A plague o’both your houses…

Plague: A plague is a very infectious disease that spreads quickly and kills large numbers of people.

In the depths of lockdown in the UK, I’ve been reading about how people that came before us dealt with plagues, to see if we have learnt anything since pandemics became popular around 10,000 years ago.

I say 10,000 years because that’s about the time we started collecting together in groups larger than hunter gather bands, started to produce surpluses of food and so invented trade, international – intercontinental even – travel and started to transport bacteria and viruses around the world and infect large numbers of other people. Never forget, if we don’t move, then bacteria and viruses can’t move either, which is why I have spent the last 10 weeks in the garden.

I started with Laura Spinney’s book Pale Rider.

Pale Rider: The Spanish Flu of 1918 and How it Changed the World (Paperback)

It charts the progress of the 1918 flu pandemic, spectacularly mis-named as Spanish Flu. The Spanish called it the “Naples Soldier” and almost every other country in the world apart from the Britain, the USA (where it almost certainly originated) and France, named it after a neighbouring country they viewed with distrust. It’s a great book and well worth a read as she describes the huge societal inequalities that were laid bare, if they needed to be, by the progress of the disease. Whilst the industrialised world was able to engage in total warfare and mechanised death, both on the ground and in the air, its scientists and doctors still only had partial understanding of the germ theory of disease and medicine was on the whole unregulated. Homeopaths and osteopaths were equally as able to treat flu as more “scientific” doctors. Bacteria had been observed and understood as an agent of disease but viruses were a mystery – they were unobservable and therefore unknowable at that time. Some vaccines were available – for example, Edward Jenner created a vaccine for smallpox in 1796, with no understanding of germ theory let alone viruses, simply through observation. However there were no vaccines against any kind of flu in 1918 and no defence against the novel H1N1 flu variant called Spanish Flu (and other things). This was a new disease, no one had had it before and so no one was immune (sound familiar?) neither was there any hope of finding a vaccine as no one had the first idea how to go about it. In the eyes of many this plague was an act of God. The disease ripped across the planet in three waves, sped on its way either by transporting men out to fight in the First World War or demobilising them as it ended. By the time the third wave of the pandemic burned itself out, it had killed somewhere between 50-100 million people.

However, I turned the final page of the book feeling a little relieved. Even though, at the start of the current plague, in the UK we appeared not to have learned the lessons of personal protective equipment and that took a long time to re-learn in 2020, in the UK at least. In 1918 face masks seemed to be accepted as essential protective equipment.

California coronavirus lessons from the 1918 Spanish flu - Los ...

Looking at the pictures above you may be thinking “Ha! The fools aren’t standing two meters apart!”. But why would they? They had no idea that the disease was caused by a particle that struggled to jump more than a meter.

So hey! We have learned something! Now we understand viruses cause disease and we have brilliant scientists all over the globe that have sequenced the genome of the little blighter and are desperately looking for the vaccine that will render it harmless. In 2020 we can stare into the very essence of the SARS-CoV-2 virus and pick it apart bit by bit. In 1918 they didn’t even know what a gene was. I put the book down and felt brave enough to go back further in time…

All the way back to 1665.

A Journal of the Plague Year

Well maybe not all the way to 1665 but to 1722 when the book was published. Arguments have been had as to whether the book is non-fiction or fiction but now it is regarded as a novel. The book is a first person recounting of the Great Plague in London and is attributed to a person called “H.F.” a saddler in Whitechapel district of London. Daniel Defoe had an uncle – Henry Foe – who was a saddler in Whitechapel so it may be based on his uncle’s journals. Who knows? However, Defoe is very careful to allocate events to specific streets and places and the book has a sense of a contemporaneous recording, but we just don’t know. What it clearly does give you is a sense of how they would deal with a plague at the time the book was written and I personally doubt things would have been different 60 years earlier. I opened the cover…

We start with rumours of the disease abroad. Rumours are that it is very bad in Amsterdam and, although the government did discuss it, people seemed unconcerned as it was a long way away and things were fine at home. That sounds familiar, I thought…

19 Jan 2020: Coronavirus: China reports 17 new cases of Sars-like mystery virus

https://www.theguardian.com/world/2020/jan/19/coronavirus-china-reports-17-new-cases-of-sars-like-mystery-virus#maincontent

