The Irish Medical Times - The bubonic plague versus Covid, who did it better?


The Great Plague came at a time of abject poverty and spread like wildfire, in part due to questionable hygiene choices, slum housing and adventurous medical practices. Samual Pepys, the famous 17th century London diarist of the time, wrote about an lithotomy operation he underwent (in his cousin’s house) to remove a kidney stone as big as a billiard ball, with no anaesthetic onboard. It’s unclear if the cousin was standing by, polished cue in hand, ready to play a quick game of ‘name your pocket’.

However, it is clear that thousands died during the London plague of 1665 and a staggering 25 million died during the global Black Death of the 14th century, nearly a third of the world's population. Covid 19, in an age of modern medicine and state of the art vaccine technology, is well behind with 6 million lives lost at the last count (that said, Covid has yet to finish the race).

Covid and the Plague were both devastating epochal outbreaks, but there were differences, one was viral and one bacterial. Our current insidious bug creeps around like a cat burglar slipping into our lungs and hearts like a thief in the night. Whereas the olde worlde lurgy was a cruder creature manifesting itself through fever, boils, bleeding from every orifice, and the big tell - some gorgeous gangrene. You weren’t strapping on your lycra and going for a cycle with your pal to get a follow up text saying “Sorry dude, I just got a positive antigen for the ole plague. Great cycle!”

Pathological differences aside, there were many similarities in how we as a society reacted in 2020 and 1665, most notably we shut our doors. During the plague the victim was locked into their house along with the rest of their family condemning all to death. Nowadays the majority of people usually survive isolation, although familial threats of murder and killings are frequent and expected.

According to the British National Archives during the plague a victim's home was marked - a red cross was painted on the door with the words 'Lord Have Mercy Upon Us'. In 2020 the red cross was replaced by a luminous pyroclastic flow of WhatsApp text messages pinning down - who has it, who likely has it, and who is an absolute disgrace (Lord have mercy)!

Much like today, the 17th century had it’s plague-deniers and plague-police, to quote an excerpt from Samuel Pepys diary

“On hearing ill rumour that Londoners may soon be urged into their lodgings by Her Majesty’s men, I looked upon the street to see a gaggle of striplings making fair merry, and no doubt spreading the plague well about. Not a care had these rogues for the health of their elders!”

Pepys meticulous diary has given us an incredible insight into this crucial time in history. He talked of sermons moving outside, not dissimilar to Mass moving online - where there’s a pulpit there’s a preacher. In an echo of some similar malfeasance behaviour seen in Westminster during the current crisis, Pepys broke his plague isolation to visit his mistress, risking his health in the process, but he judged it a basic need. I’m not sure it would make it on to the ‘essential travel’ criteria but everyone has their breaking point. I’m guessing Pepys didn’t have a workout routine, a meditation app and daily personal goals to distract him.

There were plague dedicated hospitals back in the day but, like our modern Covid hospitals and wards, they were overwhelmed. With a bad case of FOMO I found myself in one of the main Covid HSE hospitals during the height of the pandemic. Without the flicker of a visitor and largely confined to our wards my bedfellow patients took on an extra interest.

The man across from me was very tall and very gentle in his ways. He was "from down the country" as he explained, and talked about Dublin as "the city". Driving in the city, he would say, was a murderous thing. He got a call from his brother one evening that accidentally went straight to Speaker for the whole room to hear. It brought a huge smile to my face when the brother’s first words were "Tell me this and tell me no more, are you bored to death yet?"

According to history the plague receded due to methods of quarantining travellers entering countries and isolating the sick within countries. A wild fire that razed London to the ground also helped. The world was more stationary 500 years ago, to travel abroad was cumbersome and unusual, nowadays nearly everyone gets on planes from grandparents to screaming toddlers.

I think with vaccinations, social distancing, and mask wearing we have gotten to a better place but I don’t think Covid has finished wringing us out. I would like a plan for the future, especially for the medically vulnerable. I am not the only one wondering what lies ahead, when I was in St James’s Hospital during the pandemic I had a chance conversation with a random stranger.

It was the weekend, still no visitors were allowed, I was walking along the corridor on my tenth walk of the day. Out of a side passage an old guy suddenly appeared, a lump as big as a baseball on his temple. His mask pulled down, slurping on a tea "When is the lockdown ending anyway? Is it tomorra?" He said to me. "Eh, yeah" I said as I quickly checked the empty corridor to make sure he was in fact talking to me (just in case NPHET had materialized behind me).

"About bloody time!" said the man.

I spotted a harried nurse in the background barrelling down the hall.

"What do you think is gonna happen in the future?" He said.

I didn’t know if he was talking about Covid, the nurse or that worrying lump on his head - none of them were looking great.

"What future?" I said.

The nurse had caught up to us and was directing the man back to his ward.

"What bleedin’ future, is RIGHT!" His declaration echoed in his wake.

He was right, what future, bleeding or otherwise, lies ahead for us all? And perhaps, more interestingly, what legacy are we leaving behind? Will the next generation in the playgrounds shun the plague inspired Ring-a-ring-a-rosey and instead swap banana bread recipes?

Time will tell, perhaps to leave my mark I should start my own Pepys diary.

For the original article read here - Covid versus the bubonic plague, who did it better?