The discovery that seven elderly New Yorkers died from the West Nile virus last summer has sparked one of the most intense public health campaigns in the city's history.
The Mayor has taken three basic steps. First, through press conferences and public service announcements, he has tried to awaken individual New Yorkers to the potential dangers of the disease, urging personal vigilance in emptying places where stagnant water can collect, wearing bug repellent, and keeping indoors during the early evenings when the mosquito tends to feed. Second, he has sought to calm public fears: We are told in virtually every public statement that no human cases of the mosquito-borne virus have occurred this year. Third, he has given broad authority to the Department of Health to spray wide swaths of the city with pesticides.
The program thus tries to find a balance between sounding the alarm and preventing panic, between giving citizens a sense of personal control over the threat and demonstrating that officials are taking public action to address the crisis.
But, as the finding of dead birds carrying the virus continues to mount, suspicions grow about the Mayor's program. Parents have protested the spraying of entire neighborhoods, worrying about the impact on children. Environmentalists worry that the pesticides will destroy useful bees, beautiful migrating Monarch butterflies, and other insects that pose little danger to humans. Lobstermen believe that the use of these pesticides has already led to the virtual destruction of the lobster industry in Long Island and Connecticut.
For the public health historian, the case offers an opportunity to reflect on the long history of New York's efforts to control epidemics.
A CITY OF EPIDEMICS
From its beginning, New York's mayors and public health leaders have been in a constant struggle to find ways both to protect the public from epidemics and to calm public fears regarding their consequences. Whether it be the efforts to prevent smallpox in the Colonial period; cholera, diphtheria, typhus, yellow fever and malaria in the nineteenth century; or influenza and polio in the twentieth century, public health officials have been forced to confront a variety of contradictory demands that often pit them against the very public that they are supposedly serving. Traditional tools of public health, such as quarantine, isolation, or institutionalization, have often been viewed as an infringement on individual rights, while massive fumigation efforts to eradicate rodents were easily seen as disrupting or even poisoning the communities that the city was seeking to protect.
In the Colonial era, the appearance of broad epidemics was a comparatively rare event in a city that was still relatively small and healthful. But, when disease did strike, the reaction was often one of surprise and religious fervor. During a period when little was understood about the methods by which infectious disease was transmitted back and forth among mosquitoes, ticks, rodents and humans, and nothing was known of germs and viruses, disease was seen as a form of Godly retribution. Individuals, then, were urged to engage in personal soul-searching, and ask for divine forgiveness. Political leaders, in the meantime, would sometimes seek ways of isolating the morally suspicious by keeping strangers out of town and quarantining homes of the sick. While today we may view these activities as misguided, their effect was to maintain order in a city where panic was all too possible.
CHOLERA AND GOD'S DISPLEASURE
In 1832, as cholera swept through Europe, most New Yorkers felt safe from danger. Because predominant views of disease linked its cause to immorality and corruption, the relatively small, homogenous and apparently moral majority of Anglo-Saxon New Yorkers believed that the city's virtuous citizens were virtually immune to its horrifying impact.
So, when the poor along the city's shoreline began to sicken, vomit, and die in the city's streets, some saw it as a sign of God's displeasure with the victim. The personal failings of any one individual, not a biological process rooted in viruses or germs, were understood to determine how susceptible someone would be to God's "terrible swift sword." As the death count mounted, however, it became difficult for anyone, no matter how virtuous he saw himself, to feel safe from an epidemic where victims could appear healthy in the morning and lie dead from dehydration by that night.
Some New Yorkers began worrying that it was an indication of God's displeasure with the community as a whole, perhaps with the city's burgeoning commercial activities. New York's Board of Aldermen (forerunners to today's City Council) formed a temporary committee of ministers and businessmen who joined with three physicians to address the issue. Calming the citizens of this city of nearly 200,000 was as central to the committee's mission as actually doing anything to stop the spread of the disease.
The committee ordered clean-ups of the city's streets, quarantine of foreign vessels, and implored the city's citizens to attend a special day of prayer set aside to ask for God's forgiveness for sins that had left the people vulnerable to His wrath. The activities seemed to work: in little more than a month, the cholera epidemic left the city, and New Yorkers were grateful to their leaders.
