Remember Polio? This COVID-19 Pandemic Is Surprisingly Similar | Orthopedics This Week - Part 3

Remember Polio? This COVID-19 Pandemic Is Surprisingly Similar

(L to R): Gymnasium converted to iron lung ward in Los Amigos Hospital and Vanderbilt University Hospital Parking Garage Converted for COVID-19 response / Source: Smithsonian National Museum of American History and American Institute of Architects

Albert Sabin’s Solution

While Salk was first, Albert Sabin’s approach would ultimately become the dominant form of polio vaccine. In contrast to Salk, Sabin produced an attenuated virus vaccine using a mutated, avirulent strain of polio virus. This vaccine was taken orally and delivered protection from the virus for much longer than the injected Salk vaccine, and had less risk of causing polio.

The Amazing Parallels Between the Polio Virus and the Corona Virus

Orthopedics This Week was able to speak with Dr. Paul Anderson, a spine surgeon at the University of Wisconsin Department of Orthopedics and Rehabilitation. Dr. Anderson developed a personal interest in polio after attending a congress of the Brazil Orthopedics Society where he learned of Brazil’s history with the disease and Albert Sabin’s work in the South American country. Dr. Anderson pointed out that modern orthopedics stems largely from work done to help children afflicted by polio. In fact, the word “orthopedics” translates to “straight child.” According to Dr. Anderson there are “lots of parallels about what we’re going through now [with the coronavirus] as with polio when it was active. People did a lot of the same things as now. The polio vaccine was multivalent, it is as yet unclear how a coronavirus vaccine will play out.”

While the poliovirus and coronavirus, and poliomyelitis and COVID-19, are very different symptomatically it is apparent that there are many parallels between the current pandemic and the polio epidemic of the 1930s-1950s. Thankfully, some aspects of the epidemics are different, such as the beneficial impact of social distancing, the rapid development of vaccine candidates, and the relative low-cost and mobility of modern ventilators.

However, it is clear that many concerns are still shared between the two diseases such as the uncertainty of symptom severity, an early a lack of understanding of how the virus affects individuals, and a shortage of critical equipment such as personal protective equipment (PPE), ICU hospital beds, and especially mechanical ventilators.

Gymnasiums were converted to house iron lung wards to care for the surge in polio cases, similarly gyms and parking garages have been converted to take overflow patients due to expected COVID-19 cases. The lasting effects of COVID-19 are not well understood either, but permanent lung damage is possible, much like the permanent deformity or paralysis left by poliomyelitis.

The Race to Develop the COVID-19 Vaccine

Due to technological advancements of the last decade vaccine candidates for coronavirus were developed in a matter of hours and days based on sequencing of the viral genome. Despite the rapid identification of potential vaccines, increases in regulation surrounding vaccine development and testing are likely to slow and extend the completion of clinical trials compared to the poliovirus vaccine.

The increased prevalence of coronavirus infection will allow for more robust statistical measurements with smaller populations, and hopefully less time to determine the efficacy. Additionally, positive results, recently announced for antiviral candidates suggest improved outlooks for those most sickened is another positive difference in the response. Such medication was not available for polio, so little could be done but let the virus run its course.

We Have Been Here Before

Hopefully, the coronavirus pandemic will be short-lived and a successful antiviral will soon be approved to reduce symptoms and save lives. Much as it did in the 1950s, a vaccine developed to stop COVID-19 will allow everyone to breathe a sigh of relief and return to more normal activities.

Similar to the polio epidemic, it is likely that everyone alive today will be affected or know someone affected by the disease. We have been here before. And we have prevailed by doing our part and we will do so again, whether it be developing a new drug or vaccine, sewing masks for healthcare workers, or reducing the spread of the disease by staying at home.


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