Government responsibilities during quarantines.
Pandemics diseases with no known cure can be contained by quarantine. This will only work if everyone in the community cooperates. For hundreds of years people have realized that it is essential to provide for the basic needs of everyone under quarantine. If food, medicine and other necessities are provided to people under quarantine they have less excuse for breaking the quarantine and spreading the disease.
If someone in a household was infected with Plague then everyone in the household could be quarantined with them. Wealty families with two homes were allowed to leave people who were infected in one home with hired nurse-keepers while healthy members of the family went to their second home. Wealthy families could also send infected servants to a Pesthouse where poor people were isolated if they were believed to have the Plague. Shutting people up in their houses in quarantine was accepted as necessary if unpleasant way to stop the spread of Plague. In the monarchy everyone did not have to do their part because some were considered more Noble than others. Quarantines can only be fully effective if nobody is "more equal" than others.
Samuel Pepys was a government official who stayed in London during the plague of 1665-1666. His diary gives an interesting contemporary account of the spread of the Plague in London.
Great fears of the sickenesse here in the City, it being said that two or three houses are already shut up. God preserve as all!
There was no known cure in 1665.
the plague growing upon us in this towne; and of remedies against it: some saying one thing, some another
So home by hackney-coach, which is become a very dangerous passage now-a-days, the sickness increasing mightily,
Sad at the newes that seven or eight houses in Bazing Hall street, are shut up of the plague.
People who were well off tried to leave town when the Plague struck.
Up, and advised about sending of my wife’s bedding and things to Woolwich, in order to her removal thither. . . . I by water to Woolwich, where I found my wife come, and her two mayds, and very prettily accommodated they will be; and I left them going to supper, grieved in my heart to part with my wife, being worse by much without her, though some trouble there is in having the care of a family at home in this plague time,
The 1665 pandemic was the worst outbreak in England since the outbreak of Black Death in 1348. More than 68,000 Plague deaths were recorded in London although the actual number of deaths due to the Plague may have been over 100,000. It is believed that 15% to 20% of the people who remained in London died. There were no effective treatments, although whole booklets of "remedies" and "preventives" were published.
I went away and walked to Greenwich, in my way seeing a coffin with a dead body therein, dead of the plague, lying in an open close belonging to Coome farme, which was carried out last night, and the parish have not appointed any body to bury it; but only set a watch there day and night, that nobody should go thither or come thence, which is a most cruel thing: this disease making us more cruel to one another than if we are doggs.
Daniel DeFoe published A Journal of the Plague Year in 1722. It is fictional, but is closely based on accounts of the visitation of the Plague in London in 1665. DeFoe directly quoted from goverment documents written during plague pandemics so his descriptions events in 1665 are based on sources written during that visitation and earlier visitations of the Plague in London.
Chirurgeons (surgeons) and Searchers (commonly elderly widows experienced in caring for the sick) determined if someone had the Plague. They were responsible for identifying which households needed to be quarantined. It was clearly understood that medical professionals themselves could get infected and spread the disease to other patients.
‘And forasmuch as the said chirurgeons are to be sequestered from all other cures, and kept only to this disease of the infection, it is ordered that every of the said chirurgeons shall have twelve-pence a body searched by them, to be paid out of the goods of the party searched, if he be able, or otherwise by the parish.
People who could afford the services of the chirurgeon paid them, but the government paid for medical services for those who could not afford them. Providing this medical service to the poor helped protect the entire community from the Plague.
Poor women, often widows, could be hired to care for the sick. These nurse-keepers obviously risked their own health to care for others. Economic necessity likely pressured them to do this work. It was understood that they were at high risk of getting the Plague themselves and that they might spread the Plague in the community if they did not complete the quarantine with the afflicted family.
‘If any nurse-keeper shall remove herself out of any infected house before twenty-eight days after the decease of any person dying of the infection, the house to which the said nurse-keeper doth so remove herself shall be shut up until the said twenty-eight days be expired.’
Once a family was quarantined a large cross was painted on their door. Watchers were hired not only to keep quarantined people in the house, but also to bring food, medicines and other things the family might need during the quarantine. People who could not afford these things because they could not work during the quarantine were supported by the parish.
