By Melissa Walsh As I write this, leaders and healthcare workers of my home community of metro Detroit, and other communities around the nation, are faced with rising casualty counts due to the spread of the novel coronavirus COVID-19. In the past 24 hours, 1,719 new cases were reported in Michigan 78 Michiganders died, most of them in the tri-county area of metro Detroit, tallying 337 deaths. In the state, 9,334 people are infected. The virus is in the air, as is fear. Now we can imagine the horror faced in the fall of 1918, when Detroit's Department of Health reported 18,066 cases of influenza between October 1 and November 20, during which 1,688 people died. The disease reemerged in December and continued throughout January 1919. Another 10,920 cases were reported by late February 1919. What's especially eery, is that Michigan's rate of increase of contraction of disease from COVID-19 infection and rate of flu-induced death in March 2020 are uncannily similar to the numbers released by the state in October 1918 due to the spread of the Spanish flu. Like today's spread of the Covid-19 flu virus, the Spanish flu virus hit hardest in the state in Detroit and its surrounding suburbs. What Detroit history of fall of 1918 teaches us is that the rescindment of closure of public spaces and businesses too soon will lead to another wave of horror. While new cases of the Spanish flu of 1918 slightly waned by early November, the disease found new momentum only weeks after public spaces were opened the week of November 3. The curve wasn't flattened and sustained in 1918, leading to a deadly W pattern of the disease. 'Spanish flu' Hindsight Though leaders, news reporters, and residents referred to the virus as a "grip" or influenza "epidemic," history tells us it was in reality a pandemic of the H1N1 strain of viral pneumonia, with symptoms much like those brought on by infection by the COVID-19 strain of viral pneumonia. The assumption among scientists and doctors in 1918 was that the Spanish flu was caused by the spread of a bacterium. Scientists reacted accordingly and released a bacteria-killing serum to be administered via inoculation. The virus, which was too small to be detected by the microscopes of the day, could not be destroyed and was not contained, thereby infecting an estimated 500 million people around the world, or one third of the world's population. It killed an estimated 50 million people. Lives lost in the United States amounted to close to 700,000. One theory published in 2004 asserts that the virus originated at a military camp in Haskell County, Kansas, in the spring of 1918, after soldiers set fire to a large mound of manure, expelling billows of toxic smoke into the air. Scores of soldiers died of pneumonia weeks later. However, other scientists uncovered and analyzed reports of a mysterious and deadly respiratory affliction in Europe as early as 1917. We know from history that the first brutal wave of the disease struck in the United States on its East Coast in early September 1918, beginning in Boston, where soldiers on furlough arrived by ship from Europe. Children under 5-years old and adults over age 65 are normally the most vulnerable to succumbing to harsh flu symptoms. Yet, in 1918, a high mortality rate among healthy adults from the late-teen years to mid-30s baffled heath care leaders and scientists. The casualty rate among soldiers on furlough supported the notion that the the virus spread via soldiers returning home, a narrative that fed a larger political debate of whether America's sons should have been in the European fight at all. The flu hit hard during the fall of 1918, then waned, then reappeared, then waned, then reappeared. This W curve baffled doctors and scientists, as well as community leaders, who reopened public gathering places when the worst of the epidemic had seemed to pass. In 2018, scientist Michael Worobey explained this W-curve and the high mortality rate among the young. Immune systems are usually able to battle viruses first encountered in childhood. In 1889, the spread of an H3N8 virus caused a pandemic — the so-called "Russian" or "French" grip/flu. Young adults in 1918 would not have been exposed and therefore had not developed an immune response. And the fact that children fared better in surviving the 1918 flu outbreak suggests that less deadly flu viruses of the same strain were in the air several years prior to 1918. Other scientists attribute the high fatality rate among young adults to their strong immune system, which sends cytokine proteins to build inflammation to protect an attacking virus. The resulting inflammation in the victims' lungs— as a natural guard against a rapidly multiplying virus -- led to the fatal increase of fluid in the lungs. In 2018, the CDC embedded this statement in an article on its website about the 1918 influenza pandemic: "Since 1918, the world has experienced three additional pandemics, in 1957, 1968, and most recently in 2009. These subsequent pandemics were less severe and caused considerably lower mortality rates than the 1918 pandemic. The 1957 H2N2 pandemic and the 1968 H3N2 pandemic each resulted in an estimated 1 million global deaths, while the 2009 H1N1 pandemic resulted in fewer than 0.3 million deaths in its first year. This perhaps begs the question of whether a high severity pandemic on the scale of 1918 could occur in modern times. "Many experts think so. ..." Unfortunately, Trump and many in his administration, as well as his supporting media pundits, did not agree, dismissing the potential deadliness of the novel coronavirus COVID-19 for American residents throughout January, February, and part of March 2020, as the disease found its initial victims in the United States. Residents didn't hear much from President Woodrow Wilson about the influenza pandemic in 1918, as he was at capacity as Commander-in-Chief of American troops fighting in Europe during the final weeks of the Great War. He also was immersed in Fourteen Points-based peace talks with world leaders. However, U.S. Congress passed an emergency million-dollar package for funding scientists to come up with a vaccine. Of course, not knowing the disease was caused from a virus, science failed to protect the population from this deadly flu. As Reported by the Detroit Free Press I searched the Detroit Free Press (Freep) database (remotely from home) at the Detroit Public Library for news articles about the 1918 "Spanish" flu pandemic written in October and November 1918. Like what we’re experiencing today, schools and businesses were closed, concerts and sporting events cancelled. Medical workers worked to exhaustion. Controversy brewed about the spread, risk, and graveness of the disease. Health officials and government leaders disagreed about whom to quarantine and what to close and when and how. To appreciate how harsh things for Detroit's flu victims in 1918, it's critical to understand what life in Detroit was like in 1918. The United States was at war. People were grieving the deaths of young men in Europe. Residents were coping with wartime rationing of goods and fuel. When the influenza pandemic hit the home front, politicians did not discuss a stimulus package of money given directly to citizens.
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