From Inoculation to COVID Vaccination: The Wonder of It All

Me after dose #1 of the Moderna vaccine, outside of my car.


Skip this post if you detest emotionally-charged posts because that’s what it’s going to be.

From March 4th: I got my first shot of the Moderna vaccine today, jumpstarting my immune system to protect me against COVID-19. How, you might ask? I volunteered at our campus vaccine clinic. At the end of the shift, they had extra doses to distribute to the volunteers. I got lucky. Of course, we (as in the faculty) should have been included anyway. But that is (and was) another post.

Instead, I want to revel in what a true miracle this is. My use of this word should not convey surprise or lack of scientific rigor. Rather, it refers to, as I say above in the title, my absolute amazement that we have come to this point. For the world to have multiple effective vaccines against a strain of coronavirus that is little more than a year old, is almost inconceivable to me, a layperson who has never worked in a lab.

This happened because of the ability to build upon what others have done to move up a few steps. To capture knowledge, distribute it, and then preserve the content for future innovators. Our moment now occurred because of thousands of experiments that produced nothing, failed to support the hypothesis, or protect the test subjects from becoming infected.

Salk’s vaccine emerged decades after the first scientist prematurely promised a vaccine (40 years, to be exact). But we also need to consider what was not known when that initial declaration was made in 1912.

I am so incredulously grateful that we can be at this moment. We have never had a point in time in which an outbreak grew into a pandemic and while it was still ravaging society, scientists successfully developed a vaccine. In 1918, some scientists claimed to have a vaccine and injected soldiers with vials of something. However, since they didn’t even know that influenza was a virus, it did little to protect anyone.

How can anyone doubt such innovation? Why would a person question such an amazing gift? Even stranger are the conspiracy theories about the vaccine. How would a microchip fit inside the syringe? Wouldn’t you see it floating around? How would it fit through the needle?

What had to come together for this moment? It’s not just about what’s in the syringe. We had to have the technology to create the vials that contain the vaccine, the syringes themselves, and the needles. Take a step back and add the freezers that can store the vaccine, gloves and an understanding to protect those administering the vaccine. Lister and the process of antisepsis to prevent infection from dirty needles. I could go on and on.
Instead I am going to eat some cheesecake and watch TV. Because I can.

Written on April 3rd: I received my 2nd dose on the morning of April 1st. I’ve waited until the side effects have subsided to write out my thoughts.

Once again, I felt equally amazed as the needle went into my arm. It only lasted a second and it barely hurt. I felt like king of the world as I strutted out of there, beaming under my mask. Ten hours later, I started to feel the effects — first tired and then achy all over. Around 2:30 a.m., I woke up with chills, more aches, a headache, and some nausea. Fortunately, the latter two subsided by morning. Friday was a Netflix day, referring to the only thing I felt like doing, especially when fever set in during the early afternoon. By evening, though, I felt much better. And today (Saturday), I am 100% myself. Totally worth it for protection against COVID-19.

For this round, I’ve been thinking more about inoculation than 20th century vaccinations. It is unclear exactly when inoculation first started in Turkey, India, and China. We only know when it was brought to Europe and Colonial America. An enslaved person, Onesimus, first conveyed to Reverend Cotton Mather that intentionally infecting oneself with smallpox could ward off a deadlier version of the disease. Inoculation, also known as variolation, had already been practiced in India, Turkey and China. When smallpox broke out in Boston in 1721, Mather encouraged local physicians to try inoculation. Dr. Zabdiel Boylston was the only doctor willing to attempt the dangerous practice and did so with success. Even with early 18th century record-keeping, it was clear that those who were inoculated with smallpox were significantly less likely to die of the disease. (For more on this story, read my book).

Unlike vaccination, inoculation produces an infection of smallpox. Therefore, it wasn’t practiced unless there was an outbreak of the disease. Following 1721, inoculation became more common and refined with each epidemic, playing a crucial role in protecting soldiers during the Revolutionary War against the disease. At the turn of the 19th century, Dr. Edward Jenner’s work led to vaccination as a replacement for inoculation, sparking immunity without having to suffer from an infection of the disease itself.

So many brilliant people have come together to make the COVID-19 vaccines happen. But we can’t forget where the ideas originated. Like I said on March 4th, this feels like a miracle, NOT because the process was rushed (it wasn’t), but because of all of the components that had to come together over hundreds of years for us to have this moment. It is truly amazing.

Me after dose 2 in the 15-minute waiting period

Lessons from the past: Radio in the Chicago 1937 polio epidemic

This literacy activity is based off of my article for The Conversation, found here.

Until the last half of the 20th century, it was not unusual for schools used to briefly shut down for weeks or even months. I’m not just talking about holiday or summer breaks. Hunting season, the fall harvest, and inclement weather kept students at home. Times of crisis also impacted education, as coal shortages in the 1930s and 40s forced schools in cold regions to temporarily close, as illustrated in this newspaper article from 1936.

