What polio in post-WWII America can teach us about living in a pandemic – NOVA Next

“Dear Miss Zurovsky,” the editor of The Patchogue Advance, a small upstate New York newspaper, began. “Thank you for your letter of September 16th making application for a position as a reporter on this newspaper. I regret to advise you that this job decidedly calls for a man.” 

The year was 1946, and my grandmother had graduated from journalism school at the University of Minnesota a few months earlier. But finding a job as a woman presented unexpected obstacles—obstacles that made her angry enough that she kept those letters and, many decades later, passed them on to me.

When I declared my intention to become a journalist in my late teens, she talked to me about her frustrations and read me her rejection letters. And when I entered the workforce, she told me how glad she was that I could finish what she started. In my first months of work at NOVA, I’ve thought of her often. She died two years ago but would have been thrilled (and, I hope, proud) to hear of my joining the staff of a show she loved to watch.

And there’s one more reason my memory has sought those letters during this time. We spoke often before she died about the sexism she experienced as a young professional woman. Only once, though, did she mention another aspect that made her first foray into journalism difficult: the “polio summer.” Everything was closed, she said; everyone stayed home. What was there to write about in a newspaper except polio?

As we drift into the depths of our “coronavirus summer,” I wonder what she would have made of all this. What would have been familiar about the surreal limitations of life in the COVID-19 era? What lessons did polio teach us that over the years we’ve forgotten?

A mysterious virus

In the throes of lockdown cabin fever, I often find myself—on my walks around my now-quiet neighborhood or sitting on the couch that has become my office—wondering what that polio summer was like. So, I put my journalism skills to work: I find old newspapers and radio coverage, I read public health reports and academic journal articles, and I talk to historians who have spent their lives studying the polio era.

Polio is an endemic virus, they tell me, which means it’s always been around. Until the turn of the twentieth century, children usually inherited immunity from their mothers, or else got minor cases early in life (a sore neck here, an upset stomach there) and developed immunity after that. It was only about 150 years ago that severe cases started to spike.

“It was really bad in the 1940s,” Conis says. “There was this really big disconnect between the U.S. experience winning the war—so triumphant in its science and technology, with the development of the atomic bomb and radar—and this new infectious disease everyone was powerless to stop. It was terrifying.”

Poliovirus is transmitted when tiny amounts of feces or saliva from an infected person end up in the mouth of a healthy person—often because one or both of those people did not wash their hands before eating. In a severe case of polio, the virus travels from the nose and throat to the intestines, then enters the bloodstream and begins to attack the nervous system. Spreading along nerve fibers, it destroys the motor neurons that control our skeletal muscles, leading to weakness and even paralysis. 

I learn that a polio outbreak often looked a bit like COVID-19 has so far. Some 95% of patients were asymptomatic; only around 4% experienced minor illness. And it was a fraction of those that were left paralyzed—the majority children. Some, paralyzed up to their necks, spent years or decades inside iron lungs, the coffinlike early respirators that helped them breathe. “Whole wards were given over to these enormous contraptions and the patients within them,” UC Berkeley vaccine historian Elena Conis tells me, “with health care workers to feed them, wash their hair, brush their teeth.”

Nurse next to child inside iron lung

A 1960 photo of a nurse beside a polio patient inside an Emerson respirator, or iron lung, in Rhode Island. Image Courtesy of Public Heath Image Libarary/Public Domain

One widely accepted explanation for the surge in severe polio cases follows the so-called “hygiene hypothesis,” positing that increasing standards of living led to cleaner homes and less opportunity for low-grade exposure to the virus from infancy (although recent research has challenged that theory). Regardless of the reason, the disease began a cruel reign around 1900, spiking annually during the hottest part of many years—what became known as polio summers.

“It was really bad in the 1940s,” Conis says. “There was this really big disconnect between the U.S. experience winning the war—so triumphant in its science and technology, with the development of the atomic bomb and radar—and this new infectious disease everyone was powerless to stop. It was terrifying.”

A tough and lonely season

That summer when my grandmother fought her way into journalism, Minnesota became the center of an especially ferocious outbreak. The Army turned a local military base into a makeshift hospital, but even that wasn’t enough. Minneapolis’ real hospitals overflowed, patient beds lining their hallways. That summer alone, Minnesota diagnosed 3,000 polio cases. More than 2,100 of those cases were children; of the 226 people that died, more than half were under the age of 15.

Yale University medical historian Naomi Rogers attributes the devastation of that year’s polio outbreaks in part to the end of World War II. All over the country, soldiers were demobilizing and coming home, she says. And they brought the disease with them.

“If people remember anything from the late 1940s, it’s often that as a child, you were hot, you were bored, but your parents wouldn’t let you out of the house to play with your friends.”

In the face of uncontrolled infection, Americans did the only thing they knew to do under the circumstances, Conis says, “which is basically what we’re doing now: isolating, closing churches, cancelling festivals and parties, closing parks.” Informational pamphlets from that period published by the likes of Lysol and MetLife urged children to stay away from basically anything fun—movie theaters, beaches, pools, and public transit. Newspapers warned families not to eat outdoors. High schools held graduation over the radio.

