I was born with this confidence is within me. Like I mean I always had a voice very vocal, and now we say what I wanted to say: that's cardy, be from the Iheart radios, see her here. Her even join its mark, eight at eight p m on Iheart radios, Facebook and Youtube channels. As we celebrate the talent, competent and fearlessness. It takes to make it an music. This international women's day, very an especial thanks to our partner. Elegant aesthetic school empowers confidence, was choices backed by science. Everyday discover how an elegant aesthetics, dot com site, I W D,

however, where there was a podcast that had real conversations like the ones you have with your friends. Well you're in luck, pie, I'm Aaron, Andrews and I'm Corazza Thomson, and we wanted to call it everyone hates us, but the suits didn't like that. So meet our new podcast calm down with an increase of just two checks. Talking about all this stuff, others, while like this current break out, I'm having or Willis getting kicked out of dog day care for paying on other dots. It's the good, the bad, even the ugly and everything in between Lisbon and follow calm down with an incorrect thou on the IRA, radio, app apple podcast or wherever you listen upon calf. Welcome to snuff, you missed in history, glass approach of Iheart radio hello and welcomes the pod cat, I'm Tracy! Well, I'm Holly fry we're coming up

a one year anniversary of the World Health Organization's announcement that covered nineteen could be characterized as a pandemic. Bad happened on March eleven of twenty twenty and then a couple weeks after that, Holly and I talked on the show about what it was like to be living through such a massive and worldwide, clearly historic event, while also hosting in history podcast, and we re aired our previous episode on the nineteen eighteen flu pandemic. As a Saturday Classic seem irrelevant what was happening. I don't think either of us really foresaw that we might be in place to do kind of one year later So not even a little like I have a friend who was a nurse at Boston area, hospitals, and we Boston was one of the early hard hit places and

fact about getting a briefing. It works thing that we were probably looking at eighteen months to two years of pandemic, but like there's a big difference between intellectually having that possibility in your minds and actually living through it. So I researched and wrote are episode on the nineteen eighteen flu pandemic that we as a Saturday classic after the cove and nineteen pandemic started. I wrote that back and twenty fourteen and over the last year I have one over and over is this what it was like? A nineteen eighteen and how would I have approached that episode differently if I were working on it to day instead of seven years ago, we know typically revisit odor episodes in this way, but the last

It has just profoundly reshape the way. I have thought about that earlier pandemic. To me, it's a really good example of how your own perception In your own knowledge and experiences influence your understanding of history, so we're gonna take another look at the nineteen eighteen flu pandemic, I do want to note here that the nineteen eighteen flu pandemic was global and so is the covert nineteen pandemic. But a big part of today's episode is how my own lived. Experience has shifted my my understanding of that earlier event and drawn my attention to a totally different parts of the nineteen eighteen pandemic. we're on my mind back in twenty fourteen. So by definition this gives things more. U S, centric focus! I can't

Tell you how how a person's lived experience another place would have changed their understanding. I also didn't start out thinking. This was going to be a two part episode, but it is turned out. There was a lot of talk about that. We did not touch on pack and twenty fourteen much or at all. Ok, so we're gonna do a quick review here as we lead in the nineteen eighteen flu pandemic. Stretched from early nineteenth eighteen into the spring of nineteen twenty, although the largest peak was between October of night, in eighteen in January, of nineteen nineteen, with a smaller but still significant peak between February and April of nineteen nineteen it is estimated that one third of the world's population contracted the flu during this pandemic about six hundred seventy five thousand People died in the United States worldwide estimates vary considerably at the time The global death toll was estimated at twenty million people, but today

estimates are more, like thirty million to fifty million people and sometime Even more so, illnesses like the flu are often particularly lethal for the very old and the very young- and that was true of the nineteen eighteen flu. But then, in addition to that, it also disproportionately killed young, otherwise healthy adults, people who were in their twenties and thirties and fence. This pandemic took place in the last months of road where wine, its effects on troops were extreme. The virus just moved through entire ships and entire military units and waves, for example, in June and July of nineteen eighteen, more than two hundred thousand of the two million british troops in France all got to sick to report to duty earlier episode on this pandemic. We talked about how, in nineteen eighteen the world the germ theory of disease, but not antibiotics, we knew which

