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The Black Death pandemic, or the ‘great mortality’, happened during the 14th century and wasn’t fully eradicated until the end of the Middle Ages. The main wave of the Black Death was between 1349 and 1350 when one in three people were killed. There was a second wave between 1360-62.

The plague spread across Europe from Asia and it is thought that the illness killed around 75 million people. The first record of deaths from the plague in Wales was in Carmarthen, an important port at the time. Similarly, the plague also had an early impact on Abergavenny, Caldicot, Pembroke, Haverfordwest and Holywell.

Symptoms included:

• sneezing
• blisters
• swelling of the armpits
• skin becoming pale and smelly
• skin turning black

There were two types of plague, the bubonic plague carried by fleas and the pneumonic plague transmitted by breathing. There was much superstition in the Middle Ages regarding the causes of the plague, with one of the main beliefs being that it was punishment from God.

The plague impacted greatly on agriculture with an increasing shortage of workers leading to much empty terrain. Some villages and towns disappeared completely, eg Llanllwch, near Carmarthen, and Radyr.

Many people who rented land left Wales for England following an increase in taxes. This meant that many lords lost money because they received less income from rents.

A lot of food-growing land was converted to rear animals as fewer workers were needed.

The consequences of the plague led to insurrection in France in 1358 and in England in 1381. It is also believed that the impacts of the Black Death were among the reasons for Owain Glyndŵr’s insurrection in 1400.

Cholera is an illness caused by a lack of clean drinking water. Overpopulation and a lack of ventilation in many houses also led to the illness spreading in Victorian times.

The first large cholera epidemic to hit south Wales happened in 1832. The areas of Rhymney, Nant-y-glo and Cefn Golau were badly affected and 203 people died in Tredegar alone.

In 1849, the illness badly affected the town of Merthyr. It was a year of drought that led to a shortage of clean water. A four-year-old girl was the first to die of cholera in the town in May 1849. By the summer months, 36 people were dying every day on average. There were 1,682 deaths from cholera in Merthyr in that year.

The disease affected Cardiff in the same year, killing 382 people. Many of Cardiff’s population received their drinking water from the Glamorgan Canal that was polluted by rubbish and sewage.

Thomas Webster Rammell, an inspector leading the Health Board’s work, was employed to write a report in 1849-50. In his report, he argued that overpopulation and a lack of drinking water were the main causes of the cases in Cardiff. His report referred to:

• a house in Stanley Street where 54 people lived in just four rooms – the children had no beds and had to sleep in boxes with other children
• worms in the water of a well in Mary Ann Street
• the Waterloo Buildings, where 11 or 12 households shared just two toilets

Despite this report on Cardiff, cholera remained a problem until the 1880s. A hospital was established on Flat Holm Island specifically for cholera patients. On 8 September 1884, three sailors from Marseilles were taken to the island as they had cholera.

The Spanish flu epidemic occurred between 1918 and 1919, and despite its name, the first cases were recorded in the United States of America followed by France, Germany and Britain. There are differing estimates of how many people died, with figures ranging from 17 to 50 million over four different waves of the illness.

The pandemic started at the end of the First World War and news of the flu was kept quiet to avoid affecting people’s spirits after the war. Newspapers in Spain, a country not involved in the war, were the first to report the flu, hence the name of the illness.

The flu had a greater impact on Wales during the second wave. 144 deaths were recorded in the Rhondda in July 1918. The industrial areas of south Wales suffered greatly from the disease as the population lived close together. Rural areas also suffered badly. The highest death rate for the epidemic period in Wales was in the old county of Caernarfonshire.

The Cambrian Journal newspaper announced 349 deaths in Carmarthenshire in January 1919, showing that all areas of Wales felt the impact of the Spanish flu. It is believed that around 11,400 people died of the flu in Wales.

The Covid-19 pandemic has shown that there have been considerable medical advances such as vaccines to deal with illnesses. As well as this, effective planning of homes and hygiene standards have prevented the re-emergence of many illnesses, such as cholera. Cholera is still seen in some parts of the world such as Africa, south-east Asia and Haiti.

Although research and medical advances have substantially improved the treatment of diseases, there are similarities between the impact of the Covid-19 pandemic and that of historical diseases, eg a greater number of older people killed, the lack of a vaccine to prevent the disease initially and a negative impact on the economy.