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PREFACE
It has not been possible to prepare other than a
much abridged report upon the health of the Borough for the
year 1939. The various statistical rates are based upon the
two estimates of population provided by the Registrar General.
The estimated resident population at the mid-year of 270,800
was clearly not applicable after the evacuation in September
and the calculation of death rates is based upon an average
population of 254,300.
The winter of 1939 though almost unprecedently
severe did not coincide with any serious epidemics with the
exception of cerebro-spinal meningitis. The anticipated
measles epidemic did not inflict itself upon the child
population at a time when every circumstance of weather and
lack of ventilation from the "black out" was in its favour for
striking a severe blow.
The position in the coming winter is however far less
favourable. Measles has started, and with the thoughtless
preference of the general public for public shelters instead
of private ones not only will measles be likely to menace
the young members of the population but outbreaks of diphtheria,
cerebro-spinal meningitis, scarlet fever, the common cold and
perhaps Influenza are anticipated and may assume alarming
proportions. A more chronic danger to the younger population
but by no means less to be feared is the risk of infection from
active cases of pulmonary tuberculosis unknown numbers of whom
are also shelterers.
These infections are by no means the only "horrors of
war" likely to be met with through the public shelter habit.
Numbers of children as well as adults have not removed their
clothes for weeks, bedding is left in shelters permanently and
has been known to be used in the day time by others. The
opportunities for the spread of scabies are matchless and its
cure in such circumstances impossible without admission to
hospital of all sufferers from- a shelter at the same time,
synchronising with cleansing of all their clothes and bedding.
The ticket system for bunks will help in many directions but
it must be remembered that some part of every public shelter
must still be available for casual visitors and be open to them
day and night. Active protection against these risks is almost
confined to the one measure, viz., dispersal of population.
Evacuation of all who are not obliged to stay in London and
much greater use of private family shelters, Anderson shelters
and the like should be the prime concern of every family.
There are no known means of prophylaxis which can
be used in the circumstances against colds bronchitis and
pneumonia, against measles and influenza, against cerebro-spinal
meningitis, or against scarlet fever and whooping cough.
Against diphtheria and typhoid well tried and proved means are
known. Diphtheria can be prevented and typhoid rendered
unlikely by inoculation but without some compulsion there will
be so few willing to be treated as to render an attempt to stem
these epidemics in this way of no avail.
Those who believe that the risks are exaggerated
might do well to remember that underground dwellings have
for years been regarded as unfit for human habitation and where
found have been closed by law. Public shelters are in the
same category but their unfitness is magnified many times by the
large numbers who unfortunately use them.
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