Bermuda, Epidemics and the Lessons of History

The global Covid-19 pandemic has significantly disrupted our world for more than a year now, and it is natural to think we are living in unprecedented times, in which the Government, medical experts, our community and individuals are all wrestling with both a deadly virus, and uncertainty and confusion about that virus.

This is actually nothing new. Since Bermuda’s first decade, viruses have been trying to sneak on to the island and residents have battled to suppress them. Today it is Covid-19 in various variant forms. In 1615, it was a debilitating sickness called “The Feagues” which left early settlers too weak to feed themselves. Five years later, a ship arriving with indentured servants introduced bubonic plague (of Black Death fame); luckily, the Governor kept it from jumping to Bermuda’s then-considerable rat population and wiping out the entire colony, but he got sick himself and the next governor died within weeks of arriving.

The infrequent arrivals of slow ships made Bermuda a healthy place for most of the 17th century: European endemic diseases tended to burn out during months-long passages before vessels arrived, either killing or leaving immune and noncontagious those on board. But as Bermudians shifted to seafaring and trading with closer Caribbean and American ports in the 1680s, their numerous shorter voyages multiplied the chance of viruses hitching a ride and landing here.

In June 1692, Bermudians’ collective luck ran out. Yellow fever was raging throughout the Caribbean and an especially fast sloop brought it — and its mosquito carriers — home. In just three months it swept through the island like a hurricane, killing 767 people, or 12 per cent of the population — proportionally equivalent to 7,451 Bermudian deaths today.

Not unlike Covid, the yellow fever virus incubates three to six days undetected in a person before becoming virulent; half of those experiencing severe symptoms die. The two doctors in the colony were powerless to fight the epidemic and government collapsed after six of the nine councillors died. Families locked down, but mosquitoes crept through shutters and under doors to transfer deadly viruses from sick residents to healthy ones. The “Great Sickness”, as it was called, offers a terrifying example of the terrible damage an out-of-control epidemic could do. Thankfully, yellow fever did not take hold and become an endemic, year-round killer, as it did in parts of the Caribbean, or Bermuda’s history might have been radically different.

Endemic in Europe and Africa but rare in the Americas, smallpox was the biggest threat to maritime Bermuda. The variola virus is highly contagious, spread through breathing in airborne virus droplets during prolonged face-to-face contact with persons within six feet — if only they had known about wearing masks then.

Once contracted, it incubates for about 12 days, enabling infected carriers to travel considerable distances while healthy and asymptomatic. It then erupts with a fever and flu-like symptoms, followed by a skin rash that forms painful contagious pustules, or “pocks”, which persist and scab over during the next two weeks. One in three victims died during the ordeal. Survivors gained lifelong immunity, but three quarters of them were left with scars as reminders. Unlike the 1692 yellow fever epidemic, doctors and government knew more about how to treat and contain this ancient disease, but Bermuda was highly vulnerable to this far-travelling, slow-developing killer.

Bermudian sailors encountered smallpox regularly in foreign ports, and records in the archives reflect numerous cases of it breaking out on sloops mid-voyage and killing half or more of a crew. Indeed, yellow fever, malaria and smallpox probably claimed more mariners’ lives than shipwrecks, storms or battles with pirates. Bermuda’s lawmakers were merchants, shipbuilders and mariners, and knew it was only a matter of time before a virus made landfall on their crowded island and afflicted their wives and children. The challenge was to strike a balance between maintaining trade on which Bermuda depended and putting in place restrictions to keep infected arrivals from starting an epidemic.

Quarantine and Inoculation

Bermuda’s first quarantine law was passed in 1731, after smallpox was introduced by a sloop from New York and started to move from household to household — by reckless people visiting homes afflicted by the “mortal and violent distemper” and spreading it to healthy ones. The law authorised local justices of the peace in each parish to detain them and “remove them” to “His Majesty’s Islands” in St George’s or Castle Harbour or the Great Sound to serve a 40-day quarantine at their own expense. (My archaeological work at Smallpox Bay on Smith’s Island is investigating one such site.)

Vessels arriving with sick passengers or crew were similarly quarantined. Justices and elected leaders in each parish also formed committees to designate “sick houses” — makeshift hospitals where smallpox patients were taken to isolate them and keep them from infecting others. Violators were whipped or fined up to a year’s pay. It was the best the Government could do, since there were no hospitals, few doctors, no nurses other than family members, and no police. The community itself was basically organised to stop the spread of a highly contagious, highly deadly disease. And it did: smallpox vanished by the autumn without ravaging the entire population.

The next year, George Forbes, a university-trained Scottish doctor arrived and set up a practice in St George’s. He introduced the newfangled but controversial practice of inoculation — deliberately infecting a healthy person with live smallpox virus (from scabs) in a controlled setting to give them a mild case and lifelong protection.

It was an expensive procedure that required patients to be in quarantine for nearly a month, until fully recovered and noncontagious. It was also risky in that patients violating their quarantine could introduce smallpox into the general population and start an epidemic. The Bermuda Government wavered between closely regulating and banning doctors from performing inoculations, but uncontrolled island-wide epidemics in 1746-48 — introduced by American privateers — and 1757 encouraged those who could afford it to protect themselves and loved ones through inoculation.

In 1760, a new law deputised Bermuda’s many skilled enslaved pilots to inspect arriving ships for sickness and order them to quarantine, and also designated nine anchorages and 12 islands as official quarantine sites.

