

Which brings us to today

While lessons learned from past pandemics are with us today, we’ve seen changes to policy mid-pandemic. March saw the formation of the National Cabinet to endorse and coordinate actions across the nation.

Uncertainty over border control continues, especially surrounding the potential for cruise and live-export ships to import coronavirus infections.

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Then there are border closures between states and territories, creating tensions and a potential high court challenge.

Border quibbles between states and territories will likely continue in this and future pandemics due to geographical, epidemiological and political differences.

Australia’s success during COVID-19 as a nation, is in part due to Australian quarantine policy being so closely tied to its island nature and learnings from previous pandemics.

Lessons learnt from handling COVID-19 will also strengthen future pandemic responses and hopefully will make them more coordinated.

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Susan Moloney, Associate Professor, Paediatrics, Griffith University and Kim Moloney, Senior Lecturer in Global Public Administration and Public Policy, Murdoch University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Comets, omens and fear: understanding plague in the Middle Ages

A comet depicted in medieval times in the Bayeux tapestry.
Bayeux Museam, Author provided

Marilina Cesario, Queen’s University Belfast and Francis Leneghan, University of Oxford

On August 30 2019, a comet from outside our solar system was observed by amateur astronomer Gennady Borisov at the MARGO observatory in Crimea. This was only the second time an interstellar comet had ever been recorded. Comet 19 or C/2019 Q4 , as it is now known, made its closest approach to the sun on December 8 2019, roughly coinciding with the first recorded human cases of COVID-19.

While we know that this is merely coincidence, in medieval times authorities regarded natural phenomena such as comets and eclipses as portents of natural disasters, including plagues.

One of the most learned men of the early Middle Ages was the Venerable Bede, an Anglo-Saxon monk who lived in Northumbria in the late seventh and early eighth centuries. In chapter 25 of his scientific treatise, De natura rerum (On the Nature of Things) , he describes comets as “stars with flames like hair. They are born suddenly, portending a change of royal power or plague or wars or winds or heat”.

Plagues and natural phenomena

Outbreaks of the bubonic plague were recorded long before the Black Death of the 14th century. In the 6th century, a plague spread from Egypt to Europe and lingered for the next 200 years. At the end of the seventh century, the Irish scholar Adomnán, Abbot of Iona wrote in book 42 of his Life of St Columba of “the great mortality which twice in our time has ravaged a large part of the world”. The effects of this plague were so severe in England that, according to Bede, the kingdom of Essex reverted to paganism.

The Anglo-Saxon Chronicle records that 664 “the sun grew dark, and in this year came to the island of Britain a great plague among men (‘micel man cwealm’ in Anglo Saxon)”. The year 664 held great significance for the English and Irish churches: a great meeting (or synod) was held in Whitby in Northumbria to decide whether the English church should follow the Irish or Roman system for calculating the date of Easter. By describing the occurrence of an eclipse and plague in the same year as the synod, Bede makes this important event in the English Church more memorable and meaningful.

In the Middle Ages, comets like 2019’s C/2019 Q4 signalled a calamitous event on earth to come.
NASA, ESA & D. Jewitt (UCLA), CC BY

Plague and medieval religion

In the Middle Ages, occurrences like plague and disease were thought of as expressions of God’s will. In the Bible, God uses natural phenomena to punish humankind for sin. In the Book of Revelation 6:8, for example, pestilence is described as one of the signs of Judgement Day. Medieval scholars were aware that some plagues and diseases were spread through the air, as explained by the seventh-century scholar Isidore of Seville in chapter 39 of his De natura rerum (On the Nature of Things):

Pestilence is a disease spreading widely and infecting by its contagion whatever it touches. When plague (‘plaga’) smites the earth because of mankind’s sins, then from some cause, that is, either the force of drought or of heat or an excess of rain, the air is corrupted.

Bede based his On the Nature of Things on this work by Isidore. In a discussion of plague in the Old English version of Bede’s Ecclesiastical History we find a reference to the “an-fleoga”, meaning something like “the one who flies” or “solitary flier”. This same idea of airborne disease is a feature of Anglo-Saxon medicine. One example comes from an Old English poem we call a metrical charm, which combines ancient Germanic folklore with Christian prayer and ritual. In the Nine Herbs Charm, the charmer addresses each herb individually and invokes its power over disease:

This is against poison, and this is against the one who flies,

this is against the loathsome one that travels throughout the land …

if any poison come flying from the east,

or any come from the north,

or any from the west over the nations of men,

Christ stood over the disease of every kind.

