In fact, the infection rate of staff was as high in the high-protocol wards as in the improvised hospitals. The protocols followed in the contagious annex of the US Naval Hospital in Annapolis, MD, were sufficient to prevent cross-contamination of “cerebro-spinal fever” (aka meningitis), diphtheria, measles, mumps, scarlet fever, and German measles. “Epidemiological and Statistical Data, US Navy, 1918,” Reprinted from the Annual Report of the Surgeon General, US Navy, (Washington, DC: Government Printing Office, 1919) 434.Īlthough the Surgeon General of the US Navy acknowledged that wearing masks by hospital staff was good practice, “the morbidity rate, nevertheless, was very high among those attending the sick,” and may only have prevented infection from a direct, close hit from a cough or sneeze of a patient. The mask is designed only to afford protection against a direct spray from the mouth of the carrier of pathogenic microorganisms … Masks of improper design, made of wide-mesh gauze, which rest against the mouth and nose, become wet with saliva, soiled with the fingers, and are changed infrequently, may lead to infection rather than prevent it, especially when worn by persons who have not even a rudimentary knowledge of the modes of transmission of the causative agents of communicable diseases.” “No evidence was presented which would justify compelling persons at large to wear masks during an epidemic. Mask skepticism was officially sanctioned by the Surgeon General of the US Navy in a 1919 report: Vaughan, Influenza: An Epidemiologic Study, (Baltimore, MD: American Journal of Hygiene Monographic Series, No.1, 1921 ) 241. When, in pneumonia and influence wards, it has been nearly impossible to force the orderlies or even some of the physicians and nurses to wear their masks as prescribed, it is difficult to see how a general measure of this nature could be enforced in the community at large.” “One difficulty in the use of the face mask is the failure of cooperation on the part of the public. A more pessimistic appraisal of masks came in a study published in 1921 by physician William T. People were using cheese cloth for masks, with predictable outcomes. Part of the disappointment was that medical authorities had advised using medical gauze, which had a tighter weave than what most people understood as “gauze.” Then as now, not everyone had access to the personal protective equipment solutions that were recommended. So, early on, authorities were skeptical of the effectiveness of masks, but they also felt that masks were not used properly. The above graph showed very little difference in death rates between Stockton, which mandated the wearing of masks in public, and Boston, which did not. This is from a study published in 1919 by the California State Department of Health. (Sacramento: California State Printing Office, 1919) 22. Influenza, A Study of Measures Adopted for the Control of the Epidemic. I’m quoted as saying the gauze masks of 1918, “may not have been much use to the user but did offer protection to those around them.” I had in mind the ultimate public health lessons learned from the 1918 flu way down the line, in a study concluded a little more than ten years ago.īut back in 1918, public health leaders who studied the problem thought that the mask laws and mask use by the public were minimally effective. However, my statement at the end of the article, applied historically, is not correct by itself. It’s a fascinating exploration of the politics of masks in California during the 1918 flu, and the fact that Mayor Davie of Oakland was jailed for not wearing a mask in Sacramento. I was recently asked this question for an article that just appeared in the Smithsonian Magazine. However, we need to be very careful about how we use history to inform our current context. A large number of recent news items have reflected on our current crisis by looking to the past for comfort, commiseration, and even some answers.
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