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historian Medical

Medical historian compares the coronavirus to the 1918 flu pandemic: Both were highly political – CNBC

Members of the American Red Cross remove influenza victims in 1918.

St. Louis Post-Dispatch | Tribune News Service via Getty Images

In less than nine months, the coronavirus has quickly spread to more than 33 million people across the globe, killing more than 1 million and becoming the third-leading cause of death in the United States, behind only heart disease and cancer. 

There is nothing in recent history that compares to a contagious crisis of this magnitude, according to historians who study infectious diseases and disasters. The H1N1 flu pandemic in 2009 infected an estimated 60.8 million people in its first year, but the virus wasn’t nearly as severe as Covid-19, killing between 151,700 and 575,400 worldwide, according to the Centers for Disease Control and Prevention. MERS, another coronavirus that emerged in 2012, was much deadlier than Covid but significantly less infectious with only 2,494 reported cases.

Covid-19 is “a scary virus and definitely one that you do not want to get,” said Howard Markel, a physician and medical historian at the University of Michigan. “It’s a very dangerous, very crafty, stealthy virus.”

The 1918 virus was also a “novel” virus, meaning it was brand new. Like Covid-19, no one had any immunity to it, and it was highly infectious, spreading through respiratory droplets that pass when an infected person coughed or sneezed.

Different symptoms

The viruses attacked the body in different ways. Covid-19 can be mild, sometimes causing no symptoms whatsoever, or severe — putting patients in hospitals and on ventilators for weeks and leaving them with lingering effects of fatigue and coughing for months. Covid-19 can also be unpredictable, stressing virtually every system in the body, including the heart, kidneys and brain.

The 1918 flu pandemic came in three waves, occurring in the spring of 1918, the fall of 1918; and the winter and spring of 1919, according to the CDC. 

The 1918 flu killed 50 million people worldwide from 1918 through 1919, including 675,000 Americans, according to the CDC. It is estimated that one-third of the world’s population became infected with the virus.

The first wave of the 1918 flu came with the usual flu symptoms: fever, nausea, body aches and diarrhea. The second wave was dramatically worse. It could set in suddenly, killing patients within days or even hours after symptoms began. The virus would cause their lungs to fill with fluid and the lack of oxygen would make their skin turn blue until they suffocated.  

There also wasn’t a vaccine for the 1918 flu, and, like Covid-19, the crisis was highly politicized in the United States. 

“We were getting involved in World War I and it was a very patriotic effort. You know, the war to end all wars,” Markel said. “They were sending off young men in parades. Women were left behind and starting Red Cross chapters and making bandages and all sorts of things, sending the men off in a proper way.”

The pandemic became mixed in with the patriotic fervor, he said.

Like today, schools and businesses were closed and infected people were quarantined, according to influenzaarchive.org.

1918 mask mandates

“You told people to wash your hands, don’t cough on people, stay at home, stay away from other people,” he said. “It was the patriotic thing to do to not cough on people or stay home if you were sick.”

But the thing that really drew public backlash were mask recommendations. As it turns out, resistance to wearing the face coverings isn’t new. People during the 1918 pandemic called them dirt traps and some clipped holes so they could smoke cigars. 

In Europe, the Italian Supreme Command asked residents not to fail their cities by not wearing a mask. Several U.S. cities implemented mandates, describing them as a symbol of “wartime patriotism.” In San Francisco, Mayor James Rolph said, “conscience, patriotism and self-protection demand immediate and rigid compliance,” according to influenzaarchive.org. But some people refused to comply or take them seriously, Markel said.

San Francisco residents considered masks a nuisance while others harbored resentment for being forced to wear them, he said. Some of them were arrested.

“One woman, a downtown attorney, argued to Mayor Rolph that the mask ordinance was ‘absolutely unconstitutional’ because it was not legally enacted, and that as a result, every police officer who had arrested a mask scofflaw was personally liable,” according to influenzaarchive.org.

Pandemic news

The news in 1918 didn’t flow as quickly as it does today with the internet and smartphones, but it also couldn’t be manipulated as much as today and newspapers published at least six or seven editions a day back then, Markel said. State public health departments also held regular public press briefings, he added. 

“If you wanted to partake on it, it was there,” he said. 

Emergency Medical Technicians (EMT) lift a patient into an ambulance while wearing protective gear, as the outbreak of coronavirus disease (COVID-19) continues, in New York City, New York, March 24, 2020.