As well as fearing plague, medieval scholars attempted to pinpoint its origins and carefully recorded its occurrence and effects. Like us, they used whatever means they could to protect themselves from disease. But it is clear medieval chroniclers presented historical events as part of a divine plan for humankind by linking them with natural phenomena like plagues and comets.

Marilina Cesario, Senior Lecturer, School of Arts, English and Languages, Queen’s University Belfast and Francis Leneghan, Associate Professor of Old English, University of Oxford

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Uprisings after pandemics have happened before – just look at the English Peasant Revolt of 1381

In this 1470 illustration, the radical priest John Ball galvanizes the rebels.
The British Library

Susan Wade, Keene State College

As a professor of medieval Europe, I’ve taught the bubonic plague, and how it contributed to the English Peasant Revolt of 1381. Now that America is experiencing widespread unrest in the midst of its own pandemic, I see some interesting similarities to the 14th-century uprising.

The death of George Floyd has sparked protests fueled by a combination of brutal policing, a pandemic that has led to the loss of millions of jobs and centuries of racial discrimination and economic inequality.

“Where people are broke, and there doesn’t appear to be any assistance, there’s no leadership, there’s no clarity about what is going to happen, this creates the conditions for anger, rage, desperation and hopelessness,” African American studies scholar Keeanga-Yamahtta Taylor told The New York Times.

Medieval England may seem far removed from modern America. And sure, American workers aren’t tied to employers by feudal bonds, which meant that peasants were forced to work for their landowners. Yet the Peasant Revolt was also a reaction brought on by centuries of oppression of society’s lowest tiers.

And like today, the majority of wealth was held by an elite class that comprised about 1% of the population. When a deadly disease started to spread, the most vulnerable and powerless were asked the pick up the most slack, while continuing to face economic hardship. The country’s leaders refused to listen.

Eventually, the peasants decided to fight back.

Clamoring for higher wages

Surviving letters and treatises express feelings of fear, grief and loss; the death tolls from the 14th-century plague were catastrophic, and it’s estimated that between one-third to one-half of the European population died during the its first outbreak.

The massive loss of life created an immense labor shortage. Records from England describe untilled fields, vacant villages and untended livestock roaming an empty countryside.

The English laborers who survived understood their newfound value and began to press for higher wages. Some peasants even began to seek more lucrative employment by leaving feudal tenancy, meaning the peasants felt free to leave the employment of their landowning overlords.

Rather than accede to the demands, King Edward III did just the opposite: In 1349, he froze wages at pre-plague levels and imprisoned any reaper, mower or other workman in service to an estate who left his employment without cause. These ordinances ensured that elite landowners would retain their wealth.

Edward III enacted successive laws intended to ensure laborers wouldn’t increase their earning power. As England weathered subsequent outbreaks of the plague, and as labor shortages continued, workers started to clamor for change.

Enough is enough

The nominal reason for the Peasant Revolt was the announcement of a third poll tax in 15 years. Because poll taxes are a flat tax levied on every individual, they affect the poor far more than the wealthy. But similar to the protests that have erupted in the wake of Floyd’s death, the Peasant Revolt was really the result of dashed expectations and class tensions that had been simmering for more than 30 years.

Things finally came to a head in June 1381, when, by medieval estimates, 30,000 rural laborers stormed into London demanding to see the king. The cohort was led by a former yeoman soldier named Wat Tyler and an itinerant, radical preacher named John Ball.

Ball was sympathetic to the Lollards, a Christian sect deemed heretical by Rome. The Lollards believed in the dissolution of the sacraments and for the Bible to be translated into English from Latin, which would make the sacred text equally accessible to everyone, diminishing the interpretive role of the clergy. Ball wanted to take things even further and apply the ideas of the Lollards to all of English society. In short, Ball called for a complete overturn of the class system. He preached that since all of humanity constituted the children of Adam and Eve, the nobility could not prove they were of higher status than the peasants who worked for them.

With the help of sympathetic laborers in London, the peasants gained entry to the city and attacked and set fire to the Palace of Savoy, which belonged to the Duke of Lancaster. Next they stormed the Tower of London, where they killed several prominent clerics, including the archbishop of Canterbury.

