Transcripts For CSPAN3 Lectures In History 1918 Influenza Pandemic Public Information 20240713

Implemented. This class was film on march 10th, 2020, during the easterly zwrajs of the coronavirus outbreak in the u. S. She compares the symptom, Economic Impact and National Response between 1918 and today. So what are we going to do today . I promise you all that that i would do a little show and tell from my own research work. And the timing of this turned out that doing something Historical Perspective on pandemic preparedness might seem like a really interesting topic for us to discuss. And i think i mentioned to you all that i have been getting a lot of calls from journalists lately and its kind of like why in the middle of an an going pandemic are they calling up people like me . So i think this is a good thing for us to talk about. This is a history methods course. Its about how you become i went too fast there. How you become a historian and what you do for a living. The first week of class we talked about the reaction. Sometimes you may get from family members when they hear youre a hist plajory major tha is this useful knowledge . Why are you bothering . I can tell you personally, i get those questions a lot because of my Research Specialty in the history of health and medicine. Science is so much better today. Why should we bother looking at the past history of diseases and how we responded to them . Come on in, justin. Im really excited about what i do. So that is objective number one. I said the first week of class i want to make you proud of being a hist plajor. So heres my way of saying why im proud to do what i do. The second goal is to talk about pandemics in this class. How were forms of Public Outreach used to try to contain and mitigate a major epidemic . My work has been on Public Education or you might call it propaganda. Do we need to justin, can you just move over a little bit . We talked the week before last about propaganda. It has a lot of negative associations to it. For much of the 20th century, it did not have those negative associations propaganda is often public information. Its trying to get messages out to people that could help them in a time of emergency. So thats what were going to be looking at today. I know a lot of you saw 1917, the movie about world wore i. You know that was a pretty brutal war with the trench warfare. A lot of people died. That film is an amazing recreation of the conditions in wartime. You remember from our readings, world war i is the first world war. The combatants span multiple contents. As we see in the readings, it inspired new propaganda. Remember our draft posters that we looked at from from both the british and the u. S. Side, uncle sam, for example. As that war ground to the horrible close, a terrible influenza pandemic broke out. Its still not clear where it came from. But it spread very quickly first to troops and then to civilians. It killed more people than it did world war i. And just to give you a sense of comparison, that is we were able to isolate that is the h1n1 spanish form of the pandemic. 8. 5 million deaths. Thats bad. But look at the influenza death toll. 50 million is now the estimate it could be even higher. So more lives lost in that influenza pandemic than lost in world war i. In our lifetime, hiv aids has been, you know, a tremendous killer. 32 million during the entire course of the aids epidemic because the death tolls were so high. Now you you may think well that was a really sad story. Lots of people died. But what is the point of studying an old pandemic . After all, science is so much better today, right . How are we doing with curing the coronavirus . No. Were not doing so well. In part because this is Mother Nature issuing major challenge to us. As a new virus form that people dont have immunity to. The coronavirus and response to it in many ways is revisiting a lot of issues that came up with in the world war i pandemic. The reason were having problems with coronavirus today are similar to the problems they encountered with this new influenza in 1918, 1919. Heres a stranger fact. En that is the methods we used today to control coronavirus are drawn from the same Public Health playbook that they used in 1918. The basics are still the same. We have not evolved hugely beyond what was available in the world war i era. The methods are still the same. There has been a growing interest in the history of this 19181919 pandemic. Now it was not always the case that people paid much attention to this pandemic. And i just show you this book. It was called americas forgotten pandemic written in 1987. Very little serious work. Talked about amnesia that no one thought about it anymore. Of im here to tell you that especially in the last 20 years, it is forgotten no more. There is an upsurge of interest in this pandemic. Out of an impulse to try to learn how to manage current epidemics more effectively. Our Public Health folks are looking at a lookback, a methodology used in Public Health, to look back at previous epidemics and see what worked and what didnt work. Public Health Emergency preparedness has become a major subfield in Public Health. Its really grown a lot since 9 11. You may remember there is bioterrorism involved in 9 11. It also reflects a kindbam of gradual recognition that for a variety both of economic factors and also environmental factors and this has a lot to do with the ecology between people and animals. It also has to do with global transportation. That means a disease, a novel disease that breaks out in wuhan can then travel very quickly through not just trains and cars but airplanes now can travel very quickly. This is just kind of list of what had been major Public Health concerns just in the past 20 years starting with sars, ebola, zika and now covid19. So starting back with sars, there was a growing sense among policy leaders that they needed to start planning ahead, thinking about, well, if a novel pandemic breaks out, how are we going to control it . Even if it spreads fast and has hay high mortality rate. So they got together to investigate in particular the pandemic that im going to talk to you about. Pook look at the plague and they look at the initial disease exchange with native peoples when the europeans came with columbus. But of all the lookbacks, the one on the influenza pandemic has gotten