Fool Me Once…

Another weekend day, another trip down historical memory lane.

I started this week by paraphrasing the illustrious George H.W. Bush in a title, so it feels only fitting to end it by honoring his war criminal son. (Don’t get me wrong: The elder Bush was also a war criminal – just not on the scale of the younger.) And today’s post will be about war, after a fashion – not the war against the virus we keep hearing about from our militarized-minded, public health-illiterate politicians, but the First World War and the devastating global pandemic that accompanied it.

Here, as I did in my post on the first cholera outbreak in New York City (part of the second global cholera pandemic), I’ll lean heavily on the work of Mike Wallace. That previous post referenced Gotham – the monumental history of New York from colonization through consolidation (1898) upon which Wallace and his fellow radical historian, the late Edwin G. Burrows, collaborated – whereas here I’ll refer to Greater Gotham, Wallace’s own equally monumental history of New York from 1898 to 1919, from which all the images that follow are drawn (in particular, from pages 1008 through 1011 of that book).

With no further ado, the H1N1 Influenza Pandemic of 1918-1920 and New York City’s response thereto:

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The Politicization of Contagion, Redux

Then, as now, as in 1832, we see naming and blaming at the foreground in disease response; perhaps different from today, New York City in 1918 had a Department of Health (more) prepared for the “onslaught” of pandemic disease. It’s unnerving to note the relatively even spacing of these three pandemics – of cholera, influenza, and coronavirus, respectively – although, of course, other pandemics and epidemics have occurred in the interim (and it is largely lost in the mix that we are currently in the midst of not one, but two pandemics, as the global crisis of HIV/AIDS rages ons; unlike COVID-19 – although this too is rapidly changing – AIDS has now become largely, if not exclusively, a disease of the poor, hence the fact that it killed ~770,000 people in 2018 did not register as a global crisis, whereas the 110,00+ deaths from COVID-19 to date most certainly have registered as one).

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The Surge of Mortality

Then it was Calvary Cemetery; today, it’s Hart Island and freezer morgue trucks, but in both instances, we see the staggering and terrifying toll taken on the City’s population by a novel pathogen.

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The Safety Net Fraying

Both the fraying of our public “safety net” hospitals and the scramble to create ad hoc medical facilities should ring eerily familiar to those of us who have lived through the last six weeks in the City. Note that while our private institutions may have not conducted themselves quite so despicably this go-around, there have been stories quietly circulating that the intention of the major NYC private hospital networks is to shift the burden of COVID-19 care to the various temporary/swing facilities that have come up as soon as possible so as to be able to get back to the business of properly making money.

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Mitigation and Care

We might be inclined to congratulate ourselves that the more public health-minded New York of a century past also struggled mightily to contain a pandemic, but we should remember that the H1N1 strain of 1918-1920 was roughly 10x more deadly than SARS-CoV-2 as a human pathogen; spread at a time when health systems were, obviously, far less advanced than they are today; and, unlike the virus we face now, tended to kill healthy young adults in large numbers.

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Slowing the Spread

Slowing the spread is flattening the curve. Commissioner Copeland took more sensible actions a hundred-plus years ago than our elected and appointed officials initially took in March of this year.

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Paternalism and Public Health

Then, as now, mistakes were made, and while Wallace is complimentary of Commissioner Copeland’s strategy regarding school closure (that is, not closing schools), this informative report – The 1918 Influenza Epidemic in New York City: A Review of the Public Health Response – comes to a somewhat different conclusion.

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Prevention is the Best Medicine

Novel pathogens have humbled humans throughout the ages, and in 1918, as today in 2020, the case was and is no different. Likewise, the heroic and dangerous work of healthcare workers and caregivers connects our predicament today with that of our predecessors.

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Coordination as a Hallmark of Effective Response

Governor Cuomo’s creation of a ” new hospital network Central Coordinating Team” to engender “a more coordinated and strategic approach among the state’s healthcare system in combating the COVID-19 pandemic” reflects a similar – if narrower – push towards coordination, and I have no doubt that, at the level of the Governor’s Office – through which all business in New York State currently runs – coordination similar to that described above is taking place.

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And Just Like That, It Was Over

The power of exponential growth and herd immunity make for dynamics that – to the individuals experiencing pandemics – feel at once dizzying in their speed and ferocity and almost mystical in their passage. We all remember saying: “It just happened so fast.”

Soon enough, maybe we’ll all be saying: “I can’t believe it’s already over.”

Meanwhile, the role of global conflict and circulation of goods and people (at the culmination of World War I) in spreading the H1N1 pandemic will, I’m sure, be lost on no one.

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The Worst Is Yet To Come

I concur with Wallace’s conclusion that “Global Flu” would have been a more fitting moniker for the pandemic past, and tremble – on reflecting upon the pandemic present – at the prospect that in 2020, too, “New York’s […] fatalities” may add “relatively few to the colossal totals that [ravage] the United States” as the national death toll here has crossed 20,000 (while that in the UK – our kindred nation in Anglospheric parochialism – has crossed 10,000). We can hope that my fear is misplaced though, given how colossally bungled was our response in New York City and State, and this time – unlike in 1918 – I think it’s safe to predict we will not see New York emerge as a leader in its (public health) response to pandemic, but we can hope that, from this vast collective trauma, we emerge with a redoubled commitment to public goods and redoubled spirit of public-mindedness.

Correction: A previous version of this piece stated that the first cholera outbreak in New York City occurred in 1817; while that was the year that the first global cholera pandemic started, the first cholera outbreak in New York didn’t occur until 1832 (during the second global cholera pandemic) as reflected in my previous piece here

6 thoughts on “Fool Me Once…

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