A bait and switch

To quell the violence, Edward’s successor, the 14-year-old Richard II, met the irate peasants just outside of London. He presented them a sealed charter declaring that all men and their heirs would be “of free condition,” which meant that the feudal bonds that held them in service to landowners would be lifted.

The Peasant Revolt was one of Richard II’s first tests.
Westminster Abbey

While the rebels were initially satisfied with this charter, things didn’t end well for them. When the group met with Richard the next day, whether by mistake or intent, Wat Tyler was killed by one of Richard’s men, John Standish. The rest of the peasants dispersed or fled, depending on the report of the medieval chronicler.

For the authorities, this was their chance to pounce. They sent judges into the countryside of Kent to find, punish and, in some cases, execute those who were found guilty of leading the uprising. They apprehended John Ball and he was drawn and quartered. On Sept. 29, 1381, Richard II and Parliament declared the charter freeing the peasants of their feudal tenancy null and void. The vast wealth gap between the lowest and highest tiers of society remained.

American low-wage laborers obviously have rights and freedoms that medieval peasants lacked. However, these workers are often tied to their jobs because they cannot afford even a brief loss of income.

The meager benefits some essential workers gained during the pandemic are already being stripped away. Amazon recently ended the additional US$2 per hour in hazard pay it had been paying workers and announced plans to fire workers who don’t return to work for fear of contracting COVID-19. Meanwhile, between mid-March and mid-May, Amazon CEO Jeff Bezos added $34.6 billion dollars to his wealth.

It appears that the economic disparities of 21st-century capitalism – where the richest 1% now own more than half of the world’s wealth – are beginning to resemble those of 14th-century Europe.

When income inequalities become so jarring, and when these inequalities are based in long-term oppression, perhaps the sort of unrest we’re seeing on the streets in 2020 is inevitable.

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Susan Wade, Associate Professor of History, Keene State College

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bleach, bonfires and bad breath: the long history of dodgy plague remedies

Hippocrates refusing the gifts of Artaxerxes. Engraving by Raphael Massard, 1816.
Wellcome Images, CC BY-NC-SA

David Roberts, Birmingham City University

When a future researcher compiles a list of sayings of US presidents, this one from Donald Trump in April 2020 about using bleach as a possible treatment for coronavirus will surely make the cut: “Is there a way we can do something, by an injection inside or almost a cleaning?” Trump’s words prompted panicky warnings from bleach manufacturers to people not to drink their product and a spike in phone calls to help lines.

Press outlets leapt to describe Trump as a “mountebank – an itinerant quack doctor parading his wares from a platform (in Italian classic comic theatre, or Commedia Dell’Arte, the character is typically called Charlatano). In Ben Jonson’s 1606 comedy, Volpone, the eponymous hero dresses as Scoto of Mantua, purveyor of Scoto’s Oil. The original “snake oil”, it’s more expensive than bleach but neither harmful nor, indeed, beneficial if ingested.

Perhaps the comparison is unfair. Trump has simply joined the long line of those who, desperately seeking real cures, have found fakes. In Athens in 430BC, an epidemic struck. The air was thought to be diseased and in need of cleansing. The ancient Greek “father of medicine” Hippocrates himself is said to have come up with a solution – light bonfires, throw herbs and spices on them, and wait for the infection to pass.

Two thousand years later, bonfires were still in fashion. At the onset of the Great Plague in 1665, the College of Physicians pronounced that:

Fires made in the Streets, and often with Stink-Pots, and good Fires kept in and about the Houses of such as are visited … may correct the infectious Air.

The college added that the “frequent discharging of Guns” would have the same effect – something that might appeal to the US president’s more ardent supporters.

But in 1665, not everyone could agree on what to burn. Should it be coal or wood? If wood, was it better to burn a more aromatic variety such as cedar or fir? The author of Golgotha (identified only as J.V.), one of a large number of plague books published in 1665, denounced as “a costly mischief” the burning of “sweet-scented Pomanders”. That did not stop him from recommending instead “Wormwood, Hartshorn, Amber, Thime or Origany”.

