Humankind is resilient. While global pandemics like the Bubonic Plague and 1918 pandemic wreaked havoc on populations through the centuries, societies honed critical survival strategies. Here are five ways people adapted to life amid disease outbreaks.

  1. Quarantine

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The first quarantine was passed into law in the port city of Ragusa (today’s Dubrovnik) on July 27, 1377, during the Bubonic Plague, or Black Death. It stipulated: “Those who come from plague-infested areas shall not enter [Ragusa] or its district unless they spend a month on the islet of Mrkan or in the town of Cavtat, for the purpose of disinfection.” Doctors at the time observed that the spread of the Black Death could be slowed by isolating individuals.

Quarantine played a large role in how 20th-century American cities responded to the outbreak of the 1918 influenza pandemic, or Spanish flu, following the return of soldiers from World War I. In San Francisco, naval arrivals were quarantined before entering the city. In San Francisco and St. Louis, social gatherings were banned and theaters and schools were closed. Philadelphia became a test case in what not to do when, 72 hours after holding the ill-fated Liberty Loan parade in September, the city’s 31 hospitals were at capacity following the superspreader event.

Did you know? The term “quarantine” is derived from the Italian quarantino, meaning “40-day period.”

READ MORE: Social Distancing and Quarantine Were Used to Fight the Black Death

2. Socially Distant Food and Drink Pickup

COVID-19 was not the first pandemic to strike Italy. During the Italian Plague (1629-1631), the wealthy citizens of Tuscany devised an ingenious way to sell off the contents of their wine cellars without entering the presumably infected streets: Wine windows, or buchette del vino.

These narrow windows were cut into grand homes to allow wine sellers to pass their wares to waiting customers, much like the to-go cocktail windows that popped up cities like New York during the COVID-19 pandemic. Seventeenth-century wine sellers even used vinegar as a disinfectant when accepting payment. There are over 150 wine windows in the city of Florence, and 400 years after the plague, they were revived amid COVID-19 to serve customers everything from wine and coffee to gelato.

3. Mask Wearing

Mask wearing pandemic

Doctors treating patients during the plague wore masks with long, bird-like beaks. They had the right idea—the long beaks created social distance between patient and doctor and at least partially covered their mouth and nose—but the wrong science. Doctors at the time believed in Miasma theory, which held that diseases spread through bad smells in the air. The beaks were often packed with strongly scented herbs believed to ward off illness.

During the 1918 influenza pandemic, masks became the go-to means of stopping the spread of infection to the public. Masks became mandatory in San Francisco in September of 1918, and those who didn’t comply faced fines, imprisonment and the threat of having their names printed in newspapers as “mask slackers.” 

But newspapers weren’t just for shaming; they also printed instructions on how to make masks at home. People even got creative with masks, with the Seattle Daily Times running an article entitled “Influenza Veils Set New Fashion” in October of 1918.

Read more at History.com