Pat Gray speaks matter-of-factly about taking her last unassisted steps just before her 13th birthday in 1953.
She says she’d been suffering from a gastro-intestinal illness for a few days. Her fever was high, and her mother was caring for her on a sofa in the dining room of the family’s Kansas City, Kansas, home.
Gray was miserable, so her mother suggested she move to her own bed.
“I remember getting up, going up the steps to my bedroom, and my legs just gave out. I didn’t make it the rest of the way up the steps; I had to crawl. That was the last time I walked,” Gray, now 80, says in the library of her Lenexa assisted living facility.
While the poliovirus and the coronavirus are not the same classes of virus, are not contracted the same, and the coronavirus is much more contagious, Gray sees several parallels — including the urgent need for widespread dissemination of the vaccine.
She's disturbed by reports that as many as half of Americans will refuse the vaccine once it's available to the general public.
“I hope and pray that that number goes down. I think that unless everybody takes it, we’re still going to be fighting the virus,” Gray says.
She recalls a concentrated effort to encourage the public to take the polio vaccine in the years after her illness. And even though polio is just a word now to most people — not a vivid memory as it is for her — she thinks most parents understand the importance of inoculating their children against it.
The first major outbreak of the poliovirus in the United States was documented in 1894, and until widespread distribution of the vaccine in the mid to late 1950s, the number of cases climbed, reaching nearly 60,000 in 1952.
While most who contracted one of the three strains of the poliovirus were asymptomatic, in 1952 a third of patients, including Gray, experienced paralysis.
Polio, or poliomyelitis, is classified as an enterovirus, meaning it enters the gastrointestinal tract and attacks the nervous system. It’s contracted by fecal matter entering the body through the mouth, which is why swimming pools were associated with its spread.
The coronavirus is strictly respiratory.
“The poliovirus primarily affects the nerves, whereas the COVID virus is primarily affecting the respiratory track,” says Dr. Edward Ellerbeck, chair of population health at the University of Kansas Medical Center.
Although each virus can affect a person’s ability to breathe, the causes are not the same.
In polio patients who had the strain of the virus that hindered their breathing, Ellerbeck explains that “what happens is they lost the innervation from the nerve to the muscles that actually control their breathing. It wasn’t that their lungs were affected; their lungs were fine.”
COVID patients’ breathing is affected because the lung tissue is destroyed, though the surrounding nerves are fine. But both viruses can create long-lasting problems.
Gray has for decades struggled with complications and post-polio syndrome, a little-understood condition that causes extreme weariness. In 2006, she traded in braces and crutches for a wheelchair in order to save the strength in her arms.
A couple of years ago, she visited Kansas City Bone & Joint Clinic to be fitted for an upgrade. As she worked on the voluminous amount of required paperwork — feeling stressed and impatient — an encounter with a nurse practitioner brought her full circle with her past.
Laurel Short walked in, and Gray says she felt a calm come over her.
The two talked, and Gray told Short she was treated for her childhood bout with polio at Bethany Medical Center in Kansas City, Kansas.
“I had this odd feeling when she said that," Short says. "And I said, ‘Do you remember the name of your doctor?’ And she did not miss a beat. She said, ‘Dr. Phil Nohe,’ so then I knew that she had been treated by my grandfather.”
Gray says Short’s features must be so like her grandfather’s that she was subconsciously soothed by the sight of her.
Short has only ever seen photos of Nohe, who died the week she was born in 1983. Still, she likes to think that her style of care is similar to his.
Short says she’s already started hearing stories of clinics scheduling rehabilitation for people who’ve survived COVID..
“We know the field of rehabilitation is going to be integral to working with these folks and educating primary care providers will be really important, too,” Short says. “We don’t understand all the long-term effects.”
Gray had thought the lasting effect of being unable to walk unassisted was the long-term effect she’d be dealing with; she was well into adulthood before post-polio set in.
Short says post-polio is still not well understood, but patients experience new weakness, new atrophy of muscles and intense fatigue.
Those who contracted poliovirus were affected in a spectrum of ways from mild to life-threatening. For some, the long-term evidence is a slightly smaller foot, shorter leg, or the development of scoliosis due to asymmetrical growth caused by the disease.
“We see that with COVID-19 where some people say, ‘Oh, it’s just like the flu,’" Short says. "And we cannot predict who will get the mild form and who will get the severe form, and that is completely similar to polio, even though they’re different types of viruses.”
Fortunately, says Ellerbeck, vaccine development has advanced significantly since Dr. Jonas Salk introduced his polio vaccine in 1955 — two years after the disease interrupted Gray's childhood.
He says recipients of the new coronavirus vaccines should feel more secure than the first people who took the polio vaccine.
“Both of them had tremendous public awareness related to them,” Ellerbeck says, but “we’re light years beyond where we were in the development of the polio vaccine in our safety control methods. Now we have much better safety monitoring and safety controls on our vaccine development.”
Gray doesn’t think people are resistant to the COVID vaccine because the polio epidemic is now only a distant memory. She thinks the resistance stems from people simply not wanting to be told what to do.
“And that’s a sad thing,” Gray says, “because if we all are in this together, then we need to work together to solve the problem.”