the most attention because in many ways its the first modern Global Pandemic in the sense of what we are experiencing. One of the historians that got invited to participate in the lookback is me. Im a big player in this there are other historian thats have been much more at the forefront of where can i see this . I call out my colleagues at the embassy of michigan and alexandra stern as leading this team. But they invited me in to help because of my historical specialization in popular Public Health education. So thats my book. In many circles im called the germ lady. I get calls from journalists is germs and the gospel of germs comes right up. What was this book about . I wrote it a long time ago, 1998. I was interested in how ordinary people came to believe in the existence of something they couldnt see which was a germ. A microbe. And then to alter the way they behaved like, you know, doing the not shaking hands but the kinds of stuff were now doing, how did they learn to do that . And they were really purposeful in Public Health campaigns to teach people how to avoid giving each other germs. What i call the gospel of germs is the foundation of the kind of containment practices that we still use today. How do you minimize the sharing of microbes between human beings . I always like to give students something really a fancy phrase so you can sound really, you know, smart when youre talking to the other people. Anything that doesnt involve giving you a vaccine or drug is a nonpharmaceutical intervention so all the stuff i was looking at and by the way, there are no antibiotics. There are relatively few vaccines in this time period. The way you kept from getting sick was by practicing these habits. Easier to say is social distancing measures. You read in the newspaper and they are talking about that all the time now. When they tell us no the to shake hands or sneeze into your elbow, thats a social distancing method. Exactly the same stuff they were telling americans to do at the turn of the last century. Why is this important . Because even though we have made astounding improvements in the health sciences, we still cannot cure a virus. Limited medications to this day to slow down a viral infection. So when were faced with a novel virus using the tactics is the most important ways we have to keep people from getting sick and dying. If you have a highly contagious epidemic on your hands, the best bet is slow the spread, stop the spread and the techniques are very, very valuable. That was a lesson Public Health expert learned in world war i that we still use today. So my work has been kind of studying first i did basic germ education. I look specifically at world war i and how they tried to ramp up the Public Health education in the face of the pandemic. And thats what im going to show you more of. So let me give you some quick overview of the 1918, 1919 pandemic. This were multiple outbreaks in different parts of the world. Tsz no t its not clear which one is first. What we are sure of is that it did not start in spain. It is called the it became nicknamed the spanish flu not baust because it started in spain, spain was not a combatant in world war i so the newspapers were not being as careful about reporting on the early stages of the pandemic. They ran a story about it and somehow they got associated well, its the spanish flu. I started with troops and then civilian populations. This particular flu was much scarier. It spread easily from person to person. And the death rate was higher than the usual flu. Also, the normal flu usually kills fragile people. That can be very young or very old. People who are already sh symptoms under stress. It keilled people your age. It didnt concentrate on just the very old or very young. In Public Health circles, they talk about the dreaded w shape. Ill tell you thats the w. You can see the normal flinfluea pattern. Look at the 1918. Big spike up. It changed the life expend ancy in the United States because so many young people had their lives shortened dramatically. As a result of the influenza pandemic. This just gives you another this is from Public Health report published after. You see the extraordinary spike in death rates due to this pandemic. What did Public Health experts know about influenza in 1918 . Compared to the last biggish epidemic which was in the easterly 1890s, they learned a lot. They had convincing Laboratory Proof of something you may have heard of as the germ theory of disease. The idea that communicable disguises are caused by microbes. There had been a lot work showing that it wasnt a mysterious thing in the air that made you sick. It thats what micro organism that in the indication of bacteria they could see under a microscope and they could prove caused specific diseases. They made huge leaps forward. They were able with the current micro scopes of the time to see bacteria. They could not yet see a virus. The difference between a bacteria and virus, let me show you this very quickly. A little contagion 101. Viruses are tiny compared to bacteria. The analogy is virus is the size of a mouse and the bacteria is the size of a person. Viruss are much more primitive. But theyre more deadly in that they insert themselves into your cells and take control of your machinery to replicate. They mutate quickly which is one reason theyre still so difficult to control. Even to this day, we have limited pharmaceutical treatments for viral diseases. We can slow some of them down but were not able to cure the flu. Today we rely on vaccines. Bacteria are much bigger and a single cells micro organism. It turns out i mean they are can do incredible damage to the body. But eventually effective drug treatments were found for bacteria, antibiotics. Only work against bacteria. They dont work against viruses. Theyre easier to disrupt their machinery. The big question to go back to this is what did they know in 1918, 1919, they had a suspicion then that there was an effective particle smaller than a bacteria but they couldnt see it. They did xpirmenexperiments thas there. I can tell you ho you this he figured it out. They didnt know whether the flu was caused by a bacteria or a virus. They had a lot of scientists who tried to get in there and figure out what was the x germ. And just so you know, not until microscopes were invented in the 1930s could you actually see a