Spanish flu and Typhoid Mary show that social distancing saves lives

This article, by Priya Shukla of the University of California Davis, was originally published on the Bangor Daily News opinion page on March 24, 2020.

Edward A. “Doc” Rogers | AP
In this 1918 photo made available by the Library of Congress, volunteer nurses from the American Red Cross tend to influenza patients in the Oakland Municipal Auditorium, used as a temporary hospital.

As of 11:30 a.m. Monday, March 23, 107 Maine residents have been confirmed positive for the coronavirus, according to the state. Click here for the latest coronavirus news, which the BDN has made free for the public. You can support this mission by purchasing a digital subscription.

Mainers can help “flatten the curve” by taking preventative measures to protect themselves, each other and avoid maxing out healthcare services. As of March 23, Maine has 107 cases of COVID-19. This number is expected to rise as more people get tested throughout the state. At this rate, the health care system is underprepared to address such a large scale health emergency. So it is important that we do our part by practicing “social distancing” — avoiding close contact with one another in public spaces.

Around the country, states and municipalities are doing their part to reduce the spread of COVID-19. For instance, Gov. Janet Mills and the Maine Legislature passed a supplemental budget to support the state’s ability to respond to the coronavirus outbreak. Forty-six of the 50 states have issued public school closures and universities have transitioned online for the remainder of the school year. Governments are limiting the operation of restaurants and bars. California was the first state to take the most draconian measures by issuing shelter in place orders.

As the government does its part to stop, or at least slow down the spread of COVID-19, we can do ours by practicing social distancing. Not only is it a simple solution but history shows us that it is also effective.

The 1918 influenza outbreak infected nearly one-third of the world’s population but had drastically different trajectories in St. Louis and Philadelphia, which are separated by only 900 miles. Both cities had planned to hold parades to fundraise for World War I, but St. Louis canceled its plans due to public health concerns and prohibited public gatherings larger than 20 people. Philadelphia, on the other hand, held its parade as scheduled and crammed nearly 200,000 people within a 2-mile span. Ultimately, only 700 people succumbed to the flu in St. Louis, while every bed in Philadelphia’s 31 hospitals was filled with flu patients and more than 12,000 people died. By taking the steps that St. Louis took, we can reduce the overall number of coronavirus cases and prevent health care providers from becoming overwhelmed with sick patients during the current pandemic.

“Typhoid Mary” Mallon, who was a cook for wealthy families in New York in the early 1900s, went down in history for causing a typhoid outbreak. Unaware that she was sick, she unintentionally infected seven of the eight families that she worked for. After being involuntarily quarantined for three years, she was released under the condition that she would not cook again. In 1915, Mary started working in laundry, but low wages drove her to change her name and continue cooking. She was eventually linked to dozens more infections and permanently isolated on an island in New York’s East River.

Mary was unfairly vilified because they found later on that there were other asymptomatic carriers that infected more people. Yes, she was subjected to ethically controversial punitive measures, but she also serves as a cautionary reminder that a lack of symptoms is not equivalent to a lack of infection. We can also be stealthy carriers of the coronavirus, so it is our social responsibility to avoid close contact with others to prevent transmitting it to those more vulnerable than ourselves.

History shows us why it is important to practice restricted social contact. Social distancing will not only prevent individuals from coming into contact with each other and contracting the virus, but it will also mean that asymptomatic carriers will not unintentionally transmit it to the elderly population and those who have underlying health issues. To avoid the outcomes seen in Philadelphia during the 1918 flu epidemic and prevent ourselves from becoming “COVID Carries,” we must be willing to disrupt our daily lives by avoiding one another. Doing so may just save our lives.

Priya Shukla is a PhD student in ecology at the University of California, Davis. This column reflects her views and expertise and does not speak on behalf of the university. She is a member of the California Chapter of the Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.

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