From polio to Covid-19, book by Corkman tells a tale of two epidemics

I WAS unlucky in catching polio in Cork in 1956 as this was one of the last polio epidemics ever in Western Europe and the U.S.

Dr Jonas Salk had discovered a vaccine that had been successfully tested the previous year and, at the time I fell ill, mass inoculation was being rolled out for the first time to stop the spread of the virus in Chicago. Across the city, health workers took over vacant shops, the forecourts of gas stations, the backs of trucks, parks and street corners to vaccinate people.

The number of new infections in Chicago declined as herd immunity was established, marking a turning point in the effort to stop epidemic polio. 

The success of this decades-long campaign was one of the great American achievements in the 20th century.

Not that it did me any good at the time as I was admitted to St Finbarr’s fever hospital in Cork city on September 30. When I was released three months later, I was at first confined to bed or in a wheelchair, and learned to walk again with metal calipers on my legs and wearing a plastic waistcoat to keep my back straight.

Though my mobility improved markedly over the years, I could not run and have always walked with a severe limp. 

I was conscious of my disabilities, but never thought much about why this had happened to me or about the epidemic in general. I could not have said with any certainty – and this self-inflicted ignorance was to continue until I was well into middle age – in what year it had taken place or whether it was caused by a virus or by bacteria. I sensed that thinking about this, picking at the emotional scar tissue, was not going to help me.

Only in the late 1990s, when I was in Iraq as a journalist talking to doctors and patients in ill-equipped hospitals hit by UN sanctions, did I start to feel it strange that I knew more about sickness in Baghdad than I did about polio in Cork, when it had been me lying in a hospital bed.

I started reading about this disease that has probably been around for thousands of years. There is an ancient Egyptian sculpture of a man with a wasted leg, looking very much like my own. Walter Scott was made lame by it as a child. But these were individual cases and it was not until the first half of the 20th century that epidemics began to sweep through cities.

Before then, most people contracted the virus in infancy, when their mother’s antibodies helped them to gain immunity. 

Long before the Covid-19 pandemic made the phrase ‘herd immunity’ infamous, the pool of people who had polio without knowing it was large enough to prevent pandemics.

It was modernity that gave the virus its chance: as 19th-century cities acquired clean water and efficient drainage systems, babies were no longer contracting it in large enough numbers to provide protection. As collective immunity faltered, epidemics would surge periodically through cities like New York, Melbourne, and Copenhagen. Devastating though these were, they seldom occurred at the same time in different places because vulnerability to the virus would vary.

I was surprised nobody had written a history of the Cork epidemic which had paralysed part of Ireland for the best part of a year. 

It lived on in popular memory as a terrifying event and there were plenty of victims still alive. Nevertheless, the epidemic had never been the subject of a book or a serious academic study.

I asked surviving doctors from that period, who were far older and therefore less numerous than their patients, why this was so. 

They believed people in Cork had been so frightened of the disease, they wanted to forget about it once vaccination had removed the danger.

Polio had carried an extra charge of terror compared to other diseases because its victims, whom it crippled or killed, were young.

As I read government documents and newspapers about the epidemic, I came to understand a further reason for the silence was that many Irish people were ashamed of what had happened, mistakenly imagining the epidemic was caused by Irish under-development, a symptom of the failure of independent Ireland to successfully modernise. I embarked on interviewing any medical staff and polio survivors I could find for a long article on myself and the epidemic published in 1998. I planned to write a book on the subject, but this was delayed post 9/11 when I was to spend much of my time reporting in Afghanistan and Iraq.

In 2005, I published a memoir on the epidemic as I experienced it called The Broken Boy. I described my experiences in the context of my family and of Ireland in the 1950s. 

The title was something of a misnomer, since I felt singularly unbroken, but it did at least tell the reader the book was about the suffering of a small child.

I am glad I researched and wrote it when I did as many of the best-informed witnesses died soon after its publication. Much of the text made gloomy reading but it ended on an up-beat note that later turned out to be over-optimistic.