But hang on. It was already a hot summer in 1665. Wouldn’t all those fires warm up the infected air and cause the plague particles to multiply? Not necessarily. There were two kinds of heat, according to the 1666 work Loimographia, by 17th-century apothecary William Boghurst. There was the fierce, dry sort generated by fires in chilly northern climates, and there was the soggy, exhausting sort you found in the tropics. The former was cleansing. The latter opened the pores and made you susceptible to infection (as well as lazy and deserving enslavement).

Smoke to your good health

If this all seems like the effusion of bad science and worse ideology, consider tobacco. Recently it was reported that smokers might be less prone to catching COVID-19 (although other evidence suggests smoking makes the disease worse).

The idea of tobacco as protective has a distinguished heritage. Another treatise of 1665 recommends tobacco as “a good Fume against pestilential and infected air”, said to be effective for “All Ages, all Sexes, all Constitutions, Young and Old … either by chewing in the leaf, or smoaking in the Pipe.” On June 7 1665, the diarist Samuel Pepys was so unnerved by the sight of an infected house that he bought “some roll-tobacco to smell and to chew, which took away my apprehension”. It would later be claimed that no tobacconist died during the Great Plague.

Like Trump – but without the benefit of modern science – the bonfire lighters and tobacco chewers grasped the shadow of reality. So did the professors of heat.

Fleas carry diseases including the plague, caused by the bacterium Yersinia pestis.
Janice Haney Carr via Shutterstock

Since 1894 and the identification of the bacillus Yersinia pestis, we have known that bubonic plague was largely transmitted by fleas. Well, certain odours may deter some types of flea. And the bacillus can survive for up to a year given the right combination of warmth and humidity.

What about transmission? Physicians in 1665 struggled with distinct sets of symptoms and chances of survival. How was it that some people developed buboes over many days and had a 25% chance of recovery, while others without evident symptoms suddenly keeled over?

They named the cause “the fatal breath”. Pulmonary or pneumonic plague, we say now. It is caught like coronavirus or a common cold: the only form of the disease transmitted directly between people and is 95% deadly.

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Coronavirus: Defoe’s account of the Great Plague of 1665 has startling parallels with today

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Still, it was not quite as lethal as some people imagined. Defoe’s A Journal of the Plague Year reports a stubbornly held belief. If a man so infected breathed on a hen, rotten eggs would follow. In really severe cases, the hen would just drop dead.

Design for an amulet to ward off the plague, 17th century.
Wellcome Images, CC BY-NC-SA

The prize for bogus medicine, however, goes to the amulets and other trinkets people of 1665 carried to ward off the plague. Defoe dismisses them as “hellish Charms”, and claims they were often seen hanging round the necks of bodies in the dead carts. He captures their essence in a word the Oxford English Dictionary defines as “deceit, fraud, imposture, trickery”. The word? “Trumpery”.

David Roberts, Professor of English and National Teaching Fellow, Birmingham City University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Diary of Samuel Pepys shows how life under the bubonic plague mirrored today’s pandemic

There were eerie similarities between Pepys’ time and our own.
Justin Sullivan/Getty Images

Ute Lotz-Heumann, University of Arizona

In early April, writer Jen Miller urged New York Times readers to start a coronavirus diary.

“Who knows,” she wrote, “maybe one day your diary will provide a valuable window into this period.”

During a different pandemic, one 17th-century British naval administrator named Samuel Pepys did just that. He fastidiously kept a diary from 1660 to 1669 – a period of time that included a severe outbreak of the bubonic plague in London. Epidemics have always haunted humans, but rarely do we get such a detailed glimpse into one person’s life during a crisis from so long ago.

There were no Zoom meetings, drive-through testing or ventilators in 17th-century London. But Pepys’ diary reveals that there were some striking resemblances in how people responded to the pandemic.

A creeping sense of crisis

For Pepys and the inhabitants of London, there was no way of knowing whether an outbreak of the plague that occurred in the parish of St. Giles, a poor area outside the city walls, in late 1664 and early 1665 would become an epidemic.

The plague first entered Pepys’ consciousness enough to warrant a diary entry on April 30, 1665: “Great fears of the Sickenesse here in the City,” he wrote, “it being said that two or three houses are already shut up. God preserve us all.”

Portrait of Samuel Pepys by John Hayls (1666).
National Portrait Gallery

Pepys continued to live his life normally until the beginning of June, when, for the first time, he saw houses “shut up” – the term his contemporaries used for quarantine – with his own eyes, “marked with a red cross upon the doors, and ‘Lord have mercy upon us’ writ there.” After this, Pepys became increasingly troubled by the outbreak.