Stefan Jeremiah | Reuters

Some newspapers referred to the virus as the “Spanish flu,” even though the first known case was reported at an army base in Kansas. Spain remained neutral throughout World War I and reported on the virus freely, giving the impression that the outbreak was bad there. Eventually, newspapers would just refer to it as “influenza” or the “influenza epidemic,” Markel said.

Woodrow Wilson vs Donald Trump

Additionally, some reports have suggested that then-President Woodrow Wilson downplayed the virus, but that is a “wrong and a false trope of popular history,” Markel said. Wilson, who would later contract the virus, was organizing and commanding the U.S. effort in World War I and once the war ended, he sailed for Paris, where he stayed until April of 1919 organizing a peace treaty and the League of Nations, Markel said. 

“The federal government played a very small role in American public health during that era. It was primarily a city and state role and those agencies were hardly downplaying it,” he said. 

Unlike today, there was no CDC or national public health department. The Food and Drug Administration existed but consisted of a very small group of men. Additionally, there were no antibiotics, intensive care units, ventilators, IV fluids or vaccines. “You got a bed or maybe nursing care,” Markel said.

But there was an epidemiologist much like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who withstood criticism for publicly pressing for safety protocols, according to Forbes. 

“At the center of public health efforts in both states was a practical, plainspoken, bespectacled scientist: Dr. Thomas Dyer Tuttle, who became a powerful, if polarizing, figure in the fight against the Spanish flu,” according to Forbes. 

Scientists hadn’t even seen a virus under the microscope at that point, said Graham Mooney, a medical historian at Johns Hopkins University School of Medicine. They didn’t have the technology and they knew almost nothing of virology, which was considered a nascent science because viruses are so small, he said. In fact, some scientists thought the 1918 virus was caused by a bacteria called Haemophilus influenzae, he said.

“Now we have a much greater capacity to create a preventative mechanism through immunizations and vaccinations,” Mooney said. 

Massive death toll

The 1918 virus also tended to kill differently than Covid-19, Mooney and Markel noted. With World War I, there was a massive movement of men across all of America and Europe. While the coronavirus can be especially severe for the elderly and those with underlying health conditions, the 1918 virus was unusual in that it killed many young adults, Markel said.

“Influenza generally has a U shaped mortality curve, meaning it looks like a U, but the tops of the U are the most deadly,” Markel said. “But in 1918 it was a W shaped mortality curve and that upside-down part of the W, the V, was young people between ages 18 and 40 dying like flies. That was odd. That was not typical for previous flu pandemics or subsequent ones.”

It’s also important to consider population when talking about outbreaks or disasters, said Samantha Montano of the Massachusetts Maritime Academy, who studies disasters. In 1918, the world population was much smaller with an estimated 1.8 billion people. Today, there are nearly 8 billion on the planet.

Mooney echoed those remarks, saying, “We’re talking about a global population that is sort of smaller than it is now.” He said the death toll from 1918 virus likely had a great impact on the workforce who were unable to work from home or remotely like we can today.

“You end up having major structural, economic and social readjustments when you have such a massive death toll like that,” he said. “We have social welfare networks … people travel around the globe. We have different societies and economies.”

Medical historians say the U.S. can learn from the 1918 virus.

“It is utterly earth-shaking what we’ve done in the last century alone,” Markel said. 

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Medical suspensions

UFC 252 medical suspensions: Stipe Miocic, Daniel Cormier both need eye clearance – MMA Junkie




By |


Stipe Miocic and Daniel Cormier both need to have issues with their left eyes checked out following their heavyweight title trilogy bout at UFC 252 on Saturday.

MMA Junkie obtained the full list from the Nevada Athletic Commission on Monday. Fighters can return sooner than the duration of their suspension if cleared by a doctor.

Miocic (20-3 MMA, 14-3 UFC) and Cormier (22-3 MMA, 11-3 UFC) had a grueling five-round fight in the headliner of the event at UFC Apex in Las Vegas, with Miocic keeping the belt. A second-round eye poke on Cormier apparently tore his cornea, and that’s one of the issues “DC” will need checked out post-fight. Miocic, meanwhile, needs hie eye examined, too.

Outside of the main event, bantamweight prospect Sean O’Malley (12-1 MMA, 4-1 UFC) faces the longest medical suspension. He hurt his leg in a first-round TKO loss in the co-main event, and will need his ankle cleared, otherwise he’s out until February 2021.

