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More connections to the Spanish Flu : The science, spread, and public perceptions

A wild strain of influenza ripped through Europe, beginning in Spain, which led it to be popularly known as the Spanish Flu. This momentous disease killed more than 50 million people the world over, but did the people it lived amongst take the threat seriously as it upended their lives?

Striking the young, old, and everyone in between, health departments of the time refused to release numbers of infections, hoping to reduce panic in the population, but at the same time undercutting the public’s understanding of how dangerous the Spanish Flu really was.

The lead epidemiologists of the time were sure of what caused the Spanish Flu, a Pfeiffer’s bacillus, their issue was not knowing what to do about it.

According to the US National Library of Medicine under the National Institute of Health, pre-vaccine measures to the Spanish Flu were very similar to those precautions being suggested and undertaken recently.

The Spanish Influenza Pandemic: a lesson from history 100 years after 1918″ gives a striking overview of the virus, and one does not have to look far to see correlation between the Spanish Influenza and the current COVID-19.

Preventative measures were undertaken in the U.S. in August of 1918, including “obligatory notification of suspected cases and the surveillance of communities such as day-schools, boarding schools and barracks,” similar to the contact tracing health departments are doing today with COVID-19.

Suspected and confirmed cases were put under “voluntary and/or mandatory quarantine or isolation, enabling the spread of the Spanish flu to be curbed.” The USNLM points out that these methods were the only effective weapons against the disease at that date. There was no vaccine or antivirals readily available to the public for it yet.

March 4, 1918, a cook at an army base, Camp Fuston, came down with coughing, fever and headaches. Within three weeks, 1100 soldiers were hospitalized, thousands more becoming affected as well. The cook, Albert Gitchel, was one of the first Spanish flu cases in the U.S.

With WWI raging over the globe, the fighting and transportation of men was the best super spreader the disease could hope for. The second, much more deadly wave, found it’s way to Boston by hitching a ride with returning troops from Britain, bringing it to locations that may have seemed otherwise safe.

In New York City, the epidemic was declared over by Nov. 5, 1918. By that reckoning, the Spanish flu terrorized the nation for seven months. The majority of deaths occurred during the virus’s second wave, from August to early November.

One of the highest profile cases was the king of Spain, Alfonso XIII.

Outside of nasty flu-like symptoms, symptoms such as nasal hemorrhages, pneumonia, encephalitis, and blood in the urine were attributed to being caused by Spanish Influenza.

Australia was one of the first countries to think it was over by December of 1918. They lifted their quarantines, and were struck by a third wave, the virus afflicting 12,000 Australians.

In January of 1919, it was back in New York for a third tour.Mortality rates matched those of the second wave. In May of 1919, the U.S. declared the pandemic over for a second time.

The NLM attributes the wildfire spread of the Spanish flu to “the return of soldiers from the war fronts, the migration of refugees and the mobility of women engaged in extra-domestic activities,” and therefore, “preventative health measures were therefore essential in order to try to stem the spread of the disease.”

In European countries, health officials closed public meeting places like theaters, and suspended public meetings. Church sermons were only allowed on Sundays, and Sunday school was only to be held for five minutes.

The world over, sanitation of public streets and places were essential. Crowds outside were limited, as were people allowed per public transport unit. However, these did not prove effective. Spitting in the streets was even prohibited. So naturally, people began carrying “pocket spittoons.”

Newspapers in Spain were free to report on the flu, as they were neutral in the war. In many other European countries, and to some degree the U.S., downplayed the seriousness of the flu to keep the war effort moving ahead. Spain, reporting on its full strength, helped the flu to be known as the Spanish Flu.

In “Rapid response was crucial to containing the 1918 Flu Pandemic: Historical analyses help plan for future pandemics,” the National Institute of Health investigated why some cities were hit harder than others. Why was St. Louis hit so much less than Philadelphia?

The answer was response time and dedication to prevention. Cities that instilled prevention measures within days cut the effects of the flu two times more than cities that waited weeks.

Dr. Anthony Fauci intimated that, “These important papers suggest that a primary lesson of the 1918 influenza pandemic is that it is critical to intervene early.”

Fauci then continued, “While researchers are working very hard to develop pandemic influenza vaccines and increase the speed with which they can be made, nonpharmaceutical interventions may buy valuable time at the beginning of a pandemic while a targeted vaccine is being produced.”

“Spanish Flu, or whatever it is…: The paradox of public health in a time of crisis” by Dr. David Rosner explores the lessons learned, and not learned, by the American people and medicine from the Spanish flu.

Dr. Rosner stated that, “Yet, for the most part, despite our advances, the basic means of addressing influenza remain the same as those nearly a century ago. Public health education, isolation, sanitation, lessening congestion, closures, and surveillance are essential tools.”

The Institute of Medicine argued that “public health is defined by ‘What we, as a society, do collectively to assure conditions in which people can be healthy.”

Whether it be the Spanish flu of 1918 and 1919, or COVID-19 of 2019 and 2020, it takes a whole community to come together, play as a team, and keep each other healthy. A pandemic is no time to put individual freedoms above the entire community.

The Spanish Flu was not a hoax, and neither is COVID-19. Wear a mask.

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