What the 1918 flu pandemic tells us about whether social distancing works | Nancy K Bristow | Opinion

As the world sees armed protesters in the United States demanding an end to “shelter-in-place” orders, read stories of shopping malls in Brazil reopening as their president joins anti-blockade protests, and hears voices of laissez-faire By calling on their governments to “ease” the restrictions as soon as possible, we could do well to look back on parallel moments in history. In recent days, amazing images of scientific charts and graphs Since the 1918 flu pandemic they have been circulating on social media. Although these hand drawn diagrams may seem archaic to our eyes, they offer a clear rebuke to those who move too fast to get away from the public health restrictions that many around the world are currently enduring.

In 1918, the flu swept the world in a series of waves. Probably springing up in the spring of 1918 in the Midwestern United States, this new virus moved through the United States largely unnoticed by a nation at war. Soon, however, he traveled to Europe through American troops, infecting the first fighters, then the entire continent and beyond. But this pandemic was just beginning. In late August, a second deadliest wave crashed off the coasts of the United States, France, and Sierra Leone almost simultaneously and rushed from there to sicken the entire world. This was, in many communities, soon followed by a third wave. When the virus finally declined in 1920, an estimated 500 million people had been affected worldwide, and 50-100 million people had died. Of these, 675,000 deaths were in the United States.

When they faced this scourge in 1918, scientists lacked technology that would allow them to see the virus that caused it. However, the nineteenth-century bacteriological revolution gave American public health and medical authorities confidence that it was a contagious disease. Nationwide, the United States Public Health Service (USPHS) encouraged education and, if necessary, a variety of controls on the behavior of Americans. It is up to state, county, and local leaders to make decisions about how to handle the pandemic. His choices were critical.

Public health leaders had a variety of tools on hand. They began by training the population in basic hygiene practices: washing their hands and covering their coughs and sneezes. The USPHS printed millions of pamphlets provide information about the disease and recommend precautions to avoid and treat the disease. The American Red Cross published its own circular in eight different languages. Many communities passed laws against public spitting and banned the common drinking cup that is still shared in public spaces like classrooms and train stations.

These were the easy steps. Soon, better ventilation was required on the trams, and some cities staggered business hours and store hours to avoid overcrowding. The flu kept coming and more comprehensive controls followed. Bans at public gatherings, the closing of all but the most essential businesses, including bans on weddings and funerals frequently followed. Some cities tried to demand the use of masks. Others were quarantined to the sick. There were even cities that used new and untested vaccines.

But what is most helpful to us today is the comparative experience of Philadelphia and Seattle. Philly, despite having some warning that the pandemic was coming, did little to prepare. Although Boston was under siege in late September, Philadelphia continued to do business as usual. On September 28, he organized a mass launch parade for the Fourth Freedom Loan, the bond campaign used to support the American war effort. Three days later, the city reported 635 new cases of influenza, and the situation soon worsened. Although the city now moved to protect itself, Philadelphia was overwhelmed by the epidemic. The available health resources, already compromised by the war effort, quickly spread beyond its limits. Morgues overflowed with the dead, a desperate shortage of coffins, and a recourse to mass graves as a result of the city’s inability to move early to prepare. Philadelphia suffered one of the highest death rates in the country.

Seattle offers a very different story. On September 20, the city’s health commissioner, Dr. JS McBride, acknowledged that “it was not unlikely” that influenza would reach the city and warned citizens that, if so, it would be necessary to isolate the cases. When soldiers in nearby Lewis field became ill with the flu, the field was quarantined. On October 4, it became known that large numbers of students at the University of Washington Naval Training Station had contracted the flu. In two days, the city, despite significant opposition, closed schools, banned religious services, and closed many public entertainments. Crowding was prohibited in those businesses that still operated.

In the days to come, other measures were followed. A local hotel was required for use as an emergency hospital. Spitting in public could mean a jail cell and public embarrassment, wearing masks in public was required, business hours were shortened, and more limitations were placed on those who could remain open. Although he had initially expected the pandemic to pass in less than a week, the health commissioner maintained the restrictions, even as the number of cases began to decrease. Finally, on November 11, both the city and the state announced the end of the closings and the masking. It is not uncommon for the city to soon face the return of the disease. Again the city acted, this time quarantining the sick. As a result of these actions, Seattle suffered one of the lowest death rates on the west coast, substantially lower than that of Philadelphia.

There certainly was opposition to the kinds of restrictions Americans faced during the 1918 pandemic. Church leaders routinely protested that, in the midst of a pandemic, the needs of their congregants were best met by accessing religious gatherings. Business owners struggled hard to stay open. Theater owners chased legal challenges, while opposition voiced the closure of schools. In San Francisco, an “Anti-Mask League” was organized against facial coatings.

But the authorities who resisted this opposition fared better. Research by academics at the University of Michigan Medical History Center and the Centers for Disease Control and Prevention makes clear that the “early, sustained, and layered” imposition of non-pharmaceutical interventions such as social distancing It worked in 1918, slowing the pace of the pandemic and lowering death rates. And Seattle and Philadelphia offer a hard lesson: imposing “shelter-in-place” orders, as well as other measures like public masking and quarantine the sick and infected, saves lives. They can do it again, if we can find the courage and the resources to sustain them.

• Nancy K Bristow is a professor of history at Puget Sound University and the author of American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic and Steeped in the Blood of Racism (published July 2020)