Black Death quarantine: how did we try to contain the most deadly disease in history?
People across the globe are self-isolating to help stop the spread of coronavirus. But, says historian Helen Carr, the practice of quarantine is nothing new. Here she explores how it was used alongside other measures in the 14th century to curb the disease that became known as the Black Death…
In the autumn of 1348 a ship glided into the port of Southampton in England, carrying a disease from the east that had already ravaged the western world. It had killed men, women and children in their thousands quickly and mercilessly. This was the bubonic plague, identified by the blackening ‘buboes’ that formed within the joint area of an infected person – the groin or armpit were the most common places. These were accompanied by bodily aches, cold, lethargy and a high fever. When the infection got into the blood stream it effectively poisoned the blood, leading to probable death. Some survived the infection but most people died within days, sometimes hours. This wave of bubonic plague became known then as the Pestilence – or later, the Black Death.
By November 1348 the disease had reached London, and by New Year’s Day 1349 around 200 bodies a day were being piled into mass graves outside the city. Henry Knighton, an Augustinian monk, witnessed the devastation of the Black Death in England: “there was a general mortality throughout the world… sheep and oxen strayed through the fields and among the crops and there was none to drive them off or collect them, but they perished in uncounted numbers… for lack of shepherds… After the Pestilence many buildings fell into total ruin for lack of inhabitants; similarly many small villages and hamlets became desolate and no homes were left in them, for all those who had dwelt anthem (sic) were dead.”
The countryside went to ruin, with crops, livestock and produce dying for lack of people to tend to them. Towns were abandoned, left only with the dead to occupy them, and war with France – the first part of the later-named Hundred Years’ War – was put on hold. England and the rest of Europe was forced to come to terms with an epidemic of an apocalyptic nature that drastically changed the landscape of society.
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In a bid to take control of the epidemic, Edward III, king of England as the time, was forced to turn his attention to domestic matters. Before the outbreak in England, his daughter Princess Joan had contracted plague after her ship docked in Bordeaux. She was on her way to marry Peter of Castile as part of a diplomatic marriage alliance between the two kingdoms. She never reached Castile and, upon discovery that the plague had taken hold of Bordeaux, she took refuge in a small village called Loremo, where she died alongside a large part of her entourage.
The king was devastated by the news and acted quickly and decisively to try to curb the outbreak in England. The 1349 January parliament was postponed until Easter (however, when spring came parliament was still empty.) Officials fled to their homes in the country and sheriffs refused to conduct their business for fear of their lives. The country was in lockdown and the people looked to the king to support them in the crisis.
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Edward’s response was rational: he suspected that poor public hygiene was responsible for the epidemic. In a bid to tackle the spread of infection, he opposed the idea of digging a burial pit for the plague victims in East Smithfield – it being in close proximity to the Tower of London and surrounding residential areas. Pits were dug further away, the largest one in Smithfield. In 1349 Edward III wrote to the Mayor of London directing him to have the streets thoroughly cleaned, for they were “foul with human faeces, and the air of the city poisioned (sic) to the great danger of men passing, especially in this time of infectious disease”.
Overseas, further precautions were taken. In Italy in 1347, almost a year before the plague reached England, ports began to turn away ships, fearful that they carried the deadly disease. By March 1348, these protective measures were formalised and Venice became the first city to close its ports to incoming vessels. Those they did admit were subjected to 30 days of isolation, later raised to 40, which eventually lead to the birth of the term ‘quarantine’, for ships were forced to wait in the middle of the Venetian lagoon before they were permitted to disembark. Remote cemeteries were dug and in a later outbreak, the Venetians even went as far as establishing a quarantine island on Lazzaretto Vecchio, a small island in the Venetian Lagoon. An excavation in 2007 revealed more than 1,500 skeletons, all supposedly victims of bubonic plague. Thousands more are believed to remain below ground on the island.
The Venetians even went as far to establish a quarantine island
However, these measures were too little too late. Plague still took hold in Venice – as it did globally – killing an estimated 100,000 people, a catastrophic proportion of the Venetian population.
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England shared the same fate. In 1300 the population had reached around five million, and by 1377 this was reduced to 2.5 million. Plague had claimed half of the population, wiping out entire families, villages and even towns such as Bristol. The measures that were taken to hinder the spread of the first Black Death epidemic were powerless, but there were contingency plans for future outbreaks later in history.
In 1563, when plague struck again (as the disease did most years, although some outbreaks were more severe than others), the lord mayor ordered that blue crosses should be attached to doors of houses that held anyone infected with plague over the past week. Inhabitants were to stay indoors for one month after the death or infection of anyone in the building. Only one uninfected person was allowed out of the house, in order to buy provisions for the sick or healing. To mark their health they were meant to carry a white rod, which if they forgot would incur a fine or even imprisonment. In 1539 plague struck London again and houses were to be incarcerated for 40 days – the typical quarantine period stipulated in 14th-century Venice. By 1580 shipping was heavily monitored, and crews and passengers were quarantined either on board their vessels or in the port where they had disembarked. Merchants were kept at the port of Rye and were prohibited from entering the city, and all goods were to be aired in order not to transport infection. Movement was also monitored within the country – travellers into London from outside counties were prohibited if there was known to be plague in their area.
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Outbreaks of plague continued into the 17th century, the most savage and famous being the 1665–56 epidemic. In 1630, quarantine measures were taken in London, with the Privy Council ordering that again houses were shut up when those inside were infected. However, to enforce the order, guards were to be stationed outside the infected house. This was soon replaced with the order that the people inside were to be sent to the Pest House (an enclosed hospital for those suffering from the plague) while the house was closed up. More famously, the village of Eyam in Derbyshire bravely imposed a self-quarantine in order to prevent the spread of infection into other villages, losing 260 villagers in the process.
Over four centuries, plague devastated the lives of millions, and despite the best efforts of the authorities, there was little to be done in order to control the spread of such virulent infection. People blamed themselves, usually in the belief that they were being punished by God for their sins – some even believed that the epidemic was an apocalypse.
Although today plague has generally ceased to exist, there was an outbreak in the US in 1924, and in India as late as 1994, killing 52 people and causing mass panic as people fled out of fear of infection. However, we do not tend to experience the rate of mortality seen in the 14th, 15th, 16th and 17th centuries. With the advancement of modern medicine and practical contingency, we hope that bio-medical disaster remains as history.
Helen Carr is a historian, writer and producer