He soon observed corpses being taken to their burial in the streets, and a number of his acquaintances died, including his own physician.

By mid-August, he had drawn up his will, writing, “that I shall be in much better state of soul, I hope, if it should please the Lord to call me away this sickly time.” Later that month, he wrote of deserted streets; the pedestrians he encountered were “walking like people that had taken leave of the world.”

Tracking mortality counts

In London, the Company of Parish Clerks printed “bills of mortality,” the weekly tallies of burials.

Because these lists noted London’s burials – not deaths – they undoubtedly undercounted the dead. Just as we follow these numbers closely today, Pepys documented the growing number of plague victims in his diary.

‘Bills of mortality’ were regularly posted.
Photo 12/Universal Images Group via Getty Image

At the end of August, he cited the bill of mortality as having recorded 6,102 victims of the plague, but feared “that the true number of the dead this week is near 10,000,” mostly because the victims among the urban poor weren’t counted. A week later, he noted the official number of 6,978 in one week, “a most dreadfull Number.”

By mid-September, all attempts to control the plague were failing. Quarantines were not being enforced, and people gathered in places like the Royal Exchange. Social distancing, in short, was not happening.

He was equally alarmed by people attending funerals in spite of official orders. Although plague victims were supposed to be interred at night, this system broke down as well, and Pepys griped that burials were taking place “in broad daylight.”

Desperate for remedies

There are few known effective treatment options for COVID-19. Medical and scientific research need time, but people hit hard by the virus are willing to try anything. Fraudulent treatments, from teas and colloidal silver, to cognac and cow urine, have been floated.

Although Pepys lived during the Scientific Revolution, nobody in the 17th century knew that the Yersinia pestis bacterium carried by fleas caused the plague. Instead, the era’s scientists theorized that the plague was spreading through miasma, or “bad air” created by rotting organic matter and identifiable by its foul smell. Some of the most popular measures to combat the plague involved purifying the air by smoking tobacco or by holding herbs and spices in front of one’s nose.

Tobacco was the first remedy that Pepys sought during the plague outbreak. In early June, seeing shut-up houses “put me into an ill conception of myself and my smell, so that I was forced to buy some roll-tobacco to smell … and chaw.” Later, in July, a noble patroness gave him “a bottle of plague-water” – a medicine made from various herbs. But he wasn’t sure whether any of this was effective. Having participated in a coffeehouse discussion about “the plague growing upon us in this town and remedies against it,” he could only conclude that “some saying one thing, some another.”

A 1666 engraving by John Dunstall depicts deaths and burials in London during the bubonic plague.
Museum of London

During the outbreak, Pepys was also very concerned with his frame of mind; he constantly mentioned that he was trying to be in good spirits. This was not only an attempt to “not let it get to him” – as we might say today – but also informed by the medical theory of the era, which claimed that an imbalance of the so-called humors in the body – blood, black bile, yellow bile and phlegm – led to disease.

Melancholy – which, according to doctors, resulted from an excess of black bile – could be dangerous to one’s health, so Pepys sought to suppress negative emotions; on Sept. 14, for example, he wrote that hearing about dead friends and acquaintances “doth put me into great apprehensions of melancholy. … But I put off the thoughts of sadness as much as I can.”

Balancing paranoia and risk

Humans are social animals and thrive on interaction, so it’s no surprise that so many have found social distancing during the coronavirus pandemic challenging. It can require constant risk assessment: How close is too close? How can we avoid infection and keep our loved ones safe, while also staying sane? What should we do when someone in our house develops a cough?

During the plague, this sort of paranoia also abounded. Pepys found that when he left London and entered other towns, the townspeople became visibly nervous about visitors.

“They are afeared of us that come to them,” he wrote in mid-July, “insomuch that I am troubled at it.”

Pepys succumbed to paranoia himself: In late July, his servant Will suddenly developed a headache. Fearing that his entire house would be shut up if a servant came down with the plague, Pepys mobilized all his other servants to get Will out of the house as quickly as possible. It turned out that Will didn’t have the plague, and he returned the next day.

