WHAT WORKED IN 1918: Early Quarantines and Closures.

The US urban experience with nonpharmaceutical interventions during the 1918-1919 pandemic constitutes one of the largest data sets of its kind ever assembled in the modern, post germ theory era.

…Although these urban communities had neither effective vaccines nor antivirals, cities that were able to organize and execute a suite of classic public health interventions before the pandemic swept fully through the city appeared to have an associated mitigated epidemic experience. Our study suggests that nonpharmaceutical interventions can play a critical role in mitigating the consequences of future severe influenza pandemics (category 4 and 5) and should be considered for inclusion in contemporary planning efforts as companion measures to developing effective vaccines and medications for prophylaxis and treatment.

The tendency is to temporize, but time lost is lives lost when an epidemic is underway. If you’re going to close schools and quarantine eventually, it makes sense to do it sooner rather than later. A lot of institutions — including my own — seem to be assuming they’ll have to do it, but trying to put off that day.