In the spring of 1629, the city fathers of Florence shut down the mountain passes through the Apennines in the hopes of protecting their city from the bubonic plague, which was then ravaging northern Italy.
It didn’t work. As we’ve seen in our own time, contagions don’t have a great deal of respect for borders. By summer, the Florentine health authority, the Sanità, was grappling with a full-scale outbreak that confined the city’s entire population of more than 30,000 in their homes for 40 days.
The Sanità's management of the crisis was impressive. According to historian John Henderson, the authority opened plague hospitals (lazaretto) in converted villas and monasteries, and delivered daily provisions that included two loaves of bread and a half-bottle of wine for each person. On Sundays, portable altars were set up on prominent corners, so the public could hear services from their windows; an adaptation of the city’s physical infrastructure to the needs of the moment. It was a “most beautiful thing,” according to one Florentine who observed it. Think of it as a precursor to Zoom.
The plague, however, exacerbated the prejudices of civic leadership. The poor, highly susceptible due to substandard living conditions and malnutrition, were blamed for spreading the disease and subjected to tighter enforcement of restrictions and increased levels of incarceration — which could be deadly. Jews were locked away to suffer in their own ghetto.
History, of course, has a tendency to repeat itself. During the COVID-19 pandemic, poor and minority communities have had a higher rate of infection, prisons are especially dangerous, and xenophobia is on the rise.
Taken together, the Sanità's efforts illustrate a question that civic leaders struggle with even today: What is the responsibility of the physical infrastructure of the city in both propagating and mitigating the impact of epidemic disease?
Some of the most effective infrastructural improvements amount to basic common sense, such as turning over more street space to pedestrians and children for safe outdoor activities. The Slow Streets program launched in a collaboration between the city and the Better Block Foundation, among other advocacy groups, was an excellent example of just that kind of initiative. But with the pandemic’s spread slowing, the city chose not to renew the program, a frustrating decision.
This and other responses to disease are the subjects of a timely new book, Until Proven Safe: The History and Future of Quarantine (FSG, $28), by Geoff Manaugh and Nicola Twilley, who began their research long before the coronavirus began its spread.
City planning was a critical factor in the spread of some of the earliest epidemics on record. During the height of empire, Rome was struck by a series of plagues, in 23 B.C. and in A.D. 65, 79 and 182. Sanitation was almost certainly the culprit, in particular the dumping of bodies (human, animal) and fecal waste into open pits. Rome’s feats of infrastructural engineering, its famed underground sewers and aqueducts — designed as protections against infectious disease — were overwhelmed by the pressures of urban sprawl.
“By its very bigness and rapacity, Rome defeated itself and never caught up with its own needs,” wrote the historian and critic Lewis Mumford.
Sprawl is a problem familiar in contemporary North Texas; as in Rome, the environmental, political, social and fiscal pressures associated with our expanding infrastructure are proving impossible to manage.
The hygiene of public infrastructure has been a persistent problem. In 1854, an outbreak of cholera in London was traced to a single contaminated well, an episode chronicled in Steven Johnson’s nonfiction thriller The Ghost Map.
The idea of quarantine as a check on contagion was advanced in Dubrovnik, the picturesque walled city on the Adriatic. “As goods were coming up into the Italian area of southern Europe [by ship], they would go through Dubrovnik and thus bring in potential contagion,” says Manaugh. “Dubrovnik responded using architecture and spatial means.”
That meant lazarettos, situated on small islands off the city’s coast. They were initially built of wood, so they might easily be burned in case of infection. “Ships had to be anchored in the bay, and were patrolled to make sure people weren’t swimming into town,” says Manaugh.
The United States has had quarantine stations for centuries, and still does. Their existence has not always been without controversy or confrontation. In 1850, rioters torched a quarantine station on Staten Island because they believed it was lax in enforcing its mission.
While quarantine stations have traditionally been at port cities, America’s new National Quarantine Unit is inland, at the Global Center for Health Security at the University of Nebraska Medical Center. It opened in Omaha in 2019, in the wake of the Ebola epidemic. “The advancement of technology means that you can put the border anywhere,” says Twilley.
Borders need not be physical; the most powerful quarantines might be in our own minds. Consider W.G. Sebald’s novel Austerlitz, the story of Jacques Austerlitz, child of the Holocaust, who spends his adult life suppressing the memories of his own history.
“I was always refining my defensive reactions, creating a kind of quarantine or immune system which, as I maintained my existence in a smaller and smaller space, protected me from anything that could be connected in any way, however distant, with my own early history,” Austerlitz says. “If some dangerous piece of information came my way despite all my precautions, as it inevitably did, I was clearly capable of closing my ears and eyes to it, of simply forgetting it like any other unpleasantness.”
As we’ve seen over the last year, that is a catastrophic attitude; pathogens have zero respect for or interest in our prejudices or desires. There are steps that can be taken to design a more resilient city and infrastructure, but the first hurdle will always be honestly confronting our challenges.