In early September, Pepys refrained from wearing a wig he bought in an area of London that was a hotspot of the disease, and he wondered whether other people would also fear wearing wigs because they could potentially be made of the hair of plague victims.

And yet he was willing to risk his health to meet certain needs; by early October, he visited his mistress without any regard for the danger: “round about and next door on every side is the plague, but I did not value it but there did what I could con ella.”

Just as people around the world eagerly wait for a falling death toll as a sign of the pandemic letting up, so did Pepys derive hope – and perhaps the impetus to see his mistress – from the first decline in deaths in mid-September. A week later, he noted a substantial decline of more than 1,800.

Let’s hope that, like Pepys, we’ll soon see some light at the end of the tunnel.

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Ute Lotz-Heumann, Heiko A. Oberman Professor of Late Medieval and Reformation History, University of Arizona

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How the rich reacted to the bubonic plague has eerie similarities to today’s pandemic

Franz Xavier Winterhalter’s ‘The Decameron’ (1837).
Heritage Images via Getty Images

Kathryn McKinley, University of Maryland, Baltimore County

The coronavirus can infect anyone, but recent reporting has shown your socioeconomic status can play a big role, with a combination of job security, access to health care and mobility widening the gap in infection and mortality rates between rich and poor.

The wealthy work remotely and flee to resorts or pastoral second homes, while the urban poor are packed into small apartments and compelled to keep showing up to work.

As a medievalist, I’ve seen a version of this story before.

Following the 1348 Black Death in Italy, the Italian writer Giovanni Boccaccio wrote a collection of 100 novellas titled, “The Decameron.” These stories, though fictional, give us a window into medieval life during the Black Death – and how some of the same fissures opened up between the rich and the poor. Cultural historians today see “The Decameron” as an invaluable source of information on everyday life in 14th-century Italy.

Giovanni Boccaccio.
Leemage via Getty Images

Boccaccio was born in 1313 as the illegitimate son of a Florentine banker. A product of the middle class, he wrote, in “The Decameron,” stories about merchants and servants. This was unusual for his time, as medieval literature tended to focus on the lives of the nobility.

“The Decameron” begins with a gripping, graphic description of the Black Death, which was so virulent that a person who contracted it would die within four to seven days. Between 1347 and 1351, it killed between 40% and 50% of Europe’s population. Some of Boccaccio’s own family members died.

In this opening section, Boccaccio describes the rich secluding themselves at home, where they enjoy quality wines and provisions, music and other entertainment. The very wealthiest – whom Boccaccio describes as “ruthless” – deserted their neighborhoods altogether, retreating to comfortable estates in the countryside, “as though the plague was meant to harry only those remaining within their city walls.”

Meanwhile, the middle class or poor, forced to stay at home, “caught the plague by the thousand right there in their own neighborhood, day after day” and swiftly passed away. Servants dutifully attended to the sick in wealthy households, often succumbing to the illness themselves. Many, unable to leave Florence and convinced of their imminent death, decided to simply drink and party away their final days in nihilistic revelries, while in rural areas, laborers died “like brute beasts rather than human beings; night and day, with never a doctor to attend them.”

Josse Lieferinxe’s ‘Saint Sebastian Interceding for the Plague Stricken’ (c. 1498).
Wikimedia Commons

After the bleak description of the plague, Boccaccio shifts to the 100 stories. They’re narrated by 10 nobles who have fled the pallor of death hanging over Florence to luxuriate in amply stocked country mansions. From there, they tell their tales.

One key issue in “The Decameron” is how wealth and advantage can impair people’s abilities to empathize with the hardships of others. Boccaccio begins the forward with the proverb, “It is inherently human to show pity to those who are afflicted.” Yet in many of the tales he goes on to present characters who are sharply indifferent to the pain of others, blinded by their own drives and ambition.

In one fantasy story, a dead man returns from hell every Friday and ritually slaughters the same woman who had rejected him when he was alive. In another, a widow fends off a leering priest by tricking him into sleeping with her maid. In a third, the narrator praises a character for his undying loyalty to his friend when, in fact, he has profoundly betrayed that friend over many years.

Humans, Boccaccio seems to be saying, can think of themselves as upstanding and moral – but unawares, they may show indifference to others. We see this in the 10 storytellers themselves: They make a pact to live virtuously in their well-appointed retreats. Yet while they pamper themselves, they indulge in some stories that illustrate brutality, betrayal and exploitation.

