Lessons From the 1918 Spanish Flu Pandemic

Lessons from the 1918 Spanish Flu Pandemic

The virus struck swiftly, stoking panic, fear and mistrust as it sickened millions and killed thousands — and now, more than a century later, the 1918 Spanish flu pandemic offers lasting lessons for a world in the grip of COVID-19.

“The questions they asked then are the questions being asked now,” said Christopher Nichols, an associate professor of history at Oregon State University, in Corvallis. “And while it’s very rare that history provides a simple straightforward lesson for the present, this is one of those instances.”

Experts say there are four key takeaways from 1918.

Here’s the first: As devastating as the current pandemic may be, the Spanish flu pandemic remains the worst in world history — by far, said E. Thomas Ewing, a history professor at Virginia Tech in Blacksburg.

By the time three waves of Spanish flu swept across the globe in 1918 and 1919, at least 50 million people were dead, including 675,000 Americans. (By comparison, flu pandemics in 1957, 1968 and 2009 claimed an estimated total of 225,000 Americans and 3 million people worldwide.)

Here’s the second takeaway: There are key differences between 1918 and the COVID-19 pandemic.

“Then, they didn’t even know it was a virus,” Ewing said. “There had been decades of research on microbes, so they understood that it was transferred person-to-person through respiratory drops, by coughing and sneezing. But viruses weren’t discovered until the 1930s, because they didn’t have powerful enough microscopes.”

As a result, testing wasn’t just hard to come by. It simply didn’t exist.

Spanish flu was also more infectious than COVID-19, caused symptoms much faster and was far more deadly, Nichols said. And unlike COVID-19, which poses the greatest risk to the elderly, Spanish flu targeted the young.

“It affected everyone young and old,” Nichols said. “But it disproportionately killed the healthiest among us — the all-American 22-year-old football player, the strongest lumberjack. People in their prime were getting struck down very quickly. So, the fear that animated people in the fall of 1918 was qualitatively different.”

The third takeaway: Despite those differences, the parallels between 1918 and 2020 are still striking. In both cases, there was no vaccine and no treatment for the disease along with an overriding fear that a besieged health care system might crack.

And here’s takeaway No. 4: In both pandemics, the most effective immediate response was — and is — social distancing, Nichols said.

“It was called ‘crowding’ control” back then, he said. “But whatever you call it, limiting contact worked in 1918 — and it works today.”

And the faster comprehensive closures and social distancing are put into place, the quicker a pandemic can be brought under control, Nichols added.

“If public health is the main focus, then eradicate that from your mind,” Nichols said. “The Spanish flu tells us that social distancing works. And it works best if we act early, act fast and stick together — and base our decisions not on social or economic concerns, but on science and data and facts.”

By Alan Mozes