Thu, 04/23/2020 - 5:45pm

No island is just an island

To the Editor:

Block Island, like almost every community in the United States, is faced with very difficult choices with potentially serious consequences.

I am writing this short piece in the hope of adding some more information to help inform those in decision-making positions on the island as they grapple with how to balance health needs and economic needs.

I am trained as an epidemiologist and have spent many years studying social trends in the public health field. While only a seasonal resident, I began coming here with my partner, Peter Kinoy, many decades ago, and have developed a deep love and respect for people here. I think the town has done well listening to the counsel and advice from Dr. Mark Clark, who we are very lucky to have, and clearly, we would all be better off if testing were made universally available here.

Although the novel coronavirus that causes COVID-19 disease is not the same as influenza, my background in epidemiology led me to investigate the peak-and-ebb curves in the 1918 flu pandemic that spanned 1917-1919 and produced more civilian deaths (about 678,000) than all U.S. forces’ fatalities in the concurrent World War I.

Attached is a graphic from the Centers for Disease Control of the domestic pandemic mortality during the 1918 “Spanish” flu.

The bottom axis is time, marked out in months and years, while the vertical axis is number of deaths, marked in units of deaths/10,000.

Looking for pandemic enlightenment and some relief, I asked this question: What happened during the “troughs,” the times when there were very few cases, in the 1917-1919 epidemic in the U.S.? And how did that compare with countries hard hit in Europe? A longitudinal, multivariate 2013 Royal Society (Biology) publication on that pandemic in England and Wales compared several U.K. cities there. Overlaying their 1918 pandemic mortality graphs with those of the U.S. shows an uncanny similarity. The U.K. authors said quite definitively: “We conclude that behavioral changes, temperature trends and school closure all contributed to the observed three wave mortality patterns in the U.K. during the 1918 influenza pandemic, and that behavioral changes had the largest effect.” (Emphasis added.)

The behavioral changes they were referring to included school closures, crowd bans, quarantine of patients, penalties for knowingly exposing others, public spitting, etc. What happened locally when these strictures were lifted? In each of the cities studied, another huge upswing of the curve. In fact, the second peak in the U.S. was much worse than the first. Of course, in the U.K. and the U.S., there were no influenza vaccines or sound medical treatments then, and in the U.S. it was medical students who were at the frontlines for civilians, since MDs had been drafted into the WWI effort.

In terms of a medical approach, we are in better shape than in 1918. For COVID-19, there are dozens of companies working globally on developing vaccines and some that are moving toward clinical trials, but most optimistic projections don’t have a vaccine available until early 2021. And vaccine availability will depend on the level of international cooperation, the types of technologies available, clinical trial results, and the world’s willingness to accept science and rush regulations in the face of an emergency. 

According to many health experts, a second wave of COVID-19 is possible in the fall of 2020. While there might possibly be a vaccine to combat a second peak of infections, what more clearly might be available by that point could be widespread and easily available initial testing for the virus and subsequent testing for the presence of antibodies.

Japan, Korea, Germany and a hospital in Michigan (Beaumont) are testing most workers for COVID-19 antibodies; Germany proposes issuing “immunity passports” for its workforce. Remember, “herd immunity” is effective but only if a very large, general population is COVID-19-positive, but fully recovered, or around 85 percent vaccinated.

Unfortunately, most of Block Island’s economy relies on a large, uncontrolled flow of people coming to the island from many different places, so we would be wise to think about not only current prevalence of the virus here on the Island and non-symptomatic residents, but in the areas where people are coming from.

Personally, I believe that a “safe, smart and targeted” rollout opening up of the Block Island economy should be determined on the basis of the prevalence of this deadly virus (e.g. testing), and not on the GDP or dollars lost. Clearly the most important thing is for as many people as possible to remain alive through this pandemic, and if island wage earners can remain alive and weather a storm of economic recession with the help of community, state, and federal support, I am certain that over time a healthy, viable Block Island economy can re-emerge.

Mary Lutz, Phd, MPH Sheltered in place on Corn Neck Road.


A Block Island ‘thang’

To the Editor:

Hi Block Island community.

I wanted to send a big shout out to the Easter Parade committee. I was overwhelmed with gratitude for the drive-by parade of bunnies, dogs and whatever else I saw. (The happy tears and the mask were fogging up my glasses.) A new norm as we continue to be safe. Thank you again.

It was so full of love and such a typical Block Island “thang.” I love this place!

Nancy Worth Beach Avenue