Part Two – Plagued by Worry: An Historical Look at Pandemics in Four Parts

Part One can be read here.

Part Two

The Little Towns that Could (Quarantine)

The bubonic plague made a large resurgence in Europe in the mid-1600s.  Venice was one of the first ports of entry.  Knowing their history, however, once it showed up, all boats were quarantined for a time outside of the harbor.  If a person started showing symptoms, they were sent off to one of the islands in the Venice Lagoon – Lazzareto Vecchio.  It was already in use as a leprosarium and was the quarantine point for incoming ships.  The hospital there had been built in 1403.  There, under the care of doctors, and having access to fresh water, nourishing food, and sanitary conditions, people actually began to recover.  It was a tactic that saved tens of thousands of people.  Venice is unique, however, in that it has a lagoon of islands on which it could quarantine people.  Other inland cities always run a risk of someone getting through a quarantined area.  For those wondering, Lazzaretto Vecchio is not open to tourists today, but it is an active archaeological site.

Caption: Santa Maria della Salute in Venice. This church has two domes of blueish gray that are topped with spires. It is sitting on an island in the Venetian lagoon, with water and a boat in front of it.

Venice residents and leaders made a pledge to the Virgin Mary to build a church in her honor if she delivered the city from the plague.  Even though they lost a third of their population (46,000 in the city, and a further 94,000 in the Venetian lagoon) in the 1630 plague, enough survived that they made good on their pledge, constructing Santa Maria della Salute (“Our Lady of Health”).  Construction began in 1631.  It is filled with relics of the plague and art referencing plague.  Obviously, on my trip to Italy last year, it was one of my most anticipated stops.

Eyam in England (Derbyshire) went a slightly different route than Venice.  On September 7, 1665, the first resident died from the plague, which arrived in the village in a bolt of cloth from London that was (unknowingly) infested with fleas.  The final victim died on November 1, 1666.  In all, 260 villagers (of a population between 350-800) died in a 14-month span.  But the plague did not escape from the village, as the leaders made the decision to shut down the village to anyone coming in or leaving.  The villagers agreed to this plan, sacrificing their lives to spare the surrounding area.  The quarantine worked.  Eyam was devastated.  Neighboring villages and towns, however, were nearly unscathed.

Non-Plague Pandemics

Not every pandemic is caused by plague, in any of its forms, however.  The definition of pandemic is an epidemic of an infectious disease that spreads across a large region.  Diseases such as smallpox, polio, tuberculosis, and AIDS have been the bases of pandemics in the past.  To contrast, an epidemic is a rapid spread of an infectious disease to a large number of people in a given population – not spread out over a region.

The 1918 Flu Pandemic is but one example of a non-plague-related pandemic.  It infected up to a third of the world’s population, with a death toll as high as 50,000,000 (some say even higher, going up to 100,000,000).  The flu still kills thousands of people a year – what made the 1918 one so deadly?  In a few words, World War I.

European countries were noticing an unusually high mortality rate for flu in 1918 (actually, the higher numbers began showing up in 1917, but exploded in 1918).  It can largely be attributed to wartime conditions – soldiers in foxholes have far more to worry about than sanitation, and insanitary conditions breed disease.  But the Allied powers needed help, and America joined the fray.  European governments, media, and military downplayed the flu numbers.  Of course it was a little higher than normal.  We have all these folks from different countries fighting against each other in trenches – of course they’ll get sick!  Only Spain (officially neutral) reported its actual numbers, which gave people the impression that it was the only country truly suffering and led to the outbreak being misnamed as the Spanish Flu.  In fact, we are not sure where precisely it originated.

Regardless of where it started, as soldiers began to go home, it spread to their countries.  With travel being more prevalent, travelers took it to even more countries.  And we must remember that even in the 1900s much of the world was living in conditions where they didn’t have running water in their homes, being able to keep homes and people clean.  Soldiers with severe cases of the flu were sent home, while mild cases stayed at the front.  This reverses what is usually seen in flus, where severe cases tend to isolate themselves in their homes, and mild cases roam about.  This was also part of what contributed to such a high mortality rate.

The first wave of the pandemic was bad.  But then, once people started recovering and going on as life had been, the second wave took over.  In August of 1918, roughly five months after the start of the pandemic, the second wave was already starting to hit France and the United States – and hard.  In all, October 1918 had the highest death toll of all the months of the pandemic (which ran from spring 1918 to summer 1919).  The soldiers returning home continued to carry the flu with them.  A third wave (January – June 1919) was deadlier than the first wave, but not as bad as the second.  This one was generally led by celebrations of the end of World War I and again, soldiers returning home.

A 2013 study by He, et al. examined the implications of school closings, temperature change, and human behavior on how they impacted the 1918 Flu.  Some areas of the United States had shut down schools due to the pandemic.  Some towns and cities had implemented mask requirements and quarantines and/or curfews.  The flu had covered more than a year, so temperature change effects could be noted.  Out of all the factors, human behavior had the most effect on transmission.  The more a city had quarantined, or required masks, or kept people home after a certain hour, the less impact the flu had on that city.

Historical look at plaguesAnne E. Lynch is the Executive Director of Three Rivers Community Foundation, an organization dedicated to funding progressive social change in the Southwestern Pennsylvania region. She graduated from the University of Pittsburgh with a BA in anthropology and a minor in history. She penned On This Day in Pittsburgh’s Progressive History, a small book with important events and people from the region that furthered social justice, and from that developed the Progressive History of Pittsburgh Facebook page ( She is also the author of two cookbooks under her Vegan Goddess persona. She has some odd passions, however, one of which is the history and imagery of the Black Death and other plague outbreaks.


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