All of the decisions about the response to the pandemic in the 1870s were taken at a local level. There was little evidence of a national strategy. There is some evidence of information sharing between different local authorities but this seems to be more about who you knew or what you were particularly interested in. One interesting piece of collaboration of which John Leigh was a part concerns the feeding of babies. The data showed how high infant mortality was in Manchester – one of the highest in the country. By collecting data locally and from other areas, he was able to compare the Manchester data with those of other similar sized towns which had different or less industry. His conclusions were that in these other towns the majority of babies were breastfed, most up to and beyond their first birthdays. In Manchester this was not the case since a lot of women went out to work and so were not able to breastfeed. He also concluded that their their diet was totally unsuitable. This piece of work shows John Leigh’s interest in and use of data. It also shows that there was evidence to show that breastfeeding prevented a high death rate from infectious diseases but the scientific evidence as to why this was the case was not as yet understood.

Public Officer of Health Reports to the Health Committee

In order to collect data specifically about the spread of smallpox and its links to poor living conditions, the council employed disinfectors to go into houses where the disease had been identified. Any people in these houses were to be taken to isolation facilities. The disinfectors then disinfected the dwelling and collected information about it. This information was about what type of house it was e.g. back-to-back, the number and size of rooms, the number of families and the total number of people. They were also tasked with stating whether the dwelling was dirty or clean, whether there was a smell from the drains and the general condition of the house and privy. There was also consideration of the ventilation of the dwelling since bad ventilation had been recognised as an aid to the spread of the disease something echoed in the pandemic 150 years later.

Bradley Street, Demolition of back-to-back house m00428

The hospitals also collected data which was used by the Public Officer of Health (POH). They recorded the progress of the disease in individual patients by the number and scope of the pock marks and recorded the deaths from smallpox as those who were unvaccinated, those who were vaccinated and those who had received a second vaccination. All of the medical facilities within the city were stretched by the demands during this pandemic which led to a local strategic review of hospital provision, specifically isolation, and the numbers in the population who were vaccinated. The results of the inquiry into the number of beds available for isolation concluded that the middle and upper classes were able to isolate their families at home. Those members of the community considered paupers had sufficient provision within the workhouses which could be easily expanded at the will of the Board of Guardians. However, for what was called the ‘independent’ poor the means of isolation were totally inadequate since the majority lived in overcrowded accommodation, the number of available beds was insufficient and some could not afford to pay for hospital care. In addition, the number of beds available for children was extremely small since children were expected to be cared for at home. The Royal Infirmary did not admit any children and there were only 5 beds available at the hospital on Bridge Street. There was a concerted effort to improve this picture and there was subsequently a children’s hospital opened at Pendlebury but in order to attack the problem head on the POH and the Health Committee decided to increase its efforts to get as many people vaccinated as possible.

Royal Manchester Children’s Hospital, Pendlebury m80165

This was not an easy task even though the council provided the vaccinations free of charge. There had been an anti -vaccination movement after the 1853 Act. Some Victorians felt that the law marked an infringement of their civil liberties and some thought that the government was enacting these laws so as not to damage the economy rather than for the good of the people. Others, mainly the poor objected to the Poor Law connection while others objected on religious grounds. A national Anti-Vaccination League was founded after the 1853 Act while an Anti -Compulsory Vaccination League was founded in 1867 for which the public campaign espoused the view that this was an ‘infringement of personal choice’. The organisation produced a series of pamphlets, books and journals to spread their message as well as holding rallies. For those members of the population who were illiterate, the rallies and the passing of the message from person to person were how they got their information – maybe a form of Chinese whispers or the social media of the day.

In order to counteract these negative messages the city decided to take a direct personal approach. Using the data that had been collected, streets and individual dwellings most at risk from the disease were identified – 67,430 in total. Through the Board of Guardians they employed 19 inspectors who obtained responses from 62,254. On these visits the inspectors informed them about the increasing number of cases of smallpox among children in Manchester and Salford. They also told them about the benefits of vaccination: children who were vaccinated either escape smallpox altogether or have a very mild version and that those who die are the unvaccinated. Those who have had a double vaccination are in no danger at all of catching the disease. Each family was given the name and address of the public vaccinator and the times and places for these vaccinations which were free. The inspectors also collected the vaccination status of everybody in the household and this information became part of the data collection which was used to counteract this pandemic and other infectious diseases prevalent at the time. The number of vaccinations increased and by 1875 the pandemic was over.

It may appear that there are more differences between today’s pandemic and that of the 1870s – a new disease rather than a recognised one, no vaccine rather than an established one, a comprehensive, cohesive free health service rather than a piecemeal collection of institutions, national strategy rather than local, old people at risk rather than children, the use of technology to spread information rather than non-technological means. Although there were more differences than similarities, the similarities were crucial to the management of smallpox in the 1870s. Firstly there was the shared understanding that these diseases flourished in overcrowded places and that isolation prevented the spread of the disease. Secondly there was the understanding that the most effective way to tackle the disease was through vaccination. Thirdly and possibly the most significant was the use of data to inform policy. This data may have been collected and displayed differently but in both pandemics it was a crucial tool. As a picture of the two pandemics, in 2021 I can see a roomful of people, both men and women at the Office for National Statistics sitting in front of screens (or they may have been working from home) collating and analysing the data. In 1871, I can see a roomful of men in suits, possibly in the old town hall on King Street, with tall desks next to windows, doing the same job with pen and ink. In the end, 150 years apart, their jobs were crucial in order that the policy makers could decide the best courses of action to control and eliminate these diseases.

Manchester Town Hall, King Street m52152

This vision of men sitting at tall desks is actually a memory from my early childhood. My grandfather was an accountant who managed a Friendly Society, a form of health insurance, which enabled people to pay an amount per week which they could then use when they needed to pay for medical care. He, therefore ,was collecting data about individuals which in 1948 was transferred to the NHS. He worked for the NHS to ensure that the data was properly transferred. In another coincidence my eldest grandson is currently working for a company that processes data for the NHS and other health services across the world. I was fascinated from the beginning of this process by the meticulous data collected by John Leigh and by how he used it. It seems as if this interest in data runs in the family.

This blog post was written for Archives+ by one of our volunteers.