Pepys’s plague: How the reaction of the individual, society and the medical profession to the Great Plague of 1665 is similar to our experience of Covid-19

Introduction: The celebrated diarist Samuel Pepys kept a detailed diary of exceptional candour throughout the years of The Great Plague of 1665, in which he recorded his own observations as well as the reactions of society and the medical profession to this unprecedented event. In this paper we examine his diaries at the time of the plague, as well as in the proceeding years and consider how the experiences of Pepys are similar to our own experiences of the 2020 Coronavirus Epidemic. Method: We examined the entire diaries of Samuel Pepys from 1664 to 1670, as well as supplementary source material, looking for all references to The Great Plague. Results and Conclusion: Though written over 350 years ago the diaries paint a very co-orientated response of society to The Plague. Accurate official statistics were available weekly, isolation was imposed and the government made provision for ‘pest houses' to be set up. Pepys is grateful to the doctors who remain in London but critical of the majority who flee the city. Pepys's own reactions, which progress from fear of contracting the disease to fear for his business interests, mirror today's reaction to The 2020 Coronavirus Epidemic.


Introduction
Samuel Pepys (1633-1703) kept a detailed diary between 1660 and 1670, when he was a civil servant in the Admiralty, based in London ( Figure 1). In the diary he recorded the events of the day and commented on these with exceptional candour. This time period coincides with many events in English and European history, including the First Anglo-Dutch War, the Great Fire of London and the Great Plague ( Figure 2). This paper examines the diary of Samuel Pepys and considers how the reaction of Pepys and society to The Great Plague of 1665 is similar to the experiences of the authors during the 2020 Coronavirus epidemic.

Methods
We analysed all ten volumes of The Diary of Samuel Pepys, 1 between 1660 and 1670, looking for factual references to the plague, in addition to Samuel Pepys's observations on the response of society, the medical community and the establishment. (All dated references in italics are from the collected diaries)

Results
The plague first came to Pepys's attention in 1663. Like Covid-19, it had originated in the East and spread to Europe, though England was not initially affected.
I took coach to the Coffee-house in Cornhill; where much talk that the plague is got to Amsterdam, brought by a ship from Argier (Algiers).
19th Oct 1663. 1 St Mary's Hospital, London, UK 2 Queen Mary University of London, UK Plague was relatively commonplace at the time, having been endemic in the population to a lesser degree for most of the 15th and 16th centuries, with England having experienced a plague epidemic three times that century: in 1603, 1625 and 1636 ( Figure 4). Pepys does not mention the plague again in his diary until the following year, by which time the Netherlands, at war with England, was experiencing a surge in cases. It was not until the spring of 1665 that rumour spread of an increase of deaths in London, beyond the level expected for the time of year.
Thence to the Coffee-house with Creed, where all the newes is of the plague growing upon us in this towne.

May 24th 1665.
Surprisingly accurate statistics were readily available to the literate population in the 17th Century. These were widely circulated and discussed with the same interest as today's official government figures. The 'Bills of Mortality' (Figure 3), published every Tuesday, were compiled from the official records of the 120 London parishes. These lists also included total deaths according to cause and area as well as change from previous weeks. They also mentioned 'rare and extraordinary' deaths. Londoners were aware that a sustained rise in plague fatalities in early summer was a strong indication of an epidemic to come and Pepys's diary makes frequent reference to them.
Putting several things in order to my removal to Woolwich, the plague having a great increase this week beyond all expectation, of almost 2000making the general Bill 7000 and the plague above 6000.
However, as with today's Office of National Statistics (ONS) data, these figures were not always accurate or believed by the people.
In the City died this week 7496; and all of them, 6102 of the plague. But it is feared that the true number of the dead this week is near 10000partly from the poor that cannot be taken notice of through the greatness of the number, and partly from the Quakers and others that will not have any bell ring for them.
The government response was also well coordinated, with a set of 'Plague Orders' being issued by the Lord Mayor, enforced by the aldermen and influenced by the medical thinking of the time. Though a formal 'lockdown' was not initiated, the orders made provision for infected people and households to be isolated. The wealthy left London for the countryside, though Pepys, as a civil servant, remained. The city emptied quickly and entertainments such as theatres and bear pits were closed. Pepys laments seeing his favourite pubs shuttered and the city deserted.  Lord, how sad a sight it is, to see the streets so empty of people.
my finding the Angell tavern at the lower end of Tower-hill shut up; and more then that, the alehouse at the Tower-stairs; September 14th 1665.
At work, on hearing a rumour that the servant of a colleague had died of the plague, he sends the colleague home, though continuing to socialise with him outside of working hours.
By and by Captain Cocke came to the office and I did send to him that he would either forbear the office or forbear going to his own office.

