long read modern history

The Spanish Flu – Your Great Granddad’s Coronavirus

Think Coronavirus is bad? Well it ain’t got shit on the 1918 flu outbreak...

Assuming you haven’t been living in a hole, you’ve definitely heard of Coronavirus. The big bad that might turn out to just be a pretty gnarly flu outbreak or could wipe out millions. Yeah, it’s a pretty scary either or situation.

Whilst the world waits to see which side of the coin Coronavirus lands on, global media are passing the time by unearthing the ghost of 1918’s Spanish Flu pandemic and excitedly shining a spotlight on it, shouting ‘Look, this will happen again! We’re all going to die! Boogety boo!’

It’s being repeated again and again from country to country: this virus is as infectious and deadly as the 1918 flu strand.

But what exactly caused was the 1918 flu outbreak? Why did so many people die and with the knowledge of time is there anything we can do to stop this happening again?

Basically – are we totally fucked? Let’s find out!

What was the Spanish flu?

Fun fact, The Spanish flu didn’t originate in Spain, it’s just got a confusing name. Sadly we can’t pin point the exact geographic location this flu strain started, however we do know that the first officially recorded cases were in a military base in Kansas.

Between that first recorded case in March 1918, to the last known case, two years later in March 1920, an estimated 50 million people world wide would die from ‘the Spanish flu’ (though it’s now thought this was estimate could be as high as 100 million, roughly 5% of the worlds population.)

The flu hit in three waves. First in Spring 1918, then autumn 1918 and finally through winter 1918 to spring 1919. With the second outbreak being the deadliest.

Soldiers from Fort Riley Kansas being treated for Spanish Flu at Camp Funston
US soldiers being treated during the Spanish Flu pandemic. A Pandemic is when a medical epidemic spreads across multiple countries.

The initial Spanish Flu symptoms were similar to that of most flu’s. Including a fever, headaches, feeling weak and joint pain. However it was what happened after these initial symptoms that was what made Spanish Flu so deadly.

In September 1918, Dr Roy Grist, described what happened to the men he treated at Camp Devens in Massachusetts:

‘…They very rapidly develop the most vicious type of pneumonia that has ever been seen. Two hours after admission they have the mahogany spots over the cheekbones and a few hours later you start to see the cyanosis extending from their ears and spreading all over the face until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours until death comes. It is horrible.’

The majority of people died not from the flu itself, but from complications that came with it.

What really made the flu stand out was those that it killed. Generally people who die from flu tend to be old or very young, often with pre-existing health conditions.

However, the big killer of ‘the Spanish flu’ was young adults.

This is even crueller when you consider that just as the flu hit the The First World War was starting to come to an end. So now the millions of soldiers that had survived the traumatic trenches got a congratulations prize of another thing that might kill them. In fact more US servicemen died from the flu than in combat.

Spanish Flu patients being treated at Walter Reed Hospital in Washington
Spanish Flu patients being treated at Walter Reed Hospital in Washington

How did the flu spread?

There is never just one route that a pandemic uses to spread (they’re tricksy like that) however in this instance, The First World War was a key factor in the spread.

The Spanish flu was highly infectious. Take for example that first case in Kansas. Within hours of the soldier being taken to the infirmary, over one hundred other men at his base were also reporting symptoms.

Thousands of men all gathered together in cramped quarters, it’s the perfect brewing ground for infection.

But this was war and war doesn’t stop because some soldiers are feeling a bit peaky. Men with symptoms were still deployed, which resulted in people on all sides catching Spanish Flu.

Just to make this worse, The First World War was the era of trench warfare. Already living shoulder to shoulder in unhygienic holes in the ground, surrounded by death, the soldiers were given something unbeatable to contend with.

Then there were those soldiers that were in the most dangerous stages of the flu, who were sent to field hospitals. To get there they were often transported along with hundreds of other people, military and civilian. So the virus easily hopped from the infected person to dozens of others, with those people then heading off to unknowingly continue the spread.

With infected troops travelling all over the world, it’s no surprise that the flu spread so quickly.

But don’t worry. It gets worse.

Clipping from Oct 17 1918's edition of Santa Ana Daily Record and Register
Clipping from Oct 17 1918’s edition of Santa Ana Daily Record and Register – Let’s not let a silly thing like a deadly pandemic stop this great war we have on!

Because the world was at war, public morale was key. Those countries at war, didn’t want to expose their people to just how lethal this pandemic was. So they didn’t.

Newspapers in America, Britain and countries across Europe were censored so they didn’t reveal the true magnitude of the pandemic. Spain was one of the few countries that was covering the spread in its early days and their wide coverage of the pandemic led to the flu being named ‘The Spanish Flu’ (they were unsurprisingly not happy about this)

The impact of media not telling people how bad the pandemic was shouldn’t be underestimated. When people are aware of a public health crisis, they tend to be cautious. If you know there’s something going around, you’ll naturally do things like washing your hands more, be less likely to go to crowded areas and generally take more precautions.

That’s not to mention the other ways many countries chose to put propaganda above public health.

