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
The novel coronavirus, technically designated SARS-CoV-2, causes COVID-19 and has tragically been gobbling up global headlines with staggering numbers of new cases and deaths each day. The world is at a standstill with Asia, Europe, and nearly every U.S. state under stay-at-home orders and travel restrictions. Anxiety is spiking as jobs are lost and feelings of isolation set in. Among the headlines are glimmers of hope, indications that regions have passed the peak in new cases or reassurances that social distancing is helping to “flatten the curve.”
Typically, expert commentators have been comparing COVID-19 to Ebola, SARS, or MERS outbreaks, as well as the Spanish Flu from over a century ago. Few are few alive today who lived during the 1918-1919 Spanish Flu pandemic.
There was, however, a more recent global epidemic that struck fear across the world, seemed unstoppable in its ability to strike anyone down. During the 1930s, 40s and 50s Americans feared poliomyelitis with the same kind of deep, visceral anxiety that they fear COVID-19. Like COVID-19, poliomyelitis seemed to strike down children, mostly, but also adults (Franklin D. Roosevelt) seemingly at random. Like COVID-19, polio was relentless, unmerciful and the only solution, aside from isolation, was a desperate race for a vaccine.
Polio
Poliomyelitis is the disease caused by the three strains of the poliovirus and can cause paralysis in severe cases. Approximately 24% of infections cause symptoms of poliomyelitis, and 1% of infections result in acute flaccid paralysis. Few treatments existed to relieve the symptoms of poliomyelitis, such as bed rest, and pain management. The poliovirus attacked the nervous system, and in the worst cases the virus affected the brainstem resulting in paralysis of the muscles in the chest, such as the diaphragm, prevented children from breathing on their own. The inability to breathe independently resulted in the death of 5-10% of paralytic patients.
Physical therapy was important to prevent deformities due to muscle loss in less severe cases. The device most closely associated with the severe effects of polio was the tank respirator, also known as the iron lung. The iron lung, in the 1930s, cost as much as $1,500 (nearly $24,000 today) and was equivalent to the cost of a home at the time. Due to the size and cost of the units, the early mechanical ventilators were often in short supply. During the peak of the epidemic hospitals increased their supply of iron lungs, removed walls, and installed wards full of iron lungs to support the afflicted children.
Paralytic poliomyelitis virus peaked at over 21,000 cases in 1952. Poliovirus typically infects young children, as adults in the 1950s were likely to have been exposed as children. We now know that changing hygienic standards were a contributing factor in the surge of poliomyelitis cases. Children who were exposed to less hygienic environments were observed to have a lower incidence of poliomyelitis during the epidemic.
Social Distancing in the 1950s
Not having a cure or preventative for polio and not really the source of the virus or understanding how it moved through the population, led Americans to practice social distancing; swimming pools, theaters, churches, and schools were closed in attempt to stymie spread of the disease.