Complete UFC 252 medical suspensions included:

  • Stipe Miocic: Must have retinal specialist clearance on left eye; minimum suspension until 9/30/20, no contact until 9/15/20
  • Daniel Cormier: Must have left eye cleared by an ophthalmologist or no contest until 2/12/21. Minimum suspension until 9/30/20, no contact until 9/15/20
  • Marlon Vera: No suspension
  • Sean O’Malley: Must have orthopedic doctor clearance on right ankle or no contest until 2/12/21. Minimum suspension until 9/30/20, no contact until 9/15/20
  • Jairzinho Rozenstruik: No suspension
  • Junior Dos Santos: Must have laceration under left eye cleared by a doctor or no contest until 10/15/20, no contact until 9/30/20
  • Daniel Pineda: Suspended until 9/30/20, no contact until 9/15/20 due to left eyebrow laceration
  • Herbert Burns: Suspended until 9/30/20, no contact until 9/15/20 due to right eyebrow laceration
  • Merab Dvalishvili: No suspension
  • John Dodson: No suspension
  • Vinc Pichel: No suspension
  • Jim Miller: Must have cut on bridge of nose cleared by doctor or no contest until 9/30/20, no contact until 9/15/20
  • Virna Jandiroba: No suspension
  • Felice Herrig: No suspension
  • Danny Chavez: No suspension
  • TJ Brown: Must have left orbital fracture cleared by an ophthalmologist or no contest until 2/12/21. Minimum suspension until 9/15/20 with no contact until 9/6/20
  • Livinha Souza: No suspension
  • Ashley Yoder: No suspension
  • Chris Daukaus: No suspension
  • Parker Porter: Suspended until 9/15/20, no contact until 9/6/20
  • Kai Kamaka: Must have facial lacerations cleared by doctor or no contest until 9/30/20, no contact until 9/15/20
  • Tony Kelley: Suspended until 9/15/20, no contact until 9/6/20 due to forehead laceration

, , , , , , , , , , , , , , , , , , , , , , , News, UFC

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Medical Miami

Miami medical teams feel helpless as COVID-19 devastates South Florida – Reuters

MIAMI (Reuters) – As the coronavirus ravages Florida, healthcare workers in Miami hospitals are struggling to cope with the emotional and physical impact of treating a crushing wave of COVID-19 patients.

After seeing 10,000 new cases a day become the norm across the state in July, many of those on the frontlines are frustrated with the apparent inability of local, state, and federal governments to coordinate an adequate response. They are equally aghast with what appears to be the reluctance or refusal of many Floridians to honor safety precautions to stop the spread of coronavirus.

“I know, and my colleagues know, that we’re putting a Band-Aid on a problem, we’re supporting people as best we can to get them through, but the real fight happens outside,” said Dr. Eric Knott, a pulmonary and critical care fellow working in three of Miami’s largest hospitals. “If you can’t stop the spread, all of my work is for nothing.”

For Miami doctors, concerns about the virus far surpass those stirred up by even the largest hurricanes.

“A hurricane tends to be a sort of finite amount, and this is infinite,” said Dr. Mark Supino, an attending physician in Jackson Memorial Hospital’s emergency department.

Many healthcare workers and union leaders were critical of Miami’s reopening several weeks after the number of cases of the novel coronavirus first began rising in early March.

On Friday, state health officials reported a total of 402,312 cases across Florida, with 135 new deaths bringing the total to more than 5,600.

While the death toll in South Florida has not approached that of New York City, an early epicenter of the U.S. outbreak, hospital beds and intensive care units across the region have filled to capacity, and in some cases surpassed it.

At Jackson Memorial Hospital, the largest facility in the region, officials have called in hundreds of additional medical workers as employees have fallen sick and had to stay home or be hospitalized. An auditorium was sealed and prepared for COVID-positive patients with a negative pressure system to limit the air flow to prevent new infections.

“In 10 years of medicine I never had to put another nurse on life support, I never had to worry about my co-workers dying,” said Kevin Cho Tipton, a critical care nurse practitioner who works at one of Miami’s largest public hospitals. “It’s been emotionally very challenging, physically very challenging.”

Among the most difficult and stressful parts of the job are the sheer number of ICU patients.

Healthcare workers must constantly keep tabs on the vital organs of patients on ventilators, and many of the sick have to be flipped over and over again to stave off any complications from lying in one position for a prolonged period. To do so without risking detaching any of the life support systems can take up to six people.

The intensity has overwhelmed some.

Jude Derisme, vice president of Service Employees International Union 1199, which represents 25,000 medical workers across Florida, said the union had to help get one nurse, a 25-year veteran, off a hospital floor after a “break down.”

