Learning From History: The Anti-Mask League And The Flu Pandemic of 1918
The US has seen a wave of people protesting the stay-at-home orders that were issued in order to fight the current coronavirus pandemic. Some people might be doing this because of economic fears. However many of the protests are driven by fringe groups, such as the group of guys with guns that stood in front of the State Capitol in Lansing, Michigan.
As usually happens, this is nothing new under the sun. Often history repeats itself, or at least it rhymes. Many of the things taking place now have parallels in past events. Looking at different analogies from history could help us in seeing how things might evolve in the current situation. This can then guide us in the choices that we make today.
Around 100 years ago, in 1918, the world was in the grips of another pandemic. The so-called Spanish Flu spread around the world and caused millions of deaths. It hit the US particularly hard, and around 500 to 850 thousand people died in the country. Globally, the number of deaths has been estimated as being anywhere from 17 million all the way up to 50 million people.
San Francisco was one of the cities with a high death toll from the virus. How this happened is an interesting tidbit from history, one that could serve as a powerful analogy for the current period.
On his Twitter feed, NPR reporter Tim Mak posted an interesting piece of information that he found. He came across an essay that described what happened in 1918 in the city of San Francisco. Reflecting on these events gives a lot of food for thought on what is happening now.
Apparently, in September 1918, a man returned to San Francisco from a trip to Chicago. He was suffering from symptoms of the Spanish Flu, and was ordered into quarantine by the city’s Health Commissioner.
However, this did not stop the spread of the flu, and by October 9th, cases already numbered in the 100’s. A week later, it was already 2000 cases. Things were getting out of hand, so the city mandated a closing order to take effect on the 18th of October.
All the theaters, social gatherings, as well as schools were closed. Many professions were ordered to wear masks, something that was enforced by the local police. The greater public was also encouraged to wear them. In a few days, this ceased to be voluntary, and instead became mandatory for everyone.
At the end of October, San Francisco had over 20 thousand cases, with over 1 thousand deaths. However, by November the situation seemed to be improving. Based on this good trend, city officials rescinded all the different bans and rules, and the city was re-opened.
What ensued was mayhem. People starved of entertainment and contacts for over a month, rushed to get what they had been missing. Theaters were packed, numerous shows were staged, boxing matches resumed to huge crowds.
The result of this free-for-all seems predictable in hindsight. The virus once again picked up. The second wave of the pandemic quickly arrived in full force. In December 1918, the cases were on the upswing.
So in January 1919, the city once again tried to force everyone to wear a mask to cover their faces. However, this time the opposition to this order grew very strong. A so-called Anti-Mask League was formed, and drew supporters in the thousands to their rallies.
The opposition to the masks was so strong that on February 1st, the mayor of the city rescinded the order. Once again, residents did not have to cover their faces, and could stroll about freely.
When the statistics came out a few months later, it became apparent that San Francisco had been one of the worst hit cities in the US. It had a death toll which ranked among the highest. This number was especially striking if you compare it to some of its West Coast neighbors. In cities like Los Angeles or Seattle less people died in the pandemic than in the Golden City by a significant margin.
A study done by a group of researchers found that many of the cities that had ended social distancing too early had experienced a powerful second wave of the epidemic. Those that were more disciplined in their policies weathered the storm much better.
What are the lessons for today?
Dr. William Hassler was San Francisco’s Chief Health Officer at the time, and the man who pushed for social distancing measures, including the wearing of masks.
According to sources, he despaired at the fact that the orders were rescinded too early, and that the dollar sign was put ahead of the health sign. The lessons for Hassler were stark. As he stated:
“When the masks were removed in November, only 10 cases a day were being reported. Nine days later the daily total was reaching 75. And it has increased ever since until now we have had well over 200 per day for several days.”
The lesson here is not to rush too early into going back to normal. While things might seem to be improving, the nature of the virus is such that it can go back to spreading very quickly.
Another study done by a group of economists has shown that the cities that had implemented the most strict social-distancing measures, and kept them the longest, actually ended up recovering much more quickly.
To cite the authors of the study:
“We find that cities that implemented early and extensive NPIs suffered no adverse economic effects over the medium term. On the contrary, cities that intervened earlier and more aggressively experienced a relative increase in real economic activity after the pandemic subsided.”
“NPIs” in the quote above stands for non-pharmaceutical interventions, and includes different types of social distancing measures.
The conclusions of the study were that while the economic losses due to the Spanish Flu Pandemic were huge, social distancing measures not only kept the mortality from getting worse, but in the medium term actually improved the chances of a city for recovering quicker.
While no pandemic is the same, there are certain parallels which we can use as analogies for what is happening today. These can then serve to guide us when we are making decisions on how to proceed next in the current Coronavirus Pandemic.
There are many different factors at play at the moment, and each part of the US, and each part of the world, has its unique circumstances and challenges to tackle. The nature of the pandemic is probably not the same in New York, as it is in Florida, and circumstances in Sweden are very different from those in Italy.
The responses therefore should not be the same for each place. However, history teaches us not to be too complacent. A second wave is a very high possibility, and could be even worse than the first one. That’s why it is important for cooler heads to prevail.
Now is not the time to go back to normal.