virus under a microscope. It wasnt until the 1990s that our tools of extracting the influenza virus and replicating the dna that our tools were good enough that we could actually extract it and replicate the dna. This is another whole school story there about how they went and got samples of people who died from the flu. Its really pretty creepy. But interesting that i can tell you on is it bake teara or virus . They dont find out. In the end, that doesnt make a whole lot of difference. Because the way you protect against a bacteria and the way you protect against the virus is basically the same. And so the social distancing methods that as the pandemic spread, people were supposed to use to keep from catching it were essentially the same ones that were used for any upper respiratory infection. They understood influenza as an upper respiratory infection was caused through sneezing, could having, spitting, that is a habit we have given up. But they spit a lot. Also if you shared glasses or utensils, sometimes thats called fomite. That is a really weird word. Its an object that carries, like if i had coronavirus and you touch my phone and you get this is a fomite. You should not be messing with other peoples phones right now. But you know that. It can be transmitted that way and various kinds of casual contact, you know, you all are hearing now dont touch your face. Dont touch your nose. They basically have figured that out that stuff is getting on your hands and that could make you sick. And they already had the idea not just about influenza but about a lot of other diseases. Now one of the things that they realized pretty soon, remember that w i showed you, is this strain seemed much more deadly than the usual annual influenza. And experts are still arguing, they reconstructed the virus that they thought out of people that died from the spanish flu. Some of them look and scary information about this. There is a context. Remember 1917, you look at those trenches. You think, boy, you would get a lot of yucky stuff being in that trench. And the wartime hygiene may have made people more vulnerable and perhaps that is why it was so deadly. As a historian and not a virologyist, i dont know. My guess is theyre never going to be able to firmly determine why it was that this particular virus caused that w shape. Yeah . [ inaudible ] is there like a specific reason why it was affecting people in their 20s to 30s compared to the normal flu . We dont know. And thats kind of the puzzle of this is thats so unlike the normal flu. Now that agegroup we know would have been military. That would have been the young men and troops. But it also in the civilian population killed a lot of young people as well. Maybe the nutrition overall. I mean even though it was the home front things were maybe people werent fed as well. But i am not sure they really come up with a good answer yet. For why it took that y shape. And to be honest, the uncertainty about this one is something that carries over into other new ones is there is always this worry that its going to happen again and we dont know exactly why. Fortunately, it does not appear in the coronavirus to be doing that w shape so far, so good. Whatever the call so again, we dont know was it a mutation that made it so bad or was it the underlying wartime conditions . What do know is xpacompared to annual flu, the 1918 version was really, really scary in the symptomology. People would come do with an extremely high fever. They would develop a really is severe upper respiratory infection. Often compounded by nausea and diarrhea. In the worst cases it caused such a devastating assault on the lungs that the lung tissue was destroyed and they could not get enough oxygen in the lungs. The lungs were that damaged. There was also a secondary problem and this is true with flu to this day is that the virus weakens you and then a bacteria comes along in the case of the influenza pandemic, it was pneumonia. Viral or bacterial would come in and if the flu hadnt killed you, the pneumonia would do it. Yeah . Can you hold on just a immun this virus . A very good question. So one thing about when you do have a virus, you may then have an immunity to it. One of the theories about why this was so bad is that, in fact, it had been almost 20 years the one i mentioned in the early 1890s may have been this strain. And that the people who had that immunity had either lost it or had died off. So it was basically a virgin population that had not been exposed to this particular flu and then that would make it you wouldnt have the immunity of having been exposed to it. So thats one possible explanation to why a lot of people didnt have an immunity to this particular strain of it. Okay. So its hard to exaggerate how scary this epidemic became very, very quickly. And im just going to talk about the United States here but it was, in fact, a Global Pandemic. The first two cities hit were boston and philadelphia. And in part they got hit first because they had military camps that jumped to the civilian population. We were caught unawares by the speed and the deadliness of the pandemic. And by the time they started to put those distancing, quarantining, isolating measures into place, the epidemic was already out in the general population and very hard to shut down. In boston, the kind of center of infection was camp devins. There were 14, again, military camps, 14,000 cases of the influenza, 757 deaths. In philadelphia, it was the navy yards that became the kind of focal point for the spread. So many people were dying in philadelphia that they were having to take cold storage plants that they used for other purposes and turn them into morgues. The death tolls of that original pandemic in those two cities were really staggering. Seeing what was happening in boston and philadelphia, everybody else could say oh, no, this looks really bad. We need to start getting ready. Let me just read you, this is a description from september 1918 from then United States Surgeon General rupert bloom. The disease is characterized by a sudden on set, people are stricken on the streets or while at work. First there is a chill, then fever with temperatures from 101 to 103. Headaches, backache, reddening and running of the eyes, pains and aches all over the body and general profitration. People should immediately call a physician. Sounded