Pacific Micro organisms caused some diseases, including tuberculosis, malaria and cholera, but not influenza. We had themes for some diseases as well, including smallpox, rabies, cholera and typhoid, but again, not influenza. It wasn't just that researchers didn't know which specific pathogen caused influenza. They were also headed down the wrong track on that the prevailing theory before the pandemic was a bacterium known as pfeiffers bacillus. That was named after its Discover Richard Friedrich Pfeiffer. During the nineteen eighteen pandemic, it became clear that this bacillus was not the cause of the flu. A huge number of people became ill They had no sign of this bacillus and their cultures. Today, this bacillus is actually called hemophilia influenza and while it does not cause influenza, not the flu virus, it does cause things like pneumonia. Cellulite US and meningitis

We also talked about nineteen eighteen, public health recommendations. Lake stay home you're sick, avoid crowds cover since. These is why those hands thoroughly and often enough words a lot of the exact same things that we have all been hearing for the last year most. which are also what everyone should still be doing, even when there is not a pandemic yeah. I have a lot of you. Things about handwashing, because I used to work in vain like food safety, education, and when things started, trending toward pandemic in in February and March of last year, I definitely noticed when I would be in a public restroom. Suddenly people were at the sink for as long as I was when I was like wow. This is, let's keep the creep up this habit for the rest of our lives. There were, though, some notable differences in the public health recommendations and nineteen eighteen now

at least in terms of U S, culture. The idea that spitting on the ground is rude and unsanitary was really fairly new in nineteen eighteen. The first anti spreading campaigns had gotten under way just a couple of decades before that, to try to prevent this tuberculosis, common drinking cups and shared towels were also frequently found in public places. So back and nineteen eighteen. In addition to those recommendations that feel pretty familiar today, there are also slogans like spit, spreads death. An advisory to avoid Those common cups and towels public health officials also advised people to wear masks in nineteen eighteen, which brings us to the biggest most obvious thing. We'd approach will differently now, verses back in twenty fourteen treatment masks in the earlier episode is essentially just a sentence. We said that public health,

It is recommended that people wear them and that in some places they were even required by law, but that this was not effective. We described that lack of efficacy coming from virus particles being too small to be blocked by simple fabric, which is true in which actually came from a U S: Department of Health and Human services website that was written about the nineteen eighteen pandemic. But as has been discussed at length in the last year. Well, fitting masks made of tightly woven clause can't stop respiratory droplets that are carrying those virus particles. Vat is not necessary, the true of the masks that were being worn in nineteen eighteen, though those are typically made of gauze, which is a very thin fabric, with an open weave. Some of them were made from cheese cloth, which also has a similar

and we ve, even with multiple layers. These fabrics might leave you with a relatively poorest mask. If you look at photos from the nineteen eighteen pandemic, sometimes you'll see people's facial features through their masks pretty clearly, sometimes you can see the gauzy holes in the material. Sometimes people also cut holes in their masks to smoke or if they didn't have gauze or cheese clause They made Basques out of materials that were way too thin to do any good at all. They almost like wearing a translucent veil instead of a mask, like. I saw one photo of Red Cross nurses and it was literally only attached of over the bridge of their nose and had this Oh me, diaphanous quality and I was just like that's not help. I know what's interesting too, because I mean even then cheese claw

was being used in kitchens to stream things. So you new stuff could go right through its. So it's an interesting choice. Publication called an experimental study of the efficacy of gauze masks, which was published in the American Journal of Public Health in nineteen. Twenty looked it there. The masks themselves were effective and the other concluded that a gauze mask that had enough layers to actually block respiratory droplets was so very hard to breathe through an a person's exhaled breath just escaped around the sides of the mask instead, so if your hearing a sack about

