Memory Monday: Third Week of January 1918
by meep
…and others looking back 100 years.
I checked out this week’s paper from then, and not seeing much — I’ll put a few clips at the end of this post. That said, I have been seeing more in our current news discussing the Spanish flu pandemic and also the fairly nasty seasonal flu epidemic we have going on now in the U.S.
LOOKING BACK AT THE PANDEMIC
From JSTOR: THE FLU PANDEMIC OF 1918, AS REPORTED IN 1918
The 1918-1919 influenza pandemic killed more people than combat did in the First World War. Maybe a lot more: fatality estimates range from 20-40 million to twice that around the globe. In the United States, a quarter of the population came down with the flu; some 675,000 died. Only the American Civil War has been more lethal.
At the time, medical authorities scrambled to combat the disease and its spread. Reviewing medical and scientific journals from a century ago offers up a fascinating window into a global medical crisis that burst out from the disasters of the First World War.
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In October of 1918, the Canadian Public Health Association’s Public Health Journal reproduced a newspaper broadside from Chicago’s Commissioner of Health and the U.S. Surgeon General aimed at informing “every man, woman, and child” about the disease. There’s nothing here that sounds strange today: if you get sick, stay in bed and take plenty of liquids; seek medical attention if conditions worsen. Most people, after all, recovered after 3-4 days. Death usually came from complications, notably pneumonia. As a “catching disease,” severe attacks could be spread to others from the germs of someone who only manifested mild symptoms. (Cover your nose and don’t spit!) The term of art here is “germ.” “Virus” in its modern sense dates to Dmitri Ivanovsky’s 1892 discoveries, but the word does not seem to have been in general circulation.
Note: most flu deaths currently are due to pneumonia – and are mainly older people dying.
This March 1919 issue of Public Health Reports details a preliminary epidemiological study of the disease in parts of Maryland. Noting that “most sections of the United States“weren’t required to file reports of the disease, and that doctors were too “overwhelmed with urgent relief work” to do so, “morbidity reports received through the usual channels furnished no reliable index of prevalence of the disease.”
The U.S. Public Health Service (founded in 1798) conducted door-to-door surveys in Baltimore and other areas of the state “upon the subsidence of the first wave of the epidemic.” Among other findings, the survey found that flu incidence was very high in young children, but their death rate was unexpectedly low. The death rate, however, was “was markedly high among adults of 20-44.” Annual flu outbreaks generally hit the youngest and oldest (and immune-compromised) members of a population the hardest. Maryland’s data were typical of this pandemic, which took an unusual toll in young and middle-aged adults. Rather like war.
I’ve pulled some of the tables and graphs from the linked research survey.
EARLY RESEARCH ON THE PANDEMIC: FROM 1919
I want to share two graphs – one which provides the death rate from the flu/pneumonia in that 1918 epidemic from the Maryland survey.
This second one provides the fatality rate per 100 flu cases:
So note: it’s mainly younger adults who died from the Spanish flu — but if older folks caught the flu (or were diagnosed, to be more specific), they were much more likely to die.
In general, older folks are much more likely to die of infectious disease if they catch it… the question is whether they catch it.
I imagine a lot of the older folks were still fairly rural, and perhaps did not mix as much as the younger adults, who were more likely to be drawn to urban areas, especially during the war.
CURRENT COMMENTS ON PANDEMIC PREPAREDNESS
From the WSJ: An Action Plan for Averting the Next Flu Pandemic
This year’s flu outbreak is unusually bad, but it could be much worse. It’s time to accelerate a range of public-health measures, including work on a universal vaccine
This year’s flu season is hitting early and hard, the worst the U.S. has seen in more than a decade. Every day more people are falling ill and getting hospitalized, and some are dying, including young children. Though we are not yet at the peak of flu season, schools have closed in communities across 49 infected states. Businesses can expect employee absenteeism to soar, and the Centers for Disease Control and Prevention expect the death toll to rise.
The outbreak has thrown the health-care system into turmoil, with some hospitals unable to treat the people flocking to emergency rooms and clinics. Crucial supplies are running low across the nation, including lifesaving ventilators, and staff shortages are deepening as nurses and other personnel fall ill.
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Despite medical advances, we are just as vulnerable today to a flu pandemic as we were a century ago. Vaccines in recent years have, on average, reduced the risk of flu illness among those vaccinated by just 40% (less than 30% this year). Current antiviral drugs only slow the virus—we have no reliable way to destroy it.
