I have written about our experience locally with the Spanish Flu and the Great Depression to illustrate how resilient our ancestors were, managing to not only survive but prosper with far fewer resources at their disposal and with a determination that we have inherited.
As we experience the COVID-19 pandemic, causing shutdowns, economic strife and general widespread fear, I think it would be helpful to have a look at how our ancestors handled a similar health crisis, a polio epidemic that peaked locally around the 1950s.
I realize polio is significantly different from COVID-19, however, the many similarities between the two outbreaks, particularly during the height of the polio crisis in Canada, are interesting.
Initially, it was believed polio only affected a specific age group, eventually it spread to patients of all ages. Our government’s initial response was to quarantine those who were sick and severely restrict the movement of those deemed to be at risk.
Just like COVID-19, most polio cases were mild in the beginning, but in time, severe cases began to appear, resulting in mass hospitalization and thousands of deaths. Those of a certain age will remember those who were severely ill required a machine to help them breathe: the dreaded “iron lung”. Some still carry the effects of the disease.
Poliomyelitis (its scientific name) is an infectious viral disease initially known as “infantile paralysis” since it primarily affected children under the age of five. The disease became the scourge of Canada from the 1930s to 1956. However, polio had existed worldwide long before it became a crisis in North America — outbreaks were recorded in Europe as early as the early 1800s.
The virus attacks the nervous system savagely and depending on the severity of the illness, it could permanently damage the nerve cells controlling the muscles, causing weakness in some limbs, or even paralysis. If it attacked the muscles of your heart, you could die; if it attacked the muscles that control the flexing of your lungs, you would often end up in an iron lung; and if it attacked the muscle of your leg, or your arm, they would tend to wither away.
Canada has been officially declared polio free since 1994, however, there is still no cure for polio, it can only be prevented by vaccination. I suspect that this may be the case with COVID-19.
The first Canadian case of polio is said to have occurred in 1910, however, it was a decade or more later that waves of polio outbreaks reoccurred mostly during the summer and fall seasons. The peak period in Canada occurred between 1927 to 1953, each year bringing multiple waves affecting our local families.
The threat of polio was a constant fear for local parents of young children during this period. I can remember my family being constantly on the lookout for symptoms in little Richard MacLeod.
We are told that the worst single year of polio in Canada was in 1937. There were nearly 4,000 cases of the virus with around 2,500 of those occurring in Ontario. Newspapers chronicle how schools were shut down amid a provincewide public health panic (sound familiar?).
The late 1940s and early 1950s saw a wave of outbreaks in our area, according to The Newmarket Era. At the peak of the polio epidemic nationally, in 1953, there were nearly 9,000 cases and 500 deaths reported. The Air Force was enlisted to help deliver iron lungs across the country; with more and more patients developing the most extreme type of polio: bulbar polio.
Most of us who were around in the early 1950s will remember the iron lung, the precursor to the modern-day ventilator. Amazingly, in 1937, there was only one iron lung in the entire province, prompting a scramble to find the necessary materials to get more machines built (you can see a correlation with what we are experiencing with COVID-19 today).
Twenty-seven iron lungs were manufactured in the basement of what was then Toronto’s SickKids Hospital, before being distributed to the areas of the country most in need.
While ventilators currently being used to help patients with severe COVID-19 work by inserting a tube down the throat to force air into the lungs, bypassing any inflammations in the air-passage caused by the virus, an iron lung is almost the exact opposite. First, it is all outside of the body with the patient’s head sticking out of the machine, the entire body encased in what appeared to be a huge metal coffin. A collar around the neck made an airtight seal, and the machine worked by using negative pressure to expand and contract a person’s chest, forcing one to breathe.
By the 1950s, the huge demand for iron lungs was causing national shortages. Some hospitals had to run multiple iron lungs at once. It was clear that the only real solution to the crisis was a vaccine.
With polio and COVID-19, we lack a general understanding of the virus itself. Researchers studied the polio disease, but alas it yielded few answers. Like COVID-19, polio was shrouded in mystery for far too long. Polio is a human-only virus, and human viruses are always problematic to understand.
Many treatments were proposed with little solid evidence that they would actually work. In 1927, a convalescent serum made from human spinal fluid was stockpiled despite little evidence that it worked as treatment or prevention.
A prophylactic nasal spray was tested out in the U.S. with no clear results. Public pressure surged in Canada to test it here and a much-hyped clinical trial of the spray using 5,000 children was conducted but findings showed that the spray did nothing to prevent the virus, along with numerous side-effects.
Papers of the day speak of panic-stricken parents demanding sprays from their doctors or even manufacturing their own. We see this type of desperation for treatment today with COVID-19, where some find themselves in hospital or have even died trying to obtain treatments that have yet to be tested properly.
Today we see a run on a form of chloroquine used in aquariums, chloroquine phosphate, after U.S. President Donald Trump touted the pharmaceutical version of the drug as a treatment for COVID.
In 1935, two early attempts at polio vaccines in the U.S. only served to increase the tragedy there, due to an inaccurate understanding of the virus. When a viable vaccine was finally developed, Canadian researchers were instrumental in producing a version that could be tested on humans.
