Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
Business must be conducted in epidemic as well as in normal time, and
employees must go to and from their places of occupation. In cities
where the distance from the residence to the business districts is
great, street cars and other public conveyances must be used. Their use
undoubtedly increases the number of contacts and leads to a wider
distribution of the disease, but, like eating in public restaurants, it
is a chance which many have to take. Few places offer better
opportunities for exposure than street cars—where people of all grades
of intelligence, representing all states of health and degrees of
cleanliness and uncleanliness, are crowded closely together, breathe
into each other’s faces, and handle the same straps and supports.
In Pittsburgh the cars have a seating capacity for from 30 to 50
persons, but during the morning and evening hours they are crowded to
capacity, and are commonly seen to carry more than 100 passengers at a
time. Here, too, the unkempt, indifferent foreign element is
conspicuous, and these people are known to disregard all hygienic
teachings. A few days after the appearance of the epidemic the street
cars were placarded with warnings against coughing, spitting and
sneezing. The cards instructed people who became ill to go home, to go
to bed and to remain there until they were well. Later a second order
appeared which gave notice that all windows in street cars were to be
kept raised six inches and that no heat was to be allowed in the car.
The order was intended to improve ventilation, and, for a wonder, it was
enforced. During the first few days the weather was fine, warm and
clear, and the draught caused by the open windows brought no discomfort;
but later the weather became cold and several days of drizzling rain set
in. The cars with open windows became very uncomfortable, but the
streetcar employees insisted upon obeying the order to the letter. No
judgment was exercised by them, and the windows were kept open night and
day, cold or warm, crowded or empty, in fair and rainy weather alike,
and no heat was allowed to be turned on. Many people preferred standing
to exposing their backs and necks to the cold draughts, and it is more
than likely that such use of open windows did far more harm than good.
As above quoted, Vaughan pointed out that crowding is just as dangerous
out of doors as indoors, and it is certain that crowding in cold,
draughty cars is dangerous, both from the close contact and because of
the added danger of lowering bodily resistance.
In an attempt to decrease the crowding on public conveyances the
so-called “stagger-hour” system was adopted in New York. Under this
arrangement manufacturers and business houses changed their working
hours in such a way that the morning and evening travel was spread out
and the average number of people carried per hour was proportionately
decreased.
Public-domain text, read in full here on John Shaqi.
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