What Spanish flu disaster can teach us about Coronavirus

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Of course, a century ago, science was the light years from today. The influenza epidemic was much more lethal than ours in the time of my grandparents, because the treatments were nowhere developed. But even in 1918, developments in medicine and public health made diseases such as cholera, typhoid and diphtheria – in recent memories, definite killers – manageable or even preventable. America’s cities and army had extensive experience in quarantines and other social measures to stop transmission vectors. Still, the government’s attack and lack of general preparedness helped spread the outbreak like wildfire.

Professional historians often return (not really) from the reaction of ancient history that “history has to repeat itself.” And yet, it happens sometimes. The lesson is quite simple. See what went wrong in 1918. Then do the opposite.

It went very wrong in 1918. Start with the worst example of Philadelphia, where the local government has not been able to meet the public health crisis. The problem quietly took root on September 7, with 300 sailors anchoring at the Navy Garden, some of which were already infected. Boston was already infected with epidemics, so city officials were aware of their deadly potential. The city, whose infrastructure had collapsed even before the war, was now full of new workers and immigrants, which carried housing stock, streets and transport to capacity. However, it took 10 days for more than 600 soldiers and civilians to be sick enough to require hospitalization, including several doctors and nurses treating sick patients.

As in many other positions, Philadelphia’s Director of Public Health and Charities, a gynecologist without an epidemiology training, a distrust of the city’s political machine. It was Wilmer Krusen. From the very beginning, he downplayed the seriousness of the threat and made sure that the office of the public “can limit this disease to its current limits, and we are sure that we will be successful in this regard. Death was not recorded. Whatever it feels, don’t worry. “When the deaths began to increase, he insisted that there was nothing to worry about – it wasn’t” Spanish flu “, but rather just a few of the” old fashioned flu or flu “cases. … Now the disease will decrease. According to his statement, Krusden did not take any steps to identify doctors and nurses who could be present at mass hospitalizations. He resisted the calls of other medical experts who quarantined the city’s Navy Garden.

And then, on September 18, the city held a monster parade to support the Fourth Freedom Credit Drive.

These were the days of high water stamping America’s participation in World War I. The federal government forced, embarrassed, and compelled citizens to comply: From the Sedition Act, which forbids intervention in the sale of war bonds, he made patriotic speeches in cinemas as the reels were changed to the Legions of the Four Minutes Men – to say the horrific acts of popular violence against German Americans – asked the public spirit parade to continue. Tens of thousands of Philadelphians lined the streets to cheer up the parade and provided a tragic opportunity to spread the disease.

In 10 days, more than 1,000 Philadelphians died, an estimated 200,000 more fell ill, and the state government in Harrisburg ordered a ban banning the city’s public entertainment and gathering venues, lounges, theaters, ice cream parlors and movie theaters. Too little, too late: As the number of bodies continues to increase, the Catholic archbishop appointed three thousand nuns and seminars to recruit temporary hospitals and dig mass graves. By March 1919, when the flu threat disappeared, Philadelphia lost over 15,000 citizens.

In Pittsburgh, local officials ignored the price of inaction to the east. They could not list the “hospital countries and medical professionals” that the local Red Cross department later observed, despite the “sad stories from other parts of the country of the majority of the dead”. When the governor ordered all towns to close most of the housing estates, the mayor shook calls for a patient attack with a ‘bloodless observation’ repeating the city’s public health chief, objecting that “everything seems wrong”. the disease did not affect Pittsburgh much. Of course, he did it soon. Mortality rates (though not difficult figures) ultimately exceeded that of Philadelphia, but compliance with the city’s state ban was delayed, and the aggressive action of the Red Cross and other voluntary organizations as well as curse may somehow slowed down the rate of infection. it saved the funeral homes from the same overcapacity that hit other places.

The Philadelphia government’s inability to respond quickly and strongly warned other elected officials against the crisis. In some cases, as in San Diego, city officials caught the attention of the massacre that surpassed eastern cities such as Philadelphia, Boston and New York, and churches, dance halls, gyms, libraries, swimming pools, etc. public meetings, of course, with the exception of non-war bond drives. The police followed these measures aggressively. When the number of infected citizens did not fall immediately, municipal officials worked with the Red Cross to produce and distribute thousands of gauze masks that many citizens prevent wearing, despite the input of public health officials. San diego Unity He dismissed the idea, observing that “modern civilization lifted the mask as part of the human apparel… only the highways, thieves and waiters were wearing masks professionally”. Still, the city’s early and active efforts contributed to smaller deaths than other municipalities.

The wider pattern, however, was the dismissal, dispute, and openly deception of public officials who did not perceive or accept the seriousness of the threat. What mayor or governor wanted to go to war with local businesses in every city, who were against voice closures? Which paramedic wanted to escape the compelling spirit that promotes warfare rides and other solidarity actions with uniformed men? In Denver and Cheyenne, the authorities subjected to work pressure and lifted the restrictions, but to redo them after infection and death rates increased again.

