We are lucky to have a history behind us. And history is always the best teacher. The history of 1918’s Spanish Flu can be our best teacher now during the coronavirus pandemic. If we understand what the world went through at that time, the mistakes made in 1918, we can prevent and safeguard ourselves making the same in the current crisis.
What happened during the Spanish Flu?
The origin of the influenza virus that caused the Spanish flu is still not known clearly. Some findings say it originated in China (yes quite a coincidence, one might think) and some readings conclude that it first occurred in 1917 in Austria.
However, patient zero of Spanish flu is regarded to be from Kansas, USA. His name was Albert Gitchell, who was supposedly a cook in one of the army camps of USA in March 1918. The cook and his food rapidly spread the virus among the army men in the camp making hundreds of them sick. The symptoms were much similar to that of Covid-19 - High fever, severe headache, and breathlessness. Within a month there were 1,000 sick men in the camp and 47 of them died.
Soon the virus started spreading across the army camps of the allied troops. Wherever the ships of the army men unloaded, it left the strain of virus that started spreading like wildfire across Europe and later the globe. Rumors started emerging that men are dying due to shortness of breath as some unknown poisonous gas has been leaked by Germany on the troops.
The Governments, not to take away the attention from the war, maintained silence about the spread.
In August 1918, as the troops started returning home, they brought in the deadly virus with them. And very soon, the virus that was only affecting the soldiers till now, was ready to mass slaughter the civilians.
The Deadliest Second Wave
The first wave started in March 1918, but was controlled within the army camps. However, August 1918 can be regarded as the beginning of the second wave that two months later turned deadly.
October 1918 is regarded as the deadliest of all months in the entire tenure of the Spanish flu. USA witnessed so many deaths in October that it is said, open cart drivers screamed ‘Bring out your dead’ as they passed the streets of the city of Philadelphia. That month, Philadelphia alone had witnessed almost 11,000 deaths. The same was the case of many other cities across USA and the globe. The cities went under lockdown – Public gatherings were banned, schools, theatres and churches were closed.
And after causing dreaded havoc in the lives of the people, by November the flu almost vanished, like it never existed.
But in reality, it was just waiting for one wrong move by the authorities, which they did on the 11th day of November 1918.
The Return of The Virus
As the number of cases dropped, the authorities took it as the end of the disease and put their guards down. They gave permission for public gatherings on the occasion of the Armitice Day parade on November 11, 1918. Patriotism was running high among the public after the war and huge crowds gathered during the parade in different cities. Within three days, USA witnessed the second phase of the second wave that again brought another round of destruction with it.
In all this chaos, there remained only one country that stayed unaffected from the pandemic due to timely isolation from the world by sealing their sea routes – It was Australia. They came up with the idea of today’s ‘quarantine’ and effectively applied it to control the spread.
The Third Wave
It is said that the third wave of pandemic came up in January 1919. And surprisingly it started off in Australia from where it again came back to USA, UK, France and all over the world.
But this time the war was over. And the governments started thinking about their civilians’ health. Widespread awareness program was started about ‘physical distancing’ (today’s social distancing), wearing masks and gloves, avoiding gatherings, closing religious events and quarantining. The third wave was as deadly as the second one, however, it killed a lesser number of people as compared to the second wave. People were more aware and they chose the best for themselves.
There was another fourth wave of the Spanish flu that appeared by the end of 1919 and ended in the beginning of 1920. But it was very mild and killed very few.
By this time, the flu had infected almost one-third of the total world population and killed 50 million people worldwide. Some say the number stands at 100 million.
Coronavirus started from Wuhan in China in 2019. However, it became a conversation point only around January-end. The first major lockdown started in China around the time of Chinese New Year and most people thought that this may well be contained in the sub-continent.
However, that was not to be the case so. Coronavirus spread and spread fast. Soon Italy became the second hotspot for the virus and from there it travelled all over the world.
On March 11, 2020 World Health Organisation (WHO) declared coronavirus as a global pandemic. Following this, most countries decided to impose lockdowns, ground airlines and do everything to get into quarantine and save themselves from this virus.
Even with the best efforts being made and all the technological advancements that we have achieved since 1918, coronavirus as of May 20 has managed to infect almost five million people (data from worldometer) across the people. It has also claimed 323,493 deaths.
US is currently the worst impacted country from the COVID-19 outbreak. Almost 1.6 million people have caught the virus in US so far and as many as 93,000 people have lost their lives. The death toll also remains high in UK and Italy. India currently is at the 16th rank in terms of death toll alone. (All data sources from Worldometer)
In terms of people infected, US is followed by Russia, Spain, Brazil, and UK. Italy which was at the top spot for a while has now slipped to the sixth in terms of the number of people impacted and India is curretnly at the eleventh position.
One of the most pro-active states in USA that acted against the Spanish flu was Philadelphia. Their response was instant when it got to the civilians.
The first case in Philadelphia was detected on September 17, 1918. The state took all measures to stop the virus from spreading by telling people not to sneeze, cough or spit in public.
However, as the numbers were less, the state went on to host the ‘Liberty Loans’ parade 11 days later on September 28, 1918 that allowed the public to gather in lakhs.
