We are currently in the grip of the worst pandemic in a generation. The wearing of masks, social distancing, and quarantining is the new normal, but there is nothing new about pandemics in the annals of history. The bubonic plague decimated Europe’s population in the mid 1300’s, and hundreds of years later, an ocean away from the crowded cities of Europe, our new country was not immune to disease.

Cholera, smallpox, and typhus were prevalent diseases afflicting population centers. In 1793, a yellow fever epidemic broke out in Philadelphia (at that time the nation’s capital) killing 5,000, approximately 10% of the population. The disease was thought to have been brought from ships arriving from Haiti and the West Indies. Many residents fled the city including, George Washington and Thomas Jefferson. Alexander Hamilton contracted the disease and recovered.  With the city’s depopulation, government and businesses shut down.

Fearing spread to New York, the Governor, George Clinton, established the city’s first Health Committee to monitor shipping and quarantine vessels coming from abroad and Philadelphia. Restricting trade and immigration were thought to be a way to stem the tide of the disease. In 1794, the city purchased Belle Vue, the estate of Brockholst Livingston (an associate Supreme Court judge) a few miles north of the city on the East River, and set up a quarantine hospital (now the site of Bellevue Hospital, the oldest public hospital in the US).

It was not until the hot and humid summer of 1795 that yellow fever started spreading rapidly in New York, with the first cases near the waterfront. The city began quarantining affected residents. One resident wrote, “The whole city is in a violent state of alarm on account of the fever. It is the subject of every conversation, at every hour, and in every company.” 

As it turns out, denial, politicization, and obfuscation are nothing new. The press at the time did not want to publicize the lethal outbreak for fear of affecting the economy, and local merchants worried it would affect trade and commerce. The Health Committee downplayed the severity to calm fears stating “no CONTAGIOUS fever, in any particular difference from what this city has been accustomed to, for some years past at this season, exists at present.” Some residents did not believe the threat to be real. Business owners decried the quarantines. One wrote, “business continues there as lively as ever: men, women, and children continually walking the streets, under no apprehension of danger. For heaven's sake what has created such alarm?” Nonetheless, the death rate ticked up and the quick burial of victims was paramount. Land was purchased in 1797 for a potter’s field on the outskirts of the city (now Washington Square Park). By the time the first frost arrived, about 2,000 people had succumbed to the disease.

The disparity between rich and poor was highlighted by the wealthy residents’ ability to relocate outside of the city limits, leaving the poor to face the disease. The disease ebbed and flowed for the next few years, diminishing in cold weather and reappearing in the summers. Outbreaks occurred in 1798, 1803, and 1805.

No one knew what caused the disease or how to treat it, but it was suspected that it was spread by poor sanitation, impure air, rotting food, or the living conditions of the poor. In 1805, the newly established NYC Board of Health made efforts to improve sanitation, remove hogs and dead animals from the streets, and endeavored to clean up the fetid, putrid squalor of the poorer neighborhoods. Quarantined patients were removed to a new Marine Hospital on Staten Island. Evacuations of affected areas emptied out neighborhoods, leading to job losses and an economic crisis. The city provided shelter and food for the indigent families that were starving. The efforts of the Board of Health helped reduce the death toll to a fraction of the deaths in the 1798 epidemic.

When the fever reappeared in 1822, the city had grown by leaps and bounds, so the potential consequences were even more dire. The cemetery at Trinity Church was overflowing, leading the city to ban burials south of Canal Street. Wealthier residents once again migrated to less populated areas, such as the small independent Village of Greenwich, north of the city. Businesses also decamped from Lower Manhattan to Greenwich. Banks, coffee houses, grocery stores, barber shops, and pubs sprang up, and the Village of Greenwich became a de facto center of commercial activity. St. Luke’s in the Fields Church was established, the name representing the patron saint of physicians and surgeons and the rural nature of the area. The demographics quickly changed as more families from Lower Manhattan arrived. One resident stated, “Our city presented an appearance of a town besieged.” The migration helped to stem the tide of the outbreak. When cold weather arrived, many residents moved back to Lower Manhattan, but some stayed. The population explosion resulted in the independent Village of Greenwich being absorbed into the city.

The city’s efforts to address squalid and fetid conditions helped to mitigate the onslaught of the disease and yellow fever eventually subsided. By the end of the summer, 720 people had died in a city of 40,000, the equivalent of 150,000 people today. However, it was not until 80 years later that the actual cause of the disease was discovered.

Yellow Fever is a typically tropical disease transmitted by the mosquito Aedes aegypti. Propagated by standing, stagnant pools of water, upon infection most victims experience severe headaches, exhaustion, and a high fever followed by delirium. As the disease progresses, their skin takes a distinctive yellow hue, hence the name. Once this happens, approximately ten percent of individuals die. Yellow fever still kills thousands of people every year, mostly in Africa, and Central and South America. The 1822 outbreak would be the final large-scale outbreak of yellow fever in New York. 

Cities throughout history were prone to epidemics due to the nature of urban density. New York and other cities were to suffer through other diseases in the years following yellow fever — cholera, typhoid, diphtheria, polio, smallpox, tuberculosis, influenza, all have had an impact on the life of the city. Parallels can be drawn between epidemics of the past and the current Covid-19 pandemic. Although we are in an unprecedented crisis, the scale of which is global, the city has weathered similar circumstances. Quarantining was the most effective tool to stop the spread of a virus and, barring a widespread dissemination of a vaccine, it still is.

These past events shaped our city. New York always perseveres, recovers, and thrives…and will again! It’s just a matter of time.