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What Can the 1918 Spanish Flu Tell Us about the End of COVID-19?


As we approach the one-year mark since the start of the COVID-19 pandemic here in the US, many of us are wondering when this nightmare will come to an end. If only there were a historical precedent that we could look to for answers.

Actually, there is. Over a hundred years ago, the Spanish Flu wreaked havoc on the entire world, killing an estimated 50 million people and around 675,000 here in the U.S.

As deadly as this period was, it also led to what became known as the Roaring Twenties, a time when Americans finally started enjoying the pleasures of modern life. 

Like COVID-19, the Spanish flu was considered a “novel” virus when it was first discovered during the aftermath of WWI. No one had any immunity from the deadly virus, making it extremely dangerous and infectious. While COVID-19 and the Spanish flu are from different viral families, they behave in similar ways. Both are transmitted via respiratory droplets. Just like today, social distancing, proper hygiene, and protective gear were instrumental in the fight against the Spanish flu pandemic.

This period is conspicuously underrepresented; records of the Spanish flu pandemic can be hard to find, as if the U.S. and its allies were anxious to forget about this time in history. However, historians, economists, and infectious disease experts are looking back to this time period to gain insights into our present.

The Timeline of the Spanish Flu

Before we start making predictions about the current health crisis, let’s explore what happened all those years ago when the Spanish flu was raging across the globe.

Contrary to its name, the first cases started popping up in the US, France, and Germany. Disease experts believe WWI may have incited the virus as millions of troops from all over the world gathered on the front lines with poor sanitation.

Historians believe it became known as the Spanish flu simply because Spain was the first country to report its presence. Other countries censored the news to focus on the wartime effort, but Spain remained neutral throughout WWI, so it was free to cover the novel virus in real-time.

According to the CDC, we can safely say the Spanish flu pandemic lasted for about two years, with three distinct waves or peaks. The first outbreak was reported in the U.S. in March 1918, when over a hundred cases were discovered at Fort Riley, Kansas. The massive relocation of troops helped contribute to the spread of the virus, especially as soldiers returned home after the war.

By the summer, the first wave had subsided, but the second wave came during the fall of 1918. To worsen matters, many healthcare workers had served in WWI, leading to a shortage of providers during the pandemic. Thousands of businesses and factories were forced to close their doors as the virus spread. This wave was responsible for most of the deaths attributed to the Spanish flu.

The final wave came during the winter of 1918 and spring of 1919 before finally petering out in the summer of 1919. The virus never went away entirely. By 1920, health experts believe most people had built up some form of immunity, bringing the pandemic to an end.

As you might expect during the early 1900s, there was only so much the country’s healthcare system could do to treat and prevent the spread of the virus. There were no vaccines or experimental treatments that were shown to be effective. The first flu vaccine didn’t come along until 1940. Many providers and health organizations prescribed aspirin in large doses, which we now know leads to aspirin poisoning.

Instead of a vaccine, citizens were urged to practice proper hygiene, wear cloth face masks, and avoid large crowds. Some countries imposed quarantines to limit the spread. People were also advised to stay indoors and stop spitting on the street. Boy scouts would even go up to people spitting and hand them a card that read, “You are in violation of the Sanitary Code.”

What Happened Next?

As the U.S. started to come out of the pandemic, life in American took off in more ways than one. As a new global superpower in the middle of the Industrial Revolution, the country’s economy began to soar. This was the time of The Great Gatsby, as major parties and events started popping up all over the country. People started venturing out their homes to drink, dance, eat, and enjoy the wonders of the U.S. as we know them today.

By the mid 1920s, the medical community had developed a vaccine for bacterial infections, as people began to pay more attention to their health and sanitation. However, there were plenty of new diseases to be concerned about as well, including the spread of syphilis, tuberculosis, and scarlet fever.

Syphilis seem to spread due to uptick in unprotected sex. The disease can be fatal if left untreated. Many Americans were anxious to get back to the pleasures of human life, only to encounter new health problems along the way.

Excess eating and drinking also became acceptable. Even though the U.S. implemented the 18th Amendment in 1920, which banned the manufacture, transport, and selling of alcohol, the new law seemed to have the reverse effect. Drinking suddenly became the epitome of social life as mobsters and speakeasies found ways to circumvent the law. Historians believe the average American drank three times as much as they do today.

Consumption began to drop in the lead up to 1920, but during the Era of Prohibition, the government didn’t have a way to track how much alcohol people were drinking as boozers went underground. Consumption soon began to rise once again as more people looked for a way to escape and let loose.

So, How Will COVID-19 End?

If we compare the two pandemics side by side, you might think that the coronavirus will play itself out after three waves or peaks, or within two years. While that may be true, there are some key differences to note.

For starters, there’s still a lot we don’t know about the Spanish flu. Scientists didn’t have the equipment or training to fully study the virus at the time. People also didn’t have the luxury of working from home or ordering food from their couches. With limited sanitation and health services, preventing the spread of the virus was nearly impossible, especially after a war and in urban communities. This may have helped the world reach herd immunity faster than it would have otherwise.

Historians believe some 500 million people – one-third of the global population at the time – were infected with the Spanish flu.

Today, there are over 7 billion people on the planet, and large swaths of the global population have yet to contract COVID-19, so it will take us longer to build up immunity naturally. The COVID-19 vaccines may help, though.

Health experts predict the COVID-19 pandemic won’t end until we reach anywhere between 65% to 95% immunity. That means getting at least two-thirds of the population vaccinated. Dr. Anthony Fauci of the National Institute of Health recently said that once we get between 75% and 85% of people vaccinated, he predicts it will take another few months to reach herd immunity.

Even though this may be a dark period in American life, history shows us that we will celebrate once it all comes to an end.

Steven Briggs
Steven Briggs is a healthcare writer for Scrubs Magazine, hailing from Brooklyn, NY. With both of his parents working in the healthcare industry, Steven writes about the various issues and concerns facing the industry today.

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