Yet within a flash, the plague breaks out in London in Drury Lane, where two Frenchmen die of the Plague after opening a bale of silk from Holland. It then all goes quiet for a few months although Defoe says that he suspects that cases during this quiet period were being hushed up…

13 May 2020: Ian Murray accuses Nicola Sturgeon of ‘cover-up’ over Edinburgh Nike conference outbreak

https://www.scotsman.com/health/coronavirus/ian-murray-accuses-nicola-sturgeon-cover-over-edinburgh-nike-conference-outbreak-2852401

But then people start dying in large numbers and, helpfully, the numbers are recorded and published in parish “bills” which Defoe reproduces throughout the book as the Plague progresses… just like we do today! But there are problems with the numbers…

…for now for about nine weeks together there died near a thousand a day, one day with another, even by the account of the weekly bills, which yet, I have reason to be assured, never gave a full account, by many thousands; the confusion being such….

Journal of the Plague Year. D Defoe

As you can see, he sees a discrepancy between the numbers of deaths reported and the number of deaths actually occurring – by the thousands. 300 years later in the UK, we seem to be be better at recording the total number of deaths, but there are still discrepancies between those recorded as dying of COVID-19, and the total number of people dying – by the thousands. Its the number between the red and blue lines…

UK now has highest number of coronavirus deaths in Europe as toll ...

And so the comparisons go on: the refusal of shops to accept cash payments; the quack remedies that do much more harm than good – including smoking… I recall us doing that one too; the differential effect on various occupations – butchers being particularly mentioned – we have exactly the same this time round; how pregnant women are grievously affected by the Plague in a part of the book that is pretty devastating; and the huge financial intervention made by the Lord Mayor to prevent civil unrest – Defoe says hundreds of £thousands. Today we have hundreds of £billions.

The similarity is astonishing with one difference. He says that throughout the Plague, London was never short of food or any other supplies and prices increased only slightly. He doesn’t mention toilet roll in particular.

However what really made me stop and think is how they dealt with risk of the onward transmission of the infection. They did it by the only means at their disposal. People who had symptoms were shut up at home with their family (today we are calling it household) and told they couldn’t go out and someone else had to do their shopping for them, until they either got better or died.

Not to put too fine a point on it… 300 years later, in the face of a novel disease that no one has immunity to, we have appeared to have made very little progress indeed in how we to deal with a plague, because we are doing exactly the same thing.

We even whine the same whine as they did 300 years ago…

This shutting up of houses was at first counted a very cruel and unchristian method, and the poor people so confined made bitter lamentations. Complaints of the severity of it were also daily brought to my Lord Mayor, of houses causelessly (and some maliciously) shut up.

However…

… after all that was or could be done in these cases, the shutting up of houses, so as to confine those that were well with those that were sick, had very great inconveniences in it, and some that were very tragical, and which merited to have been considered if there had been room for it. But it was authorised by a law, it had the public good in view as the end chiefly aimed at, and all the private injuries that were done by the putting it in execution must be put to the account of the public benefit.

At the end of the day though, our hero seems to despair that, by the time people display symptoms and are shut up in their houses, it is too late. He says it’s not those people you need to worry about, it’s the people who are infected but are not showing symptoms. They are the real killers! He muses that what you need is some system to track all of the people that the symptomatic people have met, before they became symptomatic, and shut all of them up too!! But that’s probably impossible. Sound familiar at all?

However, when all the options are considered…

it is my opinion, and I must leave it as a prescription, viz., that the best physic against the plague is to run away from it.

I tend to agree.

And finally, before I close, Mr Defoe ends on a brighter note! The terrible economic slump that was caused by the Great Plague was followed by the V-shaped recoveries to end all V-shaped recoveries! The economy bounced back and accelerated into period of sustained growth as unseen before. Economic growth that was occasioned, of course, by rebuilding of London after the Great Fire… that was waiting in the wings.

If you would like to read the Journal of the Plague Year, you don’t even have to buy it. Those fine people at the Gutenburg Project have made it available online for free.

http://www.gutenberg.org/ebooks/376

Stay well, stay safe, stay at home, work out.

PS I have just opened my next book which is, of course, The Plague by Albert Camus and the book opens with a quote from… why Mr Daniel Defoe!! Sometimes life is very pleasing. 😊