Why didn’t the U.S. learn from the polio epidemic?

It was December 24, 1956.

I sang “I’ll be Home for Christmas" in full throated jubilation from the back of the green Pontiac station wagon. Home, indeed, after four and a half months on East River Road, St. Paul, sequestered in Sheltering Arms Hospital. It was an institution for the childhood victims of “infantile paralysis," the “last” polio epidemic, whose memory will always bring me to tears of gratitude. It was the product of an understanding, compassionate, and benevolent government and philanthropists. Sorrowfully, so many friends from home and in hospital never returned, never survived the “Iron Lung” or the “mutilation worse than death,” poliomyelitis, the “torturer and maimer."

For several nights, I’d endured horrific night terrors — a massive boulder always hurtling toward me, unstoppable. My feverish polio delirium. Then, after lumbar punctures (spinal taps), came the diagnosis, poliomyelitis, by “Doc Pete," later my model and mentor.

To my weakened yet contracting muscles of the shoulders, lower back, hamstrings and Achilles came the daily dreaded regimen: every four hours, a stack of near scalding Army blankets stacked from my neck to my soles, quickly followed by excruciating stretching, then attempts at strengthening. No other exercise allowed so as to conserve energy. And food —unending. Desserts. Ice cream. So much from the community.

Then followed years of recovery, never to return to baseline, but alive and forever grateful for what my family and government provided for me.

Mr. Frank Snowden, Yale Professor Emeritus of Medical History, through his book, “Epidemics and Society, From the Black Death to the Present,” has provided an extensive exploration of poliomyelitis from which I have drawn.

Poliomyelitis is a highly infectious virus. It has been recovered from 3,500 years ago in Egypt. But only in the past century was it an overwhelming epidemic.

Similarly to COVID-19, if a polio victim recovers from symptoms mild and similar to the flu, during those two weeks, they are highly contagious (victims are also highly contagious during the 1-3 week incubation period). Most victims recover, but the degree of disability is hugely variable.

The virus enters via the fecal-oral route (contaminated food, water, objects) and airborne droplets-sneezing and coughing. The virus enters the lymph system, then the blood, and proceeds to all organs, including the brain and spinal cord, where it invades and destroys motor neurons for muscles throughout the body. The severity, like COVID-19, is highly variable. Only about one in 200 cases progress to a paralytic form. But in the most severe cases, muscles lose function and atrophy, leading to flaccid paralysis of the limbs, chest and diaphragm, and progressing to the Iron Lung (in some morose manner, the equivalent to a coronavirus ventilator) and, except in rare cases, death. Mirroring COVID-19 today, the most exacting public health precautions are mandatory.

From 1890-World War I, the virus transformed into a much more virulent strain and raced across Europe and North America especially in summer months, and attacked older children and youth as the “plague", the “crippler." Fear of “the terror and tragedy” seized the world, and exacerbated, like 2020, by “fake news,” rumor, and even witch hunts ensued. The fear was compounded by the mystery, its sudden emergence, incurability and the terrible burden of disease, disability and death. The public feared only nuclear war more than polio. Yet government could not offer truthful reassurance.

Franklin Delano Roosevelt contracted it 12 years before he was elected. He acknowledged that he had polio but concealed the extent of his disability. In 1938, he founded what would become the March of Dimes. In the halcyon post-World War II days of grand optimism and accomplishment, President Harry Truman in 1946 declared polio a monstrous threat to the U.S., saying, “The fight against polio cannot be a local war. It must be nationwide. It must be a total war in every village, town and city. For only with a united front can we ever hope to win any war.” He enlisted the full force of the U.S. toward a common enemy.

The polio epidemic peaked between 1949 and 1955. In 1952, polio claimed 60,000 victims. The heroic research of John Enders, Thomas Weller and Frederick Robbins, fully supported by government, led Dr. Jonas Salk to develop a formalin-inactivated (killed) polio vaccine, officially released to the public in 1955 after two years of the most thorough testing protocols. It was greeted euphorically across the entire world as a godsend, and the government provided it to all at no cost. When CBS’ Edward R. Murrow asked Dr. Jonas Salk who owned the patent to his vaccine, Dr. Salk replied “There is no patent. Could you patent the sun”? No profiteering, no patent protections, no public gouging.

Comparisons of the polio “war” with COVID-19 are daunting. The role of a benevolent government in the battle to understand and eliminate polio left a profound legacy, unconscionably disregarded in 2020. The American public desperately needed to trust our national government then, and it delivered. The polio effort cemented the absolute role of science in discovery and research. It established the need for thousands of medical and public health professionals dedicated to the prevention and eradication of epidemics. Vaccinations became universally desirable, as opposed to the vaccination skepticism espoused until recently by Donald Trump. Transparency between government and the people became essential. Public health measures, based on science and epidemiology, such as isolation and quarantine became the unquestioned standard. The American public received treatment regardless of ability to pay, ensuring that no one must ever forego food and basic necessities. Today?

I hope COVID-19 efforts will soon proffer widespread availability of accurate testing, an indispensable element in pandemic understanding and eradication.

When Dr. Albert Sabin developed his oral polio vaccine he could only employ it in the Soviet Union after extensive testing, at the height of the Cold War. In 1962, his successful immunization of over a million Soviet citizens heralded the advent of international cooperation and sharing, the “hidden universality” of global health, without which pandemics such as COVID-19 might decimate all peoples. Later, collaborating with Rotary International, Dr. Sabin advanced the immediacy of worldwide public health education, an indispensable prevention tool.

Why, in the 21st century, does this U.S. government unashamedly refuse to acknowledge and embrace these invaluable public health and pandemic lessons, so valiantly earned at greatest national sacrifice? That I survived because my government simply took the right and just action, only to watch in horror as President Trump willfully, amorally, and unforgivably victimizes our people, grips me with incredulous disbelief.

Peter Mjos is a retired general medicine and public health physician. He lives in Anchorage.

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