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New York City's public health officials are pioneering a program to reduce the spread of the influenza epidemic that hit the city over one month ago. The city's approach to disease control is unlike that of any other city in the nation and has been met with much criticism and fear for the lives of New Yorkers. The city's Health Commissioner, Dr. Royal S. Copeland, has refused to close schools, theaters, churches, and places of "public amusement" despite many requests to do so from prominent members of the government's medical community. Public health officials in Philadelphia, Washington, Boston, and Baltimore have taken such measures to reduce crowding--a known cause of the spread of disease.
But according to Copeland, closing places of public amusement does not necessarily lessen the instance of physical contact among citizens. Rather, it displaces it and causes panic. (However, he does advise against attending dance halls.) In defending his position to keep schools open, Dr. Copeland commented, "Now how much better it has been to have those children under the constant observation of qualified persons than to close the schools, let the children run the streets and assemble when and where they would and if they get influenza to let them get it under conditions of which the Health Department had no knowledge and in which it was not prepared from the start to deal with the situation in the best way." Copeland went on to explain that the children are inspected from the start of the day and those who have symptoms are either sent home or to a hospital, depending on the caretaking conditions of their homes. Copeland also believes that the schools serve as places of education about the epidemic for children who may also carry the information back to their parents.
In response to this approach, former Health Commissioner, Dr. S. S. Goldwater, has announced that Copeland's plan is failing at the expense of the public. He said that the measures to exclude sick children from school are "lamentably weak" and that there is "almost criminal laxity" for carrying out education on the epidemic. Goldwater is currently working to get schools and theaters ordered closed to avoid the dangers that crowding brings.
But Copeland's first concerns are ventilation, sanitation, and education. Therefore, theaters are used as centers of education and must remain open.
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Although Goldwater dominates the opposition to Copeland's policies, other suggestions for dealing with the epidemic have been made. For example, the Surgeon General of the Russian Army, Dr. M. Iogolevitch, thinks that schools where influenza has been brought in should be closed for a few days until the next case walks through its doors. He instructs that the city be divided up into "sanitary districts" which will be overseen by one doctor and one inspector. The cases will be made known within the district, and nurses will be sent to the patient's home, where the patient is to remain. Iogolevitch also stresses the importance of staying indoors during sunset "to avoid the transition from day warmth to the night coolness." His plan is reminiscent of traditional public policy regarding plague.
However in this modern society, people are highly mobile. The city has one large center, not several isolated districts. Accordingly, Copeland has made the subway system a chief concern. He recognizes that sick people do not go to the theater or to church, but they do go to work, and everyone goes at the same time. To Public Service Commissioner Travis Whitney's delight, the city's big employers have been instructed to change work hours in order to spread peak travel times and reduce congestion of the subways. This has long been a goal of Whitney's and his predecessors. He explains, "Increasing numbers of lines to accommodate congestion just makes it possible to concentrate business and industry within a very small area." Of course, this will not be an issue if influenza becomes epidemic in Irvine.
Irvine can, however, learn from New York's policies on schools and crowding. Though strongly opposed by some, Copeland has announced that he will stick to his unconventional methods of combating the epidemic. Take note, Irvine--statistics show that he is on the right track.
Death rate per thousand by the end of epidemic week 4:
New York, 50
"Asks Experts' Aid To Check Epidemic." The New York Times 13 Oct. 1918: 18.
"Epidemic Lessons Against Next Time." The New York Times 17 Nov. 1918: C10.
"Epidemic May Solve Transit Problems." The New York Times 13 Oct. 1918: E2.
"To Defend City's Health." The New York Times 5 Nov. 1918: 13.