During the Potato Famine in Ireland, 1.5 million Irish immigrants came to America. Many of them settled in New York. Not long after, rising anti-semitism in Eastern Europe pushed over 2.5 million Eastern European Jews to immigrate to the United States between 1880 and 1924. Italians also hoped for a better life in New York, and between 1880 and 1924, 4.6 million came through Ellis Island. The majority of these particular immigrant groups settled in or near the Lower East Side, making it the most densely populated neighborhood in the entire world. These immigrants came to this country in search of a better life, and better opportunities – however, conditions in tenement neighborhoods made life difficult and offered the perfect opportunity for disease to spread.

During this time, “social distancing” (the recommendation from public health officials to have as little close contact with others as possible) was simply not an option. Tenement apartments were cramped and offered very little, if any, natural light or ventilation. Most families of six or more members lived within approximately 600 square feet.

Thanks to the 1901 housing reforms, landlords were required to provide a shared toilet in the hallways of tenement buildings. But before that regulation, toilets were outside in the backyard or elsewhere in the neighborhood in the form of shared bathhouses. Hot running water was a luxury; no tenement dweller was able to frequently wash their hands with soapy water for 20 seconds. According to the architect and tenement reformer Ernest Flagg, the “New York system of tenement-houses” was “the worst curse which ever afflicted any great community.” Despite their ubiquitousness, it was well known at the time that these living conditions were horrendous and unhealthy.

One of the first major outbreaks to hit New York City was cholera in the 1800s. Throughout the 1800s, cholera outbreaks sporadically attacked the city and were responsible for the death of over 3,500 New Yorkers. These types of outbreaks were a direct result of the jump in population that the city had been experiencing. They also served as the first test to the newly formed health department, which had been enacted in the late 1700s as a response to Yellow Fever crisis. The "Spanish Influenza" of 1918 is the most commonly cited parallel to today's coronavirus. It hit the city in two major waves. The first was during the normal “flu season,” winter, when approximately 10,000 people were killed. The second wave was more unusual and more deadly - it rose during the summer and killed about 21,000 people. In all, the death toll was slightly above 30,000 in a population of 5.6 million. This flu spiked a massive modernization of the New York Health Department that was primarily based in education. City officials spent a considerable amount of effort simply teaching New Yorkers to cover their coughs and their sneezes and urging them to stay out of crowds. This sounds pretty familiar, right? However, immigrants on the Lower East Side and other dense neighborhoods would have had a hard time avoiding crowds and close contact with others. The Floating Hospital opened in 1866 and was founded by St. John's Guild of Trinity Church. These boats toured the East and Hudson rivers in the summer and remained dockside during the winter. Doctors and nurses were aboard to solve medical concerns, teach passengers about health and hygiene issues, and provide check-ups and baths. Quality food and milk was also available on board for children and mothers. The Floating Hospital boats were used until 2002 (!) before becoming a land-based facility. Today the Hospital is headquartered in Long Island City, where they continue to fulfill the medical needs of underserved populations.

It is interesting to compare the reactions of historic New Yorkers and New Yorkers today. During the first big flu outbreak, the Health Department forced shops to stagger their opening and closing times in order to alleviate heavy crowds traveling on public transport during rush hours. This is similar to policies enacted by many New York offices at the start of the Coronavirus outbreak, encouraging employees to work staggered hours in order to avoid packed subways. Similar restrictions on grocery store hours and capacities have also been enacted across the country. Home quarantines were a method used by the Health Department in 1918. If a case of influenza was found in a building or home, all residents would be confined to that space.