The quarantining of ships may have had a modest impact on the spread of disease, and the cleaning of the streets certainly improved the quality of life in the city, at least temporarily. But, as public health measures it is highly unlikely that they directly affected the course of this disease that rampaged through the city in July and August of 1832. What really happened is that colder weather set in, killing the bacteria responsible for the disease.
TYPHUS, YELLOW FEVER, AND BLAMING THE IMMIGRANT
By the late nineteenth century, as the city grew in size and as millions of non-English speaking immigrants poured into New York, the health crises became a more or less permanent fixture. Epidemics of measles, cholera, smallpox, diphtheria, yellow fever and malaria regularly swept through the city as poverty increased and as people were crowded into airless housing that lacked such rudimentary sanitary measures as plumbing. Thousands of children died in infancy every year from diphtheria, diarrhea and other childhood plagues. Death from tuberculosis claimed thousands upon thousands of city dwellers cramped in the Lower East Side's tenements. Death rates from infections in general sky rocketed.
Disease, still popularly understood as a sign of God's wrath, was linked to the growing numbers of Irish Catholics, Italians and Eastern European Jews. Nativist campaigns aimed at limiting immigration were linked to images of the immigrant as a "microbe," infecting a previously health body politic.
It is not too surprising then, that the city instituted some harsh measures: strict quarantining of arriving ships, the establishment of Ellis Island as a place for medical inspections however incomplete, and the periodic sweeps through poor neighborhoods by the police officers who had been deputized by the recently-created Department of Health as public health police. These actions were as much symbolic acts aimed at reassuring the population as they were logical, reasonable and effective public health activities. During the 1894 epidemic of typhus, for example, the city took an entire building filled with immigrants and placed them in the city's quarantine hospital on North Brother's Island in Long Island Sound which, while looking like decisive action, probably did little to stop the spread of the epidemic.
THE FLU AND FEELING GOOD WITH FACE MASKS AND FUMIGATION
By early in the twentieth century, the development of a more sophisticated understanding of germs and their relationship to infectious disease gave new authority to the now-permanent Department of Health. Killing the bacteria was now more important than improving morals or controlling people.
Still, there were many epidemics for which the precise cause remained unknown, and for which officials were therefore still in the dark about effective treatments or even sound preventive measures. Yet, these officials were still required to give the community a sense of control and a sense of reassurance.
During the epidemic of influenza shortly following World War I, for example, literally thousands of New Yorkers died as the flu swept through neighborhood after neighborhood. Although public health officials had no understanding of how to prevent it, very public measures were taken to make sure that the city remained calm and the public felt safe. City officials encouraged individuals to use face masks, and ordered massive fumigation campaigns, sweeping into poorer neighborhoods and especially homes where victims of the disease had died. There is very little evidence that these measures were useful in stopping the epidemic. They were certainly effective, though, in maintaining a sense of control and order during a period of real crisis.
THE MOSQUITO HAS HELPED SHAPE THE CITY
In certain ways, today's response to the West Nile virus plays out many of the themes that have marked previous public responses to epidemics in general and to those borne by the mosquito in particular. Both yellow fever and malaria, mosquito-borne diseases, have plagued the city literally from its founding in the seventeenth century. Yet, it was only at the beginning of the twentieth century that Walter Reed and others specifically identified the mosquito as the culprit transmitting these diseases to human beings.
This identification has played an important role in shaping the city. Mosquito eradication campaigns and the draining of mosquito breeding grounds became a central activity for the Department of Health. Between 1905 and 1918, the "Mosquito Extermination Division" of New York's Department of Health cleared and drained 25,000 acres of land (laying 2,600 miles of drain pipes) in an effort to get rid of the pest that had just recently been identified as a health threat. Entire neighborhoods were created out what was previously swampland. Ironically, some of these newly created communities were in Queens, adjacent to Jamaica Bay, where many decades later the West Nile virus was first identified.