Herman Schools Close During Week. Herman Record (Nebraska). Feb. 20, 1936 -
From the Herman Record, Feb. 20, 1936

Before the advent of vaccines and treatments for scarlet fever, measles, diphtheria, and polio, outbreaks of these common childhood illnesses also prompted officials to close schools.

School closings typically halted formal learning, granting kids extra time for play or work on the farm. Schools sometimes compensated for the additional closings by shifting the academic calendar or by mandating Saturday attendance once school was back in session.

The concept of distance-learning did exist, mostly through correspondence courses (classes taught by mail), but wasn’t commonly used during school closures. That is until Fall 1937, when school officials in Chicago decided to teach children at home using a relatively new technology: the radio.

It might seem weird to us now, but people in the 1930s were very used to just sitting and listening to the radio. By this time, over 90% of urban American homes had at least one radio — and they tuned in often, spending more than 4 hours a day listening to news and entertainment. (For an overview, watch this video). Individuals and families gathered around the radio much like we would a TV.

Radio had been used as an educational tool periodically since Penn State first offered broadcasted college courses in 1922. On a small-scale, radio programming occasionally served as a substitute for in-person instruction, as in 1932, when radio provided summer school curriculum in Chicago after budget cuts eliminated the regular session. Yet, no one had tried using radio to teach large groups of children.

Polio was a feared disease back then. While most people only had mild cases, the disease sometimes led to either temporary or permanent paralysis. Photos of children in iron lungs (machines to help them breathe) or using crutches frequently appeared in newspapers and magazines, making people more afraid of polio.

Pictures like this contributed to the fear of polio.
The U.S. Food and Drug Administration, Public domain, via Wikimedia Commons

In the summer of 1937, a polio epidemic erupted. On August 31, 1937, the Board of Health in Chicago ordered the start of school to be postponed due to the record number of polio cases (109, just for August). Instead of just keeping kids at home, a “radio school experiment” was launched, led by Assistant Superintendent Minnie Fallon. She worked with 14 principals to design the curriculum for 317,000 children in grades 3-8. (It was decided that those in lower grades might not do as well with radio learning).

On Monday, September 13th, students tuned in for their first day of radio school. Three radio stations broadcasted the lessons, with local newspapers printing daily schedules, like this:

The schedule for Sept. 14, 1937, printed in The Chicago Tribune

Over a week, students were taught math, English, social studies, physical education, and science, with each lesson lasting 15 minutes.

Unlike our video technology now, the radio was a one-way form of communication. Teachers couldn’t talk with their students directly, however, a telephone helpline was set up for questions. Similar to today, parents had to oversee the radio learning, captured in this photo of a mom helping her kids:

Printed in The Rock Island Argus on Sept. 14, 1937.

The experiment only lasted three weeks. Declining polio rates meant that children got to go back to school in person. Even with this brief time, the radio school was a success, demonstrating that the technology could be used to teach people. Radio stations began to partner with local educators and found more ways to make radio educational. By February 1938, radios had been placed in many classrooms and opportunities for kids to do their own news shows had begun.

Discussion Questions

  1. Why did the children of 1937 have to stay home? How is that similar to our need to have distance learning in the past year?
  2. What would it be like to learn through the radio? What do you think were some of the obstacles to this approach? How would that be different from lessons through Zoom or other video platforms?
  3. Not everyone had a radio then, just like not everyone has a computer now. What does it mean for the children who are left out in remote learning? What can be done to help families who don’t have internet access or computers?
  4. Radio learning led to the use of more technology in the classrooms. How will distance-learning now lead to new kinds of learning in the future?
  5. Media content from the past give us a glimpse into different cultural moments, like the radio school. After the COVID pandemic is over, what will people know about this time period from the news, social media posts, and other content produced in this time? If you only watched TikTok or Youtube videos from 2020-2021, what would you think that living through this pandemic was like?

Why aren’t higher ed instructors considered teachers? (And where they stand in different parts of the country)

Not everyone has been teaching online.

On December 30th, The Tennessean announced that K-12 teachers and child care workers would receive the COVID-19 vaccine in phase 1B, after health care workers and senior citizens. Many states have similarly modified their COVID immunization hierarchies, some of which include higher ed in phase 1B.

Note: I recognize that all states are lagging behind in the vaccine rollout and that most places aren’t even to close to phase 1B. The lack of a clear, consistent, unified, plan contributes to the implementation struggles.

My quest to learn more about higher ed’s status prompted me to ask questions in a private Facebook group. The more than 580 posts abundantly demonstrated the lack of information communicated about the rollout, inconsistencies with who can receive the vaccine in 1B, and what constitutes an educator. Aided by the (very helpful) vaccine tracker in The Washington Post, I studied individual state plans and the recommendations of the Centers for Disease Control and Prevention (CDC) to ascertain if higher ed instructors were addressed at all.

