An interesting editorial from the Fresno Republican, reprinted in the Calistoga California “Weekly Calistogian” of 14 February, 1919. It strikes me as interesting in both the thought given to what they expected after the epidemic but the need for social reform to support these expectation. – JS
The Weekly Calistogian
14 February 1919
AFTER THE “FLU”
Whatever we do or do not do about the influenza, it will burn itself out after a while—the fuel being human lives, says the Fresno Republican. But we must not imagine that the problem is ended then. In the first place we shall have recurrences of the influenza itself, probably for years. The cases will be fewer, and gradually milder, until they reach the stage where they constitute an individual rather than a social problem, but we must be prepared, for a long time, to care for a great deal of sickness, some of it among people who cannot be cared for properly at home.
But the main problem of “after the flu’’ is not the influenza itself. It is the multitudes of people who will have been weakened by it, and whose health, perhaps for life, depends on the sort of food and conditions of life they have during convalescence. After influenza, and especially after influenza-pneumonia, there is always an increase of victims of tuberculosis. The better food and surroundings an after-influenza patient has, the less likely he is to contract tuberculosis. And, just as an investment, good food and conditions are infinitely cheaper, even if they had to be supplied at public expense, than the social cost of tuberculosis afterward.
This is only one of the problems that the influenza will leave behind. But the general situation challenges us to provide even better public health service and public welfare service than we have had. For there will be increased need of both, and the cheapest, to say nothing of the most humane way, of meeting such problems is to prevent things in advance, rather than bear the consequences of them afterward.
The only reason this influenza epidemic is more serious than its predecessors is its unprecedented tendency to be complicated with pneumonia. Some influenza we have normally with us every year. Great epidemics we have at longer intervals, like the “grippe’’ wave of 1889-1890. If this pandemic were unmixed influenza, it would be an uncomfortable experience, which would moderately increase the death rate among the weak and old. But when, as this time, it comes linked with pneumonia “mixed infection, ” it acquires a new seriousness. And this seriousness will be projected into the “after flu” problem.
When to the characteristic depression of influenza is added the specific lung exposure of pneumonia, the tuberculosis problem is increased. Food, clothing, warmth, ventilation, rest, personal hygiene and living conditions are the preventive. We—which means we of the nation; not merely of Fresno — will need better social organization, to watch for the places where the lack of these things is most acute.