PART 1
Daniel Horowitz · July 31, 2020
“Let us all keep a cool head about Asian influenza as the statistics on the spread and the virulence of the disease begin to accumulate.” ~New York Times editorial, Sept. 17, 1957
“So, what was it like to live through the Asian flu of 1957?” I recently asked my father.
“What’s the Asian flu?” replied my father, who was in second grade at the time.
“Well, do you remember the Hong Kong flu of 1968?” I followed up, thinking that surely he’d remember something that killed around 100,000 people (the equivalent of 160,000 today) when he was in college and very news-savvy.
“I remember the riots in ’68 and the oil crisis in the ’70s, but don’t recall anything about flus.”
Try this social experiment on anyone who lived through the 1950s and 1960s, or try it on yourself if you are a Baby Boomer or older. You likely don’t recall any disruption in your life nor any trauma-induced fear and panic. That is because there wasn’t any disruption.
The 1957 Asian flu, a form of H2N2 influenza that is believed to have originated in China, is estimated to have killed 116,000 Americans, the equivalent of roughly 200,000 in today’s larger America. Given that an estimated 25 percent of the entire country contracted that flu and a much larger share suffered from strong symptoms, one has to wonder what the recorded death toll would have been had we tested everyone and counted those deaths as liberally as we do today.
For even greater context, keep in mind that there were only about 4.9 million people over the age of 75 back then, as compared to 23 million today. So, while the general population was slightly more than half of what it is today, the over-75 population was approximately one-fifth of what it is today. The over-90 population was 1/12 of today’s advanced senior population. Accordingly, the death toll in 1957 was even more severe than with COVID-19 when one considers how many more seniors we have today. After all, the median age of death from COVID-19 is 78, roughly around life expectancy, with roughly half of all deaths occurring among sicker seniors in nursing homes.
Another more dangerous aspect of the Asian flu as compared to COVID-19 is that it seemed to be more dangerous to pregnant women and to cause birth defects, similar to what was observed during the Spanish flu. A study published in Minnesota in 1959 found that nearly 20% of deaths that occurred during pregnancy were due to the 1957-58 epidemic, making it the leading cause of death for pregnant women during those months. One-half of all women of child-bearing age who died during the epidemic were pregnant. Imagine the panic that would have induced today!
It’s not that our government wasn’t concerned at all about the Asian flu. After the virus raged on through the summer of 1957, a vaccine was produced, and by September 11, 1.8 million doses were delivered to the military and 3.6 million to the general population. The vaccine, like all flu vaccines, was partially successful, but people continued to die for several more months and, on a smaller scale, for years to come until the Asian flu mutated into the H3N2 Hong Kong flu in 1968. The government and the people understood that medical care and vaccines work, but there was never a thought to shut down people’s lives, and nobody ever thought that humans could stop the spread of the actual virus. Hence, few remember living through it.
During the onset of the H1N1 pandemic (swine flu) in 2009, D.A. Henderson, the former dean of Johns Hopkins School of Public Health, who is widely credited with helping to eradicate smallpox, co-authored an analysis of the public response to the 1957 flu in an attempt to draw parallels and glean some lessons in preparing a response to the swine flu. He noted that the 1957 epidemic began early in the year in Asia, particularly targeting those with pre-existing conditions for the most deadly cases, and eventually infected 25 percent of the U.S. population in the fall.
The virus seemed to spread widely, but much as with COVID-19, the attack rate on naval ships was 18%-45%, implying some people had some degree of inherent immunity, as indicated by the fact that “family members of patients returning from infected camps or conference centers seldom were infected despite their close contact with the cases.” Thus, much as with COVID-19, it seemed to be very contagious but also inexplicably hit a brick wall with some people. He also observed, “Serological surveys revealed that half of those reporting no influenza illness showed serological evidence of infection.” That sounds very similar to our asymptomatic phenomenon, although it seems that many more young adults and children suffered acute flu-like symptoms with the Asian flu than they do with this virus.
As the summer wore on, policymakers, many of whom had lived through the Spanish flu as children, understood the need to focus on vaccines and medical care. With a greater capacity to develop vaccines and with the advent of antibiotics, they realized that the proper targeted treatment to the vulnerable was key to mitigating deaths, because for most people, this was just like a seasonal flu. In a gathering of public health officials in Washington in late August, the Association of State and Territorial Health Officers (ASTHO) resolved to focus on “prevention, which in the absence of effective means to stop the spread of infection[,] resolves itself into an immunization program.”
Also, rather than panicking everyone and counting every last case in the country, they “recommended that ‘hospital admissions be limited as far as possible to those cases of influenza with complications, or to those with other diseases which might be aggravated by influenza.’”
Health officials understood what our leaders today clearly don’t, which is that for a virus that targets only certain people with serious complications or death and is broadly mild (and today, downright asymptomatic) in most others, the worst thing you can do is treat every case like a serious case, needlessly stressing medical care, and risk spreading the virus in hospitals to vulnerable people who are already there, often for other ailments and chronic conditions. It was all about treatment where it was needed and developing a vaccine for the vulnerable.
What about the ability to arrest the virus through superstitious Middle Ages rituals like virtue-signaling mask-wearing and social isolation of the healthy with the sick?
As Henderson et al. observed: “At the meeting, ASTHO also stated that ‘there is no practical advantage in the closing of schools or the curtailment of public gatherings as it relates to the spread of this disease [emphasis added].’ This was in recognition that they saw no practical means for limiting the spread of infection.”