My vaccine distribution scavenger hunt was more difficult than it should have been. A few state health departments provide clear graphics on their vaccine homepages to guide users through (like Arkansas). But most states barely convey any distribution information. Instead, I had to dig through lengthy PDFs to find the info. Adding to this, different states opted to name and number their plans differently. Most states use “phases,” but differ on how many phases (1A, 1B, 1C for some, but Massachusetts, New York, and Rhode Island use whole numbers. MA has 3 phases. The other two have four). Alaska has tiers. At least three states don’t explicitly list phases (Florida, Georgia, and Indiana), but somewhat describe the order.

No wonder people are confused.

At the state level, 44 include teachers in an early phase of the rollout. A few more states appear to do so, but aren’t clear in their plans. Arkansas, Mississippi, South Dakota, and West Virginia specifically include higher ed instructors in the same classification as K-12 teachers. Massachusetts, Nebraska, Nevada, Oklahoma, Virginia, and Wisconsin list higher ed instructors in the phase after teachers. The remaining states directly exclude higher ed and/or are vague in their plans. Furthermore, in some locations, counties decide the distribution and have elected to vaccinate specific groups of local college or university instructors, as exemplified with the immunization of Arizona State University instructors teaching in-person. I will note that vaccine plans do continue to change, especially at the local level.

In the midst of my research, Elizabeth Redden’s Inside Higher Ed article gave me hope about the possibility of instructors receiving the COVID-19 vaccine in the teacher phase of the rollout. In it, she quotes CDC spokesperson Kristen Nordlund, who clarified that the CDC recommendations did indeed include “college, university and professional school teachers, support staff, and daycare workers” (as quoted in the article). Redden went on to outline the positions on vaccine priority from different organizations and then highlighted counties and states that plan to vaccinate higher ed instructors. I appreciated this well-researched article and felt optimistic overall about our possible inclusion in the rollout.

However, this clarification is not part of the CDC’s official recommendations. This is a big “however,” given that the written CDC guidelines served as the foundation for the state and county vaccine plans. In other words, unless your state already listed higher ed. instructors in the rollout, Redden’s article and Nordlund’s CDC endorsement means little for the implementation. My communication with my own local and state health departments unfortunately confirmed this statement.

The omission of higher ed. instructors from COVID vaccine plans draws from the false assumption that all colleges and universities continue to only offer classes online, thereby eliminating contact. In reality, modality has depended on the program, school, and state COVID responses. I won’t go into the economic, technological, and pedagogical reasons that colleges and universities have decided to offer forms of in-person learning, but instead acknowledge that it has and is happening. According to “The College Crisis Initiative”, approximately 48% of the 2,958 colleges and universities studied included some form of face-to-face contact between instructors and students for Fall 2020. Nearly 27% of schools were primarily or fully in-person. Even in some COVID hotspots, in-person returns are underway for Spring 2021. Staff also have interactions with students and other people, putting them at higher risk for transmission.

Why is this an issue? The age range of traditional college students aligns with those most likely to transmit COVID-19.

The CDC COVID Data Tracker Cases by Age Group. Found here.

Masks and social distancing have helped to protect instructors thus far, but may not be enough for the far more contagious COVID-19 variant spreading throughout the world. Thus, given the extent to which instructors must interact with a highly-transmissible sect of the general public, they should be clearly included in vaccination distribution plans. And aside from public health rationale for this inclusion, isn’t it also problematic to suggest that higher ed. instructors are not teachers?

Farewell, 2020: Reflecting on This Cultural Moment

Picture of people in line, January 2020.
January 2020. In a line to pick up crates of Florida oranges.

One year ago, we were preparing to leave for Florida on a family vacation on New Year’s Day. By the time we were at Universal Studios on January 6th, I had heard a little bit about the new strain of coronavirus, but wasn’t too concerned at that point. When the semester began, my teaching assistant mentioned trying to buy masks to send home to her family in China. I casually remarked that I just couldn’t imagine that Americans would ever be willing to wear masks — that individualism would prohibit such collective active. I had no idea that we were on the cusp of a global pandemic.

By the beginning of February, the epidemic was raging in China and cases had started to appear in other countries. Stories of the quarantined cruise ships signified the virus’s potential spread. Locally, some people were, as I perceived then, irrationally worried about catching coronavirus, prompting me to write this op-ed. (Oddly enough, I’ve observed the same folks disregard the threat of COVID now). As cases spread throughout the world, I became addicted to the Johns Hopkins COVID-19 Dashboard, an invaluable resource that has visually depicted the rise of the pandemic in-real time. Watching the numbers increase, first in Seattle, then in a scattering of other places, I wondered what was to come. I got an email from a New York Times reporter, asking about the politicization of the pandemic (even in February). This inquiry and subsequent article prompted me to really delve into what was being done and the skewed messages conveyed to the public.

COVID-19 entered my county in March. On Wednesday the 11th, MTSU President Sidney McPhee announced that all classes would resume remotely after an extended Spring Break. With this news, I advised my kids to bring home everything that they needed on that Friday, suspecting that they would be out for a bit. March 13th marked the last day of regular school, although we didn’t know it at the time.

