Planning for pandemics

I read with interest Mark Bernstein ’83’s article on “Why Princeton was Spared” during the 1918 pandemic (feature, Dec. 17). One point that deserves clarification is the definition of quarantine, which the article didn’t get right. Quarantine is the separation of healthy individuals who were (or possibly were) exposed to the disease. The goal of quar antine is to keep these people away from others in case they become sick. They are closely monitored for signs of illness. That is why we keep animals in quarantine when they come into this country — to make sure that they are not harboring any diseases.  

Isolation is the separation of people who are sick from those who are healthy. So people with active tuberculosis, for example, are kept in isolation until they are no longer infectious after taking antibiotics (assuming the tuberculosis they have is not multi-drug resistant).

In 1918, Princeton had the advantage of having a small student body and a regimented student life: Students weren’t allowed to leave campus. Admiral Goodrich’s aggressive sequestration strategies were extreme but effective.  

Influenza is highly contagious. The virus usually is spread by inhaling airborne droplets and droplet nuclei, but there also is evidence that it can spread by contacting contaminated nonporous surfaces such as steel and plastic, since it can survive on these surfaces up to 24 to 48 hours after contamination. There is even evidence that it can survive on paper, cloth, and tissues up to eight to 12 hours after contamination. The bottom line: People can be exposed without knowing it.

In 1918, there were no vaccines or medications for influenza. In planning for a pandemic today, it would be prudent to assume that supplies of these items would be either limited or nonexistent.  

“Sheltering-in-place” or aggressive sequestration could be facilitated today if the Internet were used extensively in place of classrooms during a severe influenza outbreak. Students also would have to be diligent in washing their hands and avoiding crowds.