When faced with the threat of disease, the impulse of most Americans is to think about medical technology and miracle drugs. These are not likely to be much help in the battle against swine flu — but the history books might.
As history has proven, the best way to halt a deadly virus is to keep infected people away from others. In 1918, an influenza pandemic caused by a strain of flu similar to the one identified in Mexico killed more people than died in all of World War I. Up to 50 million people died worldwide. The greatest number of deaths occurred among young adults between the ages of 15 and 35.
At the time, young American men were being mustered into military camps from all corners of the country to prepare for the war. A few brought to those cramped quarters a new strain of flu. They quickly infected one another at an astonishing rate. As they were ordered to ship out, the epidemic spread along the train lines they used, with the flu jumping into the civilian population at every stop, right up to the harbors and port cities where they departed. Many experts think the flu followed these troops on their convoys into Europe, causing millions more to die.
We risk making that same fatal mistake this time around.
The Obama administration has developed plans to send National Guard troops from all over the U.S. to the Mexican border to help contain the violence from the bloody drug war raging there. I hope that by now the White House has realized this is a really, really bad idea. Sending the Guard right now to battle drug war lords could accelerate the spread of the swine flu among a high-risk group while giving the virus a free pass to travel all over the United States as the troops rotate home.
The 1918 pandemic offers additional stark lessons. While an effective vaccine may be found against this rare strain of swine flu, it will take many months to produce in large amounts. The best weapons we have right now are not glamorous and have little to do with doctors, drugs and hospitals: They are isolation, hygiene and controlling large gatherings of people.
New Zealand just quarantined a group of students who had flown back from Mexico. We may need to do the same thing.
Americans are not used to giving up individual liberty in the name of the common good. But that attitude is exactly what diseases such as the swine flu virus thrive on.
Heading out to church, the movies, restaurants, subways, supermarkets, day care centers, schools and other places where large numbers of people gather is a recipe for spreading the virus. What if infected people and those who have close contact with them won’t stay home? What if people with symptoms slog in to work anyway? Will we intrude on their basic rights and make them stay home? Are we willing to cancel public events and close schools, museums and churches until the infection passes, no matter how loud the protests?
Good hygiene — washing your hands frequently; wearing a filtering mask; keeping doorknobs and surfaces clean; being careful about sneezing, spitting and coughing — is helpful in controlling the spread of nearly all infectious diseases, swine flu included.
Each of us needs to take responsibility for stopping the spread of the flu.
What the nation needs is not to send an army to sit in the path of a deadly virus. Instead, we need to prepare for a short period of time when individual rights to go where we want, spend time with who we want and assemble as we want yield to the necessity of protecting the common good.
Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.