What will be the outcome as COVID-19 continues? Can we look at past viral epidemics in the country to clarify where we are now and what to expect?
My worse fears had become a reality when I was afflicted with the poliovirus at age 9 in 1952, a peak year during the polio epidemic.
The polio epidemics that peaked in the early 1950s, though an entirely different virus, can help us learn from that traumatic national crisis and give some insight into what may be the course of COVID-19. I experienced the polio viral epidemic when I was a child. To me, it was the scariest thing ever. When I did get sick with the poliovirus, it was like the horror of being pulled into a catastrophe beyond my control.
The great fear of this devastating disease was that it crippled thousands of prior active and healthy children and could cause respiratory distress leading to dependence on a respirator for several months or indefinitely for some. In the period of the polio epidemics, the iron lung was in use, an earlier form of the now more advanced respirators. This disease had no cure and no identified causes, plus its more severe forms had a high death rate.
In contrast to the survivors of other viruses and tuberculosis, the polio victims who developed paralysis were often left with a lifetime of disability. The thought of being paralyzed or worse, was terrifying, with images everywhere of crippled children in braces or of people on iron lung respirators. There are more than 200,000 people in the U.S that remain paralyzed and disabled from poliovirus. New occurrences were eradicated in this country when the vaccine developed by Salk and Sabin in the 1950s became widely available. Polio survivors continue to be one of the largest disabled groups in today's world, according to the World Health Organization.
In the early 1950s, like COVID-19, public places were closed, people lived in fear, and isolated from each other.
People lived in the constant threat of catching the disease. Other diseases of the time as influenza had much higher mortality rates but didn’t cause the lasting paralysis that polio could. At the time, it was not known how to control the spread of polio, which peaked in the summer months. It also eluded the scientists as to how it spread. One theory was that it was acquired from fecally contaminated water. Swimming pools were often closed in the summers.
The polio epidemic was widely covered by the media of the time. Sizeable national foundations developed as the National Foundation for Infantile Paralysis and March of Dimes. The organizations became important in raising funds for helping to pay for the expensive treatments and equipment needed for rehabilitation and care of polio victims. These organizations, as well as philanthropic groups, helped to provide the funding for the research that eventually lead to the vaccine that stopped polio and its spread.
My family was also aware of the horror and tragedy of viral epidemics as my mother had lost her 19-year-old brother Harry to the Spanish Flu epidemic in 1918. Harry had been one of my father's best friends, and was how my parents met. When the polio epidemics seemed to be recurring and getting worse every summer, there was always the hope that none of us would be affected.
But then it happened to me!
At the time in the summer of 1952, I was an active young boy always hiking in the woods, swimming, and playing sports, I developed high fevers and was bedridden for several days with headaches and a stiff neck. I was taken to the family doctor who, after a brief exam, told my family that I had polio and sent me to the children’s hospital.
The diagnosis shocked me when the doctor said to me that I had polio. What was said was blocked entirely out until later when my older brother began teasing me about it. I was yelling that it wasn’t true until I reluctantly remembered. To me, getting polio was like a death sentence, as I had seen all the pictures of disabled children and iron lung respirators used in those days to keep people alive.
When I arrived in hospital as a little, terrified kid, my first time away from home, the nurse said she was going to have the doctor put a long needle in my back to do a spinal tap. The nurse then left me shivering for a half-hour on a hard table until she returned with the doctor. The spinal tap was done and was not as painful as I had anticipated. I was held tightly by the nurse with my head draped over her shoulder. I was put then in a children's ward where I think there were 20 or more screaming frighten children. I was terrorized and was up most of the night, sich to the stomach and vomiting.
When the morning came, I kind of gave into the experience. I then got a lot of care and attention from the medical staff and nurses, who explained that I was positive for polio. I was told that I had the non-paralytic form – post-polio meningitis, that I was one of the lucky ones. I would have to remain in the hospital for several weeks while further tests were run.
While in the hospital, I would receive the physical therapy of the day – Sister Elizabeth Kenny hot pack therapy, physical therapy, including exercise in a heated pool. It was a natural type of treatment, and the only known potentially helpful treatment of the day. I was taken care of by an inspiring intern from Spain, who became an inspiring model for me and my later interest in medicine. I remember him visiting our home after I left on the invitation of my parents. He went on to be a leading surgeon in Madrid.
In the early part of my medical career, I realized that there was an association with the traumatic experience of my getting ill during the polio epidemic and my hospitalization with anxiety and panic attacks I had developed.