Like this spring and summer, it was a tough and lonely season. “If people remember anything from the late 1940s, it’s often that as a child, you were hot, you were bored, but your parents wouldn’t let you out of the house to play with your friends,” Rogers says. That’s because, she adds, it was impossible to identify who might be contagious and give a child polio. “In a lot of ways, it does look like today.”

One large polio virion and a microscope image of many virions

A digital model of a poliovirus virion (left) and a 1971 image of poliovirus virions taken with a transmission electron microscope (right). Image Credits: Manuel Almagro Rivas (CC BY-SA) and Public Health Image Libarary/Public Domain

To counteract the isolation, radio became the center of public life, today’s TikTok, Twitter, and Spotify, rolled into one. Local station KUOM attempted to fill the “fun” void with 150 hours of children’s programming, including a popular show called “Drawing to music,” after which kids all over the state sent in art inspired by the tracks played. When the epidemic lingered through September, delaying school, the KUOM producers also offered “School by Air,” with “classes” on topics like hygiene and geography. 

At the end of a special produced by KUOM about the summer of 1946, I listen to a snippet of scratchy programming thanking the “northwest children who are voluntarily carrying out a house quarantine as their part of a vigorous campaign to stamp out the polio epidemic,” and think of my grandmother listening, too. 

“Is it just always going to be like this?”

It seems like I feel a thrill of recognition every few minutes as I read through public health documents recounting the 1946 Minnesota outbreak. So much feels familiar, even beyond the overflowing hospitals and stir-crazy kids. As it turns out, my grandmother might have recognized the tensions the coronavirus has stirred up, the electric sense of impatience, anger, and desperation. 

As polio took over newspapers and she struggled to find something else to write about, that summer also brought a flood of GIs home from the war, eager to get back to normal by getting married, having kids, and buying a house. “People around the country were desperate to have a ‘regular’ life,” Rogers says. 

So, even as polio was spreading, 1946 marked a new era in American consumerism: the rise of fast food, the founding of hundreds of retail chains—and the beginning of the baby boom. “If you were thinking about how to do well in this society, you would either set up a toy shop or become a pediatrician,” she says. “Those were the growth industries.”

A billboard reading "fight infantile paralysis"

A 1962 billboard sponsored by the National Foundation for Infantile Paralysis (later called March of Dimes) in California. Image Credit: FDR Presidential Library & Museum, Flickr

Still, as with COVID-19, Americans found polio terrifying, in part because for many decades scientists could not pin down how it was transmitted: The virus’s long journey from the mouth to the nervous system made it difficult to untangle, and that lack of clarity stoked fear. “You have two epidemics, an epidemic of polio and an epidemic of hysteria,” one document quotes a Minnesota State Board of Health officer as saying. “It is a big mental problem. People who are normally perfectly stable go completely off the beam whenever anyone says ‘polio.’”

The late 1940s also represented a kind of golden age of American medicine, Rogers says, and the peak of public faith in medical science. Sure, “we had cool cars with fins and American Express cards for the first time,” she says with a wry smile as we chat over a current pandemic mainstay, Zoom. But scientific progress—in particular the idea that we could conquer diseases, one at a time—became an essential part of national identity and pride. That sense was only buoyed by health campaigns run by the March of Dimes, at the time the biggest polio charity in the world. The organization’s “poster children” were almost always depicted learning to walk, reinforcing the idea that medicine could provide a miracle cure.

Even before the war, “there was a sense that ‘the medical profession and scientists need to get their acts together,’” she says, a frustration that all-powerful American medicine couldn’t snap its proverbial fingers and make polio disappear. The combination of that faith in medicine with a post-war eagerness to get back to normal, and a public health situation that was anything but, created enormous tension. 

“It was that feeling that I know we have today,” she says, “You know, ‘is it just always going to be like this?’” 

Lysol, DDT, and a “weird cultural moment”

The parallels only deepen when it comes to our collective relationship with science. The fact that polio continued to spread despite public health mandates and precautions bred skepticism that doctors understood polio at all, Rogers says. Desperate for any potential weapon against the virus, Americans eventually turned not just to Lysol, but to DDT. The pesticide had been used during WWII to successfully quash outbreaks of diseases like diphtheria that were spread by flies. “It was irrelevant what any doctor said,” she says, even when those doctors began arguing that polio was likely not spread by insects. “Polio was so scary that you could understand why people would want to do over and above what the experts said you might do.”

On the day President Trump suggests injecting disinfectant to kill the coronavirus, I read an article by Conis about Americans’ obsession with DDT during polio summers. From Savannah, Georgia to Santa Monica, California, small towns and big cities sprayed streets, yards, parks, and even the insides of homes, Conis writes. In Illinois, the Army got involved, spraying the town of Rockford with three truckfuls of DDT. And during the summer and fall of 1946, my grandmother must have looked on—with fear or approval, I’ll never know—as the state of Minnesota sprayed the St. Paul state fair grounds with DDT, then allowed the previously cancelled event to go on as planned. 

