Illness across time: history’s rhythms from then to now
On a sleepy big city morning, I got the surprise of my life reading about the sleepy small town my father’s family hails from. John W. Post, my great grandfather, presided over small town Salem, Ohio, during a ferocious typhoid epidemic. In 2020, staying home, it was immediately interesting to see how we’ve managed disaster then and now.
A JAMA article from 1920 concludes “The lessons for other communities to be learned from this epidemic are not new, but they are frequently forgotten.” What happened in 1920 eerily parallels our experiences throughout the 2020 pandemic — we must look and remember.
This typhoid outbreak occurred after a particularly rainy season in 1920. Salem at the time was a typical example of a small town — though with slightly over 10,000 people, it was struck with over 800 cases. With a limited number of doctors, nurses, and vaccines, the situation was dire. Mayor Post called in the state authorities for help with personnel and equipment. The Red Cross was also brought in, and emergency hospitals were mobilized upon their arrival. They worked hard to dispute claims the epidemic was under control, and persuading others that the town needed help.
State and nearby health officials helped install chlorinating devices to get the water up to par. Houses known to be affected were promptly put into quarantine — and folks respected the rules! My great grandfather had some interesting fixes — ordering noise to be reduced and for factories to stop their whistles.
Much like COVID has quieted our streets, Mayor Post mandated quiet: “Noises from automobiles, wagons, playing children, barking dogs, whistles, and any and all other forms of public disturbance are included in this notice”. Though I don’t understand the rationale for quiet, I can appreciate that this functionally kept people apart — important for an extremely contagious disease. His order demanding “eating houses and confectionary shops” to boil their water also makes perfect sense for a water borne disease.
Boil orders, quarantining, and robust state responses weren’t unusual — they were deemed absolutely necessary to get the town healthy and back in business. Several meetings with citizens’ and public health officials were organized to explain what the federal, state, and local responses were, and how they planned on cooperating to end the epidemic as quickly as possible. Additionally, there were several post mortems, from JAMA, and the NY Department of Health exploring what went right and wrong. The NY Department of Health concluded in 1921 that vaccines were of utmost importance in Army and civilian life — and should be encouraged.
Some things don’t change, though. According to the Alliance Review, the outbreak was as tragic as it was because folks “half-heartedly followed the (boil) order, bringing it to the point of boiling and then let it cool instead of boiling for the specified amount of time”. The American Journal of Public Health noted in 1931 that the Salem outbreak was the deadliest in America. Much like we are tired of social distancing rules and mask mandates, these folks weren’t interested in following reasonable health mandates to prevent being ill.
Now, as the pandemic is thankfully on the downswing with vaccine rollouts, let us heed JAMA’s warning, and not forget the lessons from COVID. Coming together, having clear public health protocols, strong state responses: these are all things that will end crises sooner rather than later. Perhaps most importantly of all: we must remove the politics from public health. My great grandfather was a prominent Republican in the town, and he sought out robust measures anyway. We must not let our communities fall prey to wild conspiracies, or indulge in the worst tendencies towards myopia and refusal to act. As we learn more about what went wrong during COVID, we must take the lessons learned from 1920 and today, and put them into action later.
