On Sept, 27, 1918, there were 15 cases of influenza reported in Dallas. The Dallas Health Officer, A.W. Carnes, underestimated the coming pandemic and allowed the Liberty Loan parade to proceed the following day. Thousands flocked to the streets in downtown Dallas. Eleven days later Dallas had over 1,000 cases of influenza. Three days after that the count was 2,719.

The subsequent responses to the 1918 flu pandemic will sound eerily familiar today. A tent was erected at St. Pauls Hospital to handle the overflow of cases. Baby Camp, a childrens hospital, restricted all visitors. Parkland turned a chronic disease ward into an isolation ward for influenza patients and recovering patients were moved to hallway beds to make room for newer admissions. On Oct. 10 theaters, playhouses and other entertainment venues closed. Two days later, Mayor Joseph Lawther closed schools and banned public gatherings including church services.

With cases skyrocketing the mayor acted reluctantly stating, I am taking this action not because the situation in our city is alarming but as a measure of safety and precaution and because it seems to be the desire of our citizenship.

Across the country leaders unwilling to acknowledge the reality at hand and reluctant to take action contributed to public mistrust. In Philadelphia, one of the cities hardest hit, Director of Public Health Dr. Wilmer Krusen was slow to respond. Described as someone who thought most problems disappeared on their own, Krusen lost the publics trust and that mistrust led to panic and selfish behaviors. When the Bureau of Child Hygiene begged neighbors to take in children whose parents had died, the response was silence. Pleas for volunteers to feed dying patients and for nurses to deliver medical care were ignored.

From a medical perspective, surprisingly little has changed in a century. Non-pharmaceutical interventions (NPIs) are still our first line of defense against the spread of COVID-19. Isolating known cases, quarantining family contacts, limiting social interactions, and closing schools are the tools we have available to us. These actions are similar to 1918 but our understanding is better. Unlike 1918, local authorities today are proactively proposing these personal and economic sacrifices in order to suppress the spread of COVID-19.

These interventions are designed to delay peak transmission to give the health system time to prepare; blunt the peak so the health system is not overwhelmed; and buy time for researchers to develop a vaccine.

The NPIs are tough medicine but a true anticipation of the threat before us. Honest communication and thoughtful actions build public trust that is critical as we call on each other to act as a community in service of each other.

In his epic story The Great Influenza, John Barry quoted Albert Camus: Whats true of all the evils in the world is true of plague as well. It helps men to rise above themselves. Barry went on however to warn, evil and crises do not make all men rise above themselves. Crises only make them discover themselves. And some discover a less inspiring humanity.

Stories of plague and flu pandemics often tell the stories of heroes who risked their lives to save their fellow humans. That history is also replete with acts of selfishness and abandonment. Often in retrospect we are not proud of the human behavior in these crises.

In the past two weeks I have heard the stories from across the country of stolen personal protective equipment (PPE) and workers who refuse to care for potentially infected individuals. But I have witnessed many more instances of health care colleagues understanding their risks, taking appropriate precautions and raising their hands to care for infected individuals. These caregivers are ministering with skill and compassion to the sick in full exemplar of their callings to serve. We are writing the story of our response by our actions today.

Be generous interpreting the decisions of leaders. Public health officials were criticized for an aggressive vaccination campaign in anticipation of the swine flu pandemic that never materialized in 1976. We can hope for something similar.

Inform yourself. The virus has mild clinical manifestations in 80% of those infected. Those infected with minimal symptoms, however, can spread the virus to the elderly and those with chronic illnesses who have a greater chance of severe, life-threatening disease. With proper precautions (including sufficient PPE, which is needed in greater supply) our health care professionals can remain protected so they can continue to provide compassionate care to those infected.

Finally, stay connected. We will likely be dealing with this for several months. Reach out to someone socially isolated and fearful. Pay attention to the poor and the marginalized who have historically been disproportionately affected by crises like this one. Unlike 1918, you can text, email, phone or FaceTime. Staying connected is important for each individuals and for societys mental health.

Dr. Fred Cerise is CEO and president of Parkland Health & Hospital System.

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Parkland chief: Past epidemics reveal why we must take serious action now - The Dallas Morning News