With the shutdown, my blog became my outlet to the world. I wrote and shared so many blog posts that Facebook banned my website as spam. For me, writing these usually brief reflections has been cathartic. As our reality quickly morphed into a sweatpants existence, I needed a way to connect. At the same time, having just written a book on epidemics, I felt so many paralleled experiences to those of the past. Despite the blog format, I extensively researched all my historical entries — probably spending more time than one should for something with such little reach.

My explosion of media literacy activities stemmed from both my desire to give my kids something to do and to contribute to the wealth of materials that others were sharing last spring. Like many, my children had weeks with no school assignments and plenty of time to fill. I tried to give them something even remotely educational to help structure our day and attempt to teach them. (Note: they were often not thrilled with the theme days, essays, and other activities). Even though we were definitely privileged in our position, March and April were extremely stressful months for me. I was mostly failing at both teaching my own classes online and educating my children.

Picture of author dressed as Maria von Trapp
My kids were not amused when I woke them up dressed like Maria von Trapp on Sound of Music day.

Blogging provided me a way to express myself without the hassles of formal gatekeeping and to immediately respond to the moment, be it Trump’s outrageously dangerous claims about injecting bleach or the expectations of extending remote learning. Still, I periodically published pieces that went beyond this site, with articles on how past epidemics changed society, why the nickname “Typhoid Mary” shouldn’t be used, and on the shutdown’s disproportionate burden on mothers.

Summer brought more of a return to normalcy. I expect kids to be home then and we no longer faced the arduous list of online videos and assignments. Nice weather and the reopening of some businesses expanded our possible activities and made it feel more like vacation. I slowed down in blogging and writing to teach a class online and spend time outside with the kids. We focused on our Foss world, while keeping abreast of the turmoil of injustice.

With August came more mask mandate questions and school debates. Feeling like it was a lose-lose decision, we opted to send the kids back under the adopted protocol of required masks and distancing. I taught hybrid courses for the first time, lecturing under a mask in a ballroom-turned-classroom that seemed more appropriate for a time-share demo, rather than a college class. But, for what it was, it worked. We pushed through. The kids pushed through. Life seemed semi-normal for August through October as we anticipated that things would fall apart. And then they didn’t.

Masked up and ready for the mock trial of Mary Mallon
Picture of nearly empty ballroom lined with chairs
Last day of class in the ballroom.

November became the up-and-down month. The election and vaccine news delivered hope of a different reality, as did making it through the end of my semester. And yet, rising cases and school closings near locked us down again. Our family of four canceled plans and activities to return to just being us. No Friendsgiving or Christmas trip.

Picture of kids with four dogs in front of a Christmas tree
Fostering puppies to make Christmas at home a little more exciting.

What’s differed from the spring, however, has been this fractured picture of the true reality. News stories and charts have conveyed that Tennessee skyrocketed into a dire state for December, topping the list for new infections. And yet, a dissonance exists here. Everything is open. There’s no statewide mask mandate, just a county one with little enforcement. Aside from school, not much has been canceled. On local social media sites, people are asking about in-person church services, promoting “maskless Santa” before Christmas, and using the word pandemic in quotation marks. Obviously, the lack of public health observance is why were in this situation, but there’s not a lot of acknowledgement of this cause-and-effect.

We have such a split in what we know and what we’re seeing. Adding to this disconnect has been the near-absence of a unified recognition that things are bad. Aside from the numbers and the occasional story, very little media coverage has personalized the dire impact of the pandemic locally. Where are the lists of names and photos memorializing those deceased from COVID? Why don’t we have images of the COVID wards in our hospitals? And, more importantly, how is it that the leaders who endorsed and embraced the March shutdown are ignoring the actual crisis now?

I haven’t been blogging as regularly as I did in the spring, partly due to time, but also frustration. Some posts I never published because they were too heated or too intensely called out those around us. My popular articles focused on pandemic creative writing in 1918 and radio remote learning during a 1937 polio epidemic in Chicago.

Living through a pandemic is a fluid, diverse experience that shapes each person differently and at different moments. What we specifically knew in March has changed and expanded dramatically. As such, my reflective essays are very much a product of a particular moment and set of feelings, which all share uncertainty in the future and a serious concern about the pandemic. Even with the research I conducted for my book, I never could have imagined just what this would be like. I was unprepared for the large-scale denial of a disease that has killed so many people. These months have revealed both the worst in humanity and the best. I sincerely hope that 2021 brings the quick distribution of vaccines and overall, a more unifying time. Even more so, I want life to not just “return to normal,” but to become a better, more equitable version of a reality in which we can be together again, without the social distancing.

Here’s to 2021!

Where are we in the pandemic timeline? (It’s not good).

The interactive COVID-19 map, updated and published by The New York Times.

