As the summertime fades into fall, the issue of whether and how to reopen schools in light of the current Covid 19 pandemic has, understandably, been a topic of great discussion and concern to many. How education should look, from pre-kindergarten to higher education, and what form it should take, is being debated. The situation is rightly defined as fluid, by which people often mean the information available changes almost daily. Many have drawn comparisons between our current Covid-19 pandemic and a similar pandemic often referred to as the Spanish Flu of 1918, and there are some comparisons to be made. But these comparisons are most useful to the extent we can learn from them. And what we can learn is we may need to take actions without having all the information we want, that we may need to be comfortable with being uncomfortable.
Dr. Richard Shope, a well-regarded scientist who specialized in the study of flu and influenza, opened one of his most famous lectures as follows:
“We are faced at the moment with the most publicized influenza epidemic of all time, and there is great diversity of opinion concerning its eventual course and outcome. Some, who believe that the present outbreak is no different from those that have appeared periodically since the 1918-1920 pandemic, contend that it will come and go without any serious effects and that the public is being unduly alarmed. Others feel that the present outbreak bears some of the earmarks of the epidemic illness that occurred in the spring preceding the great influenza pandemic of the autumn of 1918 and that, as such, may constitute but the first wave of a more serious type of influenza to follow.”
Shope wrote this in 1958, yet his words sound like the atmosphere of today. Yes, there are differences between the respective viruses, but the point here is not to discuss epidemiology but to note how today has so many historical parallels.
In 1918 the Spanish Flu was a worldwide pandemic, first appearing – it is generally believed – in Spain in the spring of that year. This struck many troops in Europe and throughout the world, but it was relatively mild, focused on people ages 15 to 34, and then disappeared. A second wave struck starting in the last week of August, and this was a much more virulent version. Data suggests that in the U.S., the second wave started in Boston, possibly brought over from Europe. Boston was a major hub for troops and troop movement. Many young and healthy soldiers were struck down and died quickly from the disease.
Shope discussed a much-studied experiment, or what today would be called a “clinical trial,” conducted nearby in Boston. The Navy and Public Health Services in November and December of 1918 sought and obtained sixty-two volunteers, naval prisoners age 18 through 34 on Deer Island in Boston Harbor. These prisoners were offered to have their sentences reduced or commuted if they volunteered. The volunteers were exposed to the flu in a variety of ways, including but not limited to, intravenous injections, arranging for conversations and close contact between test subjects and infected individuals, and having their nose and/or throat swabbed with secretions from infected persons. One prisoner developed a mildly inflamed throat. That was it. All others showed no signs of the flu.
Why? Science is still not sure, but it leads to some speculations about flu and initiated a discussion about acquired immunity. Perhaps some of the prisoners had contracted the earlier, milder version of the flu and were asymptomatic, or were all naturally immune, or some combination thereof. Could all the prisoners have been exposed and developed an immunity? Or perhaps they had a natural immunity? With sixty-two volunteers that seemed unlikely, but not totally impossible. So the experiment was performed again in San Francisco, this time with fifty volunteers who would receive pardons for military crimes, but this trial had stricter controls. All the volunteers had been at the naval base on Yerba Buena island in San Francisco Bay, and it was believed none had been exposed to the first wave of the flu. This experiment produced the same results.
Not one prisoner was infected with the flu. Why? How could this be? The then-raging flu was striking down young and presumable healthy individuals by the thousands, particularly in military bases. Scientists then and to date have studied these cases, and while there are many theories, there is no conclusive answer. The results of these experiments are counter-intuitive to most theories of how flu spread. On a legal note: these experiments could not take place in the U.S. today, at least not as they were conducted, because of laws that have been passed since then which prohibit giving too attractive, and/or unethical incentives to participate in a clinical trial.
That uncertainty, that unknown, may not be comforting. But it teaches an important point. When one advocates not going back to school, not going back to playing school sports, not returning to in-person education, until we have “all the answers,” one has to be prepared to potentially change how things are done going forward forever. In other words, we may never have all the answers, just as the medical and scientific community cannot tell conclusively why none of the Deer Island volunteers came down with the flu. This is not meant as a criticism, but an observation. Maybe this will result in a complete change in the way education is delivered. Full disclosure – this writer has taught classes both on the ground and virtually, and believes that while virtual instruction can be effective, it is not as good an instructional method – for most students – as in-person learning. That does not mean some schools and districts should not continue with virtual learning; rather, the form of educational instruction is going to have to be tailored to the particular school and district.
Schools attempting to resume some form of in-person learning need to look at the same information and address student, teacher and staff safety. This involves such varied issues as the mandatory wearing of masks, the sufficiency of the ventilation and filtration in schools, and how student transportation is going to work. (To be clear, this writer is a masks are mandatory advocate.) That list just scratched the surface. And of course, all these precautions have costs.
We may never have “all the answers,” although we may have a vaccine – Shope was a vaccine proponent. We should always look for the answers, but we need to be prepared to act without having all of them, and for some districts, that may mean continued virtual learning. We must ask, however, is what can we do better to educate all students based on what we do know and our health and education experts recommend? Our answers to that question, our responses, will need to be as fluid as the situation we are trying to address.
William Connell is an attorney, educator, author and member of the North Smithfield School Committee. Opinions stated are his alone and do not represent the entire committee.
