choices

Rusty Reno

That older generation that endured the Spanish flu, now long gone, was not ill-informed. People in that era were attended by medical professionals who fully understood the spread of disease and methods of quarantine. Unlike us, however, that generation did not want to live under Satan’s rule, not even for a season. They insisted that man was made for life, not death. They bowed their head before the storm of disease and endured its punishing blows, but they otherwise stood firm and continued to work, worship, and play, insisting that fear of death would not govern their societies or their lives. 

Richard J. Hatchett, Carter E. Mecher, and Marc Lipsitch (2007): 

We noted that, in some cases, outcomes appear to have correlated with the quality and timing of the public health response. The contrast of mortality outcomes between Philadelphia and St. Louis is particularly striking. The first cases of disease among civilians in Philadelphia were reported on September 17, 1918, but authorities downplayed their significance and allowed large public gatherings, notably a city-wide parade on September 28, 1918, to continue. School closures, bans on public gatherings, and other social distancing interventions were not implemented until October 3, when disease spread had already begun to overwhelm local medical and public health resources. In contrast, the first cases of disease among civilians in St. Louis were reported on October 5, and authorities moved rapidly to introduce a broad series of measures designed to promote social distancing, implementing these on October 7. The difference in response times between the two cities (≈14 days, when measured from the first reported cases) represents approximately three to five doubling times for an influenza epidemic. The costs of this delay appear to have been significant; by the time Philadelphia responded, it faced an epidemic considerably larger than the epidemic St. Louis faced. Philadelphia ultimately experienced a peak weekly excess pneumonia and influenza (P&I) death rate of 257/100,000 and a cumulative excess P&I death rate (CEPID) during the period September 8–December 28, 1918 (the study period) of 719/100,000. St. Louis, on the other hand, experienced a peak P&I death rate, while NPIs were in place, of 31/100,000 and had a CEPID during the study period of 347/100,000.

Let’s be clear about this: Reno thinks the city of Philadelphia got it right, while the city of St. Louis “lived under Satan’s rule.” 

UPDATE: I just read Damon Linker’s column on Reno’s essay, which is outstanding. 

March 25, 2020

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