FILE PHOTO: Emergency Medical Technicians (EMT) arrive with a patient while a funeral car begins to depart at North Shore Medical Center where coronavirus disease (COVID-19) patients are treated, in Miami, Florida, U.S. July 14, 2020. REUTERS/Maria Alejandra Cardona/File Photo

“My fear is that if we don’t find a way to bring these numbers down over the next two weeks, if they’re worse than these last two weeks, we’re going to be stretched too thin,” said Martha Baker, a registered nurse and president of Service Employees International Union 1991, which represents about 5,600 medical professionals within Miami’s Jackson Health System. “The sad news is that that’s when patients die.”

While her chapter of the union along with others across Florida have advocated for more personal protective equipment, better overtime pay, hazard pay, and worker’s compensation for those waylaid by the virus, they also acknowledged that medical workers can only do so much against the pandemic.

“This is war, and instead of bullets we’ve got viruses,” Baker said. “If we don’t find a way to dampen our curve we just keep chasing our tails.”

Reporting by Zachary Fagenson in Miami; Editing by Frank McGurty and Tom Brown

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Medical Oklahoma

Oklahoma Medical Professionals Concerned With Spike In COVID-19 Cases In State – news9.com KWTV


Tuesday, July 7th 2020, 4:40 pm

By: Karl Torp



On Tuesday, the Oklahoma Department of Health reported 858 new COVID-19 cases.

That shatters the previous record high of 585 cases.

The new numbers have health experts once again calling for a mask mandate. 

“I strongly believe we need to have a mask mandate,” said Dr. Dale Bratzler, OU’s chief COVID officer.

Bratzler said wearing masks will dramatically slow the transmission of the virus and data said wearing a mask could ultimately improve the economy.

There is research that suggests COVID-19 has mutated to become a more contagious virus, but not less dangerous, Bratzler said.

“The studies I have read suggest there is more virus in the nose of those people, so they spread it easier,” Bratzler said.

The state health department data shows 9.8% tested positive of the more than 25,000 tested over the three-day holiday weekend.

More people are being tested, but the infection rate is also increasing.

New York Gov. Andrew Cuomo added Oklahoma to a list of 19 states under a quarantine order when entering the state.

The number of current hospitalizations in Oklahoma has more doubles in the past three weeks and now stands at 426.

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Medical suspensions

UFC 250 medical suspensions: Amanda Nunes, Felicia Spencer face potential six-month terms – MMA Fighting

Two-division UFC champ Amanda Nunes and featherweight title challenger Felicia Spencer had very different competitive outcomes at UFC 250, but both face potentially long timeouts.

According to medical suspensions released on Monday by the Nevada Athletic Commission, which regulated the ESPN+ pay-per-view event this past Saturday at UFC APEX in Las Vegas, Nunes needs an X-ray of her right tibia and fibula to avoid a six-month suspension.

Spencer, meanwhile, needs doctor clearance for an orbital fracture and broken nose to shorten a half-year timeout.

Nunes battered Spencer over five rounds to retain the UFC featherweight title. So dominant was the champ’s performance, many fighters said online that the Spencer’s corner could have thrown in the towel.

If Nunes follows through with her stated post-fight plans, a six-month suspension will have no effect on her career. The champ said she might not fight for the rest of 2020 as she prepares for the arrival of her daughter with UFC strawweight Nina Ansaroff.

In other notable suspensions, Raphael Assuncao and Eddie Wineland, who were viciously knocked out in respective bouts against ex-champ Cody Garbrandt and Sean O’Malley, received 60-day suspensions.

Here’s the full list of medical suspensions from UFC 250:

Amanda Nunes: needs X-ray of right tibia/fibula – if broken, needs orthopedic doctor clearance or suspended until Dec. 4; suspended at a minimum until July 7 with no contact until June 28.

Felicia Spencer: needs clearance from maxillofacial surgeon on left orbital floor and nasal fracture or suspended until Dec. 4; suspended at a minimum until Aug. 6 with no contact until July 22.

Raphael Assuncao: suspended until Aug. 6 with no contact until July 22.

Neil Magny: suspended until July 7 with no contact until June 28.

Eddie Wineland: suspended until Aug. 6 with no contact until July 22.

Chase Hooper: needs X-Ray of right thumb – if broken, needs orthopedic doctor clearance or suspended until Dec. 4; suspended at a minimum until July 7 with no contact until June 28.

Gerald Meerschaert: suspended until July 22 with no contact until July 7.

Cody Stamann: suspended until July 7 with no contact until June 28.

Brian Kelleher: needs right foot X-ray – if broken, needs orthopedic doctor clearance or suspended until Dec. 4; suspended at a minimum until July 7 with no contact until June 28.

Charles Byrd: needs left wrist X-ray – if broken, needs orthopedic doctor clearance or suspended until Dec. 4; suspended at a minimum until July 7 with no contact until June 28.

