How To Survive A Pandemic, According To Historians

Throughout the ages have pandemics been humanity’s test for survival. From Ancient times to the modern world, deadly epidemics have wiped out civilizations and triggered medical investigations — and today’s sanitary measures echo the painful teachings of history…

Plague, cholera, smallpox, typhus, or even the flu: mankind has faced notorious epidemics in the course of it bumpy history. The good thing is, we have always recovered… But at what cost? Let’s round up the most effective, history-backed survival tips in the case of a pandemic.

Tip #1 – Do not panic

“All were shuddering, fleeing, shunning the contagion, impiously exposing their own friends, as if with the exclusion of the person who was sure to die of the plague, one could exclude death itself also.”

This is how Pontius of Carthage described the Plague of Cyprian, which devastated the Roman Empire in the 3rd century AD. Sure, running away appears to be a normal behaviour in such a terrifying context; however, it risks spreading the epidemic further, thus worsening the death toll. This is pretty much what happened in Marseille, France, in 1720. Despite the local authorities’ best efforts to contain the plague within city limits — a 36-kilometer long stone wall was erected to prevent citizens from fleeing — the epidemic eventually reached neighbouring towns and killed more.

patente santé 1792
Interestingly, as soon as the 15th century, ‘health patents’ were delivered to vouch four the travellers’ health status. Here is pictured one dated 1792, from Provence (southern France). (Source © Bibliothèque de l’Académie nationale de médecine)

In addition, it is standard practive to recruit convicts or galley slaves so as to bury the dead or watch over the sick. Most of the time, surgeons and apothecaries — the ones whose resourcefulness is usually the most precious in plagued times — have long been infected or escaped the disease. Hence the shift towards less standard procedures, as the bishop of Bath demonstrated in 1349:

“The contagious pestilence of the present day, which is spreading far and wide, has left many parish churches without parson or priest to care for the parishioners. Since no priests can be found […] persuade all men, in particular, those who are now sick or should feel sick in the future, that, if they are on the point of death and cannot secure the services of a priest, then they should make confession to each other […] even to a woman.”

Tip #2 – Take advice from (real) doctors

Alchemists, apothecaries, barbers or even astrologists — several medieval professions claimed at least basics of medical knowledge. But what did they actually know? Like most ‘scientific minds’ of their time, they heavily relied on the works of Hippocrates or Galen. A millennia had not changed much of the medical practice. Proof is, their advice against the plague usually did not do much to cure any disease…

Here is what a common medieval prescription might look like: bloodletting, bezoars, emerald powder, cloves, mercury, venom, horse hooves… but also amulets, pilgrimages and religious donations. ‘The urine of the billy goat is good to smell,’ a medieval doctor lectured. Even later pandemics, such as cholera in the 19th century or the 1918 Spanish flu outbreak, would prove hard to comprehend to medical scholars.

glasses-showing-urine-british library manuscript
Inherited from Greek science, diagnoses drawing on the color, taste or smell of human urine are still routinely carried out in the Middle Ages — as this 15th-century manuscript illustrates. (Credit: British Library, Sloane MS7)

Tip #3 – Do not look for a scapegoat

How else would a random 12th-century anybody explain the outbreak of deadly pandemics, but by the hand of God? Most witnesses considered epidemics to be divine punishments. When the Black Death swept across Europe from 1347 on — burying a third of the European population in the process –, it triggered a wave of lynchings. Scapegoats had to be found to soothe divine wrath: Jews, beggars, prostitutes, lepers (among other ‘plague sowers’) were chased away or killed by angry mobs.

A mere few months after the Black Death broke out, several European cities were home to pogroms: Barcelona, Strasbourg, Toulon, Erfurt, Brussels, among others. Most of the time, those violent demonstrations targeted society dropouts, like the French huguenots who were hanged in Lyons in 1628. On top of that, as they often drove hundreds of people together, lynchings also favored contagion…

Tip #4 – Stay home

Only in 1377 was the quarantine process institutionalized, first in Ragusa (Sicily), then in Venice. Following the mid-14th century ‘Great Pestilence’, merchant ships were ordered to remain at bay for 40 days before being authorized to enter the harbour. The practice proved successful enough to spread to other Mediterranean locations, as well as on solid ground. In the infected cities, churches were requisitioned to shelter the sick; but they often were packed with bodies, some already dead and awaiting burial. “One is assailed with putrid smells… Has to step over cadavers… It is hell on Earth” the cardinal Spada noted while visiting a lazaretto (quarantine station).

Pestlazarett_in_Wien_–_Alsergrund_-_Ex_voto
A lazaretto during the Plague of Vienna, ca. 1680. (Credit: Wikipedia/Public domain)

How did containment work, back in the days? During the Black Death, the Milanese authorities ordered every infected person to be walled in home with his or her family. A red or black cross would then be painted on the door to prevent people from approaching. Social distancing was also the general rule when the 1918 Spanish flu pandemic broke out. Interestingly, the city of Saint Louis (USA) was a pioneer of severe sanitary measures: churches and schools were shut down, wearing a mask turned mandatory — ultimately registering one of the lowest death rates across the country.

Tip #5 – May he rest in peace (and far away)

Epidemics also raised a major concern in terms of funeral services. Rotting corpses became surrounded with flies, and to limit the scope of contagion, they had to be buried quick and deep. Sanitary authorities ordered, as soon as the 14th century, to bury corpses in layers “like lasagna” (remember, Italy was the first Mediterranean area affected by the Great Plague) because mass graves were becoming increasingly full.

Great Plague - Black Death pandemic burial in Tournai France
The inhabitants of Tournai, Belgium, bury their dead. Illumination by Pierart dou Tielt (14th century).

Here and there, local innovations demonstrate that plagueish conditions did not deter creativity. In 1720, authorities considered piling up hundreds of cadavers on a ship and then sinking the latter in the open sea. But the local governor turned the proposal down, since he feared the bodies would poison the fish. Two centuries later, in the midst of hurried, cholera-related burials, some people feared being buried alive: hence the development of ‘safety coffins’ to prevent such spooky ends… So goes the old Italian proverb: “He who does not obey the doctor, obeys the gravedigger.”

Tip #6 – Wash your hands (and everything else)

Hygiene was not always a top priority throughout history. Roman Antiquity famously promoted it with regular thermae sessions. But it was later discouraged by the Church; religious authorities indeed believed baths would favour debauchery and lack of privacy. One would have to wait until the 19th-century outbreaks of cholera for the issue to be raised again. Rapid industrialization created a very insalubrious environment in capital cities, swarming with rats and diseases. Local rivers became littered with trash and human excrement. “The Thames is now made a great cesspool,” the Londoner Thomas Cubbit lamented in 1840.

Monster_Soup_commonly_called_Thames_Water._Wellcome_V0011218
“The Monster Soup” by William Heath, 1828. (Credit: Wikipedia/Public domain)

However, cholera made its way towards recently-industrialized European cities through dirty waterways. The disease ultimately contaminated watering places, wash houses and wells. When the locals eventually understood the roots of the pandemic, the sewers of London and Paris were rapidly revamped in the 1850s, and vaccination services mushroomed throughout the continent. Same concern with the Spanish flu, which spread rapidly because of the impossible hygiene of 1918 trench life (and would infect 27% of the world’s population). Let’s now hope that sanitary measures are enough part of our daily routines for such pandemics not to strike again!

 

 


References

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