In spring of 1665, an Englishman named Samuel Pepys noted in his diary that he had been “to the cafe, where all the news is of … the plague growing on us in this city; and some of the remedies against it: some say one thing and another. “The plague had repeatedly passed through much of England and Europe in that century. The news of the last wave would have reached Londoners through the continuous stories of plague deaths in the first newspapers and documents government known as “mortality bills”.
In every pandemic since the 16th century, people have tried to piece together the dead – and then discussed how to correctly count disease-related deaths and what those numbers really mean. Pepys’ London was no exception. Weekly reports on the number of deaths in the city were voluminous, disordered and suspected of being subject to human error and corruption. They were collected by parish employees and “searching women” with little specialized experience and working at serious risk to their health. But Pepys and other Londoners depended on these local death counts, almost in real time and sometimes contradictory, like a sort of civic algorithm that could help them plan their purchases, travel and business, avoiding districts affected by the plague of the growing metropolis.
For almost the time we counted the pandemic deaths, people have been working to create tools to evaluate data quickly and easily. Tabs, summaries and data visualizations work not only to manage the scale of pandemic death counts, but also the economic impacts of a fatal outbreak. Just three years before Pepys’ trip to the cafeteria, his contemporary, John Graunt, had published his huge Natural and political observations made on mortality accounts, who had taken the weekly mortality bills from 1604 to 1660 and aggregated them into a large dataset and life chart. While Graunt is often celebrated today as an innovator in vital statistics and demographics, he began his career as a haberdashery merchant – a more elegant man – and his interest in viral epidemics was primarily focused on their impact on business.
Graunt observed that regular mortality counts were an indication that the “state of health of the city could appear at any moment” so that “the wealthy could judge the need for their removal, and businessmen could conjecture “about their future business prospects. Anxious to secure the favor of political patrons and the English king, Graunt created what could be the first demographic and epidemiological arguments about those church burial numbers. Like many at this time, Graunt was anxious to argue that “the annoying secretions of the time of the plague” represented unwarranted “major inconveniences”, and he was anxious to present the cycles of deaths of the plague as predictable enough to help those who planned university sessions, courts proceedings and major public events.
Major epidemic diseases have long been an opportunity for businesses and government agencies to work together to promote new public surveillance schemes and measures. Before the late 19th century, American mortality statistics were collected nationally only in the 10-year census; otherwise they would have been collected by small municipalities and religious communities. Then came the Cuban-American yellow fever epidemic of 1878, resulting in both the National Quarantine Act and the first ever Public Health Bulletin, which would later become the CDC Weekly report on morbidity and mortality.
The Bulletin, like the mortality bills, was designed to provide governors and port authorities with information on the health, literal and metaphorical, of international shipping. Outside of the major port cities, where business led health surveillance, there was a low enrollment of state health offices and, consequently, deaths in subsequent epidemics were significantly underestimated.
The 17th century plague plagued Anglo-American and European nations for at least 60 years. Unlike the 1878 yellow fever epidemic, which was nullified by overtime colonial non-volunteer mosquito vectors, the plague devastated communities episodically for more than a generation. The voice of Pepys’ diary suggests that despite having the advantage of Graunt’s statistical analysis, he and his contemporaries understood that the disordered information better corresponded to the reality on the field than the “clear” data that Graunt claimed could prevent the closure of activities and domestic boundaries.
As heirs to Graunt’s hubris, we urgently need ways to represent the uncertainty of our counting and grading practices for the general public and policy makers. Rather than data collection efforts that mask incompleteness and confusion, we need a language that requires us to feel comfortable not knowing yet. At the same time, we need small, local data that can help us determine how best to face our lives.