COVID cases continue to escalate and the death toll for the U.S. has exceeded a quarter of a million. Yet, as this FiveThirtyEight poll shows, over 30% of Americans are “not very” or “not at all” concerned about infection. Obviously, as we head into the holiday season, this is incredibly problematic.

The division between those who believe in science and the anti-maskers can be attributed in particular to one’s political affiliation and primary source of information. These factors are mitigated by geography, as local and state authorities set the tone for the regional public response early in the pandemic, often paralleled in local news coverage. Moreover, experience with COVID’s effects, either personally or through friends and family, also shapes the extent to which people view the disease as a threat.

We also can’t dismiss the toll of “pandemic fatigue” on public behavior, as individuals stop caring about precautions that they would have taken months ago because it feels like we’ve been doing this forever. Why are we in this spot? Unlike past outbreaks, our global access to information enabled countries around the world to learn about COVID early on and (to different extents) take action. In short, we feel like we should be past this pandemic because we’ve been in it so long. Except we haven’t.

Last spring, we pretended that the first wave had a conclusion, a denouement. It did — if you live in New York City or other places that experienced the surge and the dwindling of cases. The rest of the U.S. was really in a waiting period. In this calm before the storm, many people took the precautions needed to carry us through the pandemic. However, collectively, we acted like that was it, that we had made it through the wave. In reality, most of the U.S. has only just begun its red zone.

Let’s compare where we are to this moment in past outbreaks/epidemics/pandemics. From my study of 200 years of epidemic history, I can tell you that both small and large-scale outbreaks follow specific patterns in their construction in media messages and in public perception. For this comparison, ignore the amount of time we’ve known about COVID., focusing instead on the severity of the crisis itself.

Placed in the midst of other epidemics, we are approximately at the same timeline point as . . .

  • August 1721, Boston smallpox epidemic
  • October 1793, Philadelphia yellow fever epidemic
  • October 1918, “Spanish Flu” across U.S., “Spanish Flu”
  • Late January 1925, diphtheria in Nome, Alaska
  • September/October 1952, polio in the Midwest
  • December 1968, “Hong Kong” flu in New York and many other places

These critical points not only mark escalating cases within different outbreaks/epidemics/pandemics, they also share collective public emotions: sadness, scarcity, panic, and loss. While there are certainly variations in responses, shared characteristics define the severity of the situation. Listed above are the peaks of despair, when hospital ran short of staff, beds, and equipment. Gravediggers and coffins became in demand. Images of this moment captured rows of the ill in makeshift hospitals, stacks of wrapped bodies, and quarantine signs. Towns and local media became solely focused on the sick, dying, and deceased, seeking supplies and care providers, while banning public gatherings and funeral bell tolling. Ministers ceased holding services for fear that they were spreading disease among parishioners.

This is where we are in our COVID-19 pandemic. If you are not feeling this moment yet, it is not due to the case numbers. Rather, it is the cultural climate that is imaging a reality that is not this one. Many local news outlets have opted not to publish cause of death as COVID-19 or showcase the experiences of survivors, blocking communities from the devastation from this disease. We have convinced ourselves that we did the work last summer so we must be fine now. NOPE. Even if you are not personally seeing it, the U.S. (and most of the world) is in crisis mode.

We are at a crossroads for what will happen next. Changing the course of the pandemic needs to occur at all levels, including our individual choices. It might feel like we’ve been in this pandemic state forever. Unfortunately, though, we are deeply in the midst of the crisis — a reason to stay home, not to give up.

What Polio Can Teach Us About This Pandemic

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.

Appeared in Vogue and other media outlets

How to Reopen the Schools: Buy-in Across Levels

I’m tired of seeing posts that either protest or promote reopening of schools (both k-12 and college) without trying to explore solutions. I won’t offer advice on when different schools should open. But the fact is, whenever they do open (now, in 3 months, in a year, or ???), every institution, K-12 and higher ed, will look much differently than last February. The key to this possibly working lies in multi-level protocol and support to reduce risk, remain open, and still provide enriching instruction. Obviously, these approaches need to be adapted to specific circumstances.

Mask mandates in school and in the community. We need to both require and enforce the wearing of masks in crowded public spaces. Mandates with enforcement mean that even those who (somehow) “don’t believe in the virus” will have to don a face covering in order to enter stores, schools, and other places. Mask-wearing in the schools is a no-brainer to making this work. But the mask requirement at places of learning will be much more effective if it is the community norm.

Actually rapid testing widely available and free. Cost, access, and time cannot prohibit testing procedures that could make reopening otherwise work. Especially for college students, we need free, on-campus results that can be processed quickly while they wait. With this type of access, professors could build in exposure and testing into the class policies. Combined with contract tracing, this testing could drastically limit both transmission while unknowingly infected and the amount of class and work missed.