like good advice but quickly there werent enough doctors to take care of all of the people going home with this disease. No one of the differences between the 1893 influenza epidemic and this one was the degree to which newspapers had grown and carried this story so you could see in realtime what was happening and what was coming toward you. The pandemic occurred yes. So did the virus mutate when it was present during this time period since you talked about how viruses usually mutate . So, again, im not a virology, but my understanding is whatever mutating it had done, it had already done. There are sort of some early outbreaks of flu that may have been the milder form that turned into the more lethal form. But by the time it got to boston and philadelphia, it was the lethal kind. So did that happen in that space of those months where it was going back and forth, there is still a lot of speculation because its our methods are not that good. Yeah. When it comes to them telling people to stay home and what not in the newspapers, how did they figure that would work with the military and is that why the situation got so bad, because if youre like in an army base or what not you cant just yes. So in terms of the sort of go home and go to the doctor was when it got into the civilian side. And in terms of the timing, fall of 1918, i know i have some military historians in here, what is going on in the war in the fall of 1918 . Im looking at when is the war over . The war is basically almost over. The armistice is in november. So the troops are already being brought home, being brought home in troop ships with the sickness, then put into their barracks where they get sick and then it jumps into the civilian population. They certainly try in the military, i mean military medicine really, they understood the need to isolate but it was so overwhelming that very similar to the stories we hear, they didnt have enough doctors and nurses and then the doctors and nurses they did have got sick. So it was an overwhelming of the available resources. So this is happening in boston and philly and meanwhile you see the shortages of nurses and doctors developing. This is a newspaper outside of boston, brookline, massachusetts. The headlines, even though especially in the very early months there was a lot of war news that tended to get the top this stuff is definitely keeping in there around that of, oh, here is this pandemic, there is opinion epidemic and its really looking very, very scary. In many ways this is the first mass media pandemic in modern history because there were so many newspapers now able cover these kinds of stories. So i want to get us to think for a minute about what you did if you were not in boston and philadelphia. You could see this coming. What tools could you put at your command to try to protect your people against this invading epidemic . You had time to prepare. What should you do . Well, here is where we come back to the nonpharmaceutical interventions that i talked about before. They had a very clear game plan. They knew what they should do. They needed to set up facilities so that people who were sick could be isolated and taken care of. Didnt want them to die. Try to give them the best chance to live. But in the meantime, keep them away from the well people. So you need to spot them and isolate them as soon as possible. You could put them in a special hospital or you could try the isolation at home. You can encourage or increasingly force Healthy People to limit their activities. So they stay at home as well. So you are preventing the spread by getting everyone to stay at home. You can force encourage people to stay home by closing schools, closing workplaces, closing places of entertainment, shut down the movie theaters they had those by then. Shut down broadway shows. Then people cant go out because these public spaces are are closed. And then finally you could get out there and try to give people a refresher course on the gospel of germs. Here is how you need to behave as a healthy person to minimize the spread of this potentially deadly what, of anything i just said here, is not going on on march 10th, 2020 . Anything . Yeah. Their starting to close schools and move things online. There is a lot of events that have been shutting down already. Yep. Like st. Patricks day parades are shutting down and what not. It is basically were watching all of this unfold. If you look at what wuhan did and what italy has now done is the extreme version of this. But we are starting to see in new york the beginnings of it is a spectrum of how much you encourage people to isolate themselves but were definitely headed in the right direction. I cant tell it is so weird for me to get up every morning and feel like its deja vu all over again and the yogi berra homage to yogi berra, the uncanny similarities to the research i did on not boston and not philadelphia as they were trying to figure out what to do. So basically, like i said before, the playbook now is the same playbook that they were using during the great influenza. And how well did it work . How did they go about trying to get people to cooperate with all these techniques . So here is where we get to the subject of our class. Because, in fact, i use the term propaganda here, we might want to call it public information, Public Education, doesnt sound quite so bad as propaganda. But essential part of playbook in world war i was to try to get propaganda out there to tell people what they needed to do. And the techniques that were used by Public Health experts were taken from other forms of mess enging at the time period. So im going to show you some of the messages and ask you to look at it through the eyes and the analysis of this class at looking at different forms of advertising and propaganda. Let me step back a minute and ask you to think about what you remember. In 1918, what kinds of outreach mechanisms did they have available in the United States . Think back to the rule book that we read. If you want to get the message out, how could you do it . Thoughts . Yeah. I guess a big way is newspapers. Because that is the yellow journalism time period so getting people, putting the articles about the flu is spreading, will get peoples attention and scare people. Bingo. Newspapers, definitely. There was another format that they started to use. What were you