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Richard informs Dr. Rieux that he, too, has found swollen ganglia in his patients.
Later, Richard reports that his patients always seem to get better!
But then they die.
Understandably, Rieux is alarmed and suggests beginning a process of quarantining, but Richard says only the Prefect can do that.
In a meeting with said Prefect, Richard is all, "Let’s not overreact." He wants to treat the problem without running amok yelling "Plague!" He’d rather pull a "wait-and-see," since after all they don’t even know that the disease is contagious (though we think the rat example was rather conclusive).
Richard says they’re going to have to apply the strict measures mandated in the Code; except in order to do this, they first have to admit that the pestilence is indeed plague. To avoid having to admit this, they therefore shouldn’t take any desperate action.
He then obsesses for a bit over the word "plague" and whether or not that is really the case here.
With the pestilence at its peak, Richard declares the good news is that the plague can’t really get any worse.
The plague matches Richard’s optimism and raises him. He dies of the plague.