Each generation is experiencing the pandemic differently. For some, the trauma of the 1918 pandemic still echoes. Others worry about how to balance their own health and responsibilities with concerns about the health of their parents or children. In this episode, we’ll share stories about the impact of COVID-19 across generations.

Our first story is from Mary Sue Kitchen, who was director of the Fairfax County Health Department Laboratory in Virginia for seventeen years from 1995-2012. In Mary Sue’s story, her grandmother's experience of the 1918 pandemic inspires and informs her career in public health.

After Mary Sue’s story, our host speaks with Marta Hanson, associate professor of the history of medicine at the Johns Hopkins University School of Medicine, about how we’ve responded to pandemics of the past.

Stay tuned for two more stories on Monday!

Story Transcript

In January of 2012, I was in Atlanta in the emergency operations center of the Centers for Disease Control as part of a special tour arranged for the board of the Association of Public Health Laboratories. I was watching a live, worldwide tally of infectious disease on a huge world map at the head of the room. I felt secure, prepared. Proud of our nation and of our world for the great strides made in public health and in emergency preparedness in recent years.

I reflected on my 40-year career in laboratory medicine, in particular the past 20 years spent working in a local public health laboratory next to the nation's capital. Our laboratory routinely dealt with pathogens, like tuberculosis, HIV, West Nile Virus and rabies, and we had just built a new public health laboratory with a special molecular biology section prepared to rapidly identify emerging pathogens in the future.

I thought back to a story told by my grandmother in my childhood that had inspired my career. When I was eight years old, our family moved from Albuquerque, New Mexico to Lincoln, Nebraska. We lived with my grandparents for a few months.

One morning, in the summer of 1955, when I was home alone with my grandmother I tripped at the top of a dangerous back stairway and fell head over heels down the stairs, gashing my leg severely and crashing headfirst into kitchen cabinets at the base of the stairs.

As my grandmother tended to my wounds, she comforted me with a story of the part those stairs had played in the survival of her family many years earlier during the influenza epidemic of 1918. It had started in the spring of that year. By May, her elderly neighbors had both died of influenza.

My worried grandfather sent my grandmother and my four-year-old father to isolate with distant relatives on a remote Nebraska farm for a few months. They were eager to return home when school started in the fall.

By October, all three of them had come down with influenza at about the same time. My grandmother was so sick she was unable to get out of bed. She awoke after several days to the sound of my father crying from hunger in the next room.

She crawled on her hands and knees, up and down those same stairs that I had just fallen down, to feed her family, too sick and too weak to even stand. They survived on not much more than jugs of milk poured over saltine crackers for the next few weeks.

I listened to her story as she bandaged my leg. The bleeding stopped. The pain receded, but the story stayed. Why have I remembered it through all these years? I think because that morning, as we sat on that kitchen floor propped against the kitchen cupboards, both of us were crying out of fear and relief. I think my grandmother cried out of that fear universal to parents, the fear of failing one's children. After all, she had just failed to prevent me from falling down those dangerous stairs. And she had relived the most fearful story of her life, the time that she was so sick she had failed to feed her only child.

I cried out of relief that I had avoided stitches and broken bones, but also frightened by her unaccustomed tears and by the dread disease that had caused her fear.

Years later, as I sat in that CDC conference room, I thought my grandmother might be proud of my career and of what our country had accomplished over the years to better prepare for future pandemics. It seemed a good time for me to retire.

When COVID-19 arrived this spring, eight years into my retirement, my husband and I decided to isolate here at home for a few months until public health got things under control.

I've been frequently disappointed and angry these past few months. I was totally shocked when federal control of the epidemic was delegated to the states in early May. Every public health plan I had ever written depended on a close coordination between local, state and national public health resources. This was not the public health system I had retired from.

I had nightmares about laboratories in 50 different states bidding against each other for scarce and complicated molecular diagnostics with no federal coordination or purchasing assistance. If laboratory stock rooms currently looked anything like the pandemic hodgepodge in my garage, Lord, help us all.

So where does all this confusion and lack of coordination leave me and my family? My grandmother came home from the farm too soon in 1918. So my husband and I practice strict isolation due to our age and multiple risk factors. We are lonely because our children and grandchildren all live far away in distant states. Our family and friends are confused by different and conflicting messages from a myriad of different news sources with no clear national risk coordination and communication.

Right now, despite a century of cutting-edge science, I feel abandoned by my nation and not much better off than my grandmother a hundred years ago. I worry about my valiant lab colleagues right down the street when I hear reports of extended shifts and instrument and reagent shortages. I offer to help and then feel guilty when I reconsider and decide not to help, not sure I should risk such close exposure to co-workers both for my husband's sake as well as my own.

I do feel lucky that I have retired in a county and a state with a good public health system. And I can vote, something my grandmother could not do in 1918. Each of us have been left largely alone these days to navigate a confusing path between risk and responsibility.

One evening last week, several neighbors invited us to a socially-distanced lawn party. I started to join in and then thought of my grandmother in 1918. I paused briefly by an open window. Soft laughter, lawn chairs spaced well apart, fireflies in the dusk, dogs playing catch.

I looked again at all my dear neighbors, some gathered way too close together under a street lamp, only a few wearing masks. I watched their dogs ferry a saliva-covered ball from hand to hand to hand across the lawn. That night, I decided to stay inside.