By Lorna Ebner, Guest Contributor, Stony Brook University

As COVID-19 races through New York, we asked Lorna Ebner to tell us about previous attempts to mitigate disease in the city. Ms. Ebner is a PhD student in history at Stony Brook University, currently researching the 1858 destruction of the Staten Island Marine Hospital by residents upset at the presence of the quarantine hospital in their community.

As COVID-19 numbers continue to climb, the sounds of New York City are uncharacteristically muted. Many living in the city are understandably disquieted by the absence of the familiar soundtrack of city life, but this is far from the first time Broadway and Times Square have been silenced by an epidemic. Over the course of the nineteenth century, New York City officials have struggled to understand and alleviate the spread of disease. By the end of the century, one practice, when properly executed alongside sanitation measures, was proven to successfully stem the tide and save lives: Quarantine has conclusively mitigated the spread of disease for hundreds of years.

Throughout the long nineteenth century, New York City faced disease epidemics that felled thousands. Yellow fever (1795, 1798, 1804, and 1856) and cholera (1832, 1849, 1854, 1862) caused alarm through their high mortality rates. However, the number of deaths recorded is likely a vast underestimation as disease reporting was not kept up and counting was often skewed. From the early to mid-nineteenth century, limited medical knowledge combined with a lack of a standing public health authority limited the city’s reactions to contagious disease. Yellow fever, spread through mosquitoes, hit New York City in 1795, 1798, and 1804. In an effort to curtail the rising number of cases, a Health Committee made up of physicians was assembled and given authority by the City Council. Its first act sanctioned quarantine for all ships that carried any form of illness and those arriving from affected areas, particularly Philadelphia. In 1795, the quarantine was violated by a merchant vessel that denied incidences of sickness on board. This violation and blatant disregard for the dangers posed by yellow fever led to an outbreak in the city. Over 750 New Yorkers died, nearly 2 percent of the city’s population.[1] In 1805, New York City’s first Board of Health was appointed by the mayor and City Council. It was generally an apathetic government body with little power that met only at irregular intervals over the next six decades until called upon by a crisis.

The nineteenth century saw more devastating outbreaks as cholera swept through the city in 1832, 1849, and 1854. Cholera’s victims suffered from acute dehydration which caused patients to turn blue.

Horatio Bartley. Illustrations of Cholera Asphyxia; In Its Different Stages. Selected from Cases Treated at the Cholera Hospital, Rivington Street. New York: Printed by S. H. Jackson, New-York, 1832.

The visceral sights relentlessly reminded New Yorkers of the disease’s dangerous presence. In 1832, a cholera pandemic approached New York City after leaving a destructive trail through Asia and Europe. After cases were reported in Quebec in late June, Mayor Walter Browne enacted a blanket quarantine on all incoming vessels. The Board of Health was called out of hibernation to enforce quarantine and enact efforts to clean up impoverished neighborhoods, such as the Five Points District. The board also commissioned special quarantine hospitals. These were either converted warehouses, taverns, and schools, or were hastily constructed on empty lots, as hospitals at the time did not accept patients with infectious diseases. New Yorkers of means fled the city in hopes that the country air and distance would deter cholera’s onslaught. Between June and September of 1832, 3,515 deaths were attributed to cholera, while 70,000 New York citizens fled for the country, spreading the disease unknowingly across the United States.[2] Cholera descended upon New York City again in 1849. The Board of Health quarantined all incoming vessels and made it illegal to keep hogs within city limits as part of its ongoing sanitation efforts. In this outbreak, the Board of Health reported 5,017 deaths over the course of the summer.[3] Preparedness and stringent sanitary measures during the 1854 epidemic led to a lower mortality rate, and the number of deaths attributed to cholera dropped by almost half, to 2,509.[4]

During the mid-nineteenth century, cholera was not the only disease for which public health officials demanded immediate quarantine for all contaminated incoming vessels. As yellow fever approached New York in 1856, the head physician of the Marine Hospital, which served as a quarantine hospital for both people and products, mapped the incoming quarantined vessels. Elisha Harris’s map indicates where in the harbor the quarantined ships anchored as well as areas along the coast that he believed were susceptible to contaminated paraphernalia.