going to say, david. Same thing. Same thing. It is probably not one that would immediately come to mind but that is why were talking about it. So, yes, jordan, newspapers. And newspapers at this time, they could be really snarky about political stuff, but basically in terms of conveying epidemic information, if the Public Health Department Said please tell people x, they would tell people x. There wasnt a lot of back biting about youre not doing it right or whatever. The newspapers are really an important way for Public Health departments to get out there and say, here is the threat, you really need to do something about it. This is the newspaper from seattle. And you could see churches, schools, shops closed. The one on the right is from washington, d. C. It shows you nurses making gauze masks to protect people from the infection. So, yes, newspapers were a really important source of messaging about pandemic preparedness. The other tactic they used youre also familiar with but have never seen remember we looked at the french posters and how they were used to advertise all kinds of products. Well the Public Health people saw those posters and said, well we could make posters too. Were going to make posters about Infectious Diseases and try to help people learn how to guard against them. The big show in town in 1918 was not influenza, it was tuberculosis. Also a respiratory lung infection. Very different pattern of much more of a chronic infection, hard to spread from persontoperson. Lasted a lot longer. Killed a whole lot of people. But ironically the ways that you prevent the spread of the tuberculosis or essentially the same ways that youre going to prevent the spread of the influenza germ. Coughing, spitting, of those things that i mentioned to you. The antitb people said you need to be careful how you cough and sneeze because you dont want to get tuberculosis. They basically took that message and layered influenza. They just changed tuberculosis and put influenza in there. And basically put out the same message. So now im going to show you way, a sort of selection of influenzarelated messaging material. And were kind of going to do what weve done with some of our other ad and propaganda analyses. Im going to show you a series of text and images and where they came from and as you look, i want you to think to yourself what does this remind me of that weve already looking at, what are they borrowing from, but i also want you to think about what is the story theyre telling, what values are they drawing on to try to get people to act in a careful way about the influenza. So what is the kind of big picture of do this because fill in the blank. So im going to show you these and then im going to see what you come up with, all right. Okay. So one way to go about this was to put up these Public Notices in public places. On the left is people took trolleys back in the day in cincinnati. This was they called it a car card that told people to keep their bedroom windows open to prevent influenza, pneumonia and tuberculosis. On the right is a poster that was developed for use by the Chicago Department of health specifically to be used in theaters that told people gave them basic information about what they should do if they were not feeling well and also what they should do just to stay safe. So this kind of very textbased, here it is, here is what you need to do, very common in this time period. I was working on this over the weekend and i went into new york city and i was sitting on a relatively new subway car and what do you think was scrolling . It was covid19, do this and this and this, first in english and then in spanish. Im thinking it is like a digit car card, much for sophisticated but its the basic concept still very, very similar. Messaging at your place of work. So remember navy yards, places where military supplies were being made, had been a real breeding point. So youre going to put up signs saying please be careful because we dont well please be careful, okay. So that is the workplace. And then you had posters. Posters that look at how different were no longer just the words. Remember how we looked at old ads that were nothing but words but then they started to put pictures with them. They started to get that in Public Health, maybe if you put a picture, it was worth a thousand words. So the one on the left well theyre both by from antituberculosis societies that, again, basically theyre taking images that they already had for tuberculosis and just retrofitting them for influenza. This is from rensa lear county, new york city, where troy, new york is, telling people to be careful about spitting, coughing and sneezing. And then this one is kind of hard to tell but can you see who are these people . Can you tell by the way theyre dressed . Theyre not just a rond om group of individuals. It is not a very good reproduction. Yes. Is it military because the hats its the hat, absolutely. And i apologize it is not very good but again youve seen them in the movies, they look like a little dome hat, those are soldiers that their showing you. And then they began to experiment with cartoons. In the golden age of newspapers, cartoons became very exciting. Some of you may have heard in your other classes that yellow journalism really was a term that came from a cartoon strip that everybody became insanely wild about that was about the yellow kid and i think pulitzer had it and then hertz stole it and then pulitzer tried to steal it back. But any way cartoons. People bought newspapers because they wanted to read the cartoons. So these Public Health folks start realizing, well, if we want to get people to pay attention, maybe we should try more cartoonlike figures as well. Both of these are from the United States Public Health service in 1918. All right. Okay. So youve seen them now. Talk to me about what themes do you see in here . How is pandemic preparedness being pitched to get people to cooperate . Yeah. So, i notice on the second one at the very bottom it says spread of spanish influenza, menaces, where did it go the second one that was on that slide. This one. No, keep going. This way or back the other way. It was on one of the posters. No, it is not those. It said spanish influenza menaces on the war production. I think it was this one. No, it is another one. So bingo, you got it, it is menacing the war