“We have to recognize that people had to adapt to polio,” Conis says. We learned to mold our lives around the virus and its whims. As wars raged and waned, as the economy shrunk and recovered, we found a way through, but it wasn’t easy, and it wasn’t quick.

Rogers also sees echoes of this polio past in the current maelstrom raging over masks; in fact, she sees 1950s ideas about hygiene as the root of some of our 2020 conflict over basic COVID-19 precautions. Though early public health messaging focused on simple acts like hand-washing and cleaning the house as an essential part of disease prevention, the way Americans thought about dirt slowly began to drift away from focus on the germs themselves, becoming something more aesthetic and gendered. 

“MOTHERS!” she quotes a polio-era Lysol ad as trumpeting. “Do this to help keep your home hygienically clean—as many health authorities recommend.” Gradually, what had been a universally applicable message of hand-washing, for example, or not spitting, was taken up by advertisers selling water filters and liquid soap, she says. “It was increasingly seen as part of the domestic area and not connected so much with science, with medicine, even with disease.” 

The COVID-19 era, then, represents a “weird cultural moment” in that public health officials are struggling to reconnect the two ideas, she argues, ideas that have not been connected in the American psyche for some 70 years. That drift from dirt-as-disease to dirt-as-aesthetics “helps to explain how very difficult it’s been for health officials and scientists to start talking about the kinds of things your grandmother would have talked about,” she says, her tone rising with dry humor. “‘Wash your hands’? Like, who says that? That’s not an expert speaking!”

Looking out at the political and cultural landscape, “It is striking to see how much we are not in a golden age of American medicine; how challenging it is for health experts and scientists to gain public attention,” Rogers says. They might not have needed help from my grandmother in 1946. (She did eventually get a job, after the summer ended, editing a small-town Minnesota paper called The Crosby Courier.) But the work we do at NOVA feels especially essential now.

Vaccine hopes—and realities

I do think that, if she were here, she would want to make sure I’m washing my hands. I wonder what else she would advise me to do to get through this strange period in our history; what other parallels she would see that I’ve missed. Since I can’t ask her, I ask Rogers and Conis instead.

After polio, the U.S. pumped out vaccines for mumps, measles, and chicken pox, and Americans started to take medicine for granted, Rogers says. Public health became boring; unconquered diseases were seen as the concerns of “lesser” developing countries. In the 1960s and 70s, the prevailing attitude was, “Who would go into infectious disease? It’s not cool, it’s not interesting, it’s not important.” Vaccines were a fact of life, the development of a successful vaccine to combat a new virus merely a matter of time. AIDS, she points out, eventually upended this narrative, reminding us that “you don’t get a vaccine just because you want one.”

Child reciving oral polio vaccine drops

There are two polio vaccines: one administered by injection and another taken orally. The United States has only used the injected vaccine since 2000. Image Credit: shylendrahoode, iStock

As we blunder through the pandemic’s second season, we’re “looking for an instant solution, and there are none,” Rogers says. The story we tell about polio is that 1955 arrived and it melted away. Yes, church bells did ring at the announcement that a new vaccine had been deemed safe. But what followed became known as the Cutter Incident, a tragic misfire that caused 40,000 cases of polio, ultimately killing 10 children and paralyzing 200 more. And when a safe and effective vaccine finally did debut, it still required a protracted struggle to set up the infrastructure to distribute it. That took some two decades of confusion and chaos.

“One vaccine manufacturer planned to vaccinate its employees’ children first, and then sent a letter to shareholders promising their children and grandchildren priority access, too,” Conis wrote in a recent New York Times Op-Ed. Subsequent debate over how to distribute the vaccine in Congress got so heated that the speaker of the house was forced to call a “cooling off” recess.

So, Conis counsels both patience and flexibility. Modern polio epidemics started in 1894, she reminds me. It took us until the 1970s to bring the disease fully under control in the U.S. My grandmother’s polio summer was one of 10 years of cyclical epidemics that forced change on American life.

“We have to recognize that people had to adapt to polio,” Conis says. We learned to mold our lives around the virus and its whims. As wars raged and waned, as the economy shrunk and recovered, we found a way through, but it wasn’t easy, and it wasn’t quick. “If we’re lucky enough to have a vaccine in a year and a half, we’ll be luckier than any of our ancestors in history ever were.”

From where I sit—sheltering in place at home, writing an essay for a respected media outlet that will be edited by my female supervisors—I do feel luckier. Newspapers like The Patchogue Advance had a “very defined place for women” in the 1940s, Rogers says—namely, the fashion and home sections. Using that lens, “the polio epidemic was kind of a crossover topic,” she adds sardonically. “Crying children are kind of a ‘woman’s issue’ and hospitals have women in them…” 

But science was unequivocally a man’s realm. So, I’ll publish this essay in her honor, proud to follow in her footsteps as someone eager to tell the story of the viruses that have shaped our world.

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