Leadership matters in the first days and weeks of an outbreak: lessons from the Great Plague of Marseille, 300 years later

It seems as though American society has all but ground to a halt: all sporting events postponed or canceled, Broadway shuttered, entire states closing schools and businesses, and issuing stay-at-home orders. While these tactics may seem extreme, the goal is to “flatten the curve”, or prevent local outbreaks of the COVID-19 from overwhelming our medical system and exacerbating a once localized crisis.

This year, we mark the tricentennial of an important event in the history of infectious disease, one that carries many lessons for us today as we assess the threat of the novel coronavirus in the United States, and debate the extent to which we must impose such social distancing and interrupt the daily routines of millions of Americans.

On May 25, 1720, a ship named the Grand Saint-Antoine, which had journeyed for nearly a year in the eastern Mediterranean, arrived back at the port of Marseille, France carrying bales of cotton, imported fine silks and other valuable goods destined for the foire de Beaucaire, one of the most important trade fairs in the Mediterranean. Unbeknownst to those on board and on land, it also carried the bacteria that causes plague. Within two years, as much as half the population of the port city had succumbed to the infection.

Eighteenth-century engraving of the Foire de Beaucaire. Musée de Nîmes.

The Great Plague of Provence, or Great Plague of Marseille, brought southern France to its knees, and led much of the rest of the world to impose strict measures to prevent its spread. Understanding how the outbreak was mismanaged in its earliest days reveals that human actions and inactions can turn what begins as a local outbreak into a rampant pandemic. The key lesson for us today: we must demand more from our leaders than we have received to date, and they must prioritize containing the pandemic over everything, including economic well-being.

About two months prior to the arrival of the Grand Saint-Antoine in Marseille, a passenger died of what appeared to be bubonic plague days after boarding the vessel at Tripoli. Soon thereafter, another seven or eight men, including the ship’s surgeon, are said to have died on the route from Tripoli to Livorno, where Captain Jean-Baptiste Chataud made an emergency stop before heading back to Marseille. In this time, another three likely perished from plague.

Even so, local Italian doctors inspected the ship and declared the illness a case of pestilential fever rather than plague. As a result, authorities in Livorno allowed the ship to depart for Marseille with a patente nette, or certificate of health, that declared it free from infection, and the ship’s captain – who was reportedly in a hurry to get back to Provence in time for the trade fair – was more than happy to depart.

Upon the vessel’s arrival in Marseille, the ship endured an unusually short quarantine – only a few days, rather than the full term of about six weeks – despite the deaths that took place on board. Jean-Baptiste Estelle, the city’s premier échevin, or municipal magistrate, who owned part of the ship and a large portion of its cargo, had used his influence to arrange for the premature unloading of his shipment into the city’s warehouses – already infected with the bacteria, Yersinia pestis – so that they could be sold soon thereafter at the trade fair.

Dramatic scenes of suffering along Marseille’s Cours Belsunce during the Great Plague of Provence. Vue du Cours pendant la peste de 1720, by Michel Serre (1721). Musée des Beaux-Arts de Marseille.

Meanwhile, however, the signs of plague were becoming unmistakable as it claimed more victims. Several porters who had reportedly handled the ship’s merchandise fell ill and perished within two to three days. At this time, a local surgeon was called to inspect the bodies and determine the cause of death. Only then was the ship redirected to the quarantine station on the island of Jarre. But it was too late – plague had arrived in Marseille.

And yet, despite people purportedly “dropping like flies” according to one local eyewitness, rather than undertaking emergency measures to contain the plague, officials instead launched a major and elaborate campaign of misinformation. Local authorities hired doctors (for a large sum of money) to diagnose the local distemper as merely a malignant, pestilential fever, and thus, not plague. The reason? Money and feckless leadership. At stake was both the reputation of the city’s leaders, and more importantly, the livelihood of this ancient port city, which by the 18th century had become a major commercial capital.

Another representation of the plague in Marseille by Michel Serre. It depicts the city’s hôtel de ville with scenes of death and dying in the foreground. Vue de l’hôtel de Ville de Marseille pendant la peste (1721). Musée des Beaux-Arts de Marseille.

Amidst rumors throughout Europe, and fearing the consequences that a plague epidemic could have on Marseillais commerce, the city’s leaders and the Bureau of Health sent letters in July 1720 to the Regent in Paris, as well as to health officers in ports all over Europe, stating that local authorities had managed to contain the contagion. But they hadn’t. A full two months after the beginning of the outbreak, when plague in Provence could no longer be refuted, French authorities finally suspended all commerce out of Marseille, quarantined the city (and later the entire region), and put a number of measures in place to prevent the spread of the epidemic.

Unfortunately, however, thanks in part to the lies of local officials, it was too late. The epidemic had already begun to spread throughout the region of Provence, where it ultimately took as many as 126,000 lives.

In those first crucial weeks after the start of the outbreak, Marseillais authorities prioritized economic interests over public health. As a result, what began as a few dead aboard a ship became a virulent epidemic that raged in southeastern France for two years.

Such negligent misdeeds are all too familiar to us today. The first several weeks of the current health crisis saw the President of the United States, and his backers in the conservative media, refer to the novel coronavirus as a hoax, part of a conspiracy to destroy his presidency. Much like Marseille’s officials in 1720, the current administration claimed, incorrectly, that the virus has been contained. The president has also wrongly insisted that sick people should go to work, and that “anyone who needs a test gets a test.”

In an effort to downplay the pandemic, he ignored the advice of the CDC that the elderly avoid large crowds and long trips. And on March 11, his Oval Office speech – key parts of which his administration later scrambled to clarify – all but proved to the American people, and the world, that the president cannot be trusted to sensibly and effectively manage the current crisis.

Much as in 1720, the administration’s failure to act prudently in the earliest days of the coronavirus outbreak has resulted in an emergency that is now more difficult to predict, to track, and to contain.

Not for the first time, we are witnessing a breakdown of institutions that we would otherwise trust in times of crisis. Inept leadership and a campaign of misinformation helped turn yet another disease outbreak into a full-blown emergency.

In times of public health crises, and especially in those crucial early days of a new outbreak when concentrated, steadfast measures are essential, the quality of leadership matters.

– Cindy Ermus

Cindy Ermus is assistant professor of history at the University of Texas at San Antonio, and executive editor for the online journal, Age of Revolutions. She is currently completing a book on the Great Plague of Provence. Follow her on Twitter @CindyErmus.

A version of this article first appeared in The Washington Post under the title, “The danger of prioritizing politics and economics during the coronavirus outbreak: Three hundred years later, the lessons of the Great Plague of Provence are sounding an alarm.”