The Black Death was the worst pandemic to strike England but not the only one. Nor was the plague the only killer disease, but it was the most deadly. It was endemic for long periods in major towns, Norwich and London in particular, biding its time, awaiting the arrival of a more virulent strain from the Continent to burst into a full-blown epidemic. Outbreaks recurred over the years, in one place or another, erupting in the spring and summer months, their character never understood. The last major blast was the Great Plague of 1665 which in April struck the land, ‘leaving hardly any place free from its insults’.

A town was more in danger than a village, a city than a town, and a big city most of all. London in particular – the City and Westminster, the liberties and out-parishes, Southwark and the suburbs – with its enormous population largely herded into confined and cramped tenements amidst teeming streets festooned with the dirt and detritus of an urban life virtually devoid of sanitation, was devastated. Of its perhaps 450,000 inhabitants well over 70,000 – some say over 100,000 – were to die in less than a year. The rich, or many of them, the king included, escaped the City and Westminster, the poor being left largely to their own devices and the care of some devoted and often dissenting clerics and a few officials, schoolmasters and medical men, to face the wrath to come. The mayor stayed on but transacted all his business from a specially constructed glass cage, a prisoner by his own design.

In an attempt to stop the spread of infection, the authorities had recourse to a simple, long-tried and wholly disastrous strategy in terms of plague prevention and public health. When one member of a household exhibited plague symptoms, the building was sealed off, a red cross, like a stigma, daubed on their door, and all those inside – sick or sound – were shut in for forty days, consigning them to almost certain death, prisoners encoffined in their own homes.