Even when his city was shaken by the onset of the disease, New York’s public health manager called for more alertness, saying “Spanish flu, not other bronchial diseases … [caused] The disease of most people who are reported to have influenza. “Although the Federal Public Health Service encourages cities and states to adopt best practices, US Surgeon Rupert Blue, in the early days when quarantines and closings (to borrow from the contemporary view) can straighten the curve,” there is no reason for an alarm if Americans comply with the measures “- newspapers broad A cold-blooded statement that he reported across the globe and evokes a false sense of calm. Colonel Philipp Doane, who manages health and safety in military shipyards where the disease first spread, rejected “Spanish flu” as “something more or less than the old-fashioned grip”, even if the body count was otherwise clearly demonstrated. “

Woodrow Wilson, who mobilized great public relations efforts to provide population support for the war, said nothing. This was a period before presidents began routinely consulting, consulting or calming the nation with a pandemic.

Only many elected and appointed officers could not afford this moment. In many ways, Americans were unprepared to face a pandemic. The state of the country’s health system was primitive according to modern standards. In Pittsburgh, a city full of factories and industrial workers, low air quality contributed to common and devastating breathing problems. Even before the influenza settled, pneumonia rates reached 253 deaths per 100,000 – which is more than any city except New York. In 1923, the Mellon Foundation found that irregular institutions and ashes in factories destroyed the health of workers and their families, a condition that many other communities also faced. Pittsburgh also had no health infrastructure to talk about: only 20 community hospitals, some of which were operated by only one nurse, with acute bed shortages. Housing stock was also poor, most of the working class residents were stuck in rented homes with petri dishes for disease under the right conditions. They were better not only with excellent strangers, but also with 50,000 residents living in their room houses, where they shared the beds they occupied in shifts.

Rural America was not better equipped than big cities to air the storm. In the 1920s and early 1930s, researchers would discover the scourge of Southern poverty affected by large areas of the population, malnourished and widespread parasites and diseases. No less than their urban counterparts, small-town residents and country communities were physically compromised even before catching the flu.

In the absence of calm and stable leadership from the top, there was no shortage of standing, ready-to-profit huckster. A Dr. Franklin Duane gave an interview and published ads for a fake home remedy (“Dr. Pierce’s Pleasant Pellets”). He advocates, “The more you are afraid of the disease, the more you will get.” Bell’s Pine Tar Honey, Schenck’s Mandrake Pills, Beecham’s Pills and Miller’s Antiseptic Snake Oil also promised to be protected from flu. “When [Vick’s] VapoRub is applied over the throat and chest, ”explains a broad circulation ad to readers,“ medicated vapors relax sputum, open air passages, and encourage mucous membranes to remove microbes. “

Ordinary people can be forgiven from a certain level of purity, despite the very real advances that just cause suspicion of such snake oil ads in science. But in many regions, they resisted closure and quarantines as much as the owners of shops, halls, theaters and restaurants. They did not distinguish themselves at the first sign of infection. According to a local newspaper in Seattle, “every worker who sniffs [a] serum… they blow their noses and go back to work. After the mayor cleverly suggested that the “epidemic will end in five days” if he follows the quarantine and closure rules, residents began to swim the restrictions completely. After all, if the mayor is not worried, why should he be? One afternoon, when a souvenir “cup train” parked in the city center, thousands of Seattle citizens gathered for nine hours to inspect their property.

We do not yet know how heavy the COVID-19 toll will be in the United States. But we know a lot. As in 1918, the White House and federal government were hopelessly ineffective – worse still, irrelevant to the national reaction. Donald Trump looks like president shrink every other hour. While reading a teleprompter, he could not even make a truly correct speech to the nation.

As in 1918, state and local officials responded in a variety of ways. Some, such as Ohio Governor Mike DeWine and New York Democratic Governor Andrew Cuomo, have stepped in to compensate for the apparent shortage of the Trump administration. Others like Democratic Mayor Bill de blasio trembling to close bars, restaurants and schools, and even yesterday, each expert visited his own gym – which challenges expert advice – or the Governor of Oklahoma Kevin Stitt and California Congress Devin NunesEncouraging people to shut down and ignore their own quarantines, Republicans likely endangered thousands of other Americans.

As in 1918, cities have been slow to apply the types of sacrifices and challenges to local businesses and ordinary people that may slow the spread of the disease and thereby straighten the curve. And too many ordinary people published the advice of medical specialists until they faced blunt police force.

As in 1918, gaps in America’s healthcare infrastructure are potentially fatal. Any red state governor or legislator who rejects Medicaid reimbursement of the Eligible Care Act is obliged to close the rural and small town hospitals to its citizens. Their communities are unprepared for this disease. Most of its citizens are exposed to respiratory or immune deficiency diseases that are not treated and make them more susceptible to COVID-19. The absence of universal health coverage has contributed to poorer health in general, and will likely encourage people in the red and blue states to ration health when it should not be.

There was a lot to learn from the 1918 example, but we did not know. There is much more we can learn. A critical week in America, and now more than ever, a small date may just be what the doctor ordered.


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