Map of quarantined vessels in New York City. Elisha Harris. The Annual Report of the Physician-in-Chief of the Marine Hospital at Quarantine: Presented to the Legislature February 4, 1857. Albany: Charles Van Benthuysen, 1857.

While public health officials and many in the medical field espoused the belief that yellow fever was indeed contagious and in need of strict quarantine, some expressed other concerns. “The restrictions laid upon commerce, with a view to prevent the introduction of yellow fever, are grounded upon the supposition of its contagious and infectious character; whereas, it is a disease of local origin, and incapable of propagation from person to person, or by emanations from the human body.”[5] Though restrictions on commerce continued, despite people’s belief that trading should continue, yellow fever ran rampant through Staten Island and the shores of Long Island. Fort Hamilton and Tompkinsville suffered dozens of cases. Because health was not prioritized by all and quarantine regulations were not strictly adhered to, New York again suffered loss of life.

The cholera epidemic of 1866 saw the advent of the Metropolitan Board of Health, which proactively enforced strict quarantine and sanitary measures prior to the outbreak. Unlike with the previous epidemics, the newly established board set out strict sanitary measures that applied to all businesses and tenement owners. While many New Yorkers vocalized their dissatisfaction with what they thought of as harsh and unnecessary measures, the numbers speak for themselves. Despite an exponentially growing population, the third cholera epidemic claimed the lives of 1,137 New Yorkers as compared to over 5,000 in 1849, and over 3,000 in 1832. As historian of medicine Charles E. Rosenberg wrote, “Physicians had tried to cure cholera; 1866 had shown them their duty was to prevent it.”[6]

The city’s measures proved effective in the late nineteenth century. A worldwide cholera pandemic began in 1881. For over a decade, cholera spread throughout Europe and Asia. After a century of battling the disease, most cities instituted precautions to mitigate loss of life. By the time cholera approached New York City in fall of 1892 in the form of a contagious vessel from Hamburg, Germany, city officials and public health authorities had already prepared strict quarantine procedures. As a result, the expected onslaught never arrived. It is estimated that 32 deaths occurred because of cholera in the fall of 1892, and that the majority of these occurred on quarantined vessels that arrived from contagious cities.[7] The century of experience definitively illustrated that preparation and preemptive quarantine proved effective in slowing or even stopping the spread of contagious disease.

New York’s resilience through nineteenth-century epidemics demonstrates the effectiveness of public health measures such as enforced quarantine and increased sanitation. Though the population of New York City continued to grow throughout the nineteenth century, the number of deaths from epidemic disease fell. The Board of Health, once a listless and irregular fixture, grew into a metropolitan medical authority whose public health measures alleviated the spread of contagion. A version of quarantine has always been employed during times of crisis. Public health in the twentieth century expanded the practice to include individual and self-quarantine. In late 2019, news broke of a novel, deadly, and extremely contagious virus Despite the developing information concerning COVID-19’s spread, the federal government did not have a consistent response to the possibility of a worldwide outbreak. And, unlike previous contagious threats, such as cholera in 1880 and smallpox in 1947, the city did not quarantine immediately and did not implement sanitary measures until after the coronavirus—unbeknownst to authorities—had already spread through the population. New York City’s history conclusively shows that basic public health measures, properly enacted, serve as New York’s most powerful weapon against epidemics. The consequences of ignoring and downplaying serious medical threats result in needless loss of life, a story shown over and over again in the nineteenth century, up to the great influenza pandemic of 1918, and now replayed in our current day.

[1] John Duffy, History of Public Health in New York City, 1625–1866: Volume 1 (Russell Sage Foundation, 1968), 104.

[2] J. S. Chambers, The Conquest of Cholera: America’s Greatest Scourge (New York: The Macmillan Company, 1938), 63.

[3] Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: University of Chicago Press, 2009), 114.

[4] Duffy, 588.

[5] “Yellow Fever and Quarantine—Letter from a Non-Contagionist,” New York Daily Times, September 9, 1856.

[6] Rosenberg, 212.

[7] Paul S. B. Jackson, “Fearing Future Epidemics: The Cholera Crisis of 1892,” Cultural Geographies, 2012, 43–65, 52.