production. There it is. It is the last one. Yes. Its definitely being linked to being supportive of the war effort that does anybody remember the posters that we looked at from world war ii about the slacker. Do you remember that . When i was looking at this, i thought of that. Remember the guy who is in bed and has been drinking and is not going to work, that hes letting down the whole american people. Same idea here. Is you need to be careful with your coughing and sneezing as part of the war effort. What else do you notice about the intended audience here . This is something that hit me like especially in the pictures. Look at pictures. Yes. I feel like it is targeting the men. Yes. Specifically. Because it is about soldiers and what not and its also being, like, dont spread this other people so it is your actions, the actions that youre taking instead of, like, ways to not get it. It is ways to not give it. Yes. So i cant i was maybe twothirds through my research before i realized i had yet to see a drawing of a woman in any of this influenza pandemic stuff. All of the yeah. Part of that would have been because women were typically in the home . Yes. I think that is part of it. And also when you think about even today which of the two genders is thought to be more Health Conscious . Isnt it going to be a woman compared to a man. I could also tell you because i had done all of this, that a lot of the Health Education was being focused on children and by think mothers and by their teachers. So there was kind of an association of hygiene education with women and girls. And the sense was that somehow the guys just hadnt gotten the message yet. Also, i think i mentioned the spitting habit. Spitting was associated with chewing tobacco which is not something normally that women did much of. So men were seen as the source of the spitting problem rather than women. So clearly targeting them. I think those are all good explanations, that the men are more likely to be out and about, going to the navy yard, whereas as the women are back at home. But there is also a suspicious that, you know, macho whatever, that they may not be as tuned into the finer points of not spitting or coughing on people than might be their grandma or their mom. Okay. Good. But you could see how much they were drawing from other forms of advertising and propaganda from this same time period to get their message across. So, you know, compared to at least to previous pandemics, this effort was pretty sophisticated and they really got this message out to a lot of different places very quickly. It is not easy to do. And remember they had to print all of this stuff up. They couldnt just go and post it on the internet. That said, its one thing to get the information out there, its another thing to get people to act on it. So i want to talk now a little bit about resistance. Remember when we talked about the wu book, we talk about the resistance that people develop to these messages, the attention merchants are trying to get you to do x, y and z and you hear it so much and you just turn off or listen and think i cant do that or i dont want to do that. Very similar to these messages that these ideas that were putting out there were difficult to implement. Then as now. And here is where you really, woops, see some of the similarities to what is happening to us today. Lets say they come to you tomorrow and say, we have to shut down stonybrook. We have to shut down all of the Public Schools in suffolk county, we have to stop people from going to into wall street to run the stock exchange. How are people going to respond . Businesses dont want to close. They realize the economic harm that is going to be done through closures. Workers dont want to stay home. Why . Because they dont get paid. There is no sick pay in this time period. There is not sick pay. If i could tell you the number of conversations ive heard from people here talking about what are we going to do if we have to stay home and we dont get paid. These were many of the people that lived from paycheck to paycheck, being told you couldnt go to work, you might get influenza but you might starve if you werent going to work and getting the money. This one just keeps coming back to me because i read all of these accounts of why it was a bad idea to close down Public Schools. And the argument was a lot of the parents of these kids work. So the kid is going to be either left alone or more likely theyre going to start running around the streets of new york, in this case, and theyre much more likely to get the influenza running around than if we stick them in school and keep an eye on who is sneezing and also make them practice social distancing. So there was strong pushback even in the face of the w curve of people saying we cant do this. We dont want to do this. We dont think its a good idea. We cant get with the program. I dont care how many car cards or posters you put up, this is not making sense. And one of the arguments you see from basically i would say the Public Health experts, they kind of span the spectrum of some saying, i dont care. I want to you stay home and, you know, i dont care. You got to do it. And then other Public Health experts said i get your point. And some of them are saying the economic disruption from forcing everybody to stay home is a Public Health problem. So maybe we need to take a more moderate approach. And the other thing they talk about is morale. If you scare people and they have to stay home and they cant go to baseball games or the theater, their morale goes down and even though they didnt understand the psychological part of the immune system, they definitely had a sense that if people were pressed they might be more likely to catch something. So there were some strong voices, including in the Public Health community saying, uhhuh, we dont want to do the extreme of shut down everything. We want to do something more moderate. And a case in point is our own new york city. This is a really interesting story. You would think new york is boston, philly, new york, it is coming at you. That new york would have taken a very hardline and closed down. No. And a lot of this depends on who is in charge at the moment. The commissioner of health then was a guyed Royal Copeland and he basically listened to all of these arguments and decided to take the more moderate route. So