then you're thinking wait a minute. Didn't you talk about gauze masks being effective in that episode on Will, in the end, the pneumatic plague? That answer is yes, but those masks had a layer of cotton wool in the middle of all that gauze pneumatic plague is also caused by bacteria. Bacteria are much larger than viruses and those mask efficacy was really clearest among a health care professionals who would have been wearing the masks. In addition to other precautions, and probably also with better mask discipline and more thorough hygiene steps than the general, We would have had back to that nineteen twenty paper, the off cited five reasons why mask mandates did not seem to slow the spread of the disease in the nineteen eighteen pandemic quote, first, the large number of improperly made masks. They were used second faulty wearing of masks, which included the use of masks that were too small the cover?

if only the nose or only the mouth, smoking while wearing, etc. Third wearing masks it proper times when apply Compulsory masks were universally worn in public, on the streets in automobiles etc, where they were not needed, but where arrest would follow if not worn, and they were very generally laid aside when the where was no longer subject to observation by the police, such as in private offices, small gatherings of all kinds. This type of gathering, with the attendant social intercourse between friends and office associates, seems to afford particular facility for the transfer of the virus. Another study in nineteen twenty one concluded that quote the face mask as used, was a failure. The important bit there is the ass used, and that included things like the stuff. We just talk

About and people ree wearing the same masks until they were just filthy. The general advice on mask cleanliness back in nineteen eighteen was to boil them regularly in some cases daily. This study also notes that the mass did nothing to protect the eyes and that the tear ducks had been pinpointed as a possible way that the virus could get in a person's respiratory tract. We also did not talk about resistance to mask mandates in that earlier episode, we sure will after we first pause for a little sponsor break. forest presents a mini meditation. Connect to this moment. Forget your over do task list looming deadlines and bring your focus to your customer sure you for it to lunch again, but you can pennsylvanian tomorrow on your

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The most famous group of math resistors theory, the nineteen eighteen pandemic, was the San Francisco Anti Mask League San Francisco had actually been the first city and the United States to implement a mask mandate. It was a for weak, mandatory mask law that started on October, twenty second of nineteen eighteen and it ended on November. Twenty first of that year a full page add ran in San Francisco. Chronicle. That red quote, where a mask and save your wife. This add was signed by the mayor as well as civic and business leaders and health officials. The Red Cross, distributed about a hundred thousand masks to residents of San Francisco over the core. Of about a week, people who were seen in public without a mask were fine, five or ten dollars or imprisoned for up to ten days. There.

a lot of arrests, although many were because the person hadn't known about the mask law or just didn't, have a mask But that was not the case for everyone. On October, twenty seventh nineteen eighteen health off Sir Henry De Miller, escorted James Whizzer to a pharmacy to purchase a mask. The details here, a little bit fuzzy but Whizzer refused either by or where one it's not. your, which thing happened first, but these two things happened with struck Miller with a sack of silver dollars and Miller fired his gun in the AIR Miller, firing as Whizzer beat him up in the street Miller shots hit whizzer and two bystanders and Whizzer and Miller both faced charges after altercation. Some of the mentions of this

but have floated around in in the last year, have sort of made it sound like Miller, just unprompted shot somebody for refusing to wear a mask. They kind of leave out the fact that that person hidden with a sack of silver dollars and was beating up in the street, which sounds painful. Yes, yes, nothin we have, that is ok, but it definitely is not as simple as like this guy shot, somebody for refusing to wear a mask. So, as we have said before, this was at the very end of world war, one and a lot of the messaging around this first mass. mandate in San Francisco was framed around wartime patriotism and the idea that stopping the disease will help protect the troops. So when the arm This was signed on November. Eleventh of nineteen eighteen that stopped most reactive fighting and mask compliance in San Francisco started to drop then, when the mask order expired at noon.

