My father came late to parenthood. Born in Hobart, Tasmania in 1909, he was almost 50 years old when I was born. Like many, he left Tasmania to pursue a career in Melbourne; in his case it was science then medicine. He survived the Great Depression. He served in three wars, including being in Darwin during the second world war when it was bombed. Subsequently he enlisted in the RAAF and worked in two further wars as a military doctor. When he retired from the RAAF, he worked in the Victorian Department of Public Health and Hygiene as a public health physician.
However, in his later years I asked him what in his life had troubled him the most. What of his life’s experiences had weighed most upon his soul as he approached 105 years of age and realised that his end was near? Was it the carnage of war, perhaps, or was it being the last survivor of his three siblings? Maybe it was the children he saw die from salmonella outbreaks while working for the health department?
His answer was quite unsettling. My father said that he was 10 years old when the Spanish flu pandemic penetrated Tasmania in August 1919. He recalled learning in the years following the pandemic that the death rate in Tasmania was one of the lowest recorded worldwide. However, as a small boy, accompanying his father at work, he was aware of unusual happenings in Hobart; most particularly, his father, the city engineer at the time, was involved in repurposing Princes Pier as a temporary morgue where the dead were laid ahead of burial at sea – the only expedient option available. Although these were the most confronting memories of his 104 years, he told me that he wondered what life would have been like in other Australian cities, such as Sydney, where the case fatality rate was much higher!
He also remembered that his father was disappointed in the lack of clear advice from the authorities and that the Tasmanian government had appeared totally unprepared. Indeed, the public was initially reassured to “stay indoors, it will pass quickly”. There also seemed a great deal of confusion among the medical community. Along with there being a dearth of doctors following the first world war, there was the spectacle of some of Australia’s most eminent physicians squabbling with each other in the popular press over the nature, cause, prevention and treatment of the disease. With the experts in disarray it was no wonder that people with limited resources to expend on medical care avoided consulting doctors in favour of “snake-oil” remedies, especially when doctors could rarely provide anything more effective to treat pandemic influenza.
My father had senior degrees in both science (MSc) and medicine (MD) and felt that doctors could have done much better in being unified around the available scientific evidence and the medical leadership of 1919. He also valued academic credentials and life experience beyond a basic medical degree, so even in his advanced years he had a high regard for Prof Brendan Murphy, who was then the chief executive of Austin Health in Melbourne. Indeed, Australia’s peak medical and public health associations have also moved this week to back our chief medical officer who is advising the government on the coronavirus pandemic, saying conflicting advice from some medical commentators was contributing to public uncertainty about the response.
My father believed that there were many other lessons to be learned from Australia’s experience of influenza in 1919. He said that the Spanish flu pandemic told us something about how people and communities reacted to severe disease crises, particularly in a context where governments and conventional medical science lack a single “voice of truth”.
Second, Australia’s experience with the Spanish flu pandemic demonstrated how public health preparedness for such events required a full appreciation of the impact on healthcare facilities and co-ordinated actions by medical personnel across Australia.
Third, it was clear to him that the media played a defining role in presenting a pandemic to the public in 1919 and could easily temper or enflame public anxieties.
Finally, his 1919 experience demonstrated that cooperation between various state governments and Australia’s federal health authorities during such crises is critical to containing infections and any associated loss of life but could not be taken for granted.
• Associate professor Julian Rait OAM is the president of AMA Victoria
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