Now we are amid a current viral pandemic and crisis. Some parallel can be drawn with the earlier polio epidemic.
Perhaps the main difference is that we are more advance in science, especially in the ability to isolate the infectious agent and more rapidly-produce a vaccine. But we are plagued by some of the same problems that lead to so much fear, infection rate, illness, and death.
A recurring problem then and now, is our current lack of preparedness, available testing, medical resources as ventilators, and personal protective equipment as now needed in the wake of the COVID-19 pandemic. Our country and citizenry can only do the best that is possible in the current circumstances. But a lot depends on the virus activity and its characteristics that we are just beginning to understand.
The degree to which we can prevent the spread of the virus, severe illness, or death, as we don’t have a current treatment, will, therefore, depend on several factors. The main factor would be the level of social avoidance and distancing from carriers of the virus. The ability to follow public health guidelines will be a big determiner of the ultimate number of illnesses and deaths, until the spread peaks and completes its active season, of which we are not exactly sure, as of yet.
As it is a know respiratory disease and spread by close contact with another carrier of the virus, following recommended public health measures will be paramount. This also includes the avoidance of touching a contaminated surface, liberally touching our face, or inhaling the infective agent. This also means using sanitizers as hand wipes, liquids, and sprays. The virus can enter through any gateways to our respiratory system – eyes, nose, and throat.
What's new on the horizon with COVID-19?
There will be most likely another wave of the COVID-19 in the fall, as this seems typical of these types of infections. The current outbreak is expected to peak and dissipate by summer, but we will be better prepared and experienced with it if another wave occurs in the fall. Within a year or so, a vaccine will most likely be available. Our science and current experience in developing vaccines will help to speed along the process, which now is expected to be 12 to 18 months for an effective vaccine to be available.
Scientists are relooking at, what has previously been studied during the polio epidemic, the use of passive immunization, and convalescent antibodies. The plasma of someone recovering from COViD-19, rich in antibodies against the virus, is given to someone ill with the infection, which hopefully would then have a better chance at recovery. Some older drugs, as Chloroquine, a malarial drug, also use for rheumatoid arthritis, are being studied for its potential to slow down the virus's entry and spread in the body.
Also, a new rapid diagnostic test for COVID-19 is becoming available, which can be self-done by the person in need of testing. The test results are available quicker than prior testing and don't expose other healthcare workers. Plans are to mass-produce the test and make it available, If adequate testing is available, more aggressive public health measures can be put in place to contain and prevent future epidemics or pandemics,
The U.S. was unprepared, but our experience will be a helpful lesson for the future.
The U.S. is far behind the curve in being prepared for the large number of new cases appearing locally and nationally. The reason for this is due to a lot of factors, including the unknowns about the novel virus itself, as well as the inadequate preparedness and leadership on multiple levels of government. Our country is clearly behind in preparation, having an adequate strategic reserve in terms of hospital beds, respirators, personal protective equipment, and other vital resources and personnel.
Today, experts in infectious diseases feel we can’t let our guard down and be unprepared for the next new virus, as our county and most other world governments were with the COVID-19. Unpreparedness has also been the problem with many prior epidemics. The warning has been expressed that nature can always be one step ahead of us and that new forms of viruses are ever-evolving somewhere and waiting to be the next epidemic or pandemic.
Thank you for your interest and review of this article. You are welcome to make comments below.
Ron Parks MD
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**The above is for informational and educational purposes only, not as medical or mental health advice. It is the reader’s responsibility to direct personal medical or mental health questions to their primary care provider and specialty physicians. The information and statements contained in this material are not intended to diagnose, treat, cure, or prevent any disease or to replace the recommendations or advice given to you by your primary or direct care providers. Your reliance on any information provided by Dr. Parks is solely at your discretion. You are advised not to disregard medical advice from your primary or direct care providers, or delay seeking medical advice or treatment because of information contained in this article. Management of severe mental or physical health problems should remain under the care and guidance of your primary care physicians, specialist, or psychiatrists.
Lead-in photo for the article: ©Volodimir Kalina/123rf.com, Fear in the eyes
See Prior COVID-19 related article by Dr. Parks:
Reference and Further Information:
See a clip from Jane Paley CBS Sunday Morning Show Re Polio epidemic as similar in ways to COVID-19 https://www.cbs.com/shows/cbs-sunday-morning/video/C65KTUK9OPldYvZRo5vljpYSAc6pX3ef/conquering-the-polio-epidemic/