The village of Eyam lies around 12 miles from where I live: I know it well and have often taken visitors there. At a time when I was teaching demography I took groups of students to the village because of its significance as a particular case study. In the last few weeks many reporters and feature writers have produced newspaper columns and online material about the place – including the Canadian TV channel ctv, the
Ouest France newspaper and, in the UK, the
Guardian, Mirror, and
Express newspapers. The BBC has recently sent a reporter in the village, and Simon Armitage, the Poet Laureate, has been inspired to verse by its history. A handed-down version of the Eyam story is well known.
The normally-accepted story goes as follows. In September 1665 bubonic plague arrived in Eyam and over the course of the fourteen months from then until November 1666 a total of between 257 and 260 villagers died out of a population of around 700. For part of the time the village was ‘self-isolating’ (to use a term now familiar in 2020), cutting its residents off from those of all surrounding villages. They were persuaded to do so to prevent the plague from spreading more widely through the neighbourhood.
Plague Cottages, Eyam, where the first victim died in 1665
There are possible parallels between the action taken in Eyam in the 1660s and what is happening today, in 2020, around the world in the face of the COVID-19 coronavirus. We cannot, of course, put ourselves back into the world of Derbyshire villagers of the past, and there have been many retellings of the Eyam story. Historical demographers, epidemiologists and biomedical scientists have pored over the few available facts, and revisionists have questioned a number of aspects of the narrative as they have developed over the years. A list of scholarly sources for material on Eyam is given at the end of this blog, along with a reference to the account written in the nineteenth century by William Wood, normally seen as the originator of the story as we accept it today.
Two friends and colleagues have joined me in producing this blog entry, adding their experiences of quarantine and self-isolation to my own reading of the 1660s actions in Eyam. ‘C’ is a university lecturer who lives in an eighteenth floor flat in Shanghai and has a friend and his 9-year-old son staying with her. ‘L’ is a retired university teacher, a widow with two adult children, who lives alone in a first floor flat with its own garden in a town in Sardinia, Italy. I put a series of questions to both of them, and have then added answers of my own for Eyam as well as some further comments.
Who decided on self-isolation?
In
Eyam the villagers were persuaded to self-isolate by the two clergymen present in their community – the Revs William Mompesson and Thomas Stanley. Neither the county (Derbyshire) nor the national government played any role. However, the Earl of Devonshire, living nearby at Chatsworth, offered to guarantee a food supply to the village if the population would self-isolate.
In
Shanghai self-isolation was a policy handed down from the central government in Beijing. However there was some discretion left to provinces as to the detail of its implementation, and local residential communities have also determined some of their own regulations.
In
Sardinia it was the government in Rome that brought the measure forward to apply to the whole country, having first introduced it as a requirement for certain regions only. But, as in China, there has been local discretion for individual municipalities to operate as relevant to their own circumstances.
What is its purpose?
In all three cases the purpose was to halt the spread of contagion and of the disease. But in
Eyam, with no modern medical knowledge of the causes of the plague, self-isolation applied principally at the level of the village and not primarily between households. In both
Shanghai and
Sardinia ‘social distancing’ has been intended to isolate individual units such as households from each other. This is an important difference from the practice in Eyam. But in Shanghai there was a further purpose to isolation. With the situation in Wuhan, the epicentre of the outbreak, causing huge concern, the Chinese authorities asked medical personnel from other parts of the country to go to support their colleagues there. This reduced the available medical resources in Shanghai, and it was therefore vital that the population of the city should be as protected as possible from the disease reaching them. The lockdown in Shanghai was at its strictest during the weeks when the city’s numbers of doctors and nurses were depleted.
When was it imposed?
The handed-down version of the story of
Eyam gives the impression that self-isolation was imposed throughout the plague outbreak. This was not actually the case. The plague ran through the village from September 1665 to May 1666, bringing 42 deaths up to the end of 1665 and only 20 during the first five months of 1666. But mortality then started to rise rapidly again, and it was only in June 1666 that the village adopted its self-quarantining, which lasted until November of that year when the outbreak died out.
In
Shanghai self-isolation (in effect a total lockdown for most) was required from 27th January onwards. Shanghai and the nearby Zhejiang province were early adopters of rigorous self-isolation after the COVID-19 outbreak took hold in Wuhan (Hubei province). A lockdown had been imposed there on 23rd January. On 20th January one case of COVID-19 had been diagnosed in Shanghai. The city authorities in Wuhan, and in Hubei province more generally, acted very quickly to impose very strict self-isolation when the possible severity of the situation was realised, but it was later recognised that insufficient attention had been paid to the new disease when it first appeared, with the authorities arguing, against medical opinion, that it was only flu and nothing that needed bureaucratic intervention.