Alex Perez: needs right ankle, foot and right ribs X-ray – if broken, needs orthopedic doctor clearance or suspended until Dec. 4; suspended at a minimum until July 7 with no contact until June 28.

Jussier Formiga: suspended until July 22 with no contact until July 7.

Devin Clark: needs clearance from maxillofacial surgeon on left orbital floor fracture or suspended until Dec. 4; suspended at a minimum until Aug. 6 with no contact until July 22 for laceration.

Gilbert Burns: needs new MRI by June 3, must have left foot sutures cleared by doctor or no contact until July 7.

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journal Medical

Medical journal retracts study on hydroxychloroquine for Covid-19 treatment – TRT World

A medical journal has retracted an influential study which claimed the malaria drug hydroxychloroquine may increase heart problems in Covid-19 patients. The article, published in the Lancet last month, prompted the World Health Organization to stop trials of the drug. But as Shamim Chowdhury reports, scientists say there’s still little evidence that it’s beneficial in treating coronavirus.

#Hydroxychloroquine #Malaria #Covid19

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Medical Senior

Senior Medical Advisor in China Warns of Second Wave, Says Country is ‘Not Better Than the Foreign Countries’ – Newsweek

A medical adviser to the Chinese central government has warned citizens are “still susceptible” to new infections during a second wave of COVID-19.

Dr. Zhong Nanshan, a pulmonologist who rose to prominence during a SARS epidemic in the early 2000s, made his remarks this weekend after new clusters of the novel coronavirus re-surfaced in some regions of China, including in the city of Wuhan where the infectious respiratory disease caused by the coronavirus is believed to have originated last year.

Dr. Nanshan does not hold an official government position, but has emerged during the health crisis as a figurehead for China’s containment efforts on state TV, relaying the confirmation in January that the disease spreads from person-to-person.

Now, speaking after Chinese officials have moved to loosen city quarantines and reopen travel routes, the veteran medical expert says the crisis is not over yet.

“The majority of Chinese [citizens] at the moment are still susceptible to the COVID-19 infections because [of] a lack of immunity. We are facing a big challenge, it’s not better than the foreign countries… at the moment,” he said in an interview with CNN.

On May 11, Wuhan officials had reported the first new cluster of infections in the city, roughly a month after the 76-day lockdown ended, according to Reuters. There were five new cases confirmed, with citizens tracked to the same residential area.

Last weekend, Chinese authorities announced the city of Shulan, in the Jilin Province, had been re-designated as high risk after a new cluster was tied to a woman with no known previous exposure to the virus, The Guardian reported.

As a result, state media outlet GCTN reported city authorities ordered the temporary closure of all public places and told all residents to stay home.

China has officially recorded just over 84,000 cases of novel coronavirus, but the data has been met with skepticism from government officials and health experts, who have questioned the sudden drop in infectious and a lack of transparency.

On a global scale, China is not the only nation concerned about a second wave of infections, with officials in Europe and the U.S. planning for future outbreaks.

The director of the Centers for Disease Control and Prevention (CDC), Robert Redfield, told The Washington Post last month a second wave of COVID-19 in the U.S. may be even worse than the first as it could coincide with the start of the flu season.

Chinese officials deny playing down the dangers of COVID-19, although some experts have suggested the real number of cases could be four times the official figure. Globally, there have been over 4.6 million cases and more than 312,000 deaths linked to the coronavirus so far. The U.S. has recorded at least 1,467,884 infections.

Contrary to the stance of U.S. intelligence, Secretary of State Mike Pompeo claimed to have “significant” evidence the virus came from a Wuhan laboratory. He later walked back the comment, saying it may have come from “the vicinity of the lab.”

President Donald Trump previously alluded to a similar suggestion, appearing to link the pandemic to the region’s Institute of Virology. Last month, U.S. intelligence said in a joint statement it agreed the virus was “not man-made or genetically modified.”

Speaking to CNN, Dr. Nanshan said claims that the virus could be traced to a Chinese laboratory were unlikely, noting he believed the disease was linked to animals.

Dr. Anthony Fauci, a senior medical advisor to the U.S. government, recently agreed that the evidence suggested the virus had “evolved in nature and then jumped species.”

Zhong Nanshan
China’s top Severe Acute Respiratory Syndrome (SARS) expert Zhong Nanshan during his rounds in the infectious disease ward, at the Guangzhou Institute of Respiratory Diseases 10 June 2005, in Guangzhou, southern China’s Guangdong province.
GOH CHAI HIN/AFP/Getty

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