October 31st 1665.
Finally Pepys decides to undergo a form of self-isolation. This is nowhere near as strict as those imposed in the response to Covid-19. There was a curfew, which Pepys and others frequently break, but he makes some effort initially to reduce human contact.
But now, how few people I see, and those walking like people that have taken leave of the world, thus I think to take Adieu today of London streets.

August 28th 1665.
He then sends his wife and her maids to the countryside. However on visiting her, he feels the wrath of the local gentry who fear that he is bringing the plague to them, and is forced to lie. But Lord, to see how all these great people here are afeared of London, being doubtful of anything that comes from thence or that hath lately been there, that I was forced to say that I lived wholly at Woolwich.

July 17th 1665.
Though under considerable pressure and with Parliament ceasing to sit, the state continued to function and social order was maintained, though at times Pepys fears its breakdown.
Things here must break in pieces, every man his own business of profit or pleasure; and that certainly the Kingdom could not stand in this condition longwhich I fear.
The plague initially affected Pepys deeply, though his reaction changed considerably over time. Throughout 1663 and 1664 the plague was only on the continent and apart from the impact on trade and the war with The Netherlands it had little impact on his daily life. Even in April of 1665, the rumours of an increase in plague deaths was only mentioned once in the diary. That all changed on June 7th when he noticed local houses being quarantined.
This day, much against my Will, I did in Drury-lane see two or three houses marked with a red cross upon the doors, and "Lord have mercy upon us" writ therewhich was a sad sight to me, being the first of that kind that to my remembrance I ever saw.
The cross on the door was a recognised marker that the household inside had the plague and was being placed in isolation. Stiff penalties were in place for those found breaking this quarantine: including death, though provision was made for these families to be fed.
Three days later Pepys writes a will, and over the coming month he makes many candid journal entries relating to his fears and feelings. Though most people with the plague were quarantined in their homes, some were sent to 'Pest Houses'; solely plague hospitals, operated by the City of London. When the Aldermen realised that the numbers of plague victims were increasing beyond expectation in the summer of 1665, greater provision was immediately made to increase the number of beds they could provide. Pepys first mentioned seeing an infected person in August.
It was dark before I could get home; and so land at churchyard stairs, where to my great trouble I met a dead corpse, of the plague, in the narrow ally, but I thank God I was not much disturbed at it.

August 16th 1665.
It is obvious from Pepys's writing that he is well aware of the risk of transmission as he writes with horror in September 1665.
… my meeting a dead corpse of the plague, carried to be buried close to me at noonday through the City in Fanchurch-street and to see a person sick of the sores carried close by me by Grace-church in a hackney-coach.

September 14th 1665.
Eventually in early September his diary carries a heartfelt entry listing many deaths amongst his employees and the servants of friends.
to hear that poor Payne my waterman hath buried a child and is dying himself --to hear that a labourer I sent but the other day to Dagenham to know how they did there is dead of the plague and that one of my own watermen, that carried me daily, fell sick as soon as he had landed me on Friday morning last, when I had been all night upon the water … is now dead of the plague -to hear … that Mr Sidney Mountagu is sick of a desperate fever at my Lady Carteret's at Scott's hallto hear that Mr. Lewes hath another daughter sickand lastly, that both my servants, W Hewers and Tom Edwards, have lost their fathers, both in St. Sepulcher's parish, of the plague this week.
September 14th 1665. The poor, like those of a lower socio-economic group today, were more likely to live in crowded conditions, suffer from ill health and malnutrition and were unable to leave London or work in isolation. He shows great sadness at these deaths, saying that they 'put me into great apprehensions of melancholy, and with good reason'. In addition, the prolonged separation from his wife affects him. However this does not stop him visiting one of his many mistresses. Pepys's numerous extra-marital affairs increase greatly in frequency throughout the time of the plague. 3 For all his melancholy during the height of the plague, it appeared that Pepys enjoyed himself during those four months, occasioned by the combination of his family being absent and an acute realisation of his own mortality. He also throws caution to the wind on a couple of occasions; even using the death of his own doctor to justify his drinking. The onset of cooler weather decreased the incidence steadily throughout the autumn, and Pepys decided to bring his household back from Woolwich, delighted that the normal activities of daily living, not to mention his considerable business interests, could resume.
Yet to our great joy, the town fills apace, and shops begin to open again. Pray God continue the plague's decreasefor that keeps the Court away from the place of business, and so all goes to wrack as to public matters.

