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This was a fascinating semi-fictional account of the London plague epidemic of 1665 - semi-fictional because the narrator, a saddler, is Defoe's invention (Defoe himself having only been a child at the time of the events narrated here), but the historical events described are real.

Of course, the ideas of how plague spread and what to do to prevent infection from the time are largely incorrect, but many of the behaviours around a frightening infectious disease - including the premature relaxation of all caution once the disease recedes even slightly, prolonging the overall epidemic - are eerily familiar to those living through the COVID-19 pandemic today.

Defoe's narrator also clearly describes the different types of plague (most clearly bubonic and septicemic, although he potentially exaggerates the prevalence of the latter) now known to arise from Yersinia pestis.

From a modern perspective, the text itself is not exactly engaging: True to a character who is not a literary man, the narrative is rambling, repetitive and frequently repetitive, jumping from subject to subject before returning to the same. The sentence structure is often convoluted.
Nonetheless, I recommend this as a still fairly readable original historical document that is after all more than 300 years old.

I keep waffling between 3 and 4 stars. Maybe it should actually be 4?

My ratings are (almost) always based on how much I actually enjoyed reading the book and how they made me feel, not literary quality. (This goes both ways; I have books rated highly that I think are actually bad in a number of ways, but I enjoyed reading them - this is not the case here, though.)
I find this book hard to rate. Some of the literary devices (like the mystical italic passages interspersed with the main storyline) didn't work for me; they seemed contrived. I (and data on actual real-life catastrophes) disagree with the author's pessimistic outlook on overall human behaviour in disasters.
But on the other hand, I read the book all the way through in one go, and I am happy that I did; I found it very gripping. Reading this story is like getting to see the events only in patches through a thick mist, or partially through a small hole in the wall, but that is actually genius! This way, the narrative can focus on the essentials - emotions and human bonds - instead of inventing extraneous detail to explain things.

So I do recommend this! It's a very quick read, so even if you like it less than I did, it's low risk to give it a go.