It was easy to imagine, before the pandemic arrived, that societies today would handle an epidemiological challenge much better than those in the past had done. And in many ways that’s proven to be the case. Scientific knowledge and advanced technology have made it possible to quickly identify viruses and their mutations, to generate and process pandemic-related data in real time, to rapidly adjust medical care to changing understandings of the disease, and to create effective vaccines in an unprecedentedly short period.
But in other ways, we are still struggling with the very same challenges faced by societies in the past: in particular, the challenge of how to balance responses to an epidemiological crisis with concerns about the economy, the rights of citizens, and the public health. Whether the crisis was plague or cholera, governing bodies in the past were, like today, forced to take measures they knew would do long-term damage to economies, disproportionately penalize the poor and more marginalized members of society, impact trade and diplomatic relationships, and infuriate all members of society in some way or another, thus raising the risk of widespread social unrest. Of these measures, there was probably none more detested than the quarantine.
We are all familiar with historical images of quarantine: crosses on doors, watchmen keeping guard over quarantined homes on quarantined streets, provisions left in front of shut-up houses, and contemporaries’ descriptions of the misery it inflicted on those who were affected. We know that quarantine measures in historic Europe were much more restrictive and coercive than current “lockdowns” and “stay at home” orders, with people locked inside their houses or dragged off against their will to pesthouses. These aspects were real and terrible, and it’s not surprising they attract so much attention. But there was a more prosaic side to quarantine, too – one that may seem more familiar to us today. This was concerned with questions like how the measure would be implemented, how it would be enforced, how it would be paid for, and how the poorest and most vulnerable members of society would be cared for in the process.
There is a vast literature on early modern plague – particularly well-known are the works of historians such as Paul Slack, Carlo Cipolla and Jean-Noël Biraben – and the administration of quarantine is frequently addressed in these. I want to focus on two relatively recent local studies of quarantine: this article by Kira Newman, which studies the London parish of St Martin in the Fields during the 1636 plague outbreak, and this new book by John Henderson about the city of Florence during a plague outbreak in the early 1630s. Both build on a variety of source materials about local authorities’ responses to epidemiological crisis.
In both cases, the sources reveal anxiety on the part of authorities about the economic effects of plague and of a quarantine policy. Providing for those in quarantine was essential – essentials such as food, drink, and firewood would have to delivered to households for the entire period of isolation. The archives for Florence contain detailed accounts regarding the regular distribution of bread and wine to households throughout the city (how much, to whom, when). St Martin in the Fields levied a small tax on all parish households to help cover the cost of provisions for quarantined inhabitants, and its archive indicates which households were required to pay this tax in full, which were responsible for a partial amount, and which were supported entirely by the parish. The costs of support were significant and St. Martin also resorted to borrowing from neighboring parishes, liquidating assets, and floating bonds to cover them.
The implementation and enforcement of quarantine was always difficult. It wasn’t, of course, as simple as just imprisoning a community in their houses until the epidemic had subsided. There were regulations determining when a house or street should be quarantined, when someone should be taken to a pesthouse rather than shut up at home, who should be notified when an infection was suspected, and how infringements should be dealt with. In the case of Florence, there were clearly “essential workers” who required special exemptions – mainly those who provided food. Those who owned land, then, were permitted to go out to work the land; those who did not (the hired laborers) were not. (The arbitrary distinctions seem not unlike those we’re familiar with today.)
People flouted the rules and were brought before the courts in both London and Florence. The infractions were various, and included hiding or failing to report the presence of infected persons (more common among the better off residents and tradespeople of London parishes), leaving one’s residence without permission (the cases range from desperate residents seeking work to mischievous merry-makers keen on sociability), admitting people from outside to one’s own residence, trying to enter or leave the town or parish during quarantine, and many others that resemble contemporary responses to lockdown policies.
Vocal concerns about the heavy-handedness of punishments appear in the London case, and accusations regarding the use of a health crisis to crack down on activities perceived by elites as unsavory. Henderson posits a more sympathetic attitude among Florentine officials, with those brought before the courts given fairly lenient punishments. That said, denunciations and public shaming were explicitly designated tools of enforcement in Florence, with citizens not only encouraged to report their quarantine-breaking neighbors but paid by officials for doing so. (It would be interesting to examine what the effects of such explicit forms of social control were on outcomes in comparative context.)
In both cases, authorities acknowledged the disproportionate impact on the poor of public health crises and the measures taken to mitigate that impact. In both cases, the poor were given support to compensate for their loss of livelihood. Additional measures were also taken, such as offering interest-free loans to households or commissioning piece work to be done in the home for additional funds (spinning flax in the Florentine case). At the same time, the archival evidence in both localities indicates a more complex relationship between poverty and epidemic disease. Newman notes that the St. Martin records suggest that the hardest hit by quarantine measures were the middling residents, who were too well off to qualify for support but too poor to flee the city (this is consistent with studies of plague in other parts of England). These were households that often relied, for instance, on income from the housing of lodgers – a practice that was forbidden in plague times and on which the stigma of quarantine tended to have a lingering effect. Henderson observes that not all poor parts of Florence were hit equally hard by plague and that housing density rather than quality appears to have been a critical factor.
One thing that emerges from both studies is that, in addition to depriving poorer members of society of their livelihoods, quarantine disrupted the social networks and cultures of mutual assistance on which they relied. Without the means to obtain certain goods and services through market transactions, poorer residents depended on help from friends and relations. They performed essential tasks for one another and looked after one another in times of childbirth, of sickness, of mourning. Regular sociability was a part of investing in and maintaining these networks, and being denied this significant part of everyday life was a very big hardship indeed. Breaking quarantine to participate in seemingly frivolous activities – such as playing bowls on the streets of Florence – was often part of an effort to keep one’s networks intact and maintain those relationships necessary for survival.
Quarantine was considered one of the most effective measures against the spread of disease, especially in the absence of scientific knowledge of disease transmission. Still, over time, many came to see the costs of quarantine as greater than the benefits. Some even thought it might be doing more harm than good. People of all social strata dreaded its impact on their lives and did what they could to avoid being shut up, even if that meant becoming infected or spreading the disease to others. Defoe was one such sceptic, noting that:
“… for the Apprehensions and Terror of being shut up, made many run away with the rest of the Family, who, tho’ it was not publickly known, and they were not quite sick, had yet the Distemper upon them; and who by having uninterrupted Liberty to go about, but being obliged still to conceal their Circumstances, or perhaps not knowing it themselves, gave the Distemper to others, and spread the Infection in a dreadful Manner …”
Local studies of public health crises are extremely valuable in that they can provide illuminating context for the variation in outcomes we historians observe at the surface. But perhaps the main lesson of history in the case of quarantine is that some problems have no easy solutions.