Monday, December 27, 2021 – IF OUR PANDEMIC WAS BAD, THIS WAS WORSE
I am distressed to hear that neighbors have not received results from PCR tests taken at the mobile unit 5 days ago. My test at Bellevue e-mailed me results in 24 hours. Please use our municipal system that is here to serve every person, no questions asked.
TWO RELIABLE, FREE AND PERMANENT TESTING SITES ARE OUR MUNICPAL HOSPITALS. BELLEVUE HAS LARGE AND WELL ORGANIZED INDOOR WAITING AREAS FOR VACCINATONS, BOOSTERS AND TESTING.
THIS IS A MUCH BETTER IDEA THAT FREEZING ON A LONG LINE FOR POP-UP TESTING.
TAKE THE NYC FERRY AND BELLEVUE IS A QUICK WALK ON FIRST AVENUE OR METROPOLITAN IS ACROSS THE STREET FROM THE 96 STREET Q TRAIN(YOU CAN TAKE NYC FERRY TO 90 STREET DOCK FOR A WALK UP TO MET)
NYC Health + Hospitals/Bellevue
462 First Avenue New York, New York 10016
212-562-5555
NYC Health + Hospitals/Metropolitan
1901 First Avenue
New York, New York 10029
COVID-19 Testing and Antibody Testing Offered Here Monday – Thursday, Sunday, Walk Ins: 7 a.m. – 7 p.m.
Friday, 7 a.m. – 12 p.m. We will be CLOSED on New Year’s Day
MONDAY, DECEMBER 27, 2021
556th Issue
The Other Pandemic:
Comparing 1918 and Today
Stephen Blank
The Other Pandemic: Comparing 1918 and Today
Stephen Blank
So here we sit, wondering if Omicron will be worse than Delta, or indeed, if something worse is around the corner. Perhaps our minds wander to the “Other Pandemic” that devastated much of the world, the 1918 influenza epidemic better known as the Spanish Flu.
The 1918 disease came in two waves. In late spring of 1918, outbreaks of a flu-like illness were detected in the United States. This wave was mild and attracted little attention. Few deaths were reported, and victims recovered after a few days. By July of 1918, even as newspapers began calling it “Spanish influenza”, most health officials predicted that it would soon disappear.
But it appeared again in the fall, and far more deadly. The worst phase began in late August 1918, with widespread cases and a sudden increase in deaths in several army camps in the eastern US. By mid-September, cases and then deaths began to increase quickly in cities and then throughout the country, reaching epidemic proportions in a month. Victims died within hours or days of developing symptoms, their skin turning blue and their lungs filling with fluid that caused them to suffocate. In the six months from October 1918 to March 1919, an estimated 675,000 Americans died from influenza or pneumonia. Young adults, usually unaffected by these types of infectious diseases, were among the hardest hit groups along with the elderly and young children. The flu afflicted over 25 percent of the US population. In one year, the average life expectancy in the United States dropped by 12 years.
Victims of the Spanish flu at a barracks hospital on the campus of Colorado Agricultural College, Fort Collins, Colorado, 1918.
American Unofficial Collection of World War I Photographs/PhotoQuest/Getty Images
This was a global pandemic. As the war was ending, the world was on the move. Soldiers were closely packed in trains and ships, coming home. Masses of people displaced by years of fighting flowed back home or sought new living places. The disease ran along roads and rails and into ships carrying troops.
Some historians say that 20 percent of the world’s population was infected, and that 20-50 million people were killed by it, more people than any other illness in recorded history. The range of uncertainty – 20 to 50 million – is so large because data collection was poor, particularly in war-torn Europe and Russia, and almost nonexistent in other parts of the world. Many experts feel that the actual total deaths might have been even larger, even 100 million.
Back then, there were no vaccines, no CDC or national public health department. The Food and Drug Administration was a tiny office. There were no antibiotics, intensive care units, ventilators or IV fluids. Scientists hadn’t yet seen a virus under a microscope. They lacked the technology and knew almost nothing of virology, a nascent science because viruses are physically smaller under a microscope and more difficult to identify than bacterial infections.
Today’s pandemic, COVID-19, is caused by a novel coronavirus—a new coronavirus strain not previously found in people. Symptoms include respiratory problems, fever and cough, and can lead to pneumonia and death. The first reported case appeared November 17, 2019, in the Hubei Province in China, but went unrecognized. Eight more cases appeared in December with researchers pointing to an unknown virus.
Without a vaccine, the virus quickly spread around the world. On March 11, 2020, the World Health Organization announced that the COVID-19 virus was officially a pandemic after barreling through 114 countries in three months and infecting over 118,000 people. And the spread wasn’t anywhere near finished. By December 2020, it had infected more than 75 million people and led to more than 1.6 million deaths worldwide. The number of new cases was growing faster than ever, with more than 500,000 reported each day on average. Deaths in the US are reaching 800,000 as we write.
In October 1918, more than 30,000 Pennsylvanians died from the epidemic. In New Jersey, one in every 250 citizens died of pneumonia or influenza in just this one month. Six midwestern states, Ohio, Indiana, Illinois, Missouri, Michigan, and Wisconsin, totaled more than 30,000 deaths in October 1918, even with rates lower than states located to the east. California recorded nearly 5,000 deaths in October, and a slightly higher total in November, as the epidemic peaked later in the western regions.
What about New York City? In the first months of Covid, our City was the epicenter of the disease. In 1918, New York City seems to have managed better – or been luckier – than other major cities.