Risk-reducing actions built into student codes of conduct. For K-12 students, parents should sign pledges confirming that they will not partake in risk-increasing trips or activities without a voluntary quarantine and testing (weddings and other gatherings, air travel, etc.). Similarly, college students who opt for face-to-face instruction must adhere to a code of contact, in which participation in parties, concerts, or other events could result in disciplinary actions. Tough to enforce, yes, but at least it gives faculty and administration some basis to assign consequences.

Prosocial campaigns on the new protocol. This is a very confusing and hard time for everyone. To get students to comply with our new reality, easy-to-understand messages should be distributed across social media and email, campuses, and the community. These campaigns can inform students, parents, teachers, administrators, other employees, and visitors of what is expected on school grounds and in the classroom before school is in session, including

  • How to enter and exit the building (or each building) and special protocol for entering and exiting (i.e. reminding students not to hold doors for others).
  • Where masks are required and what areas are designated spaces for removing masks.
  • Where to get a back-up disposable mask if something happens to yours.
  • How and where to eat and drink at school.
  • Classroom procedures, like cleaning one’s desk.
  • Other new rules of the year (i.e. no bringing in birthday treats or policies about visitors).
  • What to do if you are feeling sick and/or if you think you’ve been exposed.
  • Procedures for class exposure, including the message delivery, testing, and incubation period.

These campaign messages also set the tone for the school year, helping to convey what is allowed and encouraged.

The importance of community buy-in. Regardless of your party affiliation or even perception of Covid risk, we need to unify to make the reopening of schools work. Simply put, if folks want schools to open (now, 6 months from now, or even later) and stay open, mask-wearing and other protocol has to be implemented and followed. So how can people help and not hinder this success? Let’s look at the different levels.

Parents. After you decide on schooling for your kids, it’s time to look for the good in the situation. No teacher/professor-bashing on social media or to their kids. This has been and will be hard for every person involved. How can I help? should be the only response. Have kids pick out cool masks and practice wearing them. Talk about how the year will be different, highlighting the positives at the same time. Make sure to tell your children that there will likely be unexpected “breaks” and Covid testing. Parents of college students should also be supportive, gently prompting their kids to communicate with instructors if something seems unclear. At the same time, dissuade your college student from attending risky activities.

Students. This new protocol is not optional. By now, anyone over the age of 3 is old enough to understand that we wear masks in public and why. If kids and (especially) college students don’t perceive themselves at risk, the threat of a shutdown should be enough rationale to abide by the rules.

Administrators. I don’t think I have to say be proactive or have back-up plans. Obviously, we do and many are already being rolled out. What I will say is that for teachers and faculty to do their best during initial opening, administration needs to be both flexible and mindful of the strain on educators, especially for those who are also caring for others.

Everyone else. Alumni, store owners, and other members of the community, for schools, and, well, society to safely reopen, it’s time to follow the rules and put aside self-centered behaviors. Play your part in helping the world put this pandemic in the past.

Why We Can’t Compare the “Spanish Flu” Waves to This Pandemic

The 3 Waves of the “Spanish Flu”
Most people had no idea that the first wave was happening, thus a faulty comparison to now.
Centers for Disease Control and Prevention / Public domain

We’ve heard the predictions of multiple COVID-19 waves for months. Our current stage is being disputed, with some people calling this the 2nd wave, while others argue that we’ve haven’t left the first. Regardless, the comparison between this pandemic and the “Spanish Flu” has been ongoing throughout this crisis. This focus on the waves of the 1918-19 influenza pandemic has particularly been used as a PSA of what not to do now. However, as I wrote in my post “Your Wise Friend Was Wrong” about a “Spanish Flu” meme that was circulating, this ahistorical comparison assumes too many similarities between then and now. Yes, we can and should learn from historical outbreaks, but we have to first understand what was known about disease at the time and what was communicated to the public.

Influenza (also called “la grippe”) was a familiar disease in 1918, predictably seasonal and usually mild. Doctors were not required to report deaths from influenza to the U.S. Public Health Service, even though it became epidemic in several years, including 1915-16. Influenza was not usually fatal, at least not for those outside of vulnerable populations.

The First Wave (from a contemporary understanding)

The H1N1 virus that attacked in 1918-19 was unique in its frequent complication of a deadly pneumonia and its high mortality among young adults. Outbreaks of this influenza/pneumonia likely first occurred in Kansas, at Camp Funston and the nearby Haskell Institute. Throughout the next two months, other military camps experienced high numbers of cases. These clusters of disease and death received almost no media coverage, other than a few stories that presented the outbreaks as isolated incidents, downplaying the severity of this new threat.

This article appeared at the bottom of page 2 of the Topeka State Journal on April 4, 1918. Coverage of (what we now identify as) the first wave was limited.

By the end of May, the outbreaks dwindled in the U.S.

Looking back, we now recognize these Spring outbreaks as the “first wave” of the influenza pandemic. However, in the moment, the lack of media coverage meant that most Americans had no knowledge of the rising cases. Most attention was directed to supporting the soldiers in World War I.