THE MOSQUITO TODAY
The arousal of public attention to a potential disaster is absolutely necessary in any public health campaign, if it is to be effective in protecting the population. Throughout its history, New York officials have sought ways to encourage people to get immunized, improve their properties by installing water and sewerage lines, and clean up public nuisances that are potential breeding grounds for disease.
But a thin line separates effective and ineffective campaigns -- separates good public health education from the needless creation of anxiety and panic. It is this line that city officials softly tread upon as they seek to engage in attempts to stem a disease that is carried by birds over political boundaries and is transmitted by mosquitoes that may escape the carpet spraying that has transformed the summers of city residents.
As we watch the unfolding of this political, social and biological drama, we must wonder how to draw the line between public health interventions that are meaningful and those that are merely symbolic. We need to find a balance between alerting New Yorkers and unduly alarming them.
David Rosner is Co-Director of the Program in the History of Public Health and Medicine at Columbia University's Mailman School of Public Health.
Eighteen days after the attack on the World Trade Center, Mayor Rudolph Giuliani appeared on Saturday Night Live. Flanked by his police and fire commissioners, and surrounded by a group of the city's rescue workers, the mayor looked into the camera and said: "On September 11th, more lives were lost than on any other single day in America's history - more than Pearl Harbor, and more than D-Day."
If it was jarring to see for the first time in the television show's 29-year history an opening "sketch" that was anything but satirical, the mayor's reference to history would not surprise anybody who had been watching his regular press conferences. In the very first week of the disaster, while he was in the midst of dealing with all the shock and panic, death and sorrow, the mayor said that he had made time to do a little reading. He read up on the history of the Battle of Britain, and the blitz of London, when a constant barrage of German bombs caused some 20,000 deaths. Londoners responded, the mayor said, by trying as much as possible to go about their normal lives. That is what, he concluded, New Yorkers should be doing now.
It was through history, then, that the mayor had found comfort and instruction. But he need not have looked solely overseas. The history of New York City itself is full of examples of crisis and recovery. It is a historical fact that after every catastrophe that New York City has faced, it has emerged - yes -- stronger and better.
By coincidence, that history is front and center starting this week in a series of events planned long ago.
The last two episodes of Ric Burns' "New York: A Documentary History", broadcast on PBS Sunday, September 30 and Monday, October 1, bring the seven-part series up to the present - or, more precisely, up to present-day New York before the events of September 11. Completed just before the attack, the producers could only add a few words acknowledging what has happened: "For nearly 400 years, the people of New York have faced adversity and prevailed. This film is dedicated to them."
The first-ever Gotham History Festival, sponsored by the year-old Gotham Center for New York History at the City University of New York's Graduate Center, runs from Friday, October 5 through Sunday, October 14. The first weekend will feature more than 100 panel discussions, on a range of topics about New York City - including the history of housing, of labor, of philanthropy and (a recent addition to the program) the history of New York City disasters. These lectures and roundtable discussions, as well as a number of exhibitions, screenings and a book fair, will be offered for free (though tickets are required) at the CUNY Graduate Center, which occupies the old B.Altman's Department Store on Fifth Avenue and 34th Street. For the remainder of the festival, more than 100 New York City institutions, from museums to schools to neighborhood groups, will offer exhibitions, film screenings, walking tours, performances, lectures and various other history lessons, in locations throughout all five boroughs.
"At first I thought that the documentary and the history festival were poorly timed," says Kenneth Jackson, the president of the New-York Historical Society and a leading participant in both. "But now I think they are wonderfully timed. History can help us to get our bearings. What we learn from history is that things are bearable, that human beings are resilient and cities are resilient." As bad as the terrorist attack was - and Professor Jackson considers it probably "the worst single event in both New York and American history" - "humanity has experienced a lot worse than this."
Mike Wallace agrees. "People are saying that September 11th marks the end of an era, that everything has changed. I don't buy it," says Professor Wallace, who is the director of the Gotham Center and co-author of Gotham: A History Of New York City, the first volume of which won the Pulitzer Prize. "This is a 400-year-old city of eight million strong, and it is not going to be knocked off course by this one event.
