Commemorating the 100th Anniversary of the 1918 Influenza Pandemic
A century ago, influenza infected an estimated one-third of the world’s population, claiming over 500,000 Americans and at least 50 million worldwide. The Center for Law, Health & Society at Georgia State Law hosted the “100th Anniversary of the 1918 Influenza Pandemic: Prevention and Control of Communicable Disease Then and Now,” in October to examine the role of law in preventing, controlling and mitigating epidemics.
Paula L. Kocher, deputy associate general counsel with the U.S. Department of Health and Human Services Office of the General Counsel at the Centers for Disease Control and Prevention, moderated the panel, which included public health experts Gerardo Chowell-Puente, Zain Farooqui and James J. Misrahi. “It is difficult for us to appreciate the scale of the devastation caused by the 1918 influenza pandemic,” said Kocher. “Today we have the comforts not only of technological advancements in identifying, tracking and treating disease outbreaks, but the knowledge that the best public health minds are working to avert future outbreaks.”
Chowell-Puente, professor and chair of the Department of Population Health Sciences at Georgia State University School of Public Health, highlighted how, similar to the 2009 influenza epidemic, the 1918 outbreak had higher transmissibility and greater impact on people under the age of 65 than seasonal influenza. He discussed how the close proximity and poor living conditions of the military in World War I, as well as interaction with local civilian communities, contributed to the spread of disease. He also depicted the disparate impact on mortality in developing countries in the 2009 outbreak, due to lack of access to health care and living conditions.
Misrahi, senior attorney with the U.S. DHHS Office of the General Counsel at CDC outlined the federal government’s role in preventing and controlling the spread of communicable disease in 1918 compared to today. Using the 2014-2016 Ebola outbreak as an example, Misrahi described the federal government’s past and current surveillance, education and funding measures, and its role in issuing guidance for state and local public health response. Importantly, Misrahi explained, the federal government’s role in isolating and quarantining persons is limited to interstate or international travel and to specific diseases.
Farooqui, associate general counsel for the Georgia Department of Public Health, concluded by differentiating the state’s role. The state has broad authority to protect the public’s health and to manage and control the spread of disease, whether an emergency has been declared or not. He explained how social distancing measures such as isolation and quarantine are implemented, the factors that public health officials consider, and the procedures in place to ensure due process.
“This panel was an opportunity to reflect on the progress that state and federal agencies have made over the past century in understanding and responding to public health threats,” said Stacie Kershner, associate director of the center. “It also allowed us to highlight the interdisciplinary nature of public health and the role of law in prevention and control of communicable disease.”