Jonas Salk, an American scientist, is widely known as the creator of the first polio vaccine to be tested on humans, however his inactivated vaccine, which seemed to work on monkeys, wasn’t ready for human trials until a collaboration took place with Connaught Medical Research Laboratories in Toronto, which was part of the University of Toronto.
U.S. researchers had created “the first purely synthetic tissue culture media” in 1949, a nutrient-based mixture of 60 ingredients, and was non-allergenic because it did not use serum from any animals. It was to be called “Medium 199,” and it seemed to solve all of Salk’s problems, because it could serve as a safe medium for the vaccine, opening the door for human testing of polio vaccine.
While it was great that they had found a vaccine, producing the vaccine on a mass scale for human trials was yet another matter.
Connaught Labs pioneered the “Toronto Method,” in 1952-53, allowing researchers to create large quantities of poliovirus in rectangular bottles filled with Medium 199. At the request of the National Foundation for Infantile Paralysis, an American foundation started by Franklin D. Roosevelt, Connaught Labs shipped as many bottles of Medium 199 with polio as possible for a massive field test in the U.S.
The 1954 trial involved more than 1.8 million children. On April 12, 1955, Salk’s vaccine was declared a success, only a couple weeks after the Canadian trial of the Connaught vaccine had been started.
But tragedy struck when 79 American children who had been given the vaccine contracted paralytic polio and the whole U.S. vaccine rollout was stopped dead. It was discovered later that due to a lack of proper batch-testing the vaccine, one company in the U.S. had produced vaccines that were not properly inactivated.
Canada was faced with a dilemma: should we also stop vaccine testing? Prime Minister Louis St. Laurent wanted to cancel the program due to pressure from the public but Paul Martin Sr., who was Canada’s Minister of National Health and Welfare, stated that he had full confidence in Connaught Labs to make it safe. It helped that Martin had a vested interest in battling polio as his son, Paul Martin Jr., who would later go on to become our prime minister, contracted polio in 1946 and Martin Sr., had himself contracted polio as a child in 1907.
The Canadian trials continued, and it helped save the vaccine. The Canadian rollout of the vaccine was extraordinarily successful. Canada’s confidence in the Salk vaccine allowed for it to be implemented internationally, vaccinating millions before an oral vaccine was produced by Albert Bruce Sabin in the 1960s to replace it. Connaught Labs were also involved in trials of the Sabin vaccine.
So how does our understanding of polio help us in our approach to COVID-19? Polio, like COVID-19, demanded a level of attention from governments everywhere not seen by other deadly diseases before.
The polio virus affected predominantly middle-class children here in Canada. Interestingly, because polio had been circulating long before the outbreaks in North America, lower-income families, exposed to milder forms of it much earlier due perhaps to poorer living conditions had more antibodies built up over the generations.
Thus, it was the middle-class families who had no group (herd) immunity when outbreaks started popping up here. Conversely, COVID-19 seems to affect all groups equally, and those living in poverty are often more likely to be more at risk.
The first polio cases in Canada were largely those who could afford to travel internationally on vacation and these victims captured media and government attention long before the virus hit the general population.
Just as COVID-19 has spurred discussions about how to economically support Canadians during the health-care crisis, polio was responsible for a similar restructuring of national benefits. Polio did not just come and go; it had the potential to bring a lifelong legacy for those who were affected. It was clear that private health insurance has its limits. Without doubt, the polio epidemics shifted the thinking of Canadian officials about universal health care, which would eventually come to Canada in 1984.
New financial programs were introduced to help families support loved ones stricken with polio and a new federal health grants program was introduced in 1948, helping provinces improve local health services.
The polio threat, just like COVID-19, exposed issues that previously existed. Because of its long-term impact, the health-care system’s limitations were clearly exposed.
From an examination of our history, it is possible for us to learn what we did right in the fight against polio, both scientifically and politically, and apply those lessons today.
COVID-19 is prompting similar levels of collaborative initiatives, research and production, scientists world-wide collaborating in the search for a treatment and eventually a vaccine, which has not really happened in the same way since polio.
Canada is taking a unified approach, while we are seeing a rather disjointed and confused response in the U.S. sadly.
COVID-19 has generated an unprecedented level of government response here in Canada, regarding public health and the economy, which reminds us of the fight against polio 70 years ago probably more than any other event in my memory.
If you have personal knowledge polio through family or friends, I encourage you to post your memories via the comments section and share with our readers.
In closing, I need to express my gratitude to Alexandra Mae Jones whose article allowed me to frame this article in a logical way.
Stay safe and keep the faith.
Sources: Resources and Services – The History of Public Health – Government of Canada Website; Announced 75 years ago, story of polio vaccine bears similarities to COVID-19: Lepore CBC Radio – The Current June 9, 2020; Looking back at Canada’s Polio epidemic through a COVID-19 lens By Alexandra Mae Jones; Social Sharing – Looking back to another health crisis in living memory By Richard Cuthbertson · CBC News April 2, 2020; The Middle-Class Plague: Epidemic Polio and the Canadian State, 1936-1937 By Christopher J. Rutty, Ph.D. Health Heritage Research Services – 1999
