In the deadly fall wave of the 1918 flu pandemic, millions of people were doomed because they didn’t know what we know now about how viruses and respiratory illnesses spread.
Lessons From 1918 Flu Pandemic
We might face a similar fate if some people continue to ignore what a century of scientific progress and hindsight has taught us about ending pandemics.
The 1918 pandemic transpired in three waves, from the spring of 1918 to the winter of 1919 — ultimately killing 50 million to 100 million people globally. The first wave in the spring of 1918 was relatively mild. A majority of 1918 flu deaths occurred in the fall of 1918 — the second, and worst wave of the 1918 flu.
The St. Louis Red Cross Motor Corps was on duty with mask-wearing women holding stretchers at the backs of ambulances during the influenza epidemic in Missouri in October 1918.
Health experts expect Covid-19 infections to increase this winter because the virus that causes Covid-19 is a coronavirus, and other coronaviruses spread more during winter. In wintry, less-humid air, virus-carrying particles can linger in the air longer. Additionally, our nasal membranes are drier and more vulnerable to infection in winter. And as the weather gets colder, we spend more time indoors without sufficient ventilation, which means the virus has a higher likelihood of spreading. Although we have coronavirus tests, one shortcoming is “that we don’t have sufficient testing ability and the tests take so long,” Kolata said. “And when you start having something like the coronavirus where the symptoms can mimic those of the flu — high fever, chills — you can overwhelm the testing system really easily if the flu season really gets underway.”
Covid-19 hasn’t “claimed as many lives yet as did influenza. Basically, around 675,000 people died in the US by the end of the 1918 pandemic,” said Dr. Jeremy Brown, an emergency care physician and author of “Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History.” “That would, today, be around 3 million people in the US. The good news is that we haven’t seen those numbers — of course, the numbers are really quite appalling.
“But, of course, the story that we’re talking about isn’t over yet,” Brown said.
Why the second wave was so deadly
There are several possibilities why the 1918 second wave was so horrible, including a virus that possibly mutated and patterns of human movement and behavior at the time. Winter meant that influenza also spread more and people were indoors more often.
“My guess is it wasn’t great at infecting people in the spring and had to sort of adapt,” said John M. Barry, author of “The Great Influenza: The Story of the Deadliest Pandemic in History.” “Then a mutation took over that was very good at infecting people and also more virulent.”
In 1918 flu patients, pneumonia often quickly developed and killed people by the second day. Efforts for the First World War had taken over, so rampant spread was facilitated by troop movements and crowded military camps.
Where military personnel traveled, so did the virus — resulting in influenza and pneumonia sickening 20% to 40% of the US Army and Navy personnel in the fall, interfering with induction, training and efficacy. “Influenza and pneumonia killed more American soldiers and sailors during the war than did enemy weapons,” a 2010 study reported.
The 39th Regiment marched through the streets of Seattle in December 1918, while wearing masks made by the Seattle Chapter of the Red Cross.
Six days after the first case of influenza was reported at Camp Devens, Massachusetts, cases multiplied to 6,674 cases. When Colonel Victor C. Vaughan remembered Camp Devens, “it was shocking,” wrote Gina Kolata, a science and medicine reporter at The New York Times, in her book