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It is human nature to believe that whatever awful thing we are going through must be unprecedented and the world forever changed. But neither this virus nor the response to the pandemic is unprecedented, and it remains to be determined how much or how long it will change our lifestyle.
While we remember truly cataclysmic events, the rest of history fades quickly from consciousness. This pandemic is no different. While it may be a novel coronavirus, a pandemic is not novel. Seventy years ago, polio was one of the most feared diseases in the US. The playbook we follow today, similar to the one used during periodic polio outbreaks between 1910 and 1955, has its origins 600 years ago in Italy. In fact, the translation of the Italian word “quarantine” is 40 days (quaranta and giorni) – as in the length of time for isolation during the Plague.
Consider the following passage referencing the familiar uncertainties, challenges and mitigation strategies of American life in the early 1950s:
“The public was horribly and understandably frightened by polio,” says Oshinsky, who grew up in Queens, N.Y. “There was no prevention and no cure. Everyone was at risk, especially children. There was nothing a parent could do to protect the family. I grew up in this era. Each summer, polio would come like the Plague. Beaches and pools would close – because of the fear that the poliovirus was waterborne. Children had to say away from crowds, so they often were banned from movie theaters, bowling alleys, and the like. My mother gave us all a “polio test” each day: Could we touch our toes and put our chins to our chest? Every stomach ache or stiffness caused a panic. Was it polio? I remember the awful photos of children on crutches, in wheelchairs and iron lungs. And coming back to school in September to see the empty desks where the children hadn't returned.
David Oshinsky is the director of the division of medical humanities at NYU and a Pulitzer Prize winning author for his book, Polio: An American Story. The quote is from an NPR interview he gave five years ago this month.
The fear was real. Polio became one of the most debilitating, communicable diseases among children in the United States. According to Post-Polio Health International, from 1951 to 1956 more than 200,000 poliomyelitis cases were reported, with over 40% of those being paralytic polio. But the scarier statistic is that, according to the CDC Pinkbook, about 72% of people infected with poliovirus were asymptomatic and resolved in a week, and another quarter presented “flu-like” symptoms. Unfortunately, approximately 3% developed meningitis and another 0.5% suffered paralysis. But the issue then, as today, was that even those who were asymptomatic were contagious – highly contagious. In 1955, the U.S. began widespread vaccinations, but it took another quarter century to eradicate polio in the U.S., and is still not eradicated globally.
We have been through this before, and it is inevitable we will go through this again. We didn’t shut down the economy for polio; we became more cautious. People have spoken about the 1918 Spanish-flu pandemic that struck the world and was exacerbated in the U.S. by the returning World War I GIs. (Arguably, immigration restrictions could have slowed the spread). But just two years before, in 1916, the U.S. was stricken with a polio pandemic, and 27,000 cases of polio and 6,000 polio-related deaths, with over 2,000 of those deaths in New York City. Such was the fear that the names and addresses of individuals with polio were published daily in newspapers, their homes identified with placards and their families quarantined.
As Keith Meyers and Melissa Thomasson wrote of the 1916 polio pandemic in a 2017 NBER working paper, “Public officials restricted movement of people, enforced broad quarantines, and stuttered schools at the start of the year. Children under 16 were prohibited from leaving NYC, unless they produced a certificate that they were free of poliomyelitis and had been since the beginning of 1916, and they were barred from movie theaters and even religious gatherings.”
Even the missteps we are taking this time aren’t novel. In a weird twist of fate, dry muriate of quinine (of which hydrochloroquine is a synthetic derivative) was part of an early polio remedy suggested by Jack Emerson, who would later be remembered for his work on the iron lung. Even FDR, the president who would lead the country through the Great Depression and most of WWII was originally thought to have contracted polio in the early 1920s. Although this diagnosis is in doubt, it shows how a single illness can capture so much attention that other illnesses are too readily dismissed.
The polio epidemic of 1916 would be eclipsed just two years later by the Spanish flu. The polio illness would ebb and flow until the outbreak after WWII; it never went away and we learned to live with it. Early work, in 1935, included testing a vaccine on 10,000 children that proved ineffective and left nine dead. But when 5,000 to10,000 annual cases became 30, 40 and even 50,000 cases around 1950, the medical community got to work. Still, the citizens of 1916 would wait another 39 years to hear the church bells toll announcing Jonas Salk’s vaccine followed the next year by Dr. Sabin’s oral vaccine. Within two years, the incidence of polio dropped 90%. Still, before the war with polio ended in 1979, the U.S. lost an estimated 60,000 people to the virus – about one-tenth of those infected. Ask anyone over the age of 50 about the sugar cube and you will hear of the fear of polio and the story of overcoming it.
It isn’t likely to take 39 years to develop an effective vaccine to this coronavirus. Modern medicine has come too far, and we know that a vaccine should be on the horizon. But pressure mounts, as we demand our freedom and expect workplace safety. We lived with measles until the 1980s, polio until the 1960s, even cholera and smallpox before – all of which were far more contagious than this coronavirus. Just as we have lived with and eventually beat those other viruses, we will either beat coronavirus or learn to live with it. But either way we have been here many times before.
Derek Klock is a professor of practice of finance in the Virginia Tech Pamplin College of Business.
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