The Covid 19 outbreak is a difficult time for London, but it is not the first time London has faced viruses, plagues, disease and pestilence. So we asked our Footprints of London Guides to come up connections to outbreaks from the past, how they affected London and how London dealt with them.

1. London Smallpox Hospital by David Brown

The worst virus in London’s History

The Smallpox Hospital St Pancras

Covid-19 might seem bad, but the smallpox virus was far worse.  It was highly infectious, and killed 3 out of 10 if its sufferers, while those who recovered could be blind or disfigured. In the eighteenth century 10% of burials in London are thought to be caused by this virus.  The virus was particularly bad in urban areas, continually present, and also regularly generating waves of epidemics that killed thousands.   Treatment was non-existent in the earlier years; London’s few existing hospitals refused to treat patients with infectious diseases.   

In 1740 Dr Robert Poole raised the money to create the first smallpox hospital in Europe, the London Smallpox Hospital, originally a 13 bed hospital in Windmill Street, Fitzrovia (opposite the current Fitzroy Tavern). The staff conducted research, administered inoculations and cared for infected patients. The hospital later moved to a larger 130 bed premises in Coldbath Fields (under today’s Mount Pleasant Post Office in Clerkenwell). By 1793 they moved again to a large purpose built hospital in Battle Bridge, where the Great Northern Hotel is currently located in Kings Cross.  The arrival of the railways at Kings Cross forced the hospital to move to Highgate Hill in 1850, the building still existing as a wing of Whittington Hospital. Its final move was to South Mimms, now a UCL Biosciences Lab.

2. St George’s Hospital by Stephen Benton

Tooting fights smallpox

John Hunter Memorial

In 1893 the Metropolitan Asylum Board bought some land in the countryside near the village of Tooting. Here they built the Grove Hospital, an isolation hospital designed to deal with scarlet fever. Then on an adjoining site, they built an annex known as the Fountains Hospital.

By the early 1900s the two hospitals were surrounded by housing. The Grove carried on as a “fever” hospital whilst Fountains became a specialist children’s hospital in 1912.

Soon after the creation of the NHS, it was decided to move the historic St George’s Hospital to Tooting. But this took many decades and really only started in earnest in the 1970s.

St George’s has an illustrious history dating from 1733. Two pioneers of modern medicine practiced there: John Hunter, known as the father of modern surgery and Edward Jenner, who was responsible for the smallpox vaccine.

The buildings of the modern day hospital all have names connected with its history, with the Medical School being located in the Hunter and Jenner Wings. And outside, relocated from the old site, is another reminder of the hospital’s history – an archway with a bust of John Hunter on top.

3. The Royal Free Hospital by Marilyn Greene

Brutalist but influential

Royal Free Hospital

The Royal Free Hospital in Hampstead is often associated with infectious diseases. Images of its brutalist 1974 architecture seem to flash up on our TV screens regularly as one of the ‘go to’ hospitals for treating unknown deadly viruses. Whatever you think of the architecture, you have to admire the work, research and teaching undertaken there. The hospital, part of the Royal Free London NHS Foundation Trust, is currently, with its own isolation ward, one of the UK’s specialist centres for the treatment of COVID-19 (coronavirus). In 2014/16, it treated a nurse and healthcare worker with Ebola and it has also previously been used to treat a patient with Crimean–Congo hemorrhagic fever.

The Royal Free was founded in 1828 by surgeon William Marsden to provide free care to those of little means. A small dispensary was set up in Greville Street, Holborn, called the London General Institution for the Gratuitous Care of Malignant Diseases. The title ‘Royal’ was granted by Queen Victoria in 1837 in recognition of the hospital’s work with cholera patients. It moved to the former barracks of the Light Horse Volunteers in Gray’s Inn Road in 1842 and for many years was the only London hospital to offer medical training for women. The current building, opened by the Queen in 1978, stands on the site of what was once the Hampstead Smallpox Hospital, completed in 1870 and converted in 1885 to what became the North West London Fever Hospital.

4. John Snow by Jenni Bowley

All hands off the pump

The John Snow Pump

Last summer a refurbished replica of a nineteenth century water pump was unveiled on Broadwick Street in Soho, outside the John Snow pub. This pump is so significant in the story of pandemics that there is a replica of the pump in the London School of Hygiene and Tropical Medicine in Bloomsbury, and the Royal Society of Public Health has named its office in the City after John Snow. So why are Snow, and this pump, so important?

The nineteenth century witnessed several pandemics of cholera, a deadly disease which could kill within hours. In the hot, dry summers of 1832 and 1849 virulent outbreaks killed thousands. Scientists and doctors believed that the disease was carried in foul air, especially in overcrowded areas with insanitary conditions. John Snow studied the 1849 outbreak in Lambeth and from his careful mapping of cases, and his study of the sources of drinking water, he concluded that cholera was a water-borne disease. His ideas were largely dismissed, possibly because he was from a working-class background.