what he said was, im not going to close schools. What im going to do is in stead ask everyone to stagger their opening and closing times in the theory here is that everybody wouldnt be on the subway or the trolley car at the same time. He decided, no, were not going to shut down broadway and the movie theaters, because that would make new yorkers too depressed. And we are go tock keep kids in school and keep an eye on them. He was the one who said i dont want hundreds of thousands of Public School kids running amok in the streets of new york city. Talk about a Public Health crisis. So he really kind of took this more moderate view of, yes, making accommodations but not going toward the total isolation. And one of the to me one of the really interesting things about what ends up happening is that one of the deals that they made and one of the fun things i did in my Research Project was i read variety, have you ever heard of it. It is a professional entertainment newspaper and it was very big even then. I sat and i read variety from the beginning of the influenza to the end of what the theater owners were saying about the epidemic. And basically the deal they struck with copeland is they would stay hope but they all did kind of mandatory Public Health education. So you would come to the movie and some im showing you this again. This was a poster designed for a theater. You would sit there, it would be like at the beginning, when they show you all of the ads now, instead they would give you, okay, here is the influenza, be careful when you sneeze, et cetera. They would turn it into a little mini Public Health lesson and then you got to see your movie or play or whatever it is. So there is a lot of messaging that gets out there that i think a lot of it was intended to just calm people down and say, yes, we are doing something. Were teaching you to be careful with your sneezes. Were not just sitting back and doing nothing but also letting people go about their daily lives if not entirely normal, quasi normal. Now, one of the most symbols of the influenza was the wearing of the gauze mask. I had many more pictures in here but i took them out for purposes of time. You could find everybody and their uncle wearing a gauze mask in this time period. Hi one with a baseball player that ill show sam when hes back in class. Lots of gauze masks as kind of a symbol im being very careful and you see them today around campus, people Wearing Masks as a way to show im trying to protect you and protect me. But, in fact, when i looked at the sort of big picture, to me what was more striking about what people were being told to do, and especially the men, was not to use the mask, but to use a handkerchief, a cloth handkerchief. As it turned out face masks were hard to wear. The ones they had were hot and sticky. All of the pictures, there is one famous one, i think san francisco, of some march where they have the Public Health commissioner and he had taken his off and dangling on his ear from his ear because have you ever worn a mask like when you do work around the house . I hate them. My glasses steam up. Theyre nasty. People didnt like wearing them. So a substitute was to tell you to use a handkerchief. For a certain generation of american men and i dont know if european men some of you who may have grandpas who grew up in a different country, for my generation you knew an older american because the man always had a handkerchief. And i see that as a kind of remnant of this to be a good patriot youve got to have your hanky and cover your nose. This is just a little cartoon from a magazine where the little boy is so excited because hes gotten a handkerchief for his birthday. I think that is probably overstated how excited the kid was to get the hanky. To stop the spread of germs when you blow your nose, whatever, youve now just touched that and whatever you touch i think it is more good for in terms of real infection control, no. But in terms of me making you more aware of protecting other people, did it do absolutely no good at all . Maybe it did some good. But again those masks were very porous so they were likely not keeping the influenza the other big winners i could see, and this is where i disagree with crosby said the flu had no impact on the way americans lived. Ocontrair. The rise of kleenex, as we know them, big thing in the 1920s. It was originally introduced for women to take makeup off but they found people were using it to blow their noses so they decided, okay, were going to market it as a paper handkerchief. So if you didnt have the linen one and then use it once and get rid of it which seems more cleanly. David. Ive seen the picture of the police, were they used to enforce any form of maintaining Public Health . Yes. So, the laws had been on the books since the 1890s that in many cities that you couldnt spit in public. But they were never enforced. During the influenza pandemic they do start enforcing the antispitting laws. That particular picture, i think, here there were a lot of staged ones where basically he took a picture of them all wearing their masks, five minutes later i think all of the masks probably came off as they went about their business because they were just too hard to to use. But people did not saying nobody wore them. In fact it became a symbol of being a sophisticated person as you would wear the mask but i think for the majority of american men, the hanky was a much more viable, easy to get. You could launder it. That is the thing. You were supposed to have enough of them that then you would wash them. So you could use them the next time. All right. So, did any of this work . Well, you may be surprised to find out that when historians have gone back and tried to correlate the social distancing measures with the death rates in american cities, that they found that cities that opted either for the moderate or total close down did seem able to control their death rates. So these techniques i mean you cant 100 show it but correlation, remember we talked about the importance of correlation, cities that implemented, for example, even the stuff that Royal Copeland did in new york city, new york city people did indeed die. And we were hearing stories from our guests here today about people in their families that did die. But compared to philly and boston, the death rates were they were able to