Boccaccio wanted to challenge his readers, and make them think about their responsibilities to others. “The Decameron” raises the questions: How do the rich relate to the poor during times of widespread suffering? What is the value of a life?

In our own pandemic, with millions unemployed due to a virus that has killed thousands, these issues are strikingly relevant.

This is an updated version of an article originally published on April 16, 2020.

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Kathryn McKinley, Professor of English, University of Maryland, Baltimore County

This article is republished from The Conversation under a Creative Commons license. Read the original article.

This isn’t the first global pandemic, and it won’t be the last. Here’s what we’ve learned from 4 others throughout history

Wikimedia/Pierart dou Tielt

David Griffin, The Peter Doherty Institute for Infection and Immunity and Justin Denholm, Melbourne Health

The course of human history has been shaped by infectious diseases, and the current crisis certainly won’t be the last time.

However, we can capitalise on the knowledge gained from past experiences, and reflect on how we’re better off this time around.

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Read more:
Four of the most lethal infectious diseases of our time and how we’re overcoming them

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1. The Plague, or ‘Black Death’ (14th Century)

While outbreaks of the plague (caused by the bacterium Yersinia pestis) still occur in several parts of the world, there are two that are particularly infamous.

The 200-year long Plague of Justinian began in 541 CE, wiping out millions in several waves across Europe, North Africa and the Middle East and crimping the expansionary aspirations of the Roman Empire (although some scholars argue that its impact has been overstated).

Then there’s the better known 14th century pandemic, which likely emerged from China and
decimated populations in Asia, Europe and Northern Africa.

Perhaps one of the greatest public health legacies to have emerged from the 14th century plague pandemic is the concept of “quarantine”, from the Venetian term “quarantena” meaning forty days.

The 14th century Black Death pandemic is thought to have catalysed enormous societal, economic, artistic and cultural reforms in Medieval Europe. It illustrates how infectious disease pandemics can be major turning points in history, with lasting impacts.

For example, widespread death caused labour shortages across feudal society, and often led to higher wages, cheaper land, better living conditions and increased freedoms for the lower class.

Various authorities lost credibility, since they were seen to have failed to protect communities from the overwhelming devastation of plague. People began to openly question long held certainties around societal structure, traditions, and religious orthodoxy.

This prompted fundamental shifts in peoples’ interactions and experience with religion, philosophy, and politics. The Renaissance period, which encouraged humanism and learning, soon followed.

The Dance of Death, or Danse Macabre was a common artistic trope of the time of the Black Death.
Public Domain/Wikimedia

The Black Death also had profound effects on art and literature, which took on more pessimistic and morbid themes. There were vivid depictions of violence and death in Biblical narratives,
still seen in many Christian places of worship across Europe.

How COVID-19 will reshape our culture, and what unexpected influence it will have for generations to come is unknown. There are already clear economic changes arising from this outbreak, as some industries rise, others fall and some businesses seem likely to disappear forever.

COVID-19 may permanently normalise the use of virtual technologies for socialising, business, education, healthcare, religious worship and even government.

2. Spanish influenza (1918)

The 1918 “Spanish Flu” pandemic’s reputation as one of the deadliest in human history is due to a complex interplay between how the virus works, the immune response and the social context in which it spread.

It arose in a world left vulnerable by the preceding four years of World War I. Malnutrition and overcrowding were common.

Around 500 million people were infected – a third of the global population at the time – leading to 50-100 million deaths.

A unique characteristic of infection was its tendency to kill healthy adults between the ages of 20 and 40.

At the time, influenza infection was attributed to a bacterium (Haemophilus influenzae) rather than a virus. Antibiotics for secondary bacterial infections were still more than a decade away, and intensive care wards with mechanical ventilators were unheard of.

Clearly, our medical and scientific understanding of the ‘flu in 1918 made it difficult to combat. However, public health interventions, including quarantine, the use of face masks and bans on mass gatherings helped limit the spread in some areas, building on prior successes in controlling tuberculosis, cholera and other infectious diseases.

Australia imposed maritime quarantine, requiring all arriving ships to be cleared by Commonwealth Quarantine Officials before disembarkation. That likely delayed and reduced the Spanish flu impact on Australia, and had secondary effects on the other Pacific Islands.