In 1854 snow proved his theory. An outbreak in Broad (now Broadwick) Street killed 500 people in 10 days. Snow demonstrated that there was a cluster of deaths around a water pump he suspected was contaminated by raw sewage. His removal of the pump handle led to a sharp decline in the incidences of cholera. Snow’s meticulous work in mapping cases of cholera and tracing the contacts of people with the disease had a significant influence on public health. His theories about disease containment and prevention are relevant today, e.g. his emphasis on cleanliness, the separation of the healthy and the sick, and the need to keep the public informed.

5. London School of Hygiene and Tropical Medicine by Alan Fortune

When a nightingale is too long?

During the heyday of the British Empire, sailors often returned from faraway places suffering from life-threatening diseases previously unencountered in Britain. So in 1899 Sir Patrick Manson founded the London School of Tropical Medicine in the Seaman’s Hospital in London Docks. Now ‘hygiene’ has been added to its name and it is a teaching and research institute only whose current premises opened in Bloomsbury in 1929. It is especially renowned for its early and continuing research into malaria, and more recently for its award-winning work on the ebola virus.

It is housed in a Grade II listed building with a carving of Apollo and Artemis riding a chariot (the School’s logo) above the entrance. Both ancient deities had associations with medicine. Apollo was god of medicine; Artemis was comforter of women in childbirth.

There were 23 names on the frieze at the top of the building, all of male pioneers in public health and medicine such as Robert Koch (tuberculosis) and Edward Jenner (smallpox). The committee who selected the names excluded women. Florence Nightingale was excluded allegedly because her surname was too long. The similarly lengthy Max Pettenkofer was included, however! To remedy this unfortunate state of affairs, in the institution’s 120th anniversary year (2019), special permission was granted to add the names of Marie Curie, Florence Nightingale and Alice Ball to the frieze.

6. Lady Mary Wortley Montagu by Anthony Davis

A Very Sharp Lady

Mary Wortley Montague

Vaccinations are on the lips of all the politicians, figuratively at least. This is the story of a very brilliant and unconventional lady who was responsible for introducing the principle into the UK; indeed, she is said to be the first person to introduce inoculations for smallpox into Western medicine in 1721.

How did this come about? After all, it would be some achievement for a man; in the early eighteenth century, for a woman it was truly remarkable. But Lady Mary was a remarkable woman – a poetess, playwright, friend (and occasional enemy) of poets like Pope, brilliant, charming and energetic. The man she eloped with, the wealthy Edward Montagu, served briefly as ambassador to Turkey. After they returned to England, a smallpox epidemic broke out and it was Lady Mary who campaigned for inoculations for her friends and their families. She interested Queen Caroline in the idea and wrote a pseudonymous essay in support of inoculations even though some members of the public hooted at her in the streets for endangering her children.

Lady Mary had a long and often difficult life with a dishonest son, unhappy love affairs, two lengthy stays in Italy (during one of which she was held prisoner by a bandit called Ugolino Palazzi). She is known now mainly for her writing, often on what would now be considered feminist themes. And where in London is associated with her? Well, she was baptised in St Paul’s church in Covent Garden; buried in the Grosvenor Chapel in South Audley Street; and lived in various locations including Great George Street Westminster where the Treasury building now stands. So you can take your pick.

7. The Rose Playhouse by Mark Rowland 

The show mustn’t go on…

The Rose Playhouse

23 June 1592. Just over three months after the earliest recorded performance of a play by a certain Mr W Shakespeare had taken place at The Rose playhouse on Bankside, it was closed abruptly. Ostensibly this was as a response to limit public gatherings in the wake of an apprentices’ riot in Southwark a couple of weeks before. Fearful of future gatherings The Privy Council ordered the Mayor to close all London theatres until 29th September that year.

An extreme response? Maybe, but the plague season was fast approaching and, whilst they didn’t know how or why (miasma was their best explanation), they knew that large crowds spread the disease quickly. It is now thought that the riot ban was a pretext to bring forward a plague ban The Council had been planning to impose anyway.

Not that the Mayor needed asking twice; The City of London Corporation had been dead set against the corrupting influence of this new secular drama from the off, banning all plays in The City in 1572 and expelling actors in 1575, so they would have been willing participants in The Privy Council’s plan.