‘That to every infected house there be appointed two watchmen, one for every day, and the other for the night; and that these watchmen have a special care that no person go in or out of such infected houses whereof they have the charge, upon pain of severe punishment. And the said watchmen to do such further offices as the sick house shall need and require: and if the watchman be sent upon any business, to lock up the house and take the key with him; and the watchman by day to attend until ten of the clock at night, and the watchman by night until six in the morning.
Defoe gives a slightly fictionalized account of a family sneaking out of a house under quarantine, leaving an afflicted member of the household to die without care. People who got the Plague were more likely to survive if they were given basic nursing care. Breaking quarantine was not unusual and many observers described the sort of conduct described in DeFoe's book.
nobody was found in the house but that young woman, who having been infected and past recovery, the rest had left her to die by herself, and were every one gone, having found some way to delude the watchman, and to get open the door, or get out at some back-door, or over the tops of the houses, so that he knew nothing of it;
Many such escapes were made out of infected houses, as particularly when the watchman was sent of some errand; for it was his business to go of any errand that the family sent him of; that is to say, for necessaries, such as food and physic; to fetch physicians, if they would come, or surgeons, or nurses, or to order the dead-cart, and the like; but with this condition, too, that when he went he was to lock up the outer door of the house and take the key away with him, To evade this, and cheat the watchmen, people got two or three keys made to their locks, or they found ways to unscrew the locks such as were screwed on, and so take off the lock, being in the inside of the house, and while they sent away the watchman to the market, to the bakehouse, or for one trifle or another, open the door and go out as often as they pleased. But this being found out, the officers afterwards had orders to padlock up the doors on the outside, and place bolts on them as they thought fit.
Clean, decent hospitals for the sick instead of Pesthouses would have made it easier to isolate people who were infected. Removing infected members of the household would have decreased the desire of people quarantined to sneak away in order to avoid contagion. People did recognize that insect-repellent herbs and fumigation decreased the risks of contagion.
Arranging somewhere for apparently healthy people who had been exposed to spend their time in quarantine would also have helped; London was very crowded at the time so this would have been more difficult than it would be now.
The conduct of those with wealth and privilege does not seem to have changed. Neither does the greater impact on the poor. Poor people were much more likely to suffer when the Plague struck.
Those who could, including most doctors, lawyers and merchants, fled the city. Charles II and his courtiers left in July for Hampton Court and then Oxford. Parliament was postponed and had to sit in October at Oxford, the increase of the plague being so dreadful. Court cases were also moved from Westminster to Oxford.
The Lord Mayor and aldermen (town councillors) remained to enforce the King’s orders to try and stop the spread of the disease. The poorest people remained in London with the rats and those people who had the plague. Watchmen locked and kept guard over infected houses. Parish officials provided food. . . .
All trade with London and other plague towns was stopped. The Council of Scotland declared that the border with England would be closed. There were to be no fairs or trade with other countries. This meant many people lost their jobs – from servants to shoemakers to those who worked on the River Thames.
Stopping trade during a pandemic does cause severe hardship to people who are not well off. This has been recognized for hundreds of years. It was also officially recognized that there was a benefit to everyone when people under quarantine were properly provided for.
Quarantine records from St. Martin give a rough indication of the socioeconomic status of quarantined individuals. The records note whether households were “chargeable,” “partially chargeable,” or “not chargeable.” Chargeable households were those who were financially dependent on the parish for material support during the period of quarantine. Partially chargeable households paid for a portion of their keep, and not chargeable ones supported themselves. Over the course of the 1636–1637 outbreak, 84% of the individuals were chargeable, meaning they could not afford to pay the 4 pence per quarantined person per day that the parish charged for support. Though this was a relatively low cost, it was significant enough to encompass some of the lower middling sort who, though comfortable, lacked the resources to endure long periods of expenditure without income.54 It also included those who were chargeable at the time of the outbreak but who were required to later pay back some of the compensation they received. Such individuals who were given loans made up a small but not insignificant portion of the chargeable households on the
The lack effort to do appropriate testing and tracing allowed Covid-19 to become an epidemic in the US. This resulted in a quarantine of most of the people in this country. The government should provide funds for necessities until the infection is fully ended. There will be pushback if this is called UBI by those who believe that UBI is communism. Providing for people during quarantine has long-standing precedents in English law and common law. This should be pointed out to any conservatives who object to caring for fellow citizens.