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What happened in the 1918 pandemic when students went to school

2020-08-19T23:04:25.572Z


This is not the first time there has been a debate about opening schools in the midst of a pandemic. In 1918, the discussion was just as heated.


To open schools or not? The 1918 Example 1:18

(CNN) –– This is not the first time leaders have faced the decision to keep schools open amid a pandemic.

During the Spanish flu pandemic in 1918, although the world was a very different place, the discussion was equally heated.

That pandemic claimed the lives of approximately 50 million people worldwide, including 675,000 Americans, before it ended.

Although the vast majority of cities closed their schools, three chose to keep them open: New York, Chicago and New Haven, according to historians.

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The decisions of health officials in these places were based largely on the assumption of public health authorities that students were safer and in better condition within schools. After all, it was the heyday of the progressive era, with its emphasis on school hygiene and more nurses per student than is now possible to imagine.

New York had nearly 1 million school-age children by 1918, and about 75% of them resided in rental housing, in overcrowded, often unsanitary conditions, according to a 2010 article in Public Health Reports , the official journal of the Director of Health of the United States and of the Service of Public Health.

Don Hoover and Joe Sistrunk of Starke, Florida, ready to go to school during the 1918 flu pandemic.

"For students in the rental housing districts, the school provided a clean and well-ventilated environment, where teachers, nurses and doctors already performed - and documented - routine and comprehensive medical inspections," according to the Public Health article. Reports .

The city was one of the first and hardest hit by the flu, said Dr. Howard Markel, a medical historian and director of the University of Michigan Center for the History of Medicine. Markel was a co-author of the 2010 article in Public Health Reports .

584 million children do not have drinking water in schools 2:02

"(Children) leave their often unhealthy homes for (going to) large, clean and ventilated school buildings, where an inspection and examination system is always in place," the New York health commissioner told him at the time. Dr. Royal S. Copeland, to The New York Times after the pandemic reached its peak there.

Students were not allowed to gather outside of school and were required to report to their teachers immediately, according to Copeland. Teachers screened students for signs of the flu, and students with symptoms were isolated.

If any student had a fever, someone from the health department would drive them home and the official had to determine if conditions were suitable for "isolation and care," according to Public Health Reports . If not, the students were transferred to a hospital.

Influenza patients in Lawrence, Massachusetts, in 1918.

"The health department required that families of children recovering at home have a primary care physician or use the services of a public health physician free of charge," the Public Health Report article explained .

The argument in Chicago for schools to be open to their 500,000 students was the same: Keeping schools running would keep children off the streets and away from infected adults, according to the argument.

If social distancing was helpful at the time, it was easier because school absenteeism soared during the pandemic, perhaps because of what a Chicago public health official called a "flu phobia" among parents.

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"The absenteeism rate was so high that it really didn't matter" that the schools were open, Markel said.

Part of Chicago's strategy was to ensure fresh air circulation. School classrooms overheated during winter so windows could remain open at all times, according to a 1918 document from the Chicago Department of Health.

This document concluded that an analysis of data showed that "the decision to keep schools open in this city during the recent influenza epidemic was justified."

Fifth graders knit for a Youth Red Cross project in Plainfield, NJ, in 1917 or 1918.

And in New York, then-Health Commissioner Copeland told The New York Times , "How much better it has been to have children under constant observation by qualified people than to close schools."

Markel, who with other researchers pored over historical data and records when analyzing the response of 43 cities to the 1918 pandemic, is not so convinced.

New York "didn't do the worst, but it didn't do the best," Markel noted, adding that Chicago was a bit superior.

Teacher prioritizes health before back to school 1:09

The investigation revealed that cities that implemented quarantine and isolation, school closings and a ban on public gatherings performed the best, he said.

"Cities that implemented more than one" of these measures "performed better. School closings were part of that contribution, ”said Markel.

Public health experts, including Markel, point out that covid-19 is not the same as influenza, a well-known disease in 1918. There is still much to learn about the new coronavirus and the disease it causes.

The right decision now, Markel said, is to close schools.

"It is better," he maintained, "to prevent than to cure."

Covid-19 Schools Influenza Pandemic Reopening of schools

Source: cnnespanol

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