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First, we must accelerate the development of a universal flu vaccine that would offer broad protection against most types of flu. Flu viruses are perpetually evolving through mutation in order to evade human immunity, and today’s vaccines target the most frequently mutating parts. A universal vaccine would eliminate the need for annual flu shots by attacking those parts of the virus least apt to mutate and most common across different strains. It would be akin to ripping out the roots of a giant deadly weed rather than just chopping off each year’s new growth.
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Second, we need more targeted investments in vital areas of flu prevention and treatment. This includes better antiviral medicines, more accurate and widely available diagnostic tests, and low-cost face-masks that are truly protective.
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Third, we must do much more—through media campaigns and programs in schools, workplaces and communities—to encourage the adoption of personal prevention habits. Good flu prevention habits (staying home when sick, proper hand-washing, covering sneezes and coughs, etc.) have been shown in previous flu pandemics to significantly reduce transmission of the virus.Social “distancing” measures, such as school closures and the cancellation of large gatherings, also reduce the spread of flu. During the 1918 outbreak, infection rates varied dramatically among U.S. cites, depending on how quickly localities undertook such measures. By acting early, New York City had the fewest number of deaths of any city on the East Coast. Pittsburgh delayed and paid with the highest mortality rate.
Interesting. I wonder if that means the Brewster area, where I’m pulling the newspaper reports, will also have a relatively low death rate.
There’s more in the article, and if you’re interested, I’ve been keeping track of infectious disease news at the Actuarial Outpost in Epidemic and Infectious Disease watch. I started it in 2014, so I caught the last Ebola breakout in there.
AP: Century after pandemic, science takes its best shot at flu
There’s no way to predict what strain of the shape-shifting flu virus could trigger another pandemic or, given modern medical tools, how bad it might be.
But researchers hope they’re finally closing in on stronger flu shots, ways to boost much-needed protection against ordinary winter influenza and guard against future pandemics at the same time.
“We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,” said Dr. Anthony Fauci of the National Institutes of Health.
It would be quite a breakthrough if we got a universal flu vaccine.
BACK TO BREWSTER 1918: AN EARLY FLU DEATH?
As noted, I’m not seeing much in the way of flu news in the local paper. I see an obituary for an older man, who evidently had been in failing health for several months before he died. I also see a short piece on a soldier who died. I will post it over multiple pictures:
Note that they don’t indicate the cause of death, but it sounds like something natural, and something that killed him quickly. He had been at an Army training camp. Interestingly, that Long Island training camp was used as an internment camp of Japanese-Americans in WWII.
But here’s the deal: there is a hypothesis that the Spanish flu pandemic was sparked off in a U.S. army training camp:
The site of the first confirmed outbreak was at Camp Funston, Fort Riley, Kansas, then a military training facility preparing American troops for involvement in World War I. The first victim diagnosed with the new strain of flu on Monday, March 11, 1918, was mess cook Private Albert Gitchell.2324 Historian Alfred W. Crosby recorded that the flu originated in Kansas,25 and popular writer John Barry echoed Crosby in describing Haskell County, Kansas, as the point of origin26 although already in late 1917 there had been a first wave in at least 14 US military camps.27
I wonder.
Anyway, I like the detail in the story explaining the need for a minyan, though they just use the latinate “quorum” to describe what was needed.
Of course, I have no idea what Private Fineberg died of, and perhaps they didn’t, either.
OTHER LOCAL 1918 NEWS: SIEGE OF ILLNESS
Look, flu is a normal seasonal occurrance, like colds. Interestingly, in my locality, Croton Falls, used the phrase “siege of illness” multiple times:
FWIW, Dr. E.N. Ryder used to live in the house I currently live in. And had his dentist office here.
SAVE FOOD FOR WAR
A few pieces in the paper on the need to save food for the war effort, one of which seems like an ad for corn:
A bakery ad for the Meatless Days:
Here’s a bit of history on Meatless Mondays (and Fridays):
Meatless Monday is not a new idea. During World War I, the U.S. Food Administration urged families to reduce consumption of key staples to aid the war effort. “Food Will Win the War,” the government proclaimed, and “Meatless Monday” and “Wheatless Wednesday” were introduced to encourage Americans to do their part. The effect was overwhelming; more than 13 million families signed a pledge to observe the national meatless and wheatless conservation days.1
I have several meatless days myself. Stu used to be a strict vegetarian for decades, and we’ve got quite the repertoire of meatless/dairless meals. It’s not actually that difficult, especially if you like beans and rice.
That’s it til next week!