In
Sardinia, as in the whole of Italy, containment measures were introduced progressively from 4th March, and then extended on 8th and 9th with a total lockdown in force from 11th onwards. Not only was the disease well-developed in China and Iran by then, but case rates were rapidly expanding in northern Italy where the first deaths had occurred on 23rd February.
Shanghai’s strict self-isolation was therefore introduced 16 days after the first death had occurred in Wuhan (on 11th January). The lockdown in Sardinia occurred 17 days after the first COVID-19 death elsewhere in Italy, which occurred on 23rd February. It might have been expected that a lesson from China might have been learned and an earlier lockdown implemented.
What were the reactions among the affected people?
Eyam in the 1660s was relatively isolated from its neighbours anyway, as a lead mining village surrounded by farming communities. We know little about whether many people fled the village – except that we do know that the Rev Mompesson, who persuaded the villagers to self-isolate, sent his children away. The suspicion is that the squire of the village also left before isolation was imposed.
In China the disease could not have broken out at a worse time – on the eve of the Spring Festival when millions of those who have migrated to the cities leave to return to the countryside. News of the intended lockdown on 23rd January in Hubei, two days before Spring Festival, was leaked 25 hours before it came into place and possibly 300,000 Wuhanese rushed to leave the city, almost certainly spreading the disease with them. Elsewhere in China, for example in
Shanghai, the lockdowns imposed shortly afterwards were seen as proportionate – and they were imposed without warning.
In
Sardinia the lesson from China of the need to impose restrictions instantly was not learned. When the Prime Minister announced stricter controls on 9th March residents of northern cities near the epicentre of the outbreak rushed to trains and planes to ‘escape’ south, including to Sardinia, bringing the virus with them in some cases.
How was self-isolation policed and regulated?
The established narrative of
Eyam is of self-policing and noble self-sacrifice. But there is also evidence of regulation by surrounding areas. An Eyam woman who turned up at a market in nearby Tideswell was ejected and had mud thrown at her. And the constabulary in Sheffield was asked to evict anyone found to be from Eyam.
In
Sardinia and
Shanghai the intended self-isolation is much more rigorous than it was in Eyam – isolation is supposed to apply between household units and not just for the settlement as a whole. In
Sardinia carabinieri and
vigili (police forces) are patrolling the streets, with the power to stop cars and pedestrians. Those stopped must produce a form (printed at home from the internet or delivered by the authorities) to indicate whether their journey is for work, for shopping, or for some other necessity (such as delivering food to older people, or going to tend to animals). There has been criticism that some people are trying to circumvent the controls by claiming to be making frequent shopping trips. A third police force has been given the responsibility for ensuring that all those who arrive from the North are quarantined for 14 days.
Shanghai has depended on self-regulation and the aim, repeated often within Chinese society, of maintaining harmony, abiding by regulations, and cultivating a sense of mutual responsibility. However the vast majority of people in Shanghai live in ‘residential communities’ with some sort of physical boundary and with a security presence. The security guards have policed the operation of self-isolation, but have generally had very little to do in communities inhabited largely by Shanghainese. There have been more anxieties about communities composed of migrant workers from many different parts of China, with many different cultural ideas and habits: there has been a more overt police presence in these cases, sometimes with police cars stationed outside the entrance to the community compound.
In both Shanghai and Sardinia there have been reports of individuals failing to abide by the regulations, and of other citizens reporting them to the police or other authorities in a spirit of taking responsibility for, and sanctioning, disruptive actions within the community.
What has happened to daily life?
We know little about the answer to this for
Eyam. As a mining village, it was clearly dependent on food and other provisions being brought in from elsewhere. During the quarantine period a series of boundary stones round the village were identified, and food and other goods were left at these points by neighbouring villagers – in return for coins which were left in vinegar in holes drilled in the stones for that express purpose in the belief that vinegar would ‘purify’ the coins. One issue of significance to the 2020 COVID-19 outbreak, and for which we do not know the answer, is what happened to the Eyam economy during the outbreak. Did lead mining continue? If so how was the product transported away? If not, what livelihood did the villagers have? Did the Earl of Devonshire (as indicated in an earlier answer) pay for all provisions? As we know today, there are economic and not just social and epidemiological issues around quarantining.