For example in America several cities held mass morale boosting events, despite knowing that large gatherings were a breeding ground for Spanish Flu. Don’t see why that could end badly? Let’s talk Philadelphia.

In late September 1918, the city had planned a huge parade to boost morale and raise money for the war effort. Doctors urged the city to cancel the event. There had already been local cases of the Spanish flu and a massive crowded event was sure to make the situation worse. But the city needed to cheer up its citizens and raise cash, so the parade went ahead.

Over 200,000 people watched the parade on 28 September. Music filled the streets, Boy Scouts marched along with uniformed soldiers. There was dancing, heaps of patriotism and tons of Liberty loans sold. The parade organisers patted themselves of the back for a job well done.

72 hours later and every bed in the cities hospitals were full. Within weeks, thousands were dead.

By 3 October Philadelphia was shut down. Morgues struggling to manage the influx, with bodies stacked up and families struggling to find somewhere to bury their loved ones.

Members of the Lit Liberty Loan Brothers Loan Comittee of Parade and the Philadelphia Parade, 1918
Members of the Lit Liberty Loan Brothers Loan Comittee of Parade at the ill-fated Philadelphia Parade

How was Spanish Flu prevented?

Hypothetically it was a good thing that the Spanish Flu hit when it did. For centuries people had believed epidemics were an act of god. However with the emergence of ever improving medical science, people were starting to put their faith into medical science. Recent epidemics, like the ‘Russian Flu’, had been studied to find a root cause.

With an arsenal of medical research, combined with peoples believe in science, the chances of beating this thing looked pretty darn good!

Sadly it didn’t work out like that.

In 1892 German bacteriologist thought he’d discovered the cause of the Russian flu, a bacterium he called, Bacillus influenzae (or Pfeiffer’s bacillus). The idea that deadly bacteria could be behind 1918’s pandemic made perfect sense, after all bacteria causes things like cholera and plague (and the 1918 pandemics symptoms had a lot of similarities with the plague!). So scientists across the world went all in on locating Pfeiffer’s bacillus in sick patients.

HOWEVER, influenza is a virus. It’s not caused by bacteria. So although loads of research was being done to stop the 1918 pandemic, they were looking at the wrong thing.

Those depending on religion to save them, we’re often also out of luck.

In the Spanish city of Zamora, a bishop went against all governmental guidelines and called the cities people together to pray for protection against the flu. The result of the gathering? Roughly 10% of Zamora’s people died from Spanish Flu.

Chart showing mortality from the 1918 influenza pandemic in the US and Europe. from National Museum of Health and Medicine
Chart showing mortality from the 1918 influenza pandemic in the US and Europe. from National Museum of Health and Medicine

What was the aftermath?

Around 1% of the European population died and that figure rises as you go across the world. It’s though that in India around eighteen million died. We will never truly know just how many lives the Spanish Flu claimed, but globally estimates vary between 50-100 million people.

It didn’t matter if you lived in a city or a village, the flu could impact you. In fact small communities who lay outside of the local mass populace were often utterly devastated if the flu reached them. For example in some parts of the Gambian countryside it was reported that

‘whole villages of 300 to 400 families (were) completely wiped out, the houses having fallen in on the unburied dead, and the jungle having crept in within two months, obliterating whole settlements.’

You were also far more likely to die if you came from a poor background. The working class, minorities and immigrants were far more likely to be living in cramped conditions without good access to decent sanitation, which meant the Spanish Flu exploded in these areas.

So will Coronavirus be Spanish Flu 2.0?

Well…it’s unlikely.

Now don’t get me wrong, I understand why so many media outlets are saying it will be – hey we all love click bait! However, in this instance history repeating itself just isn’t a super tangible outcome.

So many of the key factors that led to the spread of the 1918 flu are not even vaguely comparable to today’s landscape.

To be blunt. There’s not a world war on. That makes a difference. We don’t have hundreds of thousands of men crammed into tight often unhygienic environments that act as a perfect virus breeding ground. Those infected men are not then flitting all over the world, sprinkling the virus everywhere they go.

Yes, today we’re travelling the world more than before. But borders have already started to close, checks are being made and even when the virus slips past that, those are small numbers of isolated cases. It’s not remotely the same as the speedy global spread the First World War created.

Then there’s the science. Unlike 1918, medical science has far more of a clear handle on what makes up a virus like Coronavirus. In addition thanks to new fangled inventions like the internet, scientists worldwide are able to be a lot more open with their research. Meaning teams across the globe are able to be up to the minute on the latest findings. With clinical trials up and running, massive amounts of data and round the clock work being done by countless teams, we’re so far ahead cure wise than 1918, it’s not even comparable.

So whilst we may be in an international public health emergency, we’re in a far better place than we were 100 hundred years ago.

That’s not to say we shouldn’t learn from the lessons of the 1918 pandemic, but by no means should we be treating it like a crystal ball!

That was interesting where can I find out more? Definitely check out Pale Rider: The Spanish Flu of 1918 and How it Changed the World by Laura Spinney, along with these papers, Influenza – exposing the the true killer by Heather L Van Epps and Spanish Flu Part II, the second and third wave by Milorid Radusin.

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