If the coronavirus outbreak has produced a star it is perhaps England’s chief medical officer, Prof Chris Whitty, the cool-headed epidemiologist described by the Guardian sketch writer, John Crace, as “the Geek-in-Chief, whom everyone now regards as the country’s de facto prime minister”.
But Whitty is not the first medic to achieve celebrity status during a national health crisis. Over 100 years ago there was Dr James Niven, a straight-talking if shy Scot, who as medical officer for Manchester managed to cut the city’s death rate from 24.2 per thousand in 1893 to 13.8 per thousand in 1921 – thanks to his pioneering insistence on improved sanitation, maternity services, health visiting, infant welfare, smoke abatement, and preventive measures against TB.
It was during the Spanish flu outbreak of 1918 that Niven became known beyond Manchester. As a deadly strain of influenza spread across Europe and the rest of the world, it was Niven who pushed a simple – though unpopular – health message that kept many more Mancunians alive than inhabitants of other UK cities: close down society as much as possible to stop the spread of the disease.
It was a tricky decree in a working-class city that prided itself on the productivity of its factories and mills. But Niven was resolute, publishing a leaflet early on in the crisis saying the sick should “at once” be separated from the healthy for treatment “and they should bear in mind that the risk of a relapse, with dangerous complications, constitute a chief danger of the disease”.
He became a regular in the Manchester Guardian, warning readers not to be complacent and giving them a checklist of symptoms to watch out for: a sudden severe headache, pains in the back and limbs, and fever.
He warned that “discharge from nose and mouth should not be allowed to get dry on pocket handkerchiefs”. Infected articles and rooms should be disinfected, he ordered. Anyone who caught the flu must “on no account join assemblages of people for at least 10 days after the beginning of the attack, and in severe cases they should remain away from work for at least three weeks”, he said.
On 30 November 1918, the Guardian reported that the epidemic had reached its peak in Manchester. One doctor said they were unable to respond to all calls. “We are only human and cannot do the impossible,” said the medic. “It is inevitable that some people cannot be attended to at all.”
What is Covid-19?
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals.
What are the symptoms this coronavirus causes?
The virus can cause pneumonia-like symptoms. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties.
In the UK, the National Heath Service has defined the symptoms as:
- a high temperature - you feel hot to touch on your chest or back
- a new continuous cough - this means you've started coughing repeatedly
Should I go to the doctor if I have a cough?
Medical advice varies around the world - with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities.
In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
How many people have been affected?
China’s national health commission confirmed human-to-human transmission in January. As of 30 March, more than 720,000 people have been infected in more than 150 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.
There have been over 34,000 deaths globally. Just over 3,200 of those deaths have occurred in mainland China. Italy has been worst affected, with over 10,000 fatalities, and there have been over 6,800 deaths in Spain. The US now has more confirmed cases than any other country. Many of those who have died had underlying health conditions, which the coronavirus complicated.
More than 150,000 people are recorded as having recovered from the coronavirus.
The situation was so bad that Niven and the police’s chief constable met representatives of “places of amusement” and told them to ban children under 14 from all performances.
A further problem was the delay in carrying out burials and the collection of bodies from undertakers’ parlours, which Niven said was “a very unsatisfactory state of affairs”.
It was, he said, “an imperative necessity that the War Office should send skilled coffin-makers back to the workshops without delay”. He was exasperated that people still wanted fancy funerals, suggesting the situation “might be relieved by greater simplicity in funeral arrangements, but relatives were insisting on strict observance of custom, with its paraphernalia of hearse, coaches and elaborate oak coffin”.
The pressures of the job eventually took their toll on Niven. He drowned in the sea off Douglas on the Isle of Man on 30 September 1925. An inquest recorded he had taken poison and then drowned himself while temporarily insane.
His obituary in the Guardian paid tribute to a humble man who wore his intelligence and experience lightly: “He was not a great talker and had the merit of never ‘advertising’ – in fact, in later years especially he seemed to keep somewhat aloof from his colleagues. He had the reserve of the north-eastern Scotsman, and strangers sometimes fancied his manner to be somewhat chilling. But those who knew him best were able to attribute this to a kind of shyness, and no member of his profession who required help from his great experience and sound knowledge ever asked for advice and assistance in vain.”
