Reflections on 1918 and the Spanish Flu in the days of Covid-19
As research for my next book, I have recently read a number of books about the Spanish Flu epidemic of 1918. The timing of this research has been interesting, to say the least. To watch Covid-19 take hold in China, followed by the rest of the planet, has caused me to reflect on the numerous ways in which the Spanish Flu is, and is not, like Covid-19. What follows are some of my reflections on the similarities and differences between these two pandemics.
The Spanish Flu and Covid-19 produce similar symptoms, (fever, body ache and acute respiratory illness), but are caused by different disease agents. The Spanish Flu was a particularly lethal form of influenza that scientists believe originally came from a bird. Covid-19 is caused by a virus that is also thought to have jumped to humans from another species, perhaps a bat.
The Spanish Flu of 1918 was the single most devastating pandemic in the history of humanity. Millions of people died in every corner of the planet within a matter of months. Covid-19 has already travelled around the world with cases in more than 180 countries, however it does not appear to be as deadly as the Spanish Flu. Most people who become sick with Covid-19 recover.
No vaccine and little basic scientific information. In 1918, scientists were unable to study viruses directly. The Spanish Flu was caused by what they called “filterable agents”, something so small it can pass through a filter. It was only after more than a decade of scientific investigation that scientists were able to confirm the cause of the Spanish Flu. Because the Covid-19 virus has arisen so quickly, it was initially difficult for public health officials to determine accurate incubation periods, death rates, and transmission agents. However, with the speed of communication and modern technology, genetic sequencing of the virus was completed rapidly and analysis of public health data is taking place in real time. There was no vaccine for the Spanish Flu in 1918 and we will be very lucky if a vaccine for Covid-19 is produced within 18 months.
In both epidemics inaccurate and misleading rumors have circulated about the origin of the disease. In 1918, the US was at war with Germany (World War I) and rumors circulated that the German government had released the Spanish Flu as a weapon of war. Anti-German sentiment was running high at the time with attacks on German-Americans in the streets and closure of German language newspapers by the US government. In 2020, a Senator from Arkansas and a reporter from the New York Post speculated that a Chinese biomedical lab released Covid-19–either purposefully or accidentally. These statements have been repeated multiple times in numerous news outlets. However, there is no scientific evidence to support either of these theories. The most recent research on the Spanish Flu indicates that it originated in the US, not Germany. Scientists who have studied the genetic sequencing of Covid-19 have found clear evidence that the virus originated in nature and that it lacks the “fingerprint” that would be expected if it had been genetically modified.
The role of confined spaces (boats, camps and trains). While the flu is generally not lethal to young people, the Spanish Flu was particularly deadly to people in their 20’s with the result that there was an extremely high death rate among enlisted men. Crowded training camps, trains and transit ships were responsible for efficiently spreading the Spanish Flu among enlisted men. In 2020, cruise ships and airline travel have played a role in quickly spreading Covid-19 around the planet. Several cruise ships have had outbreaks among their passengers and crew. These ships often carry an older crowd of passengers and covid-19 is particularly dangerous for people over the age of 60.
Social distancing is being encouraged globally in 2020 to slow the rate of infection so health systems can serve those who are ill. Some forms of social distancing were also encouraged in 1918 with the closing of schools, theaters and places of worship. The opposite of social distancing is documented in the propaganda photos of Mole and Thomas. These patriotic images were created by lining up many thousands of soldiers who stood less than a foot apart for hours. It isn’t known for certain whether these gatherings accelerated the spread of the flu, but in the training camp where the image of President Wilson’s head was created (by 22,000 men), there were 7600 cases of pneumonia over the course of three weeks in late September and early October. 824 of those soldiers died.
The real “front line” are hospital workers, physicians, and nurses. While many soldiers died in WWI, more people died from the Spanish Flu than from the war. In addition, nurses and doctors often fell ill from the disease and sometimes also died. Covid-2019 is no different. Currently, there have been nearly 3400 health care workers in China who have fallen ill from the virus. To date, 13 have died.
Despite these similarities, 2020 is not 1918.