For the people of 1918, the influenza pandemic appeared to begin in June. Stories in The New York Times, Washington Post, and other U.S. papers reported on June outbreaks in China, Madrid, Morocco, India and Berlin and then throughout Europe in July. While cases appeared back in the U.S. at the end of the month, American media outlets only covered the epidemics elsewhere.

The Second Wave (but it seemed like the first)

It wasn’t until an eruption of U.S. cases in mid-September that the government and press publicly acknowledged that the epidemic had arrived. From September through November, the “Spanish Flu” raged throughout the United States. Quarantine was imposed at various degrees, as stores, public venues, and schools closed for 1-2 months. The people felt and lived this wave, as it affected the everyday lives of even the healthy.

The Third Wave

A third wave followed in the Spring, much of which was attributed to the mass transport of troops following the end of the war. Life didn’t shut down for this reemergence, however, at least not on a mass scale.

Why we can’t compare the pandemics

Outside of their available newspapers and magazines, the people of 1918 had very little media access. Information beyond what was in print simply wasn’t conveyed to the public, including the prevalence of influenza in Spring of 1918. To them, as presented in media, the first wave didn’t exist, the “Spanish Flu” began overseas, and even at the height of the epidemic, the war dominated all news.

With our abundant media outlets and individual-created content, we are in a different world than 102 years ago. We have known about COVID-19 since 2019, tracking its spread and watching its devastation. In other words, we cannot compare the notion of waves in 1918 as applying to this pandemic, at least not in the response of the public back then to now. What we can take away, however, is that the “Spanish Flu” eventually did subside, as will COVID-19.

Why the masks look the same in “Spanish Flu” pics: The rise of mask-wearing during the 1918 “Spanish Flu” pandemic

Vintage photos of masked individuals and crowds during the 1918 influenza pandemic have been circulating in news stories and on social media. What I find particularly interesting is that they all seem to wearing very similar masks, consisting of a white, rectangle and two ties, like this one worn by barbers:

Open air barber shop during influenza epidemic. National Archives and Records Administration / Public domain

Or this mask, covering the face of an elevator operator:

 Elevator operator in New York City, N.Y., wearing mask.
National Archives and Records Administration / Public domain

Why are they all so alike, especially considering the diversity of homemade and store-bought masks in our current reality?

Two factors explained the uniformity in masks then (and lack thereof now). First, many of the masks were created and distributed by Red Cross volunteers. And when people had to make their own masks, they could follow the straightforward, Red Cross-issued instructions that encouraged the use of white gauze and ties. Sample masks to be used as demos were sent to local chapters. Before masks were required, people were encouraged to use handkerchiefs, but this doesn’t appear to be as common as the gauze coverings.

“New mask design” from the Red Cross.
Published in The Washington Times on September 27, 1918

The Red Cross was heavily involved in directly and indirectly caring for influenza patients. Newspapers encouraged people to do their part to help the sick, especially ill enlisted men. And they did. Volunteers donated chicken, rags, pajamas, canned jellies and fruits, and other items.

And when did wearing masks become required during the Spanish Flu? Not as quickly as some “Spanish Flu as a Lesson”-type stories may lead you to believe (messages that have been using as cautionary tales for the current pandemic. I debunk one here). In 1918, many folks were still getting used to the concept of sanitary practices in the hospital. This April 1918 gem explains why nurses sometimes wear face masks to care for contagious patients.

Printed in the Rock Island Argus on April 10, 1918.

It wasn’t common practice for the general public to wear masks then (or now, at non-pandemic times). Doctors and nurses masked up during the spring outbreaks in the military camps (downplayed and ignored by media). No evidence suggests that regular people wore masks during this time.

In the summer of 1918, news media reported on the deadly disease as it spread through Asia and then Europe. However, nothing suggests that the U.S. prepped for influenza to come home. Articles focused on a different type of protection — the gas mask — needed to protect soldiers from poison gas attacks in the trenches.

Warnings of the impending influenza appeared in July. At the end of the month, 5 cases were documented at Camp Eberts in Arkansas, but incidence remained low for the next month. August newspapers documented illness and deaths aboard ships headed for the U.S.

As ships were being quarantined at New York and other ports, September 13th, Public Health Reports published the Navy’s preparation plan for handling the epidemic, including “Methods for the control of the disease.” Quarantine and isolation, at least for the Navy, were deemed “impracticable” due to the prevalence of healthy carriers. The final section advised mask-wearing for patient attendants and discouraged gatherings:

Published in Public Health Reports, September 13, 1918.

Excerpts of this report were published in newspapers across the country, paired with stories of rising cases, for the next few months.

By mid-September, influenza had become epidemic in some of the army camps and continued to spread across the country. On September 18, the Richmond Times-Dispatch reported that the local Red Cross chapter had requested 4,000 face masks for caregivers the previous day. The next day, a Connecticut paper recommended masks made from gauze for those near influenza patients.

Over the next two weeks, reports of Red Cross volunteers producing masks for nurses and other influenza attendants in military camps increased, as did cases of influenza. Still, there was no indication that regular people had started wearing face masks, nor had quarantine (outside of ports) been implemented.