December 31st 1665
As with the current experience, the authorities and the population as a whole were highly attuned to the possibility of a recurrence the following year. Pepys writes with gloom in January of the following year that the weekly cases had increased to 89. This increases throughout the spring and parliament is suspended for another year.
The plague is, to our great grief, encreased nine this week, though decreased a few in the total. And this encrease runs through many parishes, which makes us much fear the next year.
Throughout the duration of the plague, there is no record of Pepys seeking medical advice himself. However, his good friend and physician Dr Burnett is much involved. The cases originating from his house are the first ones that Pepys is aware of.
The plague is come into the City; but where should it begin but in my good friend and neighbour's, Dr Burnett in Fenchurch-streetwhich in both points troubles me mightily.

June 10th 1665
Pepys became aware of a rumour circulating that Dr Burnett killed his own manservant; however Burnett is keen to set the record straight and save his professional reputation.
I met this noon with Dr Burnett, who told me that whoever did spread that report that instead of the plague, his servant was by him killed, it was forgery; and showed me the acknowledgement of the maister of the Pest-house that his servant died of a Bubo on his right groine, and two Spots on his right thigh, which is the plague.

July 22nd 1665
It didn't end well for Burnett who contracted the plague after performing an autopsy. Like all good physicians, he set an example to his patients, quarantining himself, which drew the admiration of Pepys.
"but he hath gained great goodwill … for he discovered it himself first and caused himself to be shut up of his own accord, which was very handsome" June 11th 1665 Burnett died subsequently, but other physicians left London immediately to be away from the plague. In October of 1665, Pepys hears a rumour that all the medical professionals in Westminster had either fled or died.
And they tell me that, in Westminster, there is never a physician and but one apothecary left, all being dead.
Those physicians who had fled the city would be held accountable on their return. In 1666 at a meeting of Gresham College (founded in 1597 and still very active today) of which Pepys was a member, another physician was questioned as to why he had fled the city.
Dr. Goddard did fill us with talke, in defence of his and his fellow physicians going out of towne in the plague-time; saying that their particular patients were most gone out of towne, and they left at liberty. January 22nd 1666.
Like the cures that are rumoured to exist for Covid-19, there was much discussion in 17th century London as to how the plague could be prevented and treated.
The newes is of the plague growing upon us in this towne; and of remedies against it: some saying one thing, some another.

May 24th 1665.
At the time of the plague, the older Galenic-humoural view, still endorsed by the Royal College of Physicians, was steadily being replaced with newer Paracelsian or Chemical theories. Pepys was a believer in the former, which focuses on the balance of humours within the body. His diary occasionally mentions him being venesected by his surgeon. The Paracelsian theory, which is based in early scientific thinking, aims to treat with naturally occurring chemicals and metals. Books and pamphlets such as: Directions for the prevention and cure of the plague, Fitted for the Poorer Sort; published in1665, were widely circulated.
Finally, on November 20th 1666, 18 months after the plague reaches London, the church bells are rung out to celebrate the end of the epidemic, but Pepys wonders if this is all too premature and whether another plague might soon afflict the city.
Thence to church, it being thanksgiving-day for the cessation of the plague; but, Lord! They say that it is hastened before the plague is quite over, there dying some people still.

