The Epidemic Century
From at least 1791 to 1900, New York City experienced frequent and devastating epidemics.[3] One can even say that epidemics were a regular part of life. The "normal" baseline death rate in New York City, in a good year, in the first half of the 19th century was between 25 and 30 deaths per 1,000 residents. But constant epidemics continually moved the city above that rate. Epidemics often doubled the death rates above the baselines. Between 1804 and 1887, there were at least 25 epidemics, for an average of one every three years. In fact, in the years 1834, 1849, 1851, 1854, 1864-1865, and 1872, two epidemics were occurring at the same time.
The Diseases
By far, up until 1875, the most frequently recurring epidemic was from smallpox. This is ironic since a vaccine was known since the early 1700s. Yet it did not entirely disappear from the city until after 1902 (though a brief resurgence came in 1947). Two diseases tied for second, in terms of frequency: typhoid/typhus fever, and cholera. Typhoid/typhus fever was transmitted through contaminated food and water, and from direct contact with the infected. Cholera was also spread by contaminated food and water. Additionally, Yellow fever was a regularly appearing epidemic, which first arrived in New York in 1791 and disappeared after 1822. It was transmitted by mosquitoes, which likely spawned in the marshes and still waters of the island.
Arguably, the worst year for the city was 1849 (just at the height of immigration from the Irish Potato Famine) when over 5,000 people died of cholera, and the death rate spiked to 60 deaths per 1,000 residents. The additional deaths from cholera, if scaled up to today's population count, would amount to the equivalent of about 95,000 additional deaths in 2019! And, in the three years from 1847 to 1849, there were some 8,000 reported deaths from typhoid, cholera, and smallpox combined.
Panic in the City
The random emergence of the epidemics caused the same kind of panics then as we see with coronavirus today. As one scholar writes about the 1832 cholera outbreak,
On Sunday, July 2, despite a calculated official silence, the existence of the first cases of cholera in the city was an open secret. Mass exodus from the city had already begun. To those able, flight was the immediate and traditional reaction. A hyperbolic and sarcastic observer remarked later that on Sunday "fifty thousand stout-hearted … New Yorkers scampered away in steamboats, stages, carts, and wheel barrows." Farm houses and country homes within a thirty mile radius of the city were filled.
The feeling of dread was a common element of city life, as historical demographer, Gretchen Condran, writes,
Cholera and yellow fever defined the practical and emotional meaning of epidemics during the late eighteen and early nineteenth centuries. Virtually no deaths from these two diseases were recorded in the nonepidemic years. They arrived suddenly, ran their course in a matter of months, and then returned some years later with little or no warning….That a person could be well in the morning and dead before nightfall, a stark contrast to the lingering illness associated with many epidemic diseases like tuberculosis, added to the fear and panic that accompanied these epidemic diseases.
Was Density to Blame?
While I will have more to say about the role of urban density and epidemics in a future post, suffice it to say, the relationship between population density and the severity of epidemics is not so simple. Dense tenement districts were often hot spots for the epidemics, and the poor disproportionately suffered more than the rich, many of whom fled the city during the crises.
But over time, diseases like yellow fever and cholera would largely be eliminated, even as the tenement districts became more crowded. While poor hygiene and lack of sanitation were part of the problem, so was the city-wide environment. New York City, then as today, was a great hub of economic activity, and it was mainly through the port that diseases would enter and spread.
At the time, when germ theory was still not largely understood, health officials assigned blame for these diseases on many factors that seem strange to us today. There were also moral dimensions to their assessment—the poor immigrants huddled together in their dank, dirty tenements were responsible for these diseases because of their poor characters. Or as stated in an 1865 report by the Association for Improving the Condition of the Poor in New York (likely referring to the Irish),
[L]arge masses of the population are debased by the wretched condition in which they are compelled to live. These conditions should be improved; still, it would be true of many thousands, that if left to the uncontrolled indulgence of their reckless, filthy habits, they would convert a palace into a pigsty, and create "fever-nests" and hotbeds of vice and corruption, under circumstances most favorable to health, comfort, and social elevation.