Twenty. First there were bells and whistles that we're sounded all around the city. People gleefully ripped off their masks. They were very happy to be done with this mass situation from people set their masks on fire, The mask lie in San Francisco was just one part of the city strategy to control the flu. Other steps included, closing dance walls and ordering street cars to keep their windows open unless it was raining and eventually banning public gatherings and closing the schools judges were advised to move their services outdoors judges held court, actions outside as well and all this

together seems to have reduce the rate of infection in San Francisco during the pandemic, the worst spike in the fall of nineteen eighteen. But when flu cases started spiking again in San Francisco, with the end of nineteen eighteen and early, one thousand nine hundred and nineteen, the city's tried to reinstate this mask mandate, and that is when the anti Mask League formed in response. They were also called masks hers. Thanks to our Red Cross, poster about masking which read quote the man or woman or child who will not wear a mask. Now is a dangerous slacker. The anti mask league really politicized the idea. Mask wearing and they held a rally that was attended by two thousand people at the dreamland rink. The city eventually repealed. The second attempt at a mask mandate, under pressure from the anti Mask league and then overall San Francisco, responds to this later wave of the flu was not as effective,

earlier when had been so. This example is just from San Francisco, but a similar pattern played out in other cities as well mode, to the. U S: cities that mandated mask wearing during the nineteen eighteen pandemic were in the western part of the country, compliance with the mandates often spotty at best, but resistance. And to be more along the lines of that's ridiculous, or how silly rather forming an organised group to push back against it and a lad of the complaints about the masks will probably sound pretty familiar people found them uncomfortable to wear and hard to, we ve through and, as we noted earlier, if you actually had enough gauze layers to be effective, that probably was really hard to breathe through public health officials. Also worry that the appearance of mass

people out and about would leads a panic or that wearing a mask might lead people to be less vigilant and other ways. That's an argument we have heard in the last year. It was clear, then, as it is now, that masking really needed to be combined with other steps like social distancing and staying away from crowds, but there are lots of pictures from nineteen eighteen of Hugh groups of masked people standing shoulder to shoulder. Another recurring question that Tracy his had over the last year. We, is the EU s response to the nineteen eighteen pandemic? Such a chaotic and ineffective patchwork with different cities and states taking totally different steps to try to control the spread and with a bunch of contradictory and confusing messaging about all of it, basically go mass because I think to most of us that's what this is seem to be cheerful. Like big o master me yeah, but the shortest

or to all of Tracy's questions and probably years, I think most of us have had a similar resilience of, or the answer is yes, yes at the. U S response to the nineteen eighteen pandemic was on completely decentralized. The centres for Disease Control had not been established, yet that happened in nineteen. Forty six and the World Health Organization was established two years after that, so it did not exist either. You s surgeon, General Rupert Blue, who was also had of the public health service, also did very little to try to curb the pandemic. He directed the National Academy of Sciences to try to identify the pathogen that was at work, but then also denied funding, requests or research into that very thing. Blues efforts to organise a federal response were essentially nonexistent until September when the illness had been circulating for months and cases and deaths were increasing rapidly city.

And states repeatedly asked the federal government for direction and help, and they got very little, although the pub, Health service did eventually print about six million posters articles in signs. It was well in The pandemic before this happened and as we're gonna talk about it just a little bit a lot of the info nation that they contain really Wasn't exactly useful presidential press briefing? We're not merely of common in nineteen eighteen as they are today. But President Woodrow, Wilson ever gave any kind of public statement about the pandemic or took any steps to try to direct a federal response to mitigate it, his focus was really on the war, and this was true, even as White House staffers started to get sick Donald fairy. Who was an aid with the? U S, delegation to the Paris Peace Conference, died of the Pandemic Flu and Wilson himself. Content

acted the flu and with seriously ill during the Paris Peace Conference, the Social safety net that has been providing at least some relief in the. U S during the covert nineteen pandemic also did not exist. Yet at this time, the Blue mental Nutrition assistance programme or snap is a monthly benefit to help low income. U S, citizens by nutritious foods. grew out of the governments. First food stamp programme, but that was not established until now. In thirty nine there were union workers who had some kind of unemployment compensation as part of their union contracts in,