Daniel Horowitz · July 31, 2020
“Let us all keep a cool head about Asian influenza as the statistics on the spread and the virulence of the disease begin to accumulate.” ~New York Times editorial, Sept. 17, 1957
“So, what was it like to live through the Asian flu of 1957?” I recently asked my father.
“What’s the Asian flu?” replied my father, who was in second grade at the time.
“Well, do you remember the Hong Kong flu of 1968?” I followed up, thinking that surely he’d remember something that killed around 100,000 people (the equivalent of 160,000 today) when he was in college and very news-savvy.
“I remember the riots in ’68 and the oil crisis in the ’70s, but don’t recall anything about flus.”
Try this social experiment on anyone who lived through the 1950s and 1960s, or try it on yourself if you are a Baby Boomer or older. You likely don’t recall any disruption in your life nor any trauma-induced fear and panic. That is because there wasn’t any disruption.
The 1957 Asian flu, a form of H2N2 influenza that is believed to have originated in China, is estimated to have killed 116,000 Americans, the equivalent of roughly 200,000 in today’s larger America. Given that an estimated 25 percent of the entire country contracted that flu and a much larger share suffered from strong symptoms, one has to wonder what the recorded death toll would have been had we tested everyone and counted those deaths as liberally as we do today.
For even greater context, keep in mind that there were only about 4.9 million people over the age of 75 back then, as compared to 23 million today. So, while the general population was slightly more than half of what it is today, the over-75 population was approximately one-fifth of what it is today. The over-90 population was 1/12 of today’s advanced senior population. Accordingly, the death toll in 1957 was even more severe than with COVID-19 when one considers how many more seniors we have today. After all, the median age of death from COVID-19 is 78, roughly around life expectancy, with roughly half of all deaths occurring among sicker seniors in nursing homes.
Another more dangerous aspect of the Asian flu as compared to COVID-19 is that it seemed to be more dangerous to pregnant women and to cause birth defects, similar to what was observed during the Spanish flu. A study published in Minnesota in 1959 found that nearly 20% of deaths that occurred during pregnancy were due to the 1957-58 epidemic, making it the leading cause of death for pregnant women during those months. One-half of all women of child-bearing age who died during the epidemic were pregnant. Imagine the panic that would have induced today!
It’s not that our government wasn’t concerned at all about the Asian flu. After the virus raged on through the summer of 1957, a vaccine was produced, and by September 11, 1.8 million doses were delivered to the military and 3.6 million to the general population. The vaccine, like all flu vaccines, was partially successful, but people continued to die for several more months and, on a smaller scale, for years to come until the Asian flu mutated into the H3N2 Hong Kong flu in 1968. The government and the people understood that medical care and vaccines work, but there was never a thought to shut down people’s lives, and nobody ever thought that humans could stop the spread of the actual virus. Hence, few remember living through it.
During the onset of the H1N1 pandemic (swine flu) in 2009, D.A. Henderson, the former dean of Johns Hopkins School of Public Health, who is widely credited with helping to eradicate smallpox, co-authored an analysis of the public response to the 1957 flu in an attempt to draw parallels and glean some lessons in preparing a response to the swine flu. He noted that the 1957 epidemic began early in the year in Asia, particularly targeting those with pre-existing conditions for the most deadly cases, and eventually infected 25 percent of the U.S. population in the fall.
The virus seemed to spread widely, but much as with COVID-19, the attack rate on naval ships was 18%-45%, implying some people had some degree of inherent immunity, as indicated by the fact that “family members of patients returning from infected camps or conference centers seldom were infected despite their close contact with the cases.” Thus, much as with COVID-19, it seemed to be very contagious but also inexplicably hit a brick wall with some people. He also observed, “Serological surveys revealed that half of those reporting no influenza illness showed serological evidence of infection.” That sounds very similar to our asymptomatic phenomenon, although it seems that many more young adults and children suffered acute flu-like symptoms with the Asian flu than they do with this virus.
As the summer wore on, policymakers, many of whom had lived through the Spanish flu as children, understood the need to focus on vaccines and medical care. With a greater capacity to develop vaccines and with the advent of antibiotics, they realized that the proper targeted treatment to the vulnerable was key to mitigating deaths, because for most people, this was just like a seasonal flu. In a gathering of public health officials in Washington in late August, the Association of State and Territorial Health Officers (ASTHO) resolved to focus on “prevention, which in the absence of effective means to stop the spread of infection[,] resolves itself into an immunization program.”
Also, rather than panicking everyone and counting every last case in the country, they “recommended that ‘hospital admissions be limited as far as possible to those cases of influenza with complications, or to those with other diseases which might be aggravated by influenza.’”
Health officials understood what our leaders today clearly don’t, which is that for a virus that targets only certain people with serious complications or death and is broadly mild (and today, downright asymptomatic) in most others, the worst thing you can do is treat every case like a serious case, needlessly stressing medical care, and risk spreading the virus in hospitals to vulnerable people who are already there, often for other ailments and chronic conditions. It was all about treatment where it was needed and developing a vaccine for the vulnerable.
What about the ability to arrest the virus through superstitious Middle Ages rituals like virtue-signaling mask-wearing and social isolation of the healthy with the sick?
As Henderson et al. observed: “At the meeting, ASTHO also stated that ‘there is no practical advantage in the closing of schools or the curtailment of public gatherings as it relates to the spread of this disease [emphasis added].’ This was in recognition that they saw no practical means for limiting the spread of infection.”