At the end of the final chapter, I had written dismissively of the last prophetic line in Albert Camus’ novel The Plague, when he wrote: “The day will come when, for the instruction or misfortune of mankind, the plague will rouse its rats and send them to die in some well-contented city.” I found this a bit portentous and out of date, writing that polio might have been among the last of the life-threatening plagues, such as leprosy, cholera, tuberculosis, typhus, measles, malaria and yellow fever, to be eliminated or brought under control during the 20th century.

Polio epidemics had a surprisingly short career: less than 70 years between the end of natural immunity and widespread use of the Salk vaccine. It was a story with a seemingly happy ending and this was the topic of my original book. 

Few realised – certainly I didn’t – that if polio epidemics were a product of modernity and not of backwardness, the way might be open for other epidemics of equal or greater severity.

I was surprised but not very alarmed when Covid-19 was first identified in Wuhan at the end of 2019, as previous coronavirus outbreaks, such as SARS 1 and MERS, had not spread far and been suppressed. As more information about the virus emerged, it struck me that in some respects the pandemic more resembled a polio epidemic on a world scale than the 1918/19 Spanish flu outbreak to which it was often compared. Covid-19 and poliomyelitis – to give its full name – are alike in being highly infectious and most of those infected have few if any symptoms and swiftly recover. But they become carriers all the same, infecting others, some of whom may belong to the unlucky 1-2% – there is great dispute about the fatality rate among victims of Covid-19 – who will feel the virus’s full destructive impact.

There are similarities in the treatment of both illnesses, particularly in trying to keep people breathing: the iron lung was invented in the U.S in 1929 and the first Intensive Care Unit opened in Denmark in 1952, both in response to polio.

Simple methods of combating the two viruses such as handwashing are the same: when Queen Elizabeth II visited Australia during a polio epidemic in 1954, there were fears that the crowds of schoolchildren assembling to greet her might pass the virus to one another, maybe even to the young monarch herself. So the government launched a mass hand-washing campaign, leading to a drop in the number of children contracting polio during the royal visit. Nobody seemed embarrassed by the fact no such effort had been made before then.

The polio virus was worse for the very young; for the coronavirus it is the old who are hardest hit. 

In Cork in 1956, doctors did not seem to grasp how frightening such machines were for children: when I was in St Finbarr’s, one girl screamed and struggled when doctors tried to put her inside an iron lung because she thought it was a coffin and she was being buried alive.

Politicians often compare the campaign to suppress the coronavirus to waging war on a dangerous enemy: they wrap the flag around themselves and call for national solidarity. Fear and a need to see visible action to counter it are a feature of all epidemics.

In Cork, doctors were convinced the disease would only be stopped when it ran out of victims.

In this book I quote Jack Saunders, the city’s chief medical officer, insisting a real quarantine was impossible because “for every case detected there were one or two hundred undetected or undiagnosed in the community, principally among the children”. Similar words were to be used 66 years later in Sweden and in U.S states like Texas, Florida and North Dakota to downplay the Covid-19 pandemic or suggest there was no way of stopping it.

There were similarities too in the response of governments and peoples to the threat. At every level of society and the state, fear of death – or, more accurately, fear of being held responsible for deaths – drove decision-making. As a consequence, this was often ill-judged, with under-reaction and over-reaction succeeding each other as the authorities lurched from commercial close-downs to over-rapid re-openings.

Wuhan city in central China, with a population of 11 million, could scarcely be more different from Cork, with just 114,000 inhabitants in 1956, but popular reaction had points in common. 

As in Wuhan, Cork people convinced themselves they were being fed false information downplaying the severity of the epidemic.

“There were rumours everywhere in the city,” said Pauline Kent, a physiotherapist who treated victims, “that dead bodies were being carried out the back door of St Finbarr’s at night.”

The medical authorities in Cork were truthfully announcing the number of new cases and fatalities each morning, though they were simultaneously undermining their own credibility by issuing upbeat statements, dutifully reported in the local newspapers, with headlines such as ‘Panic Reaction Without Justification’ and ‘Outbreak Not Yet Dangerous Say Doctors’.

Arguments about lockdowns, commercial closures and quarantines raged on a miniature scale in Cork in 1956, just as they were to do many years later in America and Europe…

The Broken Boy, by Patrick Cockburn, published by OR Books. Available now. Echo readers can avail of 15% off the paperback by using the code ECHO15 at www.orbooks.com.