While every Bermudian knows about the American Revolution, the Gunpowder Theft, and the spectre of famine and challenge to trade that the war years produced, few people recognised it as a major disease event during which multiple epidemics spread across the island. As Royal Navy ships captured American privateers — and more than a few Bermudian smugglers — St George’s jail became overcrowded and POWs were packed on to hulks in the harbour (anticipating the future incarceration of convicts). Deported American Loyalists, enemy prisoners and British Army garrison troops brought smallpox and other diseases with them that killed reportedly more than a thousand Bermudians between 1778 and 1783.

Bermuda’s government was powerless to do anything, since it could not ban or quarantine naval vessels, privateers, captured prizes or British regiments; nor did it have any funds or infrastructure to help the sick. Writing to her brother in Virginia, Eliza Tucker reckoned not a single Bermudian family escaped the war without suffering sickness or losing at least one member. If you wander through a Bermuda churchyard and see a grave from 1731, 1746-1748, 1757-1760, or the late 1770s, you are probably looking at a smallpox victim.

Vaccination

In May 1796, English doctor Edward Jenner launched the first scientific attempt to control an infectious disease by the deliberate use of vaccination, when he inserted cowpox matter into a healthy boy, who then successfully resisted contracting smallpox. (Strictly speaking, Jenner did not discover vaccination but did confer scientific status on the procedure and widely popularised it.) The use of vaccination quickly spread throughout England and across the Atlantic, and its adoption saved thousands of lives and short-circuited epidemic smallpox outbreaks in numerous port cities.

In June 1804, Augustus Harvey imported cowpox matter from South Carolina and within weeks had vaccinated 200 people, at their own expense. Over the following years, most Bermudians sought and obtained this life-saving treatment. By 1813, the Bermuda Government had created official health officers and vaccinators in order to stop and quarantine incoming vessels carrying infected people and safeguard the island’s population, at least against smallpox. Yellow fever instead became the big killer in 19th-century Bermuda, especially as steam power and regular packets shrunk transit times.

Bermudian anti-vaxxers

By 1822, The Royal Gazette could boast “it is now more than 20 years since [vaccination] has been extensively known and practised and in the course of that time … many millions of people in a great many different regions of the globe have experienced the benefits of this wonderful discovery”. Although it was premature to declare that smallpox had “ceased to be a terror to the world”, the paper was right to conclude “it would seem to be impossible at the present time, that doubts as to the effects of the kine pox [aka cowpox] could exist.”

But there were. Bermuda suffered its last, sadly avoidable smallpox epidemic in spring 1830 after a vessel from Halifax introduced it on shore. It spread rapidly before it was diagnosed, chiefly among the poor — “both White and Coloured” in the politically insensitive language of the time — in and around the City of Hamilton. Most of those afflicted subscribed to “a prejudice which prevailed throughout these islands respecting the cowpox and the general disbelief (or at least doubt) of its efficacy as a preventive of smallpox.”

The Assembly immediately passed a law to fund vaccinations for all Bermudians, and two Royal Navy ships were sent to Halifax and the Bahamas to get cowpox samples. In the meantime, doctors reverted to controlled inoculation as a better alternative than patients contracting it naturally. Of the 225 total, 123 unvaccinated Bermudians caught the full virulent form and 32 died — 13 White, 19 Black — a 26 per cent mortality rate. Previous cowpox vaccination did not render Bermudians completely immune, but the few who did catch smallpox suffered a mild form of it and none died. Vaccines, then as now, are not “silver bullets” but rather greatly lessen the chances of contracting viruses and diminish the damage they do within vaccinated bodies.

We know today so much more than Bermudians of centuries past, whose medical treatments were primitive, knowledge of germ theory non-existent, and who often saw the world through religious lenses. Disease was often seen as the punishing hand of a chastising God. But devout Puritans also reasoned that the Divine Being had imbued humans with intelligence enough to study and improve their world and rise to challenges. It is said that “God helps those who help themselves”. We now have a choice of Covid vaccines. To refuse to take them, it would seem in the vein of Bermuda’s religious history, is tantamount to turning one’s back on God’s proffered help.

Governments then and now struggle to balance between protecting the citizenry they serve without overly infringing on their freedom. Bermuda’s tiny, primitive, underfunded past governments confronted epidemics with many of the same tools used today: quarantines, creating health officers, providing access to life-saving treatment, and punishing reckless islanders who knowingly broke rules and endangered the lives of others.

The Bermuda Government today is not threatening anyone with a year’s salary fine or a whipping or involuntarily confining you on a small island for 40 days — at your own expense: it is just asking you to stay at home for a while, not potentially expose others unknowingly to a still highly contagious but less deadly virus, and avail yourself of a free vaccine that protects you and those around you from a truly nasty disease whose long-term effects are still unknown.

Bermuda’s 1830 anti-vaxxers got very sick and a quarter of them died. Unnecessarily. It is said that “those who cannot learn from history are doomed to repeat it”. Does Bermuda really want to repeat the dynamics and consequences of Bermuda’s deadly past epidemics when we know so much more now than they did then?

To paraphrase health minister Kim Wilson: Stay home. Wear a mask. Get the shots.

And learn from the past.

• Michael Jarvis, PhD, studies and teaches Bermudian, Maritime, Atlantic and Digital history and archaeology at the University of Rochester. He is author of In the Eye of All Trade: Bermuda, Bermudians, and the Maritime Atlantic World, 1680-1783 (2010) and the forthcoming Isle of Devils, Isle of Saints: An Atlantic History of Bermuda, 1609-1684