What we learned about the Spanish Flu and how we can history to beat Covid-19

When influenza came along, national public-health leaders said, “This is ordinary influenza by another name. It was referred to as Spanish flu. That was echoed in nearly every place in the country. The Surgeon General said, “If proper precautions are taken, “you have no cause for alarm.” In other words, they did nothing and they lied to the public. 

In the United States alone, 675,000 people died which is comparable to about a million point seven. This is in 1918. What are we facing now? How does this resonate with today’s citizens? Most importantly they are both respiratory viruses obviously. Fortunately, this virus is, considerably less lethal than 1918’s pandemic. Unfortunately, this virus is much more contagious than 1918 so even with the lower fatality rate, which we’re still not sure exactly what it is, but it does seem to be lower than 1918, even with that lower fatality rate, because more people are going to be infected, we’re still facing, you know, incredibly dramatic and unfortunate numbers. 

Philadephia Liberty Loan Parade during Spanish Flu outbreak

One of the most chilling moments in1918 comes when you compare what happened in Philadelphia vs St. Louis. Philadelphia was one of the first cities hit. They, again, echoed the line that the national government was putting out there. They had a huge liberty loan parade scheduled. Virtually everyone in the public health community and the medical community wanted that canceled, except the public health commissioner. He was part of the political machine, had no backbone, so the parade went forward and just like clockwork, roughly 48 hours later, the disease exploded in Philadelphia. They ended up with about 14,500 deaths if my memory serves. About two-thirds of them died in a 14, 15 week period beginning in late September 1918. St. Louis imposed all sorts of social distancing measures early and had a much better outcome. They did in fact flatten the curve. 

This seems to be a minority opinion but it’s one that’s come up and it’s certainly influenced, at least for a while, Boris Johnson’s thinking in the U.K. The herd immunity thing. The idea is you let influenza sweep through the community, the death rate is higher, but you haven’t destroyed your economy because if you destroy your economy, the downstream effects of that are even worse on the public health, that a prolonged depression would lead to all kinds of horrible public health consequences, even worse than the flu. That was before the U.K. Prime Minister contracted the virus, which made him change his tone very quickly. In fact, Boris Johnson has mandated a nationwide lockdown between October 29th to Dec 2nd, 2020. It almost seems as if the concept of herd immunity is only accepted in theory but not in reality. 

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Something that is tough to hear but needs to be understood is: this virus is here forever. Just like the common cold and the variations of the flu we face every year. All small of number people are already immune today from surviving infection and when a vaccine comes along, we will be able to protect a large portion of the population. We’re told that a vaccine is imminent but the exact time it will take is clouded by political manipulation.  

Historian is, by definition, to have the luxury not to predict the future but rather to examine the past, but indulge us for this one time. What are we to expect in terms of the signs, in terms of the virus itself, playing out in the next year or two or three? If we can truly quote flatten the curve on our latest spike, and if the healthcare system can function well then we will have accomplished a lot. Most viruses do less well in high humidity and high heat but this summer showed to have record deaths in 2020 so far. We are now in what people are seeing as a third wave. How does that compare and what does history teach us about the Spanish Flur waves?

There were 3 different waves of illness during the Spanish Flu., starting in March 1918 and subsiding by summer of 1919. The pandemic peaked in the U.S. during the second wave, in the fall of 1918. This highly fatal second wave was responsible for most of the U.S. deaths attributed to the pandemic. A third wave of illness occurred during the winter and spring of 1919, adding to the pandemic death toll. The third wave of the pandemic subsided during the summer of 1919. If this is an indicator of what we will see this winter, we need to take extra precautions and hope for the best leadership possible. This can be the turning point for the country to get control of the infection and death rates, while a real scientifically proven vaccine arrives.

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The real key to success is compliance. If people don’t heed the advice, then we’re in trouble. As people are trying to live their lives and be as safe as possible, what are the key things they can do to avoid infection or worse? Wear a mask anytime you go in public or interact with strangers. There is no room for political biases or making excuses to not wear a mask. This is the key factor along with the social distancing. These are our best tools against the virus and should be applied by everyone. Let’s work together as a United States and not just people who live close by, putting their individual “rights” above the health of the country as a whole.

Together we can do it, United we will survive.

Be Safe, Be Kind and Be Smart. 

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Med Shield Team

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