one thousand nine hundred and eighteen, but in general, unemployment insurance did not exist. Yet the first of many state unemployment bills was introduced in Massachusetts in nineteen sixteen, but all of these bills failed until Wisconsin finally passed one in nineteen. Thirty, two unemployment insurance didn't really become widespread in the US until after that point, during and after the great depression, Medicare and Medicaid, also did not come into existence until one thousand nine hundred and sixty five Congress did approve a one million dollars budget for the public health service in nineteen eighteen to try to address a serious shortage of doctors and nurses had been called up or had volunteered for military service before the pandemic started and the military still didn't have nearly enough medical personnel. regardless of whether they were doing military or civilian work. Medical professionals were hard hit by the pandemic,

terribly understaffed, working in close proximity to people with a contagious respiratory illnesses and wearing often ineffective protective equipment. Every week the Journal of the American Medical Association printed pages and pages of obituaries. this million dollar public health service budget, was meant to help fill this gap by recruiting a thousand doctors and seven hundred nurses. The public health service worked on this, in conjunction with the Red Cross, the Red Cross already had a coordinated national plan for recruiting nurses before the government even got involved with this really in the: U S: the vast majority of aid during the nineteen eighteen pandemic, ones coming from charities and religious organisations and private citizens, not from the government passed This legislation was a challenge: so many representatives were ill or otherwise absent. That the house did

a quorum with fewer than five de representatives. Actually, there, the two parties worked out a unanimous consent agreement to push this legislation through the final bill proved by both the house's am Senate on October, twenty seventh Surgeon general Blue had not asked for funding before this, but after the bill past, he protested One million dollars would not be enough. Even so public health service ultimately returned one hundred and fifteen thousand to the Treasury, because it We did not recruit enough people to use of the allocated money, in a moment ago that some of our communication around the pandemic was all not particularly effective in the U S, and we will get to that after a sponsor break. Me me me me me, but also you the barrel fast forward. This paper torn film Epipolae No, not ok was my line,

the only line. I see here on a script is get options based on your budget with the, namely price tool from progressive man to tend to history, I'm sorry, I'm gonna need a few more minutes boldness Well risk the bob? It's well rhythm name, your price tool, only from progressive the hour, and I found the comic those coxswain reciprocity insurance, opening the brilliance misinterpret, which limit the stigma we'll stop. You might also got this african king of company microblog geared to share some clues of information about my must: listen blue package models like a package with Michael Blacks, and we cannot forget my call those these journeys were spread. Thanks like this right it is best for a law with me is gonna, be saying you don't want to miss. It can find one Michael blacks, it I already have one apple- Work is a whit Emma S, guests

because of the word, you ask the person, were generally more focused on maintaining morale and avoiding panic in nineteen eighteen than they were on fighting the pandemic. In the? U S as well as in many parts of Europe. Asia. The news was also subject to war time censorship, and this is why this pandemic was nicknamed the spanish flu. Spain was neutral in the war and it wasn't really censoring its news about the flu so to some people it seemed like this disease had come from Spain when really Spain was just the place that was being most. its parent about what was happening in the United States? This also tapped into isolationism and xenophobia brand.

A deadly illness as having come from somewhere else and stigmatizing people who got sick as somehow connected to this supposedly Forum Invader, and obviously this type of other ring nickname, is not unique to the nineteen eighteen pandemic. The nineteen sixty eight flu pandemic was known as Hong Kong flew the worldwide HIV epidemic started out as gay relief immune deficiency, Amby, races, racist nickname, China Virus has stuck, long after the current pandemic disease was officially named Covin nineteen, since there was no centralized agency, formalizing public health advice and nineteen eighteen people were also hearing a lot of contradictory information about what to do and how to protect themselves and in most parts of the

who ass, they were also hearing that things weren't that bad that everything was under control and that nobody needed to be alarmed. It was just the flu more direct and assertive public health messaging that we talked about in San Francisco back before the break that was far worth common than messaging. That really minimized the threat, for it ample surgeon, general blues? First public communication about the pandemic was published on September. Twenty second of nineteen eighteen, it ran, The title surgeon generals advice to avoid influenza in full, very basic health advice, lake, avoiding crowds covering coughs, sneezes. Choosing, and chewing your food? Well, avoiding tight clothes and quote: don't let the waste products digestion accumulate, basically, don't leave crap lying around Rafe basic.