Without vaccines or protective devices, New York in 1918 responded to the epidemic relying on tools it had used in the past – surveillance, isolation, and quarantine. In September, influenza was added to the City’s list of reportable diseases, requiring all cases to be isolated. Health commissioner Dr. Royal Copeland’s strategy for combating the epidemic was not to issue closure orders, but rather to quickly identify and isolate those who fell ill. He reiterated the need to put sick family members in their own room while they recovered and to limit contact with that person for the duration of their illness. Homes with cases would be quarantined while the patient recovered, while cases in tenements would be isolated in a city hospital.
www.historyassociates.com/quarantine-history/
Copeland and the board of health amended the New York Sanitary Code to allow boroughs to close public places where food and drink were handled or stored if those places were found in an unsanitary condition. In conjunction with business owners, the board enacted a staggered schedule for most stores in the hope of reducing congestion on public transportation. Each theater and movie house was assigned a specific opening schedule between 7:00 pm and 9:00 pm to spread out the evening entertainment crowds. The board also made coughing and sneezing without covering your nose or
New York City Municipal Archives
Major disagreement rose over Copeland’s decision to keep schools open. In an interview with the Times, Copeland said that three-quarters of New York’s one million schoolchildren live in tenements, where their homes were frequently crowded and unsanitary and where their parents were primarily occupied in putting food on the table and keeping a roof over their heads…It was much better, therefore, to keep the schools open so that children could be monitored for illness by school physicians and nurses.
In the end, 4.7 of every 1,000 New Yorkers died of the 1918 influenza, a lower rate than those of other cities on the East Coast: 6.5 in Boston and 7.4 in Philadelphia.
It’s difficult to compare the impact of the two pandemics in the United States. A key factor is the difference between totals and rates. The current US population, a little more than 330 million, is more than three times larger than the population in 1918, estimated at 105 million. The 675,000 deaths attributed to the influenza epidemic made up 0.64 percent of the total population, a little more than six in every thousand people. By contrast, 800,000 deaths attributed to COVID-19 make up less than 0.2 percent of the total population, or around two in every thousand people. If COVID-19 caused deaths at the same rate as the 1918 epidemic, the total would approach two million.
During the peak of the 1918 influenza outbreak in New York City, a total of 31,589 all-cause deaths occurred among 5,500,000 residents, yielding an incident rate of 287.17 deaths per 100,000 person-months. During the early period of the COVID-19 outbreak in New York City, 33,465 all-cause deaths occurred among 8,280,000 residents, yielding an incident rate of 202.08 deaths per 100,000 person-months. But studies suggest that while the absolute increase in deaths over baseline observed during the peak of 1918 pandemic was higher, the far greater medical resources of the City in 2019 than meant that the two were quite comparable. Indeed, one might argue, because baseline mortality rates from 2017 to 2019 were less than half that observed from 1914 to 1917 (owing to improvements in hygiene and modern achievements in medicine, public health, and safety), the relative increase during early COVID-19 period was substantially greater than during the peak of the 1918 H1N1 influenza pandemic.
So, what does this mean? We’re still in the middle of the pandemic, just buffeted by a new variant – with no reason to believe there won’t be another. But roughly, one might conclude that, without modern medicine and public health resources, and, mostly, without vaccines, this one might well have been as bad – or worse – than 1918.
In New York City, more than 16,000 people died from influenza and pneumonia in October 1918, an average of more than 500 deaths a day just in this one city. On April 7, 2020, there were 598 new deaths due to COVID-19 in New York City, higher than any other day since the pandemic hit the city. On December 17, 2021, 21,027 new coronavirus cases were reported in NYC, the highest single day total since the early days of the pandemic. Yesterday, 200,000 new Covid cases were announced in the US, along with 1,400 deaths. The fat lady ain’t sung yet.
MONDAY PHOTO OF THE DAY
DO YOU HAVE A STORY OF THE TREE, SEND IT TO US….
Happy Holidays ahead from New York, where we had a perfect dusting of snow this morning. But it melted away before dawn’s light might have enabled us to take a photo for you.
In substitution, here’s the slippery ice rink below the tree at Rockefeller Center. Not to brag about our ability to photograph action in the blink of an eye, but you’ll note the man in gold lamé is in the midst of an awkward fall.
Liz & Herbert
WEEKEND PHOTO OF THE DAY
ED LITCHER, HARA REISER AND JOHN GATTUSO
ALL ARE CORRECT THAT THIS THE JOHNSON WAX COMPANY
HEADQUARTERS, RACINE, WISCONSIN DESIGNED BY FRANK LLOYD WRIGHT.
SOURCES
Stephen Blank
RIHS
December 22, 2021
Sources
https://www.healthaffairs.org/do/10.1377/hblog20210329.51293/full/
https://www.archives.gov/exhibits/influenza-epidemic/
https://www.history.com/news/spanish-flu
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2769236
https://www.history.com/topics/world-war-i/1918-flu-pandemic
Thanks to Bobbie Slonevsky for her dedication to Blackwell’s Almanac and the RIHS
Thanks to Deborah Dorff for maintaining our website
Edited by Melanie Colter and Deborah Dorff
FUNDING PROVIDED BY ROOSEVELT ISLAND OPERATING CORPORATION PUBLIC PURPOSE GRANTS
CITY COUNCIL REPRESENTATIVE BEN KALLOS DISCRETIONARY FUNDING THRU DYCD
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rooseveltislandhistory@gmail.com
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