Coronavirus infection rates continue to rise, and the number of new cases is increasing in dozens of states, and the United States reports a record number of cases on individual days. Hospitalization in the United States has increased dramatically; Some cities are experiencing surges that threaten to overwhelm their health systems.
Meanwhile, protests over the police murder of George Floyd brought tens of thousands to the streets, meeting shoulder to shoulder. Many are victims of tear gas by the police, which can increase the risk of transmission and infection. The latest models indicate that COVID-19’s death toll in the United States could reach 170,000 in October. A second wave this fall, or the continuation of an undiminished first wave, could make that number even higher.
But these are not unprecedented times.
As a medical historian at the University of Michigan, I am a student of the 1918 flu pandemic. It remains the deadliest public health event in recorded history. There are lessons to be learned from what happened a century ago. It is true that there are differences between then and now. We were then a nation at war, with an economy led by manufacturing and a male-dominated workforce. We had much less medical and scientific knowledge. And it was a completely different virus. But there are striking similarities between how we reacted to the pandemic in 1918 and how we are responding now.
Getty Images / Universal History Archive
Lessons of the last century
The city of Denver, Colorado is perhaps the most relevant case study. As the epidemic skyrocketed, officials ordered schools, churches, and public entertainment venues to be closed immediately. Indoor public gatherings were prohibited. Such an action, it was argued, would save lives and money.
The business community agreed. The owner of a theater put it this way: “I will gladly sacrifice everything I have and hope to have, if by doing so I can be the means of saving a life.”
That noble sense of civic duty quickly faded as the townspeople gathered outside. They met in the busy downtown business district and at outdoor religious services and lodging meetings. Business owners and those expelled from work on closure orders denounced these meetings; They were bearing the brunt of the closings, they said, as the public shirked their duty. Calling the “criminal negligence” of those at outdoor assemblies, the Denver health officer added outdoor gatherings to the bans.
[[[[Get facts about the coronavirus and the latest research. Sign up for The Conversation newsletter.]With just two weeks to go, residents became restless. As records of new cases leveled, many demanded an end to both the closing order and the collection ban. By yielding to pressure, the mayor and health official announced that the measures would be lifted on November 11, 1918. That day, in a horrible twist of fate, turned out to be Armistice Day. Thousands packed Denver’s streets, hotels, theaters and auditoriums to celebrate both the end of World War I and the pandemic. But only one of them was really finished.
Health authorities realized that a further increase in influenza deaths was likely, but acknowledged that there was little they could do. “There is no use trying to establish rules regarding the celebration of peace,” said an official, “since the lid is completely closed.”
Getty Images / Photo Quest
The next wave hits
The surge came strong and fast. In one week, doctors reported hundreds of new cases and dozens of deaths per day. Authorities responded with another set of closing orders and bans. Theaters, bowling alleys, billiards rooms and other places of public entertainment were closed. The affected business owners, complaining that they had been selected, formed an “amusement council” and demanded that the city close all congregation sites or issue a mask order. City officials agreed. They put a mask order in place.
The application was a problem. Residents routinely refused to wear masks, even when threatened with arrest and heavy fines. The mayor soon realized the futility of the order. “Why, it would take half the population to make the other half wear masks,” he said. “You can’t arrest all people, can you?” Officials then backed off again: They would recommend wearing masks, they don’t require it.
Except for streetcar drivers. They still had to use them, the city said. Bristling at being singled out, the drivers threatened to attack. A strike was avoided when city officials again diluted the order. Drivers only had to use them during rush hour trips. The new provisions were almost useless, and a few days later the mask rule was abolished.
The Denver epidemic continued for several months. It was not controlled by any public health order, except isolation and quarantine for people with the disease. The result: a second peak in deaths higher than the first, and one of the largest death tolls per capita in the country.
History could repeat itself
Surely at least some of this sounds familiar. If the Denver story tells us anything, it is that we must do better than in 1918. We must all continue to fight COVID-19 with face masks and public distancing. Recent studies show that facial masks, along with hand sanitation and the social distancing of the majority of the population, can quickly control this pandemic.
However, those levels of compliance can become increasingly difficult. In 2020, we are bristling the same way they did in 1918. A century ago, masks were widely despised; many today feel the same way. However, if we don’t take these steps seriously, we will likely face a resurgence of the virus.
If the past gives us a glimpse of the future, it is this: Returning to the radical closings and stay-at-home orders we are leaving can be difficult. It was almost impossible to do it a century ago. It may very well be impossible today.
