Most workhouses in mid-nineteenth century Ireland had, in a separate building to the rear, a hospital, or, to use the terminology of the times, a fever shed.
When Arthur Kennedy arrived in Kilrush he discovered that in the boundary wall of the workhouse compound there was a gate that gave easy access to the fever shed for anyone so inclined. One of his first acts was to have that gate secured. Another, this time in cahoots with the workhouse’s medical advisor, was to secure a lease on a former abattoir which was converted into a separate fever hospital.
In my musings a couple of weeks ago I pointed out how low, by modern standards, was the average age at death in those times. A major reason was the prevalence and frequency of epidemics. During the period of the great Irish famine there were several. Cholera raged throughout the British Isles in 1848. Other diseases that were common included dysentery, typhoid and smallpox.
It was sometimes said that fear of cholera was worse than the disease itself. Tenants evicted from their homes might be taken in by their neighbours. It wouldn’t do for such a person to become afflicted with diarrhoea for they would once again find themselves homeless.
The elimination of such diseases as a threat to life came about because of a combination of much improved hygiene and immunisation. The discovery that they were caused by microbial organisms which could be destroyed by proper sanitation and the maintenance of clean conditions was key. So, too, was the discovery that the human body’s natural resistance to such organisms could be enhanced by the injection of antibodies.
In the UK the practice of vaccinating infants began in earnest after the second world war. I remember receiving the diphtheria injection, the only immunisation available for children at the time. Later the smallpox vaccination was administered. Polio followed in the late 1950s. Many more have been added to the cocktail of vaccines administered to infants since.
It was mandatory, if planning a trip abroad, to have inoculations against typhoid and yellow fever. All three of us had to have these injections, plus a smallpox booster, before travelling to South Africa in the 1970s.
What should we make of the hysteria surrounding the spread of coronavirus Covid 19? We are told that most of us will catch it unless we maintain scrupulous hygiene; that for most of us its effect will be little worse than a heavy cold but that we should self isolate, avoiding all contact with other people in order to reduce the possibility of spreading it.
Like ‘ordinary’ winter flu, it is the elderly and those with underlying chronic illness that are most vulnerable. Despite the annual administering of influenza vaccine to members of these groups, the disease is estimated to have killed over 26,000 individuals in the UK in the winter of 2016/7. A figure that puts the numbers to date for Covid 19 worldwide into prespective.
As yet there is no vaccine for Covid 19. This is why it is important to protect the vulnerable groups by other means – principally by the avoidance of contact between them and infected individuals.
Fear of the disease, in the early days of the outbreak in China, led first to a cover up and then to the total isolation of whole areas. This proved ineffective, as did a similar strategy in Italy.
By contrast the UK government has been open and transparent in the information it has provided and in adopting a strategy driven by the need to avoid a situation where large numbers of people are temporarily removed from the workforce by the disease at the same time.
Given that most of us are going to get it, it makes sense, if possible, to delay the peak as long as possible. I can quite see that it is easier to cope with, say, 5% of the workforce absent for 10 weeks, rather than 10% absent for 5.
That people feel the need to stock up on supplies of food and other essentials in preparation for the possibility of having to self isolate is down to over-sensationalized headlines in newspapers and on social media.
As a Canadian doctor recently stated in a facebook post, one should be afraid, not be of the disease, but of the reaction to it by selfish people.