Could The Plague Strike London Again?

By James FitzGerald Last edited 27 months ago
Could The Plague Strike London Again?
'The Pestilence': detail from a 1665 illustration in Pepys's Diary of the plague dead being buried at St Giles-without-Cripplegate. Image courtesy of London Metropolitan Archives, City of London.

If there was anything truly ‘great’ about the Great Fire of London 350 years ago, it’s that the death toll was surprisingly low (probably only six). Unless you’re talking about rats and fleas, lots of which did bite the dust during a massive blaze which — some theorists believe — helped end the devastation of the Great Plague.

That was the last time the bubonic plague was seen in Britain in an epidemic form. In the capital, it wiped out 15-25% of the population – at least 60,000 people by the lowest estimates.

In the summer of 1665 there’d been almost no such thing as hygiene in London: its filthy streets overflowed with sewage, litter, and waste from butchers’ shops; the hot weather baking this horrid mess where it lay. For poor people in their cramped dwellings, the indoor conditions were little better. The plague was easily spread.

On 16 August, Samuel Pepys wrote in his diary of a chance “meeting” with a corpse in a London alley. Death had become a familiarity. At its height, perhaps 1,000 cityfolk perished every day; bodies were simply piled up in the streets while the infected were sealed up in their homes.   

Detail from a woodcut of 1665 showing plague victims wheelbarrowed out of houses. Image courtesy of the Wellcome Library, London.

Could it happen again?    

This particular bacterial infection blighted Europe for centuries. While the plague might sound an anachronistic disease in western countries today, it does surface in other parts of the world — albeit not on the same scale. Madagascar, for instance, has seen local outbreaks since 2014.

But experts agree that the chances of plague returning to London are minute. Conall Watson, a specialist in public health at the London School of Hygiene and Tropical Medicine, reassured us that modern diagnoses and antibiotics are enough to combat such an infection.

The Stuarts had little understanding of what was making them ill, believing that nasty smells transmitted disease and that strong tobacco could ward it off. Watson reminds us just how different things are today. “While London is more populous now, our contact with the rats and their fleas that historically cause transmission has been reduced.”    

So next time you see a rat scuttling around your flat, know that things were once much worse.

Could a different disease strike?   

QMUL's Professor John Oxford says there are "novel factors" which weren't around in the 1660s.

We’ll rule out a comeback of the plague. But whether it’s Zika, Ebola, SARS, MERS, or anything else, what’s to stop a more ‘modern’ contagious disease touching down here? We asked Professor John Oxford, a virologist at Queen Mary University of London, whether that’s likely.    

“Yes, I think it is,” is the short answer. “I mean, there must be 100 people within 10ft of me in this café, coughing away.” He’s thinking of diseases which are spread human-to-human (rather than through water, for example), and by droplets in the air (rather than by sex).

That rules out many of the previously mentioned diseases, he thinks — but there’s always influenza. “That one could knock us for six.”

Prof Oxford is quick to stress that Britain has plans in place to deal with such an eventuality. He’s been surveying them over the last decade or so, while swine and avian flu have made headlines. “This is the top concern for politicians here,” he claims. “Not ISIS or bioterrorism.”

Simply put, the plans involve the government unleashing huge drug stashes: easily done in a modern, western nation. But Prof Oxford does identify certain “novel factors” which would make life harder for London’s modern doctors than for 17th century physicians dealing with the plague.

Firstly, there’s 21st century mobility. A disease could move more quickly into and out of London thanks to the transport revolution that means we can travel further and faster than in 1665. While an influenza outbreak would be contained rapidly, if it wasn’t, the spread could be far more profound.

Then there are two social phenomena, too. One is what Prof Oxford calls the “anti-science” view: that voguish distrust of ‘experts’ could manifest itself in something like a measles outbreak, after parents refuse to vaccinate their children;  and a theory that today’s London is more selfish than the “disciplined” London of the 1660s.

“In general, people are more blasé about spreading disease around,” he reckons.  “Or letting other people around them know if they have something.”    

Try telling that to the man next to you on the tube who can’t be bothered to cover his sneezes.

The city's no less busy than it was 350 years ago - so how would it cope with a deadly outbreak? Photo by Sam Moore in the Londonist Flickr pool.

The action plan

Compared to London of 350 years ago, you might say we live in an era when we know enough about disease to feel much more safe in the hands of experts, but not so much that we wouldn’t panic anyway. After all, hypochondria is a powerful thing.

NHS London has a detailed strategy for an infectious outbreak. It consists of so-called “business-as-usual-arrangements” — they exist already for norovirus or seasonal flu and are able to be scaled up for something more pandemic in nature. The plans operate at different levels, meaning that even your local council could move to combat an outbreak.

And they do get tested. But there’ll never be a test like the real thing. So, as Pepys might have exclaimed, in that very different time, “God preserve us!”

Last Updated 11 August 2016