Most historical comparisons to our current crisis have been to the “Spanish Flu.” And while several of my essays challenge some of the parallels put forth, I understand why people have been so quick to return to 1918 for answers. Its global reach and profound impact on the U.S. and most of the world feel somewhat similar.
Yet in focusing on this comparison, we miss the series of epidemics that might in fact paint a closer image to our current reality. Throughout the 1940s and 1950s, poliomyelitis emerged periodically in epidemic form, reaching its peak in the summer of 1952. Less than a year later, Jonas Salk’s vaccine was approved for a mass trial, which would prove effective.
What can these polio epidemics teach us about COVID-19? The diseases themselves are not similar. Polio is caused by a three types of a human enterovirus that spreads through contact or contaminated food and water. COVID-19 is a a novel coronavirus, transmitted by respiratory droplets.
What we can relate to is the mystery surrounding the disease. As with COVID-19, with polio, you never knew who would become ill or how bad it would be. Approximately 72% of polio cases were asymptomatic. Those who felt sick usually had mild symptoms. Only a small percentage developed the paralytic form, experiencing either temporary or permanent paralysis of a limb, limbs, the diaphragm, or multiple affected sites–its course unknown. And although it was characterized as a disease of children, adults also contracted polio, particularly in the later epidemics. [Note: I’m speaking in past tense here to refer to the mid-century outbreaks. Polio cases are still emerging in Afghanistan, Nigeria, and Pakistan).
What we can take from the periodic polio epidemics in the first half of the century are ways of living that are accustomed to interruption, the importance of a unified public response, and a healthy respect for disease itself. No one knew when polio would come to town. But when it did, local spots quickly closed down to reduce the spread of disease. People were quarantined and isolated as needed, sometimes even at camps. Movie theaters, public pools, and other gathering places shut down, as parents were advised to avoid having children mingle in new groups. Polio also led to local school closings for short periods, which were opened back up when it was believed that the threat had passed.
No one proposed that polio was a hoax or questioned the severity of the threat. The National Foundation for Infantile Paralysis (NFIP), founded by President Franklin D. Roosevelt and his business partner, Basil O’Connor, united the nation in the fight against poliomyelitis. NFIP campaigns provided education and raised money for rehabilitation and research toward a vaccine. During outbreaks, the NFIP provided additional health professionals and resources, including rocking beds, iron lungs, and other equipment, through coordinated efforts between the local and national levels.
We know the work of the NFIP was successful, demonstrated in the number of people helped and the production of two effective vaccines. At the same time, the NFIP also modeled what can be accomplished in terms of care and research when a nonprofit organization receives long-term public and governmental support.
Polio reminds us of the enigma that is disease. Privilege has shielded developed countries from experience with contagion, causing people to forget its power. In the early to mid-20th century, most people wouldn’t openly resist public health efforts to curb outbreaks. Rather, they were grateful for scientific progress against disease and celebrated the diphtheria antitoxin, each new vaccine, and the introduction to antibiotics.
It is problematic to only look to the 1918 influenza pandemic for lessons. Its first wave was largely unknown, meaning that the experiences of the Spanish Flu were limited to just a few months. As I outlined in earlier essays, we can’t even compare today’s mask mandates to restrictions of that pandemic (and yes, I’ve heard of the Anti-Mask League of San Francisco). Since World War I very much dominated public agenda and therefore, the pandemic seemed to both appear and conclude quickly. Instead, we should learn from the polio experiences. We can remember that we have done this before and can do it again. But, as in the past, we need to support health professionals, public health experts, and those working to develop a vaccine.