The Spanish Flu virus and Covid-19 are unrelated, as we know. Even so, there are some interesting comparisons to be made:
In 1918, when Spanish Flu broke out, there was no NHS. If people couldn’t find or afford to pay for a doctor, they treated themselves as best they could, using quinine and aspirin. The source of infection was thought to be Pfeiffer’s bacillus. Very few doctors were available as the younger men were away caring for the troops, leaving the rest to cope with an intolerable workload. There were fewer nurses too, as many had gone to the Western Front. As the pandemic worsened, hospitals had to close their doors.
Now, the NHS and public social care are in place, but have been underfunded and short-staffed for many years. A massive increase of people with acute respiratory illnesses would buckle the system. Despite all expert advice, how many countries can say that they’re prepared for a pandemic?
In 1918, the virus was carried all over the world by troops. Only two countries imposed a quarantine: Australia and American Samoa. Australia’s wasn’t breached until January 1919, so they managed to avoid the deadly second wave and only lost 15,000 people, compared to the 228,000 lost overall in the UK. American Samoa maintained their quarantine throughout and didn’t lose a soul. Alfred Crosby, an American historian, said, ‘The war was at right angles to the epidemic. As a society, we could only entertain one big idea at a time.’
Now, it’s a question of trade and global connectedness. People travel, people carry illness and as David Quammen says in his book Spillover, the virus ‘rides’.
In 1918, Sir Arthur Newsholme, the Principal Medical Officer of the UK, was accused of being ‘weak, vacillating, incompetent, untrustworthy and vain’.
Now, Trump has all but dismantled the US programs for combating a global health crisis, and said some days ago that he ‘didn’t know people died of the flu’. Now he’s describing the virus as ‘foreign’, and banning flights from mainland Europe – but not from the UK. Many other leaders are equally uncertain as to how best to respond.
In 1918, there was no welfare state, so the poor were helpless as factories, shops, and businesses closed.
Now, the welfare state is in crisis, and the working poor can’t afford to self-isolate.
In 1918, death usually occurred at home. The body would be kept there, in a coffin, for a minimum of three days, or more usually a week, until the funeral took place. Cremation was still infrequent and during the pandemic, with wood rationing and staff falling ill, undertakers were hard-pushed to satisfy demand. Many gravediggers had gone to war, so there was additional delay in arranging funerals. People found ways to cope because they were accustomed to the presence of death.
Now, when most people die in hospital and bodies are housed in mortuaries or by funeral directors, we’re not used to the proximity of death. It’s on the screen as drama or horror, and consequently all the more distressing in its reality.
In 1918, the world was demoralised and terribly depressed, brought low by years of war, loss and hunger. Some academics believe that the end of the war was hastened by the collapse of supply chains to all combatants at the Front. There were refugees, many hundreds of thousands of wounded and an unstable global economy. The advent of Spanish Flu, particularly virulent among young adults, caused too much death to bear and the repercussions, emotionally, physically and economically, lasted for generations.
Now, there are wars raging in many countries, global climate catastrophes and millions of refugees with no access to even basic care. Virologists have been saying for years that the question of a crisis is ‘When’, not ‘If’ . . .
One thing deriving from Spanish Flu was the appointment in 1919 of the first Minister of Health in the UK. Nonetheless, until recent years the pandemic has been largely neglected and the psychological aftermath barely considered. Understanding how the world could be so ravaged in 1918 may give us more chance of coping with the current pandemic.
Reina James is the author of This Time of Dying, a novel that starts with a doctor, newly back from the Front, trying to warn the government that the world will be brought to its knees by an imminent plague. He dies unheard. By coincidence, a Dr Li in Wuhan also died attempting to alert his own government of the risks of coronavirus.
Cover Image © British Red Cross