Sanitation and auxiliary Emily Basic Sanitation and health steps. Then, on October, seventeenth, as cases and deaths were really climbing dramatically blue issued more of a question and answer statement that was more specifically about the pandemic. He described this blue ass quote a very contagious type of cold, accompanied by fever, pains with my head eyes, ears back or other parts of the body and a feeling of severe sickness and most of the cases, the

symptoms disappear. After three or four days, the patient then rapidly recovering some of the patients, however develop pneumonia or inflammation of the ear or meningitis, and many of these complicated cases die. He also put a lot of focus on how many other epidemics there had been before and how quote the proportion of deaths in the present epidemic has generally been low in this peace Blue recommended that if a person was having to care for both sick, and healthy family members, they should wear a mask and an apron or gown while with the sick person, and remove all of that before coming into contact with the rest of the family name, and he read them that everyone eat a good diet, get plenty of rest. Keep windows open, reduce crowding in their homes and avoid crowds, while out in public the overall None of this whole thing was far more reassuring and again pretty basic. Then it was urgent.

Another example: Philadelphia Public Health director, William cruising repeatedly suggested to residents of Philadelphia that everything was under control and that the number of infections had peaked in September of nineteen eighteen cited not to cancel a Liberty loan parade, that was to promote war bonds. That operate had been scheduled for the twenty Eightth and he carried and with it, even though an outbreak had started at the Philadelphia Navy Yard just nine days before that within sight two hours after the parade every hospital bed in Philadelphia was full and sick patients were being turned away, Meanwhile, cruising kept up the refrain that everything under control and the worst was over as the daily deaths in Philadelphia climb to two hundred and then three hundred and then peaked at more than seven hundred teams were despatched to collect bodies from homes and literally could not keep up with it.

ass crews in Bam, public meetings, enclosed churches, schools and theatres. Only after Philadelphia was experiencing hundreds of deaths a day, and it wasn't just government officials who were downplaying the pandemic. A lotta newspapers carry daily or weekly updates of how many new cases, and said, occurred along with news about how they were shortages of doctors and nurses and shortages of coffins and other obviously serious problems, but at the same time they also repeated this refrain that this pandemic was just the flu or to use a term of the day. It was just the grip that people didn't need to be alarmed. That surgeon generals advice to avoid influenza, that included like the world's most rudimentary basic sanitation information that ran next to newspaper reports about outbreaks and deaths.

Lists of precautions often frame things as preventing the spread of colds, tuberculosis, pneumonia and of the flu sort of law. Being the pandemic. In with these other illnesses, as though it was Nothing unusual even sell it He is news coverage framed cruises, ban on public gatherings, as not being for public health. reasons or any cause for alarm. You wound is particularly weird like them. Then why? Then, if it wasn't for public health reasons, so this effort to avoid panic by down please the severity of the pandemic was not effective, spam them. Family members were dying, morgues were passed capacity, there were not enough. Coffins people were being buried at mass graves and in the First of all, this people, naturally were not calm and they also stopped trusting what they were hearing from official sources, because those sources were clearly not being honest,

Damn historian, John and bury author of the great influenza. The epic story of the deadliest plague in history has written this phenomenon a lot and was a subject matter expert in two thousand and five and two thousand and six when the CDC was putting other an influenza pandemic plan in a twenty two the article in the Washington Post he's described as telling a reporter. he felt like his job was to bang. On the tell the truth, tell the truth drum because lying to the public for the sake of keeping calm and maintaining order in nineteen eighteen, not only did not work, but it actually had the opposite effect minimizing the pandemic also meant that there was a big range and how serious people thought it was, especially if they were lucky enough that they did personally know anyone who had died- and you can see some of this in

but the popular media of the day. One example is the popular syndicated newspaper comic the outbursts of every true, as the two panel comic, with the first a panel being set up and the second panel being the punch line, often literally because Usually every would hit somebody in one stripped from nineteen eighteen pandemic. A masked ever it says quote. I think it's every these duty to help combat the spread of the contagion and then another man says quote: will I dont think these muzzles do any good if a person's going too edit he's going to get it and I'm going to take my chances and Second frame Everett having punch the other man's face in says. Well, then take for me where one and improve the looks of that face. You owe that much so the community, in another strip. Someone sneezes on ever it in the first panel in in the second. Ever it has him trapped under a giant box and has sent someone to fetch the feed.

