100 лет тому назад...
Feb. 28th, 2020 08:27 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
chuka_lisКогда была эпидемия "испанки".
Интересный исторический экскурс, который показывает, что с тех пор мало что поменялось.
"Yet there were warnings, ominous ones. Though few died in the spring, those who did were often healthy young adults—people whom influenza rarely kills. Here and there, local outbreaks were not so mild. At one French Army post of 1,018 soldiers, 688 were hospitalized and 49 died—5 percent of that population of young men, dead. And some deaths in the first wave were overlooked because they were misdiagnosed, often as meningitis. A puzzled Chicago pathologist observed lung tissue heavy with fluid and “full of hemorrhages” and asked another expert if it represented “a new disease.” By July it didn’t seem to matter. As a U.S. Army medical bulletin reported from France, the “epidemic is about at an end...and has been throughout of a benign type.” A British medical journal stated flatly that influenza “has completely disappeared.”
August, the affliction resurfaced in Switzerland in a form so virulent that a U.S. Navy intelligence officer, in a report stamped “Secret and Confidential,” warned “that the disease now epidemic throughout Switzerland is what is commonly known as the black plague, although it is designated as Spanish sickness and grip.
The hospital at Camp Devens, ...could accommodate 1,200 patients. On September 1, it held 84.At the outbreak’s peak, 1,543 soldiers reported ill with influenza in a single day. Now, with hospital facilities overwhelmed, with doctors and nurses sick, with too few cafeteria workers to feed patients and staff, the hospital ceased accepting patients, no matter how ill, leaving thousands more sick and dying in barracks...We have been averaging about 100 deaths per day...For several days there were no coffins and the bodies piled up something fierce...”
"Congress passed the Sedition Act, making it punishable with 20 years in prison to “utter, print, write or publish any disloyal, profane, scurrilous, or abusive language about the form of government of the United State...or to urge, incite, or advocate any curtailment of production in this country of any thing or things...necessary or essential to the prosecution of the war.” Government posters and advertisements urged people to report to the Justice Department anyone “who spreads pessimistic stories...cries for peace, or belittles our effort to win the war.”
( к свободе слова в США, +)
Against this background, while influenza bled into American life, public health officials, determined to keep morale up, began to lie."
"..public health director, Wilmer Krusen, declared that he would “confine this disease to its present limits, and in this we are sure to be successful. No fatalities have been recorded. No concern whatever is felt.” "Each day the disease accelerated. Each day newspapers assured readers that influenza posed no danger. Krusen assured the city he would “nip the epidemic in the bud.”
Много параллелей.
Пожалуй, с Ковид-19, может развернуться похожая картина, с примерно такими вот "госпиталями".
"Public health interventions and epidemic intensity during the 1918 influenza pandemic" (2007)
"Nonpharmaceutical interventions (NPIs) intended to reduce infectious contacts between persons form an integral part of plans to mitigate the impact of the next influenza pandemic.
We obtained data on the timing of 19 classes of NPI in 17 U.S. cities during the 1918 pandemic and tested the hypothesis that early implementation of multiple interventions was associated with reduced disease transmission. Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves.Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%)..
This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission..
This finding suggests that the association between early intervention and lower peak mortality may be explained in large part by the fact that later-hit cities responded more promptly.
..Communities that prepare to implement layered NPIs aggressively are likely to achieve better outcomes than communities that introduce such interventions reactively, and they may be better positioned to manage the disruption caused by the more stringent interventions, such as school closure.
In practice, and until emergency vaccine production capacity increases, this means that in the event of a severe pandemic, cities will likely need to maintain NPIs for longer than the 2–8 weeks that was the norm in 1918."
В городах, где карантинные меры были приняты рано, смертность в год эпидемии была 0.3 человека на 100 жителей (Сант Луис). Где не были- 0.7 (Филадельфия). В Филадельфии в пик эпидеми испанки умирало около 750 человек в день от пневмонии.
Интересный исторический экскурс, который показывает, что с тех пор мало что поменялось.
"Yet there were warnings, ominous ones. Though few died in the spring, those who did were often healthy young adults—people whom influenza rarely kills. Here and there, local outbreaks were not so mild. At one French Army post of 1,018 soldiers, 688 were hospitalized and 49 died—5 percent of that population of young men, dead. And some deaths in the first wave were overlooked because they were misdiagnosed, often as meningitis. A puzzled Chicago pathologist observed lung tissue heavy with fluid and “full of hemorrhages” and asked another expert if it represented “a new disease.” By July it didn’t seem to matter. As a U.S. Army medical bulletin reported from France, the “epidemic is about at an end...and has been throughout of a benign type.” A British medical journal stated flatly that influenza “has completely disappeared.”
August, the affliction resurfaced in Switzerland in a form so virulent that a U.S. Navy intelligence officer, in a report stamped “Secret and Confidential,” warned “that the disease now epidemic throughout Switzerland is what is commonly known as the black plague, although it is designated as Spanish sickness and grip.
The hospital at Camp Devens, ...could accommodate 1,200 patients. On September 1, it held 84.At the outbreak’s peak, 1,543 soldiers reported ill with influenza in a single day. Now, with hospital facilities overwhelmed, with doctors and nurses sick, with too few cafeteria workers to feed patients and staff, the hospital ceased accepting patients, no matter how ill, leaving thousands more sick and dying in barracks...We have been averaging about 100 deaths per day...For several days there were no coffins and the bodies piled up something fierce...”
"Congress passed the Sedition Act, making it punishable with 20 years in prison to “utter, print, write or publish any disloyal, profane, scurrilous, or abusive language about the form of government of the United State...or to urge, incite, or advocate any curtailment of production in this country of any thing or things...necessary or essential to the prosecution of the war.” Government posters and advertisements urged people to report to the Justice Department anyone “who spreads pessimistic stories...cries for peace, or belittles our effort to win the war.”
( к свободе слова в США, +)
Against this background, while influenza bled into American life, public health officials, determined to keep morale up, began to lie."
"..public health director, Wilmer Krusen, declared that he would “confine this disease to its present limits, and in this we are sure to be successful. No fatalities have been recorded. No concern whatever is felt.” "Each day the disease accelerated. Each day newspapers assured readers that influenza posed no danger. Krusen assured the city he would “nip the epidemic in the bud.”
Много параллелей.
Пожалуй, с Ковид-19, может развернуться похожая картина, с примерно такими вот "госпиталями".
"Public health interventions and epidemic intensity during the 1918 influenza pandemic" (2007)
"Nonpharmaceutical interventions (NPIs) intended to reduce infectious contacts between persons form an integral part of plans to mitigate the impact of the next influenza pandemic.
We obtained data on the timing of 19 classes of NPI in 17 U.S. cities during the 1918 pandemic and tested the hypothesis that early implementation of multiple interventions was associated with reduced disease transmission. Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves.Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (≈20%)..
This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission..
This finding suggests that the association between early intervention and lower peak mortality may be explained in large part by the fact that later-hit cities responded more promptly.
..Communities that prepare to implement layered NPIs aggressively are likely to achieve better outcomes than communities that introduce such interventions reactively, and they may be better positioned to manage the disruption caused by the more stringent interventions, such as school closure.
In practice, and until emergency vaccine production capacity increases, this means that in the event of a severe pandemic, cities will likely need to maintain NPIs for longer than the 2–8 weeks that was the norm in 1918."
В городах, где карантинные меры были приняты рано, смертность в год эпидемии была 0.3 человека на 100 жителей (Сант Луис). Где не были- 0.7 (Филадельфия). В Филадельфии в пик эпидеми испанки умирало около 750 человек в день от пневмонии.
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