Life in the Time of Coronavirus - Brought to you by Dr. MZ
Lethal Gatherings
The Liberty Loan Parade in Philadelphia is famous among those who study pandemics in general and the 1918 Influenza Pandemic in particular. On September 28, 1918, against medical advice, the City of Philadelphia held a massive parade with lots of marchers and spectators designed to encourage the purchase of war bonds to pay for the war effort. Around the same time, the City of St. Louis decided to cancel its similar parade. In the ensuing month, 10,000 citizens of Philadelphia died of influenza whereas over the same time period only 700 people in St. Louis died of the same disease. This event resonates today as an example of mistaken and misplaced priorities: the drive to purchase war bonds in the effort to win World War I took precedence over the efforts to interrupt the spread of pandemic influenza—with catastrophic results—demonstrating that such decisions are not trivial and can have profound and unintended consequences. To fully drive home the point, more people died during the Influenza Pandemic of 1918 than died during all of World War I.ttps://www.history.com/news/spanish-flu.
Gatherings of any significant size in the face of pandemic disease can produce lethal outcomes. This notion is a lesson that we are apt to forget, maybe out of forgetfulness or perhaps because of emotional desires that overwhelm our rational thought. Several prophetic examples, albeit on a smaller scale, have already emerged in our current pandemic, giving us due warning that the enormous lesson of 1918 is still highly relevant.
Biogen, a biotech firm just outside of Boston, held a business conference for biotech executives on February 26 and 27, 2020 at the Marriott Long Wharf Hotel in Boston. This conference quickly became a super spreader event., producing more than 100 cases of COVID-19 among attendees who then left the conference to return to their homes all across the US and Europe, taking their SARS-CoV-2 with them, and infecting others in their home states and countries. Public health officials dread super spreader events because they cause disease to spread widely, often produce loss of life, and make containment exceedingly difficult.
Super spreader events aren’t only related to wars or business. They can take place among families or social and political groups. The Centers for Disease Control and Prevention, in their April 8, 2020 Morbidity and Mortality Weekly Report (MMWR), reported on the community transmission of SARS-CoV-2 at two family gatherings that just occurred in Chicago, Illinois. This large, multi-family cluster of COVID-19 resulted from attendance at a funeral and a birthday party by an infected, mildly symptomatic index patient, and produced 16 cases of confirmed or probable COVID-19 with three hospitalizations and three deaths. In the face of pandemic disease, people with even mild symptoms should not be out in public or attending gatherings regardless of the social pressures to do so.
Denial of the pandemic problem isn’t a great strategy. That strategy was tried in Detroit, where the virus seemed to be far away, not their problem, “life was good,” and an annual sheriff’s party was held in spite of the pandemic. A wonderful time was had by all and less than three weeks later, seven party attendees were ill, many more were infected in the sheriff’s office and one well-loved sheriff was dead. Mardi Gras, the mother of all parties, took place on February 25, 2020 and fueled the horrendous outbreak of COVD-19 that New Orleans continues to struggle with today.
Asymptomatic but infected people can transmit SARS-CoV-2 and hence, no large gatherings should be held at all as they profoundly degrade efforts at mitigation (non-pharmaceutical interventions or NPI) Family, social, or political organizations should not even think about holding a face-to-face gathering while community transmission of SARS-CoV-2 continues or remains a threat. Premature relaxation of physical distancing will only result in more cases and loss of life.
So, please, don’t count on going to church on Easter Sunday, attending brunch on Mother’s day, having a barbeque on Memorial day weekend, a graduation party in June, a National Convention, or an Annual Meeting in the summertime, or even a 4th of July celebration if any of those events will be face-to-face. None of us wants to contribute to the death of someone from SARS-CoV-2. The day will come when such events can be held. That day has just not yet arrived. When possible, leverage technology and find a way to enjoy social events without personal contact. This will have to suffice for the foreseeable future. It feels harsh but extraordinary times call for extraordinary measures and sacrifices. Hang in there!
Please feel free to send questions and concerns about COVID-19 and this pandemic to healthcare [at] LWV-PA.org.
Stay safe and don’t forget to stay home, wear your mask in public, wash your hands frequently, stay six feet away from others, and, as much as humanly possible, don’t touch your face. This will come to an end and we will return to some version of “normal.” Just not yet…….
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Dr. Margan Zajdowicz is the Co-Chair of the League of Women Voters-Pasadena Area Healthcare Committee and a retired infectious disease physician who spent many years in clinical practice and emergency preparedness and pandemic planning for the US Navy. She holds a Doctor of Medicine degree from the University of Maryland School Of Medicine and a Master of Public Health degree from Old Dominion University/Eastern Virginia School of Medicine.
