When the Great London Smog of December 1952 lifted from the capital, it left behind mortuaries full to overflowing. Undertakers didn鈥檛 have enough coffins; florists ran out of flowers. But the pea-souper to end all pea-soupers also left in its wake a heated dispute between government scientists about exactly how many had died.
The official report settled on 4000, and that figure has been accepted ever since. But at a conference in London next month to mark the 50th anniversary of the Great Smog, American epidemiologists are presenting new findings that the disaster actually saw off 12,000 Londoners. Their research vindicates the work of one government scientist who, half a century ago, came up with the same figure before losing out in a bureaucratic battle with health officials.
A DENSE fog settled over London on the night of 4 December 1952. Held in place by cold air above, and with no wind to blow it away, the fog grew thicker for five days, trapping in its damp clutches the smoke of a million open coal fires. The streets filled with a choking, sulphurous smog. So did hospital wards and cinemas. It was darkness at noon.
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And Londoners started to die. Most victims retired to bed feeling breathless and never woke up, asphyxiated by the silent killer. In parts of the East End, death rates that week were nine times normal.
When the smog lifted, ministers had some questions to answer. Why had this smog been so uniquely lethal? (Answer: a bankrupt government was selling cheap, sulphurous coal so that it could export the good stuff.) What could be done to prevent another? (Answer: ban coal burning in towns, which it eventually did.) And, most pressing of all, how could the public be persuaded that the government had a grip on the problem?
The subsequent secret debates in Whitehall, whose paper trail survives in the Public Record Office at Kew, reveal an unedifying mixture of cynicism and subterfuge that permeated the corridors of power as insidiously as the smog itself. The cynicism came from the top. In Cabinet, local government minister Harold Macmillan said: 鈥淲e cannot do very much, but we can seem to be very busy 鈥� and that is half the battle nowadays.鈥�
Seeing no alternative to burning coal, ministers decided that doctors should prescribe up to 2 million cheap gauze 鈥渟mog masks鈥� to people with heart and respiratory diseases. They knew the masks were useless. It didn鈥檛 matter. Health minister Iain Macleod told Macmillan that the distribution of masks was 鈥渙nly a gesture鈥� and that there was 鈥渘o known mask鈥� which would protect those at risk.
That didn鈥檛 stop ministers turning down, sight unseen, an offer from an American tobacco company to donate 100,000 masks that used a novel filter technology designed for cigarettes. The fear was that the company might later advertise its cigarette filters as 鈥渟o good they keep out London smog鈥�.
Nobody denied that the smog had killed. But officials eagerly explained that the smog鈥檚 victims had all been sick, old and, as one internal memo put it, 鈥渞ipe for the sickle鈥�. More prosaically, Edmund Martin, a medical officer at the Ministry of Health, said in his official account of the smog, published in July 1954, that: 鈥淭he fog was in fact a precipitating agent, operating on a susceptible group of patients whose life expectation, judging from their pre-existing diseases, must even in the absence of fog, have been short.鈥�
In private, many government doctors questioned this view. Many of the dead were indeed old and suffering from heart or bronchial conditions. But only two-thirds of the 4000 official victims were over 65. The death rate actually rose most among the 45 to 64-year-olds. And then there were the babies. Twice the normal number died in the week of the smog.
Ronald Christie of St Bartholomew鈥檚 Hospital, whose wards had borne the brunt of the disaster, wrote in a formal comment on Martin鈥檚 draft report: 鈥淚 am surprised that no mention is made of infant mortality鈥he fog was a danger to infants.鈥� Publicly, Christie was ignored although later one ministry official suggested in a memo that babies might have to be evacuated from the capital in a future smog.
Martin should have known months before he wrote his report that many smog victims were far from being 鈥渞ipe for the sickle鈥�. That had been made abundantly clear by another official, E. T. Wilkins, head of air pollution at the Department of Scientific and Industrial Research. At a public lecture in November 1953, Wilkins pointed out that if Martin was right, 鈥渢he number of deaths occurring for some time after the incident would fall below normal鈥�. In fact, the death rate remained above normal through the winter and was still 2 per cent up the following summer.
And there鈥檚 the rub. Why did the death rates stay high? Was the smog still killing people months after the skies had cleared? And where did that figure of 4000 dead come from?
In the weeks after the disaster, health minister Macleod had for a while suggested 6000 had died. He reached that figure by comparing the number of people who died in the five weeks after the start of the smog with those who had died in the same weeks the previous year.
But Martin decided to overrule his minister. He used the same method, but counted only two weeks鈥� deaths. He justified this because after about 20 December, recorded death rates had returned to normal. That was true but, as his chief statistician pointed out in a memo, it ignored the fact that death registrations in that third week would have been delayed by Christmas holidays. From the fourth week on, registrations promptly went back up again and stayed up.
In fact, deaths in London remained above 2500 a week 鈥� almost 1000 more than the expected winter rate 鈥� until the spring. Again, Wilkins had spotted this. In his lecture, he reckoned that this 鈥渟econd peak鈥� in deaths amounted to an extra 8000 bodies. They were probably delayed victims of the smog 鈥渨hose powers of resistance may have been reduced by the earlier smog incident鈥�.
Hugh Beaver, an industrialist who was called in by ministers to advise on what to do to prevent future smogs, recommended 鈥渇urther and close investigation鈥� into Wilkins鈥檚 claim. But Martin appears never to have seriously attempted this. His final report did admit that 鈥渋t is possible that some people whose acute illnesses were precipitated by the December fog died during the ensuing two months鈥�. But he claimed that this was unlikely. Death rates were also high at that time in other big towns which had not experienced the smog. He had another theory. All the evidence suggested that a flu epidemic was to blame, he said.
All what evidence? Wilkins pointed out that London鈥檚 鈥渟econd peak鈥� was quite unlike that in other towns. While their death rates were 15 per cent above the seasonal norm, those in London were 60 per cent up.
And where was the evidence of a flu epidemic? Nobody questioned the wisdom of the Ministry of Health on that matter until last year, when American epidemiologists Devra Davis of Carnegie Mellon University and Michelle Bell of Johns Hopkins University trawled the files. 鈥淣o matter how hard you look, there is no evidence whatsoever to support the flu epidemic theory,鈥� says Davis. There were some people with flu, but what data there was suggested the incidence was lower than in a normal winter, not higher.
London would have had to experience a major flu epidemic to explain those 8000 extra deaths. 鈥淥ne in three Londoners would have to have gone down with the disease,鈥� says Davis. 鈥淚t just doesn鈥檛 add up.鈥� Davis is convinced that the great smog in reality killed 12,000 people during the winter of 1952-53. And her view is likely to be endorsed at a scientific meeting that will take place in London on the 50th anniversary of the smog.
We will probably never know why Martin chose to blame the deaths on flu, nor why his conclusion was accepted so readily. But we can perhaps say that the Whitehall fog has finally lifted on the truth about the world鈥檚 worst air pollution disaster, and that Wilkins, an unsung seeker after truth, was right all along.