We gating squad from the Board of Health. Somebody share these comics and a group chat that I'm in and our response was alike. Are you sure these are not from today with a thick he's in the newspaper this morning? So apart from what people were hearing from the media and government forces and all of that, the actual measures being taken also really varied from place to place we mentioned in that earlier. Third, we dead on the nineteen eighteen pandemic, but some cities shut down their public transportation systems and movie theatres or they closed schools and churches. But we didn't mention that these closures often went on for weeks or that because of the just the flu messaging. There were a lot of people who thought that this was an unnecessary and ridiculous over reaction, however, there were also business owners who supported these shutdowns

for example in San Francisco movie theater owners had already seen a huge drop in attendance before the city closed the theatres really hoping that this temporary total closure would get things under control faster? One paper that looked at this was non pharmaceutical interventions implemented by? U S: cities. During the nineteen, eighteen and nineteen nineteen influenza pandemic, a paper was published in two thousand and seven, and it looked at this time. Taken by forty three cities between September 18th, one thousand nine hundred and eighteen and February 22nd, one thousand nine hundred and nineteen that covered the pandemics largest peak in the United States. All of cities had populations of more than one hundred thousand people and were among these. Sixty six most populous cities in the United States at the time

the cities among those sixty six that weren't included in this study just didn't have accurate enough data to use. They looked specifically and information about school closures by cancelling of public gatherings and the isolation in quarantine of sick people in their close contacts and all the cities that they look. That did at least one of these. Most of them did more than one. The most common combination was closing school. Rules and also cancelling public gatherings within that September, two February window. The media in the link for these closures was four weeks, but in some cases they went on much longer. Some of the city's had at least some kind of non pharmaceutical intervention in place. For twenty weeks. or more, and this paper also concluded that these steps were generally effective at slowing the spread of disease, especially when cities took layered strategy of taking multiple steps at once. The effect was greatest when restrictions went into effect.

earlier before. Infections and deaths really started to climb, rather than afterwards in response to those increases for example, Saint Louis Missouri put multiple steps in place early in the pandemic and fared much better. most of the other cities. Overall cities that took multiple steps took longer to reach peak more quality and they have lower peak mortality and lower total mortality rates than cities that did not various cities. Take other steps, as well beyond. The cancellation

closures and quarantines that were part of that study. We talked about San Francisco, multi part response earlier, for example, some other examples in Portland Oregon, the public library was closed, but then it reopened for books circulation only with the chairs taken out of circulation, room and patrons being required to wait five feet apart from each other. Many cities shut down their bars in their pubs. At this point, the eighteenth amendment to the constitution, which prohibited the manufacture, sale and transportation of intoxicating liquors had been passed. But it had not been ratified by the states that didn't happen until January of nineteen nineteen, so in general, the nineteen eighteen bar and pub closures made prohibitionists really happy, but in some places, steps that were taken really didn't make any sense. Saint Paul Minnesota, for example, buildings under six floors were prohibited from using

elevators because of the lack of fresh air, There was a lot of resistance to this, and some of it was definitely justified. Lake shutting down the elevators- made the buildings inaccessible for disabled people and discourage people from going outside into the fresh, here, which was believed to be necessary for health ultimate. The elevators were put back into operation and they have limit of one person per five square feet of space to quota two thousand seven article in public health reports that discussed the nineteen eighteen response and many ATLAS an Saint Paul because clear orders were not being given to public health officials. The public in turn was not receiving transparent and consistent advice and information. Should the public wear masks? Why that allowable to be next to someone in a street car and not an elevator. Why we're church services closed while Red Cross workers gathered in crowded conditions in those very same churches?