1592 turned out to be a bad year for the plague, so bad that the London theatres didn’t in fact re-open until 29th December. Let’s hope ours return a little quicker than that…

8. St. Giles-in-the Fields by Sean Gay

Leper hospital and Plague pit

Leper begging for Alms c1425

The Palladian-style church of St Giles-in-the Fields lies on the borders of Soho and Covent Garden, triangulated between the Phoenix Garden, a small ornamental wildlife oasis staffed by volunteers, Denmark Street, home of musicians and musical instruments, and the much castigated yet iconic Centre Point Tower. The current church was completed by Henry Flitcroft in 1733. However, the origins of a church on this site date back to the early 12th century when it was a monastery and leper hospital under Matilda, wife of Henry I. Lepers were cared for here until the mid-1500s when the disease died out.  

The site was not done with contagion yet, however. The first victims of the 1665 Great Plague were buried in the second St. Giles churchyard and by the end of the plague year, there had been over 3,200 listed plague deaths in the poverty-stricken parish. The resulting large number of burials created a rising damp problem in the structure of the building, which necessitated the building of Flitcroft’s church, which may be more pleasurably visited today. St. Giles himself is the patron saint of cripples, lepers, beggars and outcasts and his name has been adopted by a leading mental health charity.

9. Daniel Defoe’s A Journal of the Plague Year by Rob Smith

17th Century Fake News

As we have seen in this blog London has been affected by numerous pandemics, some of them like the plague of 664 or the Black Death which posed existential threats to the city. The Great Plague of 1665 is one we know best, because of the first hand account in Pepys and other people’s diaries and the many handbills and pamphlets published at the time.

One of the most powerful pieces of writing about the Great Plague – Daniel Defoe’s “A Journal of the Plague Year” was based upon these earlier sources. Written 57 years after the event, Defoe based his book on a huge collection of material both printed, and oral accounts from people who lived through the event. What is fascinating is the way what we call now “fake news” circulates around 17th century London. With no full scientific explanation of how the plague was spreading it is easy to see why.

Quack doctors abound in 1665 London, some selling worthless cures that are little more than flavoured water, some more dangerous, like the doctor who advocates curing the plague by drinking mercury, and H.F., the books narrator notes the number of people who have died through taking fake cures.

It was believed that the plague might be driven off by fires and the City authorities create huge coal fires in public places like the Guildhall Yard, in the process filling the sky with deadly choking smoke, and in the process using up the whole of London’s coal supply, leaving people to freeze to death the following winter. One unfortunate man sought to drive the plague out of his house by throwing gunpowder onto his fire, the blast destroying him and his house. It was claimed you could diagnose the plague by breathing onto a chicken and seeing if it laid rotten eggs, a very inconvenient way for doctors to work! A comet was seen in the sky and this got the blame for the plague in some publications, imaginative observers said they could see the plague descending from the furry tail of the comet, others claiming they could hear it roar through the sky.

None of this “fake news” had a positive effect, although there was little truthful information the authorities could put out either. It is however a good illustration of why we should screen out unreliable information in today’s crisis.

10. Fictional Pandemics by Rob Smith

Future plagues to infected monkeys

Mary Shelley The Last Man

As if London did not have enough to contend with during the many outbreaks of disease in its history, there have been numerous fictional pandemics that have struck the city.

One of the most terrifying is in Mary Shelley’s book “The Last Man” written in 1818, which depicts a world pandemic that starts in 2073 eventually wiping out all the worlds population. Part of the story has travellers wandering through a now deserted London, opulent houses now empty, with the strange sight of a forlorn horse trotting down deserted but unruined streets towards them. Shelley’s post-apocalyptic work was so at odds with the optimistic view taken by literary circles after the Napoleonic war it was very harshly reviewed, and Shelley considered giving up writing for a while.

As if a population suddenly struck blind and carnivorous walking plants were not enough for London to deal with, a killer virus hits London in John Wyndham’s 1951 classic “Day of the Triffids”. In a precursor to the hippy self sufficiency movement to the 1960s the protagonists leave London for the safety of the Isle of Wight, only returning to the decaying capital when absolutely necessary, to find things they can’t grow or make themselves. It’s a very anti-London novel, with the hero Bill Masen saying that the destruction of London had led him to a more fulfilling life away from fruitless day to day struggle he had had before.

Many of the themes from Day of the Triffids are repeated in the Danny Boyle film “28 Days Later” where a deadly virus spreads across the population turning them into violent flesh eating monsters. This is taken to an even greater extreme in Charlie Higson’s “The Enemy” series where a virus sweeps across London turning everyone over the age of 16 into a killer mutant, and the children of London have to survive in small groups hidden in The Tower of London, The Natural History Museum, Ikea in Neasden and the Holloway Road branch of Waitrose.

The level of detail in describing the locations is unnerving. You can stand in Regent’s Park and exactly locate the place where a group of children have to fight mutated monkeys from the zoo.

However bad things get over the next few months, at least we do not have to worry about that!

Please stay safe, everyone and remember: