Small Choices Add Up
In August 1665 a tailor’s apprentice named George Vicars unpacked a parcel of cloth that arrived from London. The package was damp so Vicars unfolded the cloth and hung it to dry by a fire. While handling the cloth he came in contact with fleas that carried the plague. Soon, the characterist
ic fever and chills arrived. His symptoms worsened and soon he was dead as the first victim of the newest outbreak of plague in the tiny Devonshire village of Eyam.
Vicars was not the last plague death in this outbreak. Other villagers began to fall too. By year’s end, 42 of about 800 villagers had died in the outbreak. Then something strange happened. The outbreak continued into the cold winter months instead of disappearing as was typical in previous outbreaks. The villagers were nervous and so too were the residents of surrounding villages.
As cases again began to increase with the onset of summer, the villagers of Eyam made an extraordinary choice. Following the suggestion of local clergy, they decided to isolate themselves in a self-imposed lock-in designed to prevent the outbreak from spreading outside the village. No one was to enter and, more importantly, no one was to leave the tiny village until the outbreak had fully passed. The Earl of Devonshire offered support for the plan. He guaranteed the provision of goods and food to sustain Eyam. These items were deposited at the periphery of the village. When the villagers came to collect the supplies, they left coins in vessels filled with vinegar (intended to prevent contagion) to complete the trade.
The isolation worked and no additional cases were reported in villages near Eyam during this time. However, many residents of Eyam paid a hefty price. Within one week, Elizabeth Hancock lost six children and her husband to the plague. The reverend who suggested the plan lost his wife. In total nearly one-third of the village died during the fourteen-month outbreak.
The choice of the residents of Eyam likely prevented large numbers of casualties in other nearby villages and the wider countryside. After all, according to historian Kira Newman, during this time the common behavior when plague arrived was simple: “flie far… flie speedily … and returne slowly.” Of course, this strategy spread plague to others. By rejecting the customary behavior, Eyam suffered, but their lack of flight prevented their suffering from spreading to others.
When we look back to these events with the lens of history, most are astounded by the bravery and sacrifice of the Eyam villagers. It is often said that the strategies of public health are invisible. The choices within Eyam were anything but.
When we look to the height of the Covid-19 pandemic again there were very visible choices of sacrifice from first responders and essential workers that kept people more safe, saved lives, and allowed society to function. Yet, at the same time, many others made less visible choices of sacrifice that kept others safe as well. Many of these choices seem simple: skipping a crowded restaurant dinner with your employer because you are visiting an elderly relative later in the week. Reporting a positive Covid test to a school, knowing it will require your child to stay home for an isolation period and miss a championship game or perhaps an honors assembly or a special social gathering. Or skipping a family vacation because your youngest child has tested positive and, even though they are not feeling too unwell, knowing that they could spread their infection to others if they went forth in their plan to visit an amusement park.
For many, these are trivial choices that everyone should make. Yet, at the same time it is a near certainty that each of us knows people who made very different choices during the past few years. These people went to a work meeting they felt was important while feeling unwell or sent their kids to school when they were experiencing mild symptoms. I even know of a school nurse who advised parents not to test their ill children so as to avoid the possibility of the required isolation period.
Compared to Eyam, these actions to protect others didn’t require as much bravery or sacrifice. But, keeping people safe did, indeed, come at a cost. Missed events, parties, or school milestones like graduations and proms, are important. Forgoing them to keep others safe seems like it has little benefit. But that is only because you don’t see the benefits when much of public health is invisible. Each action that we take, that creates a little extra risk for others, has the potential to ripple outward like small waves from a stone tossed in a calm pond. You never know who you may infect. Who they in turn will infect, and who, perhaps several infections down the chain, may end up in a hospital or a morgue.
When many people make these small choices to keep others safe, the invisible benefits accumulate to a much larger effect than we all realize. While not as grand as the choices of Eyam residents facing the plague, we should all be thankful each time someone chooses safety for others over their own convenience.
Troy Tassier is a professor of economics at Fordham University and the author of The Rich Flee and the Poor Take the Bus: How Our Unequal Society Fails Us during Outbreaks.