With influenza, a life threatening condition or was the panic, the most dangerous element of the influenza Pandemic and Minneapolis and Saint Paul, there was no single message on any of these issues. In many cases the public had to decide for itself, in which case the effect of the messages that were communicated only serves to contradict each other. I read that, and was like is about today, so that we have talked mainly about Citys here, but in nineteen eighteen, almost half of the U S, population was living. Our rural areas and the pandemic was devastating in those areas as well. Small or communities were taking many of the same non pharmaceutical steps that big cities were in rural areas, people in general had even less access to medical care and fewer resources. It was particularly bad.

Places. They were outside of cities, but also densely populated lake in coal mines. So we have spent this episode, mostly talking about masks and the generally scattered chaotic response to the nineteen eighteen pandemic in the United States. Next time we are going to dive into some more focused topics, which Obviously, what I thought this episode was gonna be like when I started on it like, for example, was anything happening with vaccines in nineteen eighteen. Were there the kinds of food and supply shortages that we have seen through some of this pandemic and were there any places that manage to actually things under control, while we ruminate on all of this Tracy d of listener mail. I do I.

Through email. That has a connection in that it discusses some of the medical stuff that we have talked about lately, but it's not about the pandemic. This is from Megan Megan, says high galleon Tracy. I hope that this email finds you well. First of all, I want to thank you for all the great work you do. You definitely make my car drives housework and projects that I've been doing during the pandemic. More interesting, I'm writing to you, as I have just finish, your most recent podcast on the Mississippi Freedom Summer and Debbie. you Cobb when listening to your episode on freedom summer, you mentioned the Mississippi burning case. I immediately thought to myself. Why do I feel, like I know much more about this case than I would have learned and school when you mentioned Other bodies found a clicked for me. Another podcast that I've discovered during the pending it is called. Someone knows something to take a hard look at unsolved crimes, the third season

that show was on the murder of two of the bodies that were discovered when trying to find Cheney, Goodman and Sh Werner. What struck me most about this podcast was that it made me realize that for some people this is not history. One of the victims, brother, through the show followed, was still very frightened to look into this case and even a return to that part of Mississippi, as he felt it was still unsafe for racial minorities. There was definitely a check. Your privilege moment for myself

I would recommend it to any of your list nurse who enjoy true crime. The second reason I am writing to you is that I am a nursing student, so I highly enjoy any of your pod casts about medical history was latest podcast about Doktor Cobb was not any different, as you mentioned in your pod cast. You focused a lot on the disparities and health care for non wipes. I've come across a book in my attempts are better served, my patience, but I think any of your listeners in healthcare might be interested in called mind: the gap, a handbook of clinical signs and black and brown skin. It was written by a black medical student in London that realised that he was only learning the white symptoms in school and wanted to better educated speller students, as well as better serve his community open. Your listeners will look into this and we can continue to correct the disparities and our health care system.

again thank you for all that you do bring him the more obscure and let's talk about parts of history till like Megan Megan, also sent dog pictures. Thank you. So much for the dog pictures answer this email. I spent a moment looking at this the mind, the gap handbook there's a whole website for it online, and some of it has like photographs of things like skin conditions that look very different depending on the coloring of a person's skin. One of the ways that I know this is come up with the Covid nineteen Panda make is the oxygen monitors that go on your fingers. Reading people's oxygen saturation,

differently if they are black or brown, so it's that there's a whole huge and immediate relevance to this. A thank you again for this demand. Fear like to write to us about this are neither podcast. We write history pot cast that I hurt radio dot com and were also Oliver social Media atmosphere, history three or find our facebook, Twitter, Pinterest and Instagram, and you can subscribed our show on the I heard you an abattoir cath than anywhere else, gator podcast stuff, you missed the district class, the production of Iheart, radio for more broadcasts I heard radio visit by her radio have added mankind's or wherever you listen to your favorite shows. sales voice presents a mini meditation. Your mind.

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