pull it down to mitigate, if not to contain the spread of the of the influenza. You will not find a historian who has looked at the gauze mask who will say that really helped. Because too porous, people didnt wear them. But, again, i think that use was more symbolic than it was it made people feel better. After reading about all of this stuff, i think making people feel safe is not a bad thing to do. Especially if its wearing a gauze mask or mask makes you feel better, wear the mask. As long as you dont take it away from a nurse or a doctor who needs it. If you could not take away a scare resource. But if it makes you feel safer, if it helps ratchet down your anxiety i was just reading something that indicated stress makes you more vulnerable to infection. Yeah. That trying to come up with antistress measures is an important goal. So even if they arent 100 scientifically proven, theyre not hurting anyone. Why not . Why not do it. Okay. I asked you all to think about some questions about what you think is going on now. Can we do a little compare and contrast of what similarities you see between now and also what differences as history majors, we look at change over time. Anybody feel like making a comment . Let me reframe that to a more answerable question. What do you see as the challenges that were facing right now . From what youre hearing, what do you see as where we may be having trouble . I think the economic implications of a total shutdown of a college or even if you look at italy and an entire shutdown and everyone has to stay at home and things. When it comes to businesses, the stock market is plummeting, economically i dont know how this doesnt put us into a recession because of this or Something Like that. Yeah. I completely agree. The degree of interdependence and globalization. It was a Global Pandemic in but it was with ships and trains. And when i said it came at you, it came at you a lot slower. Now it is on a plane and it could be here in 12 hours. So the pace is clearly much speeded up. The economic consequences are probably worse now. I mean, one of the things there, in fact the American History people know, that 1919 there was a tremendous economic meltdown. How much of that was the fault of flu and how much of it was the fault of war, its probably more the war than the flu. But it was it was really bad. So economic disruption i think is it does seem more extreme this time around. Yeah. Everything is to interconnected globally, where like even if this did start in asia or hitting europe more than here, maybe, because of how we all are so interconnected with the economy, with the stock market, things like that, there is no way it doesnt impact the entire world. Yep. And i think we now understand that in a way that at this time period they knew about the bubonic plague had been bad and messed up europes economy. But that was a long time ago. This kind of the recentsy of it. And what would you say about the media piece of it . Tommy, yeah. The media has theyve gone out of control with it. I feel like back then they didnt have much media spreading it like every second of the day. So, remember, we had that conversation about looking in the wu book and about the third screen and how its set up as kind of competitive, the competition is so extreme and it is like someone sneezes in South Hamilton and we hear about it in new york city. I think the degree of so that 1918, that was a more mediated epidemic than before. But compared to now, 24 7 and also the social media. We could get on there and post on instagram or whatever about and, in fact, people are doing that. I just saw one from one of the sunni people that got sent to binghamton from the study abroad and posted a little video about it. They couldnt do that back then. So much more opportunity to get a lot of different messages out there that arent necessarily going to agree. I think its also so important that, like, messages from people in an authoritative position get out quickly, messages. Because you have our situation where there are so many rumors on social media no one knows what the truth is and were not hearing anything from the administrative level so more rumors are going to keep happening because social media is so instantaneous. Yes. And believe me it is not that their not trying but the complexity of getting messages signed off at multiple levels. And speaking in one voice, that is not something that is happening. Youre getting different experts saying different things. I just keep track of sometimes they say it is not as bad, sometimes they say its mutating. There is a lot of confusion and mixed messaging. Who are you supposed to it become politicized unfortunately. So used as an opportunity across the world for different groups who dont like each other to bash each other. So not its a challenge. So well try to get on the same playbook. Dont worry about what is going to happen, were going to be fine. Were going to well know more about thursday. All right. Thank you very much. You were really good. [ applause ] even with the boom. Youre watching American History tv reel america series with a focus on Health Issues beginning with md international, a film that highlights american doctors working in Health Clinics and hospitals abroad. Later a film about the roles and responsibilities on the u. S. Public health service. And after that a film that gives an overview of systematic efforts during world war ii to both heal soldiers and prevent, detect and control epidemics. Youre watching American History tv on cspan 3. Next, on reel america, we travel around the globe to medical clinics and hospitals for a look sat md international. This 1958 American Medical Association march of Medicine Program highlights american doctors working abroad and includes an introduction by Vice President nixon. In remote locations ranging from burma to ethiopia we see physicians treating locals for ailments such as tuberculosis, leprosy and eye disease. Ladies and gentlemen, the Vice President of the United States richard m. Nixon. How do you do. In a few moments youll see a march of Medicine Program entitled md international. Im pleased with this opportunity to introduce it because i believe wholeheartedly in what it has to say. President eisenhower and his state of the Union Message on january 9th stated, the only answer to a regime that wages tota c