"The city has withstood attacks, both external and internal, and disasters both natural and manmade. I wouldn't say this is the worst. Of course, it's a different world now, and any comparisons are suspect. But barring future events - if this remains a single event and we wind up pulling out of a recession - this is nothing, for example, like the full-scale invasion of the city."
THE BRITISH INVASION
In what was then the largest amphibious assault in the history of warfare, the British successfully invaded New York City in 1776. Four days after the occupation began, a fire started downtown (perhaps set by someone loyal to the American cause) that spread unchecked until it had consumed almost a third of the city, including the tallest structure of the time, Trinity Church. The crashing of the houses, the roaring of the flames and the shrieks of the men and women who died "formed a scene of horror beyond description," according to a newspaper account at the time. Another fire two years later destroyed much of the rest. By the time the British ended their occupation seven years later, New York lay in ruins, physically, economically, even demographically; its population had long since fled. "You don't get more devastated than that," Wallace observes. Yet, after the revolution, New York, though having suffered more than any other American city, not only recovered and rebuilt, it became within decades the most important port city in the hemisphere, and not long afterwards the wealthiest in the world.
THE CHOLERA EPIDEMIC OF 1832 AND THE GREAT FIRE OF 1835
The first serious cholera epidemic in New York City killed 3,513 people over a period of six weeks in 1832, which, as a proportion of today's population, would be equivalent to more than 140,000 New Yorkers. Half the entire population fled the city in fear of being infected.
Just three years later, a fire that lasted just two days destroyed 675 buildings including the Merchants' Exchange. This was virtually all of downtown Manhattan, at least a quarter of the entire city at the time. "You could live in New York City now - heck you could live in Manhattan -- and not notice what happened to the World Trade Center," observes Professor Jackson. "You could not have lived in New York City in 1835 and not known there were fires." The insurance claims were so huge that it drove 23 of the city's 26 fire insurance companies into bankruptcy.
Just two weeks after the fire, the city's leading private citizens and public officials met to map out the course of recovery. Though the federal government turned down their appeal for aid, Albany came thorough, allowing the city to sell bonds to finance the reconstruction. Just five months after the fire, a much bigger, better Merchants' Exchange was under construction, made of granite. Within a year the entire area had been completely rebuilt -- the city having entered a period of feverish building that never really ended - the blocks around Wall Street transformed into a financial district that rivaled those in Europe.
While, as public health historian David Rosner has explained previously in Gotham Gazette, it took many decades before the city began responding adequately to epidemics, the two calamities of fire and pestilence together did lead to the development of the Croton Aqueduct, the city's first reliable supply of water, establishing what is frequently called the best water supply system in the nation.
THE DRAFT RIOTS OF 1863
Over a period of some four days in July, 1863, a mob of some 15,000 men, mostly Irish immigrant laborers angered by the first military draft and by years of discrimination, engaged in what is still called the bloodiest urban riot in American history. The crowd at first turned its wrath on the draft offices themselves and on soldiers, then the rich, but their greatest wrath was directed towards African Americans, whom they blamed for the war and thus the draft. The Colored Orphan Asylum, home to some 200 children, was burned down. Black men were dragged from their homes, tortured and lynched. By the time federal troops (themselves mostly local Irish-Americans) occupied the city and restored order, hundreds of buildings had been destroyed, millions of dollars in property had been lost, thousands of African American families had been made homeless, and at least 119 people had been killed.
In some ways, it took decades for the city to recover from this mindless carnage. But it also resulted in a series of reforms aimed at improving the lot of the poor, including laws setting minimum standards for housing and the establishment of a board of health. It also led to the creation of the first modern, professional police department.
THE GENERAL SLOCUM FIRE OF 1904
The General Slocum, a wooden excursion boat with three passenger decks named after a general of the Civil War, left a pier on the Lower East Side headed up the East River for Long Island on a June day in 1904. On board were 1,331 members of the St. Mark's German Lutheran Church, on their way to their annual picnic. Some 15 minutes after the ship left port, the ship caught fire. The ship's captain did not notice the fire until the ship had entered Hell Gate, and could not maneuver in the narrow and treacherous waters. The fire hoses and life jackets and lifeboats, old and rotted, proved useless, and the heat too intense for other ships to help. Fifteen minutes later, the fire had caused the death of at least 1,021 women and children, the worst single disaster in the history of New York City - until September 11, 2001. The disaster so traumatized the city's German immigrant population that they left their old neighborhood of the Lower East Side in droves, moving en masse uptown to Yorkville.