Conclusion
Written over 350 years ago, Samuel Pepys's Diary paints a surprisingly co-ordinated response of the country to a plague epidemic. The availability of relatively precise official statistics that were closely read and discussed by Pepys and his contemporaries indicate that the public had a comparable understanding of the extent of the epidemic. They used this vital information to conduct their business and make personal decisions. In addition to the weekly bills, an annual compendium of these: 'Observations on the Bills of Mortality' was published in late 1665 so that 'the rich may judge the necessity of their removal and tradesmen might conjecture what things they were likely to have…'. 3 A copy of this survives with the weekly death numbers for 1666 annotated, by hand, inside the cover. 4 The constant references to these Bills in Pepys's diaries show that the statistics were studied and commented upon in the same way as medics and non-medics alike follow the daily Coronavirus briefing on the BBC.
Pepys is occasionally critical of the government in relation to other matters (such as the response to The Great Fire the following year) but, apart from his correct suspicion that the official death figures were an underestimate, he never voices criticism of their handling of the plague. The most likely reason is that in Restoration London, people had lower expectations as to the role of the state: the wealthy left town and the poor died. Today the majority believe that the role of the state is to protect its citizens, resulting in more discussion as to the efficacy of the Government's response.
His feelings at seeing the shops and his favourite taverns shuttered are poignant. After his initial fears for his own safety, Pepys then becomes palpably aware of the difficulty in doing business. He complains about the 'great charges' that he has incurred as a result of the plague and hopes The King would reimburse him. This mirrors our 21st century reactions to Covid-19, how once past the peak, people's attention was drawn away from the immediate health impact of the virus to the economic implications of the lockdown.
Pepys's personal feelings on the plague and its impact on those around him change significantly throughout the years 1664 to 1666. Like our reaction to the outbreak of Coronavirus in late 2019, Pepys's initial reaction is merely passing interest. Epidemics of plague, especially in the East were commonplace and they occasionally spread to Europe. In 1664 when Pepys mentions that 'the plague grown mightily amongst the Dutch, at sea and land' his interest, as Clerk of Acts to The Navy Board, seems to be related to how this will affect their maritime capacity, as England was at war with Holland, a situation which resonates with the US-China trade war that preceded the Coronavirus outbreak. He makes no further mention of the plague for another eleven months.
Pepys was fearful. The Bills of Mortality substantiated the rumour that cases were rising faster than one would expect at that time of year. At the beginning of the summer, Pepys becomes acutely aware of his own mortality after seeing houses daubed with crosses and the disfiguring effects of the disease in the streets. This prompts him to get his business affairs in order, write a will and arrange for the transport of his wife and household to Woolwich. Pepys was an immensely precise man and he displayed here a practical reaction to a situation that was outside of his control. 4 Over the summer, separated from his family and with many deaths occurring around him, he enters a period of depression. His day-to-day diary entries take on a different tone and he is acutely aware of being surrounded by death.
This results in the extraordinary bout of sexual promiscuity that we see in the later half of 1665. Pepys was no stranger to extra-marital affairs, however, over this period he makes far more frequent references to them. He admits in one entry that he is putting himself at risk by visiting Mrs Bagwell whose servant had just died of plague, but he carries on nevertheless. This increase in sexual drive during periods of turmoil is well documented throughout history: such as during the Blitz, the bombing raids on London during the Second World War. There is no evidence, as yet, as to whether this is true of the Covid-19 epidemic.
Similarities exist between the Great Plague and Covid-19: there was no cure, treatment was primarily supportive and emphasis was placed on prevention and reducing transmission. It must be said that only a small proportion of the population had access to physicians in the 17th century, in contrast to today. In view of this, the decision of doctors to flee London appears to have shaped response to the medical profession at the time. We see how Dr Goddard attempts to defend the decision made by him and his colleagues to leave town. Their decision was probably a wise one in retrospect, as shown by the death of Pepys's friend Dr Burnett and the rumour that all the physicians (and all bar one apothecary) in Westminster had died. It is unlikely we would be hearing the weekly 'Clap for Carers' if we had all left town at the first sign of trouble.
Finally, Pepys recounts his delight when the epidemic appears to be over, the church bells ring out and daily life resumes. His statement written at New Year, that he 'had never lived so merrily' is likely to be a combination of his cavalier coping strategy, combined with the human ability to look back on traumatic experiences in a positive fashion. The authors of this paper hope, that when 'the town fills apace, and shops begin to open again' we will experience a similar 'feeling of joy' as did Samuel Pepys, 355 years ago.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.