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What was it like to live in an Iron Lung and how Polio epidemic in 1950's resembles COVID-19?



The terror of not being able to breath is something that a lot of people have discovered during the recent months due to the global pandemic in 2020. It should be noted, however, that a lot of fatal viruses have been living with us for decades and centuries until the vaccine was invented. Imagine gasping for air as the muscles refuse to function and all the doctors can do to help you is to put you inside a coffin-like medical device. That is how it was for a lot of people who got infected with Polio in the 20th Century. One of the worst symptoms of acute polio was muscle paralysis. If paralysis affected the chest muscles, the patient couldn’t breathe unaided and might die. Researchers looked to technology for a way to keep these patients alive.

The solution came from a team at Harvard University. The 'iron lung', as it was nicknamed, was a huge metal box attached to bellows in which the patient was encased. The continuous suction from the bellows kept the patient breathing. It soon became a feature of the polio wards of the mid-1900s. By 1939, around 1,000 iron lungs were in use in the USA. Some of them even had to spend years in them


So how was it to spend so much time in the iron lung?

For most patients, Iron Lung was a relief

As horrific as it may sound to us nowadays, Iron Lung was a big relief to a lot of patients as it is better to breath normally through the Iron Lung than gasp for air and suffocate without it. One of the polio survivors shares her experience:

But the relief of not having a respirator on my mouth and just laying flat on my back with the breathing taken over was quite relaxing. It was restful because there wasn't much for you to do in the iron lung. There was a mirror in front of you so that you could see what was going on behind. There was a frame over the top where they could put a book or a newspaper, but you had to have someone to turn the pages so not much point really; you would usually just shut your eyes and go to sleep, it was quite relaxing.

The bit that you lay on actually pulls out like a tray. You would lay on it and get pushed inside. The mechanics are underneath the machine so you're laying on the pump. And of course you get the vibration underneath. Like: … breathing, bump; breathing, bump … It was not quite like a smooth breath.

You can eat in the iron lung because your head is outside but the rest of your body is inside, although since you are flat on your back you really need to be careful when you swallow; you have to swallow in rhythm with the machine because it's pulling your diaphragm in and then pushing it out again. You just wait until it's breathing out and then you swallow. Coughing was a bit more difficult because you don't cough in rhythm with the iron lung. It was something you had to work round. But that was just sort of a down side. You cannot turn over or anything. The iron lung had port holes on the side which came in useful for physiotherapy. They had a rubber seal so you could open them on the down breath and put a hand in, to do physiotherapy or anything inside.

Did you have to spend your whole life in an Iron Lung?

Most of the time, Iron Lung was a device that people had to spend two to three weeks in. After doing so, the patients would start to recover. So the idea that whoever who got inside the Iron Lung, will have to live with it forever was created by a sensationalist media. It is true, however, that there were handful of cases when patients had to spend years or decades in the Iron Lung due to severity of their condition.

Iron lung did not mean the end of the social life

John Prestwich contracted polio at age 17 in 1955. He spent seven years in an iron lung before transitioning to other devices, but he revisited the machine at various points during his life. After 16 years in a hospital, Prestwich married his wife, Maggie, who had been his occupational therapist. John Prestwich, who passed in 2006, described their "very full and active social life" together:


We are able to travel independently, and we turn up at the most surprising places! We are also extremely fortunate to have so many very good friends who are always there for us when we need help and who don’t seem to mind the disruption we cause when we turn up! Our biggest problem is access, but we try to organize our lives around accessible venues.

Similarly to the shortage of the ventilators situation during the COVID-19 pandemic in Italy, doctors had to choose which patients had better chances of survival and should be put inside the Iron Lung during the Polio epidemic

During the polio epidemics of the 1950s, in remote locations where more people needed an iron lung than there were devices available, doctors faced a difficult choice: whether to put the most acutely ill into the device or try to save patients with better chances of survival.

When a young woman named Louise Lake needed an iron lung, doctors opted to give the machine to another patient, a mother who had recently given birth, only to see her perish. Josephine Howard's husband and five of her children all had polio, but her oldest son, Richard, was given the iron lung first. He succumbed as his parents sat outside listening to the sounds of the device.

How to make sure that the shortage situation would not repeat itself if the second wave of COVID-19 hit us?

Due to high demand, the breathing ventilators needed to treat COVID-19 patients are still expensive and difficult to import due to suppliers asking to pay full sum upfront. Luckily, in today‘s Trade Finance market, there are new solution that helps to mitigate this problem. London-Hong Kong based company Nu-Credits can help the importers of the PPE products to finance the requested advance payment and free up the working capital on the buyer‘s side.

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This project has received funding from the European  Union's Horizon 2020 research and innovation program under grant agreement No.828888

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