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Closures, equipment shortages and insights from Canada's polio 'invasions'

Closures, equipment shortages and insights from Canada's polio 'invasions'

Starting early each morning, Gloria Stephens would slowly make her way through the Halifax ward of young polio patients, wrapping their limbs in hot towels to loosen muscles and stave off paralysis. In the background was the headache-inducing swoosh of enormous breathing machines.

Her day would end 12 hours later by carefully removing the awkward gown, gloves and mask she wore, ensuring as she did that none of her clothes became contaminated. She would return to the former army barracks where she and other nursing students lived in isolation, their food delivered from the hospital cafeteria.

"It was quite an experience and one you won't forget," Stephens, 88, said of her time working as a nursing student in the early 1950s at the polio clinic next to the Victoria General Hospital.

"It's one of the things in your life, in your nursing career, it stays in your mind. It's hard to say, but we did lose some children. And that was very, very tough. It affects me to this day."

Submitted by Gloria Stephens
Submitted by Gloria Stephens

While the current COVID-19 pandemic has drawn comparisons to the Spanish flu of 1918-20, which killed millions worldwide, polio represents a more recent health crisis within the living memory of many Canadians.

Polio hit Canada in waves

Polio epidemics hit parts of the country in waves from the 1920s to the 1950s, peaking with a particularly bad year in 1953 with 9,000 cases and 500 deaths nationally.

"It was kind of our last real national health emergency like this," said Christopher Rutty, an adjunct professor at the University of Toronto who has studied the history of polio in Canada.

The economic and social toll of COVID-19 has touched every corner of Canada on a scale surpassing polio. But much like today's pandemic, the fear was real and some of the measures now all-too familiar.

During polio outbreaks, schools, playgrounds and movie theatres were closed in pockets of the country. Public health officials in some communities gave daily briefings on new cases and recoveries, according to social historian Leah Morton, and families of the infected were quarantined.

Nurses were recruited out of retirement to help with large numbers of patients, while health officials and governments scrambled for much-needed equipment. There was the push to develop a vaccine that would finally bring it under control.

Polio is a virus most often spread through infected fecal matter entering the mouth. Although many people didn't get sick, in some cases it infected the spinal cord and caused paralysis. Many cases involved children. In the worst scenarios, polio damaged the nerves that controlled the muscles around the lungs.

University of Manitoba Archives & Special Collections
University of Manitoba Archives & Special Collections

The treatment used to keep the sickest patients alive was extreme. They were placed inside a device called an "iron lung" that created a vacuum around their body, with only their head showing. A device called a bellow sucked air in and out, forcing the chest up and down to help them breathe.

COVID-19 can also make breathing difficult. And much like the current fears that Canada will run short of life-saving ventilators, health officials dealing with polio struggled to secure enough iron lungs.

At one point, the old Sick Kids Hospital in Toronto was building them in the basement. The Royal Canadian Air Force flew mercy missions, bringing iron lungs to desperately-short communities. In Winnipeg, one hospital had 90.

"It was a major challenge as epidemics worsened," Rutty said. "Especially in the 1950s, we had more and more iron lung cases and more and more adults."

Widespread immunization needed for COVID-19: former PM

Immunizations were the great turning point in the battle against polio. First came the Salk vaccine in the 1950s, followed by the Sabin vaccine in the 1960s.

Fox Photos/Getty Images
Fox Photos/Getty Images

Former prime minister Paul Martin, who contracted polio when he was eight, noted his father, Paul Martin Sr., was instrumental in bringing the first vaccine to Canada when he was health minister in the 1950s.

He said the same sort of widespread immunization program will be needed to bring COVID-19 under control, once a vaccine is developed. But he said it's crucial it happens not just in North America and Europe.

"Polio still exists in certain countries in Africa and some in east Asia," he said. "The fact is we've got to help those countries get rid of polio, otherwise it can come back. And it's going to be exactly the same thing with COVID-19."

Martin said most Canadians his age will remember classmates in grade school who were paralyzed by polio. He recalls an iron lung being wheeled into his hospital ward when he was sick.

Adrian Wyld/The Canadian Press
Adrian Wyld/The Canadian Press

"The fellow beside me said, 'That's an iron lung and that's where you're going to spend the rest of your life,'" said Martin, noting he never was actually placed inside one and eventually made a full recovery. "I never forgot it. That's when I suddenly realized, as an eight-year-old, that I was sick."

But there is one significant difference between polio and COVID-19, he said. Polio was predictable, coming in "invasions" summer after summer, he said, unlike the surprise of COVID-19.

Martin said he contracted polio after playing in the dirty water of a ravine from which his mother had warned him to stay away. He later told her he felt like he had a "plate in his stomach."

WATCH | A history of polio in Canada:

"When I got sick, my mother knew immediately what had happened and got me into the hospital," he said.

Morton, an assistant curator at the Manitoba Museum who has studied polio epidemics in the province, said given outbreaks typically happened in the summer, debates raged over whether to close swimming pools and delay school openings in the fall.

Some doctors even discussed the same dilemmas faced by those in the worst-hit COVID-19 countries: which patients to save and which to let die because there was not enough equipment to go around.

Three Lions/Hulton Archive/Getty Images
Three Lions/Hulton Archive/Getty Images

There was not, however, the same kind of large-scale economic impact, Morton said. Unlike today, many businesses remained open. There are lessons to be drawn from polio, she said, including how people supported one another.

"I think this kind of community togetherness that you see in times of epidemics is a really important lesson," Morton said.

"There's a lot of fear and we're being asked to socially distance ourselves from people, but we still need to work together as communities. You saw that with polio, and I think you're really seeing that today with COVID-19 as well."

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