Still, those in favor of remaining open were overruled on the city level. Schools closed, and streetcars reduced their passengers by 40% and required a specific number of open windows — an unpopular mandate given that this all transpired in the winter of 1918.
After ten days of closures, the cases declined from 218 the day of the shutdown to 24 new cases, the day officials forced the city to re-open. The public protested new regulations and changes imposed, many of which burdened daily life.
Bars and nightclubs created secret back entries for patrons to avoid detection. Open defiance happened commonly, requiring enforcement.
Police dispersed crowds and sporting events that ignored that ban on large gatherings, further upsetting citizens. Our complaints are remarkably consistent across time.
Some venues stayed open for the public that wanted things to remain open. Quickly, they realized that people stay home until a location controlled the threat. It meant their economy also depended on successful mitigation.
A historical review found precisely what this suggests. Cities that controlled the spread had a better economy long term and lost far fewer people. How an area responded affected them for decades.
Most American cities learned about the critical need to protect health care workers and the problem of mask shortages. Healthcare workers’ deaths mean more deaths down the road from all causes because no one can care for the sick. In the 2015 Ebola outbreak, healthcare workers died at a rate 11 to 32 times higher than that of the public.
A 2007 study, the Lessons Learned from the 1918–1919 influenza pandemic in Minneapolis and St. Paul, Minnesota (Ott et al., 2007), found: “prior planning, clear order, as well as consistent and transparent advice and information to the public may have made a significant difference in the number of cases and deaths due to influenza.”
“I personally prefer to take my chances.” That was the response of one state health official on masks. Here one official had sown doubt about the need for masks.
At the same time, the Surgeon General was trying to secure medical students as replacements for the thinning health care worker population, which would dwindle faster thanks to the doubt cast by public debate.
We can reasonably pardon leaders of the past, long before the time of evidence-based practice and policy. All relevant commenters should share their reasoning, and all must reach a consensus, even if everyone does not feel satisfied.
It is their job to do this, not an optional nicety. That will take maturity, something far more scarce than imagined, visible even in recent modern political discourse. In a crisis, the public deserves leaders who take action that bolsters them like a rock foundation, not a detritus-filled pit of quicksand.
In 1918, people swayed toward masks on their own, but it easily might have gone the other way. Hence, people sought masks despite the lack of mandate and contrarian opinion, and not because of it.
Political consensus could have eased so much stress, confusion, and fear that gripped people. In fairness, politicians of the past did not know that uncertainty and mixed messages hurt the public worse than the actual bad news. Even so, other failings garner less excuse.
The federal government left the national supply chain unmanaged and did not consider how many masks the public might wear. Doctors and nurses died as a result.
The US devolved into a place of sheer terror-filled people who had no idea what to believe and a President who failed to acknowledge the problem with clear, concise, honest commentary.
Locations like military training camps supplied the ideal breeding ground where the virus could easily travel from person to person. The military canceled the draft in September 1918 because sick soldiers filled the camps, and they could not take or place anyone.
Still, denial reigned supreme. The President failed to see the country’s need for a visible, strong leader. High-ranking officials, like the Surgeon General and Public Health Director of Chicago, continued to reassure Americans that all was well. People dug mass graves while officials assured them all was well.
Chicago saw mortality reach 40% at one hospital. Simultaneously, the city’s public health commissioner dismissed concerns, saying, “Worry kills more people than the epidemic.”