China is the realm of big data and of the interconnection between databases and all on-line transactions: this has created potential for significant early interventions. Schools and universities in
Shanghai did not reopen after the Spring Festival holiday, and steps were very quickly taken to move teaching on-line. The 9 year-old in C’s flat has for some weeks been doing four lessons on line each day – in Mandarin, Maths, Science and English. And C herself has been in touch every day with her university students via WeChat. Most impressive of all has been the way in which food supplies have been maintained (without any of the panic buying seen in the UK). Public announcements strongly recommended that all food orders should be placed on line. This enabled the government to monitor demands for different key goods, and to move supplies around the country to avoid shortages. If necessary the government could also have intervened to restrict the number of items purchased, but this wasn’t needed. To deal with a massive increase in the number of food deliveries being made, the government implemented a rapid training programme for workers made idle by the closure of the restaurants where they normally worked.
C has now been issued with a code, which she can have on her smartphone, so that she can show it wherever she goes so that, in the event of her becoming infected, there is a full trace of her recent contacts and movements available.
In
Sardinia there has also been use of on-line services but at a lower level, for instance for education. But not all pupils, teachers or parents have the necessary equipment or expertise, so although schools and universities are instituting homework, lessons and even exams on line there are problems about inclusivity.
Shopping has been undertaken by younger members of the community for those categorised as more vulnerable (through age or health status). In L’s case, her son uses the remote control to open her garden gate and drive in: he then sanitises his hands and leaves the shopping on the garden table before having a distanced conversation and then driving out. As in Shanghai, schools, restaurants and all forms of entertainment are closed.
What about public gatherings?
The one thing we know about
Eyam in this respect is that church services were moved outdoors to take place in Cucklet Dell where the rector addressed his parishioners. Even though services were no longer taking place in church, we now understand that these religious gatherings were almost certainly responsible for increasing the incidence of the plague in the village during the worst period for deaths – which exactly coincided with the period of self-isolation. Whilst 62 residents died between September 1665 and May 1666 while there was no self-isolation, a further 198 died during the period of quarantine between May and November 1666. We do not know whether the local pub, today the
Miners Arms but in those days the
Kings Head, stayed open through the plague outbreak.
In both
Shanghai and
Sardinia all forms of public gathering have been banned.
What sources of information have there been?
It is probable that almost all information available in
Eyam would have come via the rector who was most likely to be one of the few literate members of the community.
Shanghai and
Sardinia today are very different worlds. The residents of Eyam did not know what was causing their sickness and death, but medical knowledge today is more advanced. In particular, it is now believed that plague in Eyam started in its bubonic form, transmitted by fleas. Had residents fled then, and washed fully, they might have survived. It later mutated into the pneumonic form of plague, transmitted between humans. Had self-isolation of family units been operating it might have been contained, but self-isolation of the whole community, as chosen in Eyam, had severe consequences for the population – although it prevented the spread of the disease to other communities.
L says that in Sardinia “there has been an overload [of information] on television and in the media. If you watch too much it becomes a source of anxiety.”
In Shanghai C reports that Chinese television at first cancelled all entertainment programmes to focus entirely on the coronavirus outbreak. But this led to issues of morale, and after a little while entertainment and more general programmes were brought back on internet television.
What have been the numbers of those affected?
At the time of writing (last week of March) the numbers of cases and deaths in Italy now exceeds those in China where the outbreak started. Across the whole of China the aggregate death rate to date has been around 2.3 per million population and has now stabilised (although the rate might possibly be as high as 250 per million in Wuhan itself). The current death rate in the whole of Italy is over 110 per million.
In Shanghai with its tight lockdown over an extended period, the total number of deaths from COVID-19 to date amounts to only 4: a minuscule number in a city with a population of over 24 millions. Sardinia has so far only experienced 15 deaths (or a rate of 9.1 per million) – very much lower than in Italy as a whole. But the potential for these figures to rise is considerable in a situation where the lockdown was imposed later than it might have been and where protective equipment for health staff has been in short supply.
Calculation of the death rate in Eyam is highly dependent on an estimate of the population of the village at the start of the outbreak. The number of deaths is accurately put at between 257 and 260. Nineteenth century accounts suggested that the village population was only about 350, but more recent demographic research has suggested a much higher figure – around 700. On a comparative basis that would produce a rate of around 350,000 deaths per million, or 35% of the original population. Effective medical interventions in Eyam were non-existent. In advanced modern economies, and given scientific understanding, treatment has been much more efficacious today in Shanghai and in Sardinia. But in both places medical staff have been at risk and on the front line, and some have been lost to the disease. Predominantly, however, those succumbing have had prior medical conditions such as diabetes or coronary heart disease. Very few children have been affected, unlike the situation in Eyam where deaths of infants were numerous and whole families were almost wiped out.
What next?
There are four theoretical ways that an epidemic or pandemic can die out:
1. There is total containment so that no one else is infected.
2. Community immunity is gained once a significant proportion of people have had the disease, survived, and have developed antibodies.
