We are not hearing much about the horrific tribulations of the folks in West Africa, but we can start to appreciate their suffering by considering Philadelphia’s yellow fever epidemic of 1793. With a population of about 45,000, it was America’s political, economic, financial and cultural capital. When the fever struck, nearly everyone who could leave town did so; those who stayed in town used all manner of strategies and substances to ward off the fever.
The city’s esteemed medical community was clueless about how to fight the disease, though some doctors were more clueless than others. Aggressive treatment involved bleeding patients with leeches, inducing vomiting, and feeding them mercury. The fever was thought by many to be contagious and caused by the “miasma” emanating from decaying organic matter; a prime suspect was a pile of coffee rotting on the Arch Street wharf. Actually, yellow fever is spread by mosquitoes; the fever finally ended with the onset of frost. A splendid 1949 book, Bring Out Your Dead, by J.M. Powell, conveys the horror and mayhem caused by the disease, which killed a tenth of the city’s population. A few excerpts:
“Some cases began with violent chills and temperatures, others with languor and nausea. Stupor, delirium, vomit, slow pulse, bloodshot eyes, yellowness regularly succeeded. Sometimes patients remained sensible and conscious to the last. One man shaved himself just before he died.” [A common symptom was black vomit.]
“At once the very appearance of the street changed. People stayed indoors scouring, whitewashing, ‘purifying’ their houses, burning gunpowder, tobacco, and nitre, sprinkling vinegar. Those who had to walk abroad carried their tarred ropes or camphor bags and chewed garlic constantly, doused themselves with vinegar…” [Another supposed remedy was shooting guns and cannons.]
“Children were wandering in the streets, their parents dead at home. A laborer with the improbable name of Sebastian Ale hired out as a gravedigger. An old man, he had long since lost the sense of smell. He opened a grave to bury a wife with her husband who had died a few days before. His shovel struck and broke the husband’s coffin, from which emitted such an ‘intolerable and deadly stench’ that Sebastian Ale sickened immediately and in a day or two died.”
“Calamities multiplied beyond number. A man named Collins buried his wife, two daughters, a son, his son’s wife and child; he married again, buried his new wife, and died himself….” [Dolly Todd lost her husband, an up-and-coming Quaker lawyer, to the fever and later married Congressman James Madison of Virginia.]
The city’s government and social services broke down when they were needed most. They had to be reconstituted by exceptionally courageous citizens, one of whom was a one-eyed French merchant named Stephen Girard, who reorganized and operated the city’s makeshift fever hospital, a mansion called Bush Hill. Girard went on to become one of America’s richest capitalist, with a fortune of well over $3 million when he died in 1831.
Residential Quarantine in London
The White House and CDC could learn a lot from A Journal of the Plague Year by Daniel Defoe, the prolific author who wrote Robinson Crusoe. It’s an unusual book. It’s a first person, you-are-there account of the rat-and-flea borne plague that ravaged London in 1665. Only Defoe was not there; he published the book in 1722 by piecing together contemporary accounts from newspapers, memoirs, etc.
A big issue for London then, as for the U.S. now, was quarantines and how to enforce them. The Lord Mayor and Aldermen of the City of London decreed that:
“No Person to be conveyed out of any infected House.” So if you, a family member, or one of your servants got sick with the plague, you were a prisoner in your own house, even if you were not ill. This could be a death sentence; as Defoe wrote, “This shutting up of houses was at first counted a very cruel and Unchristian Method, and the poor People so confin’d made bitter Lamentations.”
“Every visited House to be marked” with a big red cross on the front door.
“Every visited House to be Watched” by two government-appointed watchmen, one for the day and one for the night. These watchmen would run errands such as fetching food, fuel, etc.
Here was an extraordinary situation—the government making ordinary citizens prisoners in their own houses, even if just one member of the household came down with plague. The citizens did not cooperate. They sent the watchmen off on errands to buy food, and then broke the lock, or used a second key to open the lock, or broke through the wall to the next house, or bribed the watchman. On one occasion the watchmen heard violent shrieking and wailing in a shut house. They pounded on the door to learn what was the matter. No answer. At length they used a ladder to peer into the second floor bedroom; there they saw a woman dead on the floor. They opened the front door and discovered that the rest of the household had stolen away in the night.
Beyond “Science:” a Proactive and Rational Quarantine
Contrary to the condescending “scientific” assurance of Federal officials, Ebola is not that difficult to get. Many well-trained western doctors have contracted the disease in Africa, as have two nurses in Texas. And it turns out that self-quarantines don’t work; we have three cases of people who had (or might have had) the disease traveling widely in America—the nurse who flew round trip from Dallas to Cleveland, the reporter back from Africa who got take-out from a Princeton eatery, and the doctor who spent an action-packed day jogging, bowling, dining and subway-riding in Manhattan right before (we hope) he became symptomatic. Basically, Americans today do not like to be “shut up” in their houses any more than Londoners did in 1665.
Clearly, then, it makes sense to quarantine anyone entering the U.S. from West Africa who potentially came in contact with Ebola. The Feds claim this will “isolate” West Africa by dissuading healthcare workers from traveling there. A simple solution is to enforce a stay-in-your house quarantine for all returning travelers, but to pay returning healthcare workers $15,000 for enduring the 21-day quarantine. The government could provide luxury quarters for those who did not wish to be quarantined in their house. This tells the health workers, “We love you, and we want you to help out in West Africa, but we won’t let you put millions of Americans at risk.”
Once again Obama has “led from behind” with disjointed, incoherent, indecisive half measures, instead of aggressively and proactively addressing a crisis. His ineptitude forced Governors Christie and Cuomo to improvise a policy that will inconvenience a handful of people but cut the risk that Ebola spreads in the U.S.
Copyright Thomas Doerflinger 2014. All Rights Reserved.