THE TRIANGLE SHIRTWAIST FACTORY FIRE OF 1911
In a ten-story building a block from Washington Square Park, hundreds of seamstresses were at work for the Triangle Shirtwaist Company, which occupied the top three floors, when a fire began on the eighth floor shortly after 4:30 p.m. on March 25,1911. It spread rapidly, fed by the fabric littering the floor. The owners of the company had locked the doors so their employees would not be tempted to take breaks. So some of the people who were trapped rushed to the fire escape. But the fire escape was shoddy and soon collapsed. Many of those who remained, their clothing on fire, jumped from the open windows of the ninth floor. In less than15 minutes, 146 women, mostly teenagers, had died. Reaction was swift and furious, resulting in the enactment of fire safety regulations, laws mandating improved working conditions, and a huge boost to the labor movement.
New York City is full of far more than just these six crises. There were race riots, for example, in 1935, 1943, and 1964, and these led to wake-up calls that spurred the city to address some of its racial inequities. There were serious financial troubles, such as the various "panics" of the nineteenth century, the Great Depression of the 1930's and the fiscal crisis of the 1970's. There were events that have some startling parallels to the current catastrophe: A terrorist bombing, on September 16, 1920, of the House of Morgan on Wall Street, killed 38 people and injured 300; though anarchists were suspected, no perpetrators were ever found. On the foggy morning of Staruday, July 28, 1945, a B-25 bomber that lost its bearings crashed into the 79th floor of the Empire State Building, killing 14 people and injuring dozens more. Amazingly, the skyscraper itself suffered no structural damage despite the gaping hole, and it was completely repaired within a year. Many of these tragic events are virtually lost to history. "We've forgotten the General Slocum," Professor Jackson says. "It doesn't even register." The world is unlikely to forget the terrorist attacks of September 11,2001, if for no other reason than that, he says, "this is going to be the most documented tragedy in the history of the human race."
But, says Professor Wallace, this does not mean that it is in any objective way more devastating than the previous tragedies. "It depends on what happens next -- it could scatter the financial district, for example - but this will probably have less long-term impact on the city than some of the other events have had."
And, as with the other events, both historians believe, the city will do better than just survive it.
"The city won't come back better and stronger in a few days, or even a few months, or maybe even a few years," Kenneth Jackson says. "But it will recover. It always has."
City officials have announced their plans for the second anniversary of the World Trade Center attacks, including bringing back the "Tribute in Light," the twin beams that marked the forms of the towers in the sky in March 2002.
In a four-hour ceremony confined to Ground Zero, the names of the 2800 attack victims will be read aloud by 200 children of World Trade Center victims, standing and reading in pairs. The bells of the city's houses of worship will toll, and four moments of silence will be honored -- each marking a critical event of the morning of September 11.
A schedule of the commemoration program:
7:00 AM
Guests may begin to gather at the World Trade Center site. The city has said that priority will be given to victims' family members, but that the public may attend if space allows.
8:30 AM
The program will begin with a citywide moment of silence.
8:46 AM
There will be a moment of silence to observe the time that the first plane struck the North Tower, and houses of worship throughout the city will toll their bells. Then, children of September 11 victims will begin reading the names of those killed. While the names are being read, family members will be able to walk down the ramp to the lowest level of the World Trade Center site to lay flowers.
9:03 AM
There will be a moment of silence to observe the time that the second plane struck the South Tower. Reading of names will then continue, and music will resume.
9:59 AM
At this time, marking the fall of the South Tower, there will be another moment of silence. The reading of names will then begin again.
10:29 AM
The ceremony's final moment of silence will mark the time that the North Tower fell. Then, the reading of names will continue until they conclude.
12:00 PM
To close the ceremony, two trumpeters (one from the fire department band, the other from the police department) will perform "Taps."
Sundown
The two beams of the "Tribute of Light" will shine for one night.