The Lessons of the Pandemic

A colleague and friend of mine, Professor Mariana Cabral de Oliveira (Biology Institute, Universidade de São Paulo), shared with me the article by Major George A. Soper, “The Lessons of the Pandemic”, published in Science magazine 100 years ago.

It is quite impressive to read the paper by Major Soper, in special the conclusions.

Some highlights of the paper.

The pandemic which has just swept round the earth has been without precedent. There have been more deadly epidemics, but they have been more circumscribed; there have been epidemics almost as widespread, but they have been less deadly. Floods, famines, earthquakes and volcanic eruptions have all written their stories in terms of human destruction almost too terrible for comprehension, yet never before has there been a catastrophe at once so sudden, so devastating and so universal.

The most astonishing thing about the pandemic was the complete mystery which surrounded it. Nobody seemed to know what the disease was, where it came from or how to stop it. Anxious minds are inquiring to-day whether another wave of it will come again.

The fact is that although influenza is one of the oldest known of the epidemic diseases, it is the least understood. Science, which by patient and painstaking labor has done so much to drive other plagues to the point of extinction has thus far stood powerless before it. There is doubt about the causative agent and the predisposing and aggravating factors. There has been a good deal of theorizing about these matters, and some good research, but no common agreement has been reached with respect to them.

The measures which were introduced for the control of the pandemic were based upon the slenderest of theories. It was assumed that the influenza could be stopped by the employment of methods which it was assumed would stop the other respiratory diseases. This double assumption proved to be a weak reed to lean upon. The respiratory diseases as a class are not under control. They constitute the most frequent cause of death, yet it is not known how they can be prevented.

Three main factors stand in the way of prevention: First, public indifference. […]

The second factor which stands in the way of prevention is the personal character of the measures which must be employed. […]

Third, the highly infectious nature of the respiratory infections adds to the difficulty of their control. […]

The conclusions by Soper:

It is worth while to give more attention to the avoidance of unnecessary personal risks and to the promotion of better personal health. Books have been written on the subject. The writer’s idea of the most essential things to remember are embodied in the following twelve condensed rules which were prepared in September, recommended by the Surgeon-General of the Army and published by order of the Secretary of War to be given all possible publicity:

1. Avoid needless crowding-influenza is a crowd disease.

2. Smother your coughs and sneezes-others do not want the germs which you would throw away.

3. Your nose, not your mouth was made to breathe through-get the habit.

4. Remember the three C’s-a clean mouth, clean skin, and clean clothes.

5. Try to keep cool when you walk and warm when you ride and sleep.

6. Open the windows-always at home at night; at the office when practicable.

7. Food will win the war if you give it a chance-help by choosing and chewing your food well.

8. Your fate may be in your own handswash your hands before eating.

9. Don’t let the waste products of digestion accumulate-drink a glass or two of water on getting up.

10 Don’t use a napkin, towel, spoon, fork, glass or cup which has been used by another person and not washed.

11. Avoid tight clothes, tight shoes, tight gloves-seek to make nature your ally not your prisoner.

12. When the air is pure breathe all of it you can-breathe deeply.

The article by George A. Soper can be read here, if you have access to Science magazine.

Ref: Soper, G. A. Lessons of the Pandemic. Science,  30 May 1919, Vol. 49, Issue 1274, pp. 501-506. DOI: 10.1126/science.49.1274.501

Autor: Roberto G. S. Berlinck

Professor do Instituto de Química de São Carlos, USP