The effect of maritime quarantine was most striking in Western and American Samoa, with the latter enforcing strict quarantine and experiencing no deaths. By contrast, 25% of Western Samoans died, after influenza was introduced by a ship from New Zealand.

In some cities, mass gatherings were banned, and schools, churches, theatres, dance and pool halls closed.

In the United States, cities that committed earlier, longer and more aggressively to social distancing interventions, not only saved lives, but also emerged economically stronger than those that didn’t.

Face masks and hand hygiene were popularised and sometimes enforced in cities.

In San Francisco, a Red Cross-led public education campaign was combined with mandatory mask-wearing outside the home.

This was tightly enforced in some jurisdictions by police officers issuing fines, and at times using weapons.

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3. HIV/AIDS (20th century)

The first reported cases of HIV/AIDS in the Western world emerged in 1981.

Since then, around 75 million people have become infected with HIV, and about 32 million people have died.

Many readers may remember how baffling and frightening the HIV/AIDs pandemic was in the early days (and still is in many parts of the developing world).

We now understand that people living with HIV infection who are on treatment are far less likely to develop serious complications.

These treatments, known as antiretrovirals stop HIV from replicating. This can lead to an “undetectable viral load” in a person’s blood. Evidence shows that people with an undetectable viral load can’t pass the virus on to others during sex.

Condoms and PrEP (short for “pre-exposure prophylaxis,” where people take an oral antiretroviral pill once a day), can be used by people who don’t have HIV infection to reduce the risk of acquiring the virus.

Unfortunately, there are currently no proven antivirals available for the prevention or treatment of COVID-19, though research is ongoing.

The HIV pandemic taught us about the value of a well-designed public health campaign, and the importance of contact tracing. Broad testing in appropriate people is fundamental to this, to understand the extent of infection in the community and allow appropriately targeted individual and population-level interventions.

It also demonstrated that words and stigma matter; people need to feel they can test safely and be supported, rather than ostracised. Stigmatising language can fuel misconceptions, discrimination and discourage testing.

4. Severe Acute Respiratory Syndrome (SARS) (2002-2003)

The current pandemic is the third coronavirus outbreak in the past two decades.

The first was in 2002, when SARS emerged from horseshoe bats in China and spread to at least 29 countries around the world, causing 8,098 cases and 774 deaths.

SARS was finally contained in July, 2003. SARS-CoV-2, however, appears much more easily spread than the original SARS coronavirus.

To some extent SARS was a practice run for COVID-19. Researchers focused on SARS and MERS (Middle Eastern Respiratory Syndrome, another coronavirus that remains a problem in selected regions), are providing important foundational research for potential vaccines against SARS-CoV-2.

Knowledge gleaned from SARS may also lead to antiviral drugs to treat the current virus.

SARS also emphasised the importance of communication in a pandemic, and the need for frank, honest and timely information sharing.

Certainly, SARS was a catalyst for change in China; the government invested in enhanced surveillance systems, that facilitate the real time collection and communication of infectious diseases and syndromes from emergency departments back to a centralised government database.

This was coupled with the International Health Regulations, which requires the reporting of unusual and unexpected outbreaks of disease.

Advances in science, information technology and knowledge gained from SARS, allowed us to quickly isolate, sequence and share SARS-CoV-2 data globally. Likewise, important clinical information was distributed early to the medical community.

SARS demonstrated how quickly and comprehensively a virus could spread around the world in the era of air transportation, and the role of individual “superspreaders”.

SARS also underlined the importance of the inextricable link between human, animal and environmental health, known as “One Health”, that may facilitate the crossover of germs between species.

Finally, a crucial, but perhaps overlooked lesson from SARS is the need for sustained investment in vaccine and infectious disease treatment research.

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Read more:
Coronavirus is a wake-up call: our war with the environment is leading to pandemics

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Few infectious disease researchers were surprised when another coronavirus pandemic broke out. A globalised world, with overcrowded, well connected people and cities, where humans and animals live in close proximity, provides fertile conditions for infectious diseases.

We must be ever prepared for the emergence of another pandemic, and learn the lessons of history to navigate the next threat.

David Griffin, Infectious Diseases Fellow, The Peter Doherty Institute for Infection and Immunity and Justin Denholm, Associate Professor, Melbourne Health

This article is republished from The Conversation under a Creative Commons license. Read the original article.