Approximately 23,000 cases had erupted at military camps before soldiers were advised to wear masks while training. Female volunteers made them for the Red Cross, producing an average of 1 every 5 minutes. Cases of influenza reached epidemic levels in 26 states before it became common for even enlisted men to wear masks.

Like we’ve experienced in the last three months, society shut down before masks became required. Similar to now, restrictions varied by city and state. Flu mask ordinances were implemented primarily in November and December, as barber shops, theaters, and other crowded places began to open. In some places, everyone was required to wear masks. More often, though, care attendants, those in recovery, barbers, and elevator operators were required to don masks, while others were simply encouraged, especially those riding on street cars.

Contrary to numerous social media posts and contemporary articles on “Spanish Flu,” mask-wearing did not occur immediately, nor was it universally required and accepted. That said, the wide distribution of masks by the Red Cross made them much more accessible, especially for those enlisted and/or caring for patients.

Note: In researching for this blog post, I examined newspaper coverage using the search terms “masks” and “influenza” from March through December 1918 (and beyond). I weeded through numerous articles about gas masks. Even at the height of the pandemic, war news dominated media outlets.

Published in several news outlets, including the Fulton County News,
September 26, 1918

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Children in the Pandemic: Why They Should be Included in the Conversation

Note: I wrote this piece a few weeks ago. Some of my thoughts have shifted since the reopening. That said, I still feel like kids are being left out, especially as running mundane errands continue to be stressful. I decided not to revise it to preserve my unsettled nerves of the moment.

“Stay back! Stay back!” An older man said sternly to my 11-year-old several weeks ago, as she calmly pushed the grocery cart about 8 feet away from a “t” in the store. Nora brushed off his comment, and I redirected focus to our list. Inside, though, his recoil startled and upset me. I know that he was just trying to safe. At the same time, when did children become the enemy?

Past epidemics restricted the activity of minors, primarily when they were the most susceptible. In the polio epidemic of 1916, New York restricted traveling for children. The fear of later outbreaks prompted the closing of pools, beaches, and other places that attracted groups of kids in the summer. But these responses matched the fear of children contracting disease, not harboring and transmitting it to older adults, which we have seen with the current pandemic. Media stories emphasize how children typically have only mild symptoms, but can still pass COVID-19 to the adults around them. This discourse may help assuage concerns about sick children. At the same time, it stigmatizes and dismisses them in our coronavirus discussions.

Omitted from public spaces and conversation, children have been left out of this new reality that divides between the essential and non-essential. Let’s face it, everything they do is non-essential. Childhood is about toys, frivolity, and spontaneity, not n95 masks, R0 factors, and restrictions. It’s hard to fit kids into this new grim reality, in which every move feels so predictable and deliberate. Don’t touch your face. Remove gloves inside out. Have you scrubbed your phone? Wash your hands. . .no, wait, longer. Follow the arrows in the store. Is this six feet of distance?

This pandemic is incredibly tough on children, many of whom are experiencing the impact of their parents’ unemployment or fear for their safety on the job. Not to mention kids in abusive homes, thosewithout enough to eat, or without a safe place to be.

Even in the best circumstances, children are still contending with stressed-out parents attempting to both homeschool and work at the same time, while voicing their own concerns about the illness and death, the economy, food shortages, canceled appointments, and distanced loved ones. Kids don’t fit within the melancholic cloud over our pandemic reality. Day-to-day, they cannot stay in crisis mode.

Children’s experiences in epidemics have been historically ignored. We know little of their actions or feelings during yellow fever of 1793 or in the Spanish Flu. Even in polio epidemics, in which children were at the center, their voices and experiences were seldom shared, except for a sound bite or a choreographed March of Dimes poster. Only decades later did oral history projects capture adults’ recollection of surviving polio as kids.

But children do matter in this pandemic. Like all of us, they feel lonely, isolated, agitation, aimless, unsatisfied, worried, sad, and afraid. Removed from grandparents and other relatives, favorite teachers, peers, coaches, and other special people,they are experiencing a true sense of loss. Much of what structures their lives and brings them joy has been removed. Social distancing is difficult to explain and justify, even to older children, who might understand the risk, but emotionally struggle with canceled sleepovers, field trips, and competitions. Kids need to be included in the conversation. We can’t ignore the impact of quarantine, their fears of disease, or frustrations. Instead, children’s roles in this pandemic need to be considered and shared, with their experiences recorded and preserved for future generations.

After the grocery store incident, I stopped bringing my children to the store just so they wouldn’t have to experience the anxiety-ridden climate of fear. Many don’t have the luxury of shopping alone. Single parents have been cut off from their social networks, therefore, may need to bring kids along to get food or pick up prescriptions. We shouldn’t be quick to judge or ridicule children just for existing in a public space. They are not incubators of disease, but people also living in this world of uncertainty.