This chapter provides a historic survey of pandemic responses over the last 650 years from when the plague first became endemic in Europe after 1347. It will show how the role of the state – initially Italian city-states and then the British and other nation-states – changed radically in response. Superseding the appeal to divine intervention for help, governments became involved in protecting and controlling their citizens at the most minute level. Across Europe and elsewhere the full range of tools of pandemic control from surveillance, tracking, quarantine, border patrols and economic support for those unable to work have in fact existed for hundreds of years.

It will argue that it is commerce, trade and war that historically have enabled pandemics to spread – they are not random events, but substantially man-made occurrences. By 2020, we had, in our quest for ever-expanding global markets and trade, created the perfect breeding ground for a new pandemic disease to emerge as we increasingly disturbed the habitats of other species. And we had also provided it with the perfect conditions to spread with our increasingly connected world. COVID-19 was always a matter of ‘when’ not ‘if’.