This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (4)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Viral Infections  • Public Health, Other  • Humanities  • History of Medicine  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: I believe that the study by Dr Markel and colleagues¹ of the 1918-1919 influenza pandemic and the effectiveness of nonpharmaceutical interventions has a serious problem in its data that calls its conclusions into question. The authors assert that, of 43 cities in the study, New York City intervened the earliest, on September 18, 1918, at "–11" (11 days before excess deaths doubled the baseline), 6 days earlier than the second earliest city. Because New York City had a relatively benign experience, this assertion contributes to the conclusion that nonpharmaceutical interventions were effective.

However, I am aware of no evidence that New York City ever took any action that meets the authors' definition of a nonpharmaceutical intervention: school closure, cancellation of public gatherings, and isolation and quarantine.¹ The city never closed schools and never cancelled public gatherings. New York City health commissioner Royal Copeland did tell reporters on . . . [Full Text of this Article]

John M. Barry
jbarry@tulane.edu
Center for Bioenvironmental Research
Tulane University
New Orleans, Louisiana

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Nonpharmaceutical Interventions Implemented During the 1918-1919 Influenza Pandemic
Jacobo Dib, Jr
JAMA. 2007;298(19):2260.
EXTRACT | FULL TEXT  

Nonpharmaceutical Interventions Implemented During the 1918-1919 Influenza Pandemic—Reply
Howard Markel, Harvey B. Lipman, J. Alexander Navarro, Alexandra Sloan, Joseph Michalsen, Alexandra Minna Stern, and Martin S. Cetron
JAMA. 2007;298(19):2261.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Nonpharmaceutical Interventions Implemented by US Cities During the 1918-1919 Influenza Pandemic
Howard Markel, Harvey B. Lipman, J. Alexander Navarro, Alexandra Sloan, Joseph R. Michalsen, Alexandra Minna Stern, and Martin S. Cetron
JAMA. 2007;298(6):644-654.
ABSTRACT | FULL TEXT