3. Vaccination or immunisation against the disease.
4. A mutation in the bacterium or virus so that it ceases to pose a threat.
Policy dependence on the fourth of these would clearly be unwise – although it may be what happened in Eyam according to some of the epidemiological evidence.
Scientists all round the world are putting great efforts into the possible third solution – of a vaccination. But that will take time.
The experience of China and of Shanghai on the first possibility is not encouraging. China made rigorous efforts to contain the virus and to limit it to Wuhan, and then to Hubei. Total isolation was operationalized in Shanghai, with the acquiescence of the population, for two months – no mean feat in one of the world’s biggest cities. With China now undoing a lot of its restrictions, it can see that this has been a (partial) success, at least domestically. Equally, the self-isolation imposed in Eyam may be an explanation for the fact that plague did not spread outside the village. But in today’s highly connected world the likelihood of successful containment is much reduced – it only needs one carrier to ‘escape’ self-isolation to create a new wave of disease transmission elsewhere. That is now China’s anxiety. As C puts it “China’s problem is now the problem of the rest of the world. COVID-19 won’t be properly finished in China until it is finished in the rest of the world. China’s danger now is people bringing the disease back from elsewhere. If the disease is not eradicated in the rest of the world China has wasted its time.”
A final set of related points:
In Eyam plague struck in a period of very closed societies, low flows of information, and in the context of respect for authority in the shape of the clergy (even though we know that Mompesson was actually less trusted than his predecessor, Stanley, who had remained in the village).
In Sardinia – and in Western Europe more generally – COVID-19 has struck in societies that have less trust in authority, and which are very much more open to the rest of the world. In particular, politics is played out in these countries as contests between personalities, with significant proportions of the population unwilling to admit that anything put forward by those they do not agree with can be of any use or significance. And politicians are constantly balancing what it is right to do in the wider interest and what will be acceptable to the electorate. In addition, sociologists have claimed for many years that European societies and mentalities have become much more individualistic and less community-focused. There is a strong tradition of questioning opinions and directives, and particularly of contesting government policies. Further, there are multiple sources of information available – unlike the situation in Mompesson’s Eyam, and that information is often contradictory, populist in nature (telling people what they want to hear), or downright wrong.
In Shanghai – and throughout China – there is greater acceptance by ordinary people of statements and policies put forward by ‘authority’, with a less personalised perspective on individual politicians. Authority is therefore less contested and more trusted to be operating in the interests of the country as a whole. There is less of a tradition of contest and questioning: people are more willing to do what they are asked to or told to do.
There are also reflections in relation to self-isolation and its effects.
In Eyam self-isolation was imposed on the village as a whole and not on individual households who were free to continue to mix. Almost certainly this enhanced the spread of the plague within the community at a time when it had mutated from being driven by infected fleas to being passed on through human contact. Self-isolation, in the words of one recent scientist, can be seen as either a heroic sacrifice or a tragic mistake.
In Shanghai self-isolation was introduced early enough, and in a strict enough form, to protect the city from the level of infections of COVID-19 that are being experienced in many other parts of the world.
In Sardinia self-isolation has now been imposed rigorously but could perhaps have been brought in earlier, following the Chinese example. It will almost certainly need to be maintained for longer than in Shanghai, and that will create issues about stress levels and the mental health of the populations kept under lockdown.
But if self-isolation does not fully contain COVID-19 then, as China now recognises, it may not be a sustainable solution to the current worldwide health crisis. But I should end this on a more optimistic note. Descendants of those in Eyam who survived the 1665-6 plague outbreak carry a genetic mutation named CCR5-delta 32 which provides them with strong resistance to the HIV-AIDS virus. We don't yet know whether it also resists COVID-19.
Sources on Eyam
Didelot. X. 2016. Heroic sacrifice or tragic mistake? Revisiting the Eyam plague, 350 years on, Significance, Vol 13, No 5, pp. 20-25
Massad, E. et al. 2004. The Eyam plague revisited: did the village isolation change transmission from fleas to pulmonary? Medical Hypotheses, Vol 63, No 5
Race, P. 1995. Some further consideration of the plague in Eyam, 1665/6, Local Population Studies, No 55
Wallis, P. 2005. A Dreadful Heritage: Interpreting epidemic Disease at Eyam, 1666-2000, Working Papers on the Nature of Evidence: How Well do ‘Facts’ Travel? No. 02/05. Department of Economic History, London School of Economics
Whittles, L.K. and Didelot, X. 2016. Epidemiological analysis of the Eyamplage outbreak of 1665-1666, Proceedings of the Royal Society, B: Biological Sciences, Vol 283, No 1830
Wood, W. 1865. The History and Antiquities of Eyam, London