This caused a massive increase in the number of cases. Within 15 days after the emergence of the first case, Philadelphia had 20,000 more cases. By the first week of October, they had to go for a complete lockdown but the city was getting buried under piling up dead bodies.
On the other hand, St. Louis took some extreme steps. Dr. Max C. Starkloff, the city health commissioner, ordered strict quarantine rules for the citizens. He ordered closure of every shop, theatre, factories and brought the city under complete halt. The musicians, artists, businessmen resisted his actions, but his resolve continued. He did lift the lockdown briefly in October but as soon as the numbers increased a bit, he imposed it back in November. History says, St. Louis, one of the biggest of the 10 cities of USA then, had the lowest number of infection rate and death rate among them. Human lives suffered the least as compared to others at St. Louis.
Lessons to learn - This tells us why lifting the lockdown early on can be dangerous, why our impatience and reckless attitude may make us vulnerable and how the simple measures of quarantine and social distancing norms can help us stay safe.
Coronavirus can affect everyone from any age range. Yes, children and elders are the most vulnerable as the former’s immunity system is not fully developed and the latter’s immunity is weakened due to old age co-morbidities. But are the young ones too much at leverage for their fully developed immune system?
The Spanish flu during its deadliest second wave actually pardoned the old and the children. And instead turned deadly for people in the age range of 20-40 years. These people had the best immune system and yet they lost the fight with the virus.
As per experts, it was due to an overreaction of the immunity system that created a situation of ‘cytokine storm’ in the body. The overreaction caused great inflammation and the patients died due to their own hyperactive and too strong immunity system.
Some 75 children from USA have said to have reported similar cases during the pandemic of coronavirus today. Also, The Frontiers of Public Health, a journal, recently published a study that raises concern about how Covid-19 can end up harming a very fit young adult with a too good immune system. It simply wrongly directs the white blood cells to attack our healthy cells in the lungs, kidney, liver, intestines, leading to their failure.
The second wave of Spanish flu had a very aggressive form of the virus, more aggressive than the first wave (probably because it mutated) that took away many young lives. They died quickly without giving any opportunity for treatment.
Incidentally, in Rajasthan, a 25-year-old man from Pali, a 24-year-old from Jaipur and a 17-year-old girl from Delhi Gate were brought dead at the hospitals. They appeared normal but died suddenly without giving time for any proper treatment. Doctors identified they died due to ‘happy hypoxia’, a condition wherein the oxygen concentration in the body reduces to about 60 per cent. These patients were all Covid-19 positive. Similar cases of young patients dying all of a sudden have cropped up in USA too.
Lesson to learn - If you are young, don’t be too casual. Take the precautions, maintain social distance, for yourself and others. Don’t repeat the mistake. You are not invincible.
The Spanish flu is the perfect example of how changes swept into our world during and in the post 1920 era. As more men died in the World War followed by the pandemic, women had to come out and join the professional world. This increased the number of women professionals in various fields during the year of 1920. The pandemic due to the lack of doctors also witnessed a revolutionary scenario wherein lady doctors for the first time were called into work on the frontline.
The world’s first Ministries of Health were also formed after the Spanish flu. Before that, a separate ministry of health never existed in any cabinet. The first antibiotic was invented in 1923. The first flu vaccine came up in 1940. The League of Nations (now known as United Nations), founded The Health Organisation in 1923 that went on to become the present World Health Organisation (WHO) in 1948.
And now after Covid-19, the world is seeking a reform of the WHO again. The world is also seeking reforms in the way it conducted business earlier.
Coronavirus is steadily and rapidly changing the world around us. The industries that might have taken a decade more to take the digital route, may just shift that way rapidly within the next two years for the sake of survival. The education and the food industry may go virtual to a large extent.
There might be a humongous change in the global supply chain system. Countries may depend less on global exports or imports for essential products and services. Working may now come up with new norms in the much-digitized world. We may have a new groundbreaking vaccine of all coronaviruses or an antidote. Some countries may start investing more in their health infrastructure. The present global leaders may not be able to reclaim their leadership roles anymore and we may witness new leaders on the global platform. Some jobs will go, but new jobs will be created. Economies will work in a reboot mode.
Lessons to learn - Covid-19 will leave us someday. But it will definitely leave its impact and that impact will change our lives forever.
As noted earlier, history is the best teacher. Spanish flu teaches us all will be well one day. And it will be an exciting world post-COVID-19. But to live in that world, let us and our families do all that we can do to stay healthy and alive – Maintain social distance, respect quarantine norms, wear masks and gloves, don’t spit in public, avoid going out unless extremely necessary, avoid gatherings and opt for work from home if you can do so. If we follow these norms, the second wave like that of the Spanish flu may never come or never become as deadly as it was. We can take a direct jump at the third wave with minimum loss and then the mildest fourth before it finally vanishes or a vaccine arrives. Awareness was the key to protect humankind then and it is so even now after 100 years. Yes, they may open up parks, malls, beaches, shops, and schools – But it entirely remains within your control to decide the exposure to the virus. Volunteer from now to go only where it is extremely necessary and avoid the rest.
The above article is contributed to Mumbai Live by Saheli Goswami. She has been writing since the last eight 8 years now. Her experience ranges from writing on entertainment, social, education and technical sectors. The views expressed in this article are that of the writer and solely theirs.
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