Looking back at the Spanish Flu

To help protect the public from the spread of COVID-19, new guidelines are constantly being put into place. From social distancing to closing public locations, these guidelines relate closely to the regulations that were enforced in 1918 when the Spanish Flu swept the nation and the world.

The Spanish Flu Pandemic of 1918 was highly contagious strand of influenza that infected 500 million people worldwide, about 1/3 of the world’s population. This pandemic killed any number between 20 million to 50 million people, about 675,000 were US citizens. With an unknown origin, it was first observed in Europe, the United States, and parts of Asia before it spread worldwide.

The first wave of the 1918 pandemic occurred in the spring, but this strand of influenza was mild. The sick experience usual flu symptoms like chills, fever and fatigue but most infected recovered after several days. Along with the mild symptoms, the deaths were very low.

A second wave came the same year in fall, and it was far from the mild strand from spring. Victims died in hours or days of developing symptoms, their skin would turn blue and their lungs filled with fluid which caused suffocation. In 1918, the death rate was so bad that the average life expectancy in the United States dropped by a dozen years.

Even though this flu was everywhere and in numerous places, the name Spanish flu stuck because Spain was hit hard by the disease. It was reportedly that the kind of Spain, Alfonso XIII even contracted the flu.  Another contributor to the name, Spain was the first to report on this outbreak, causing many to believe it originated in Spain. Spain was able to report on this epidemic because it was neutral during World War I and they didn’t have wartime censors that covered up the news of the flu unlike allied countries and the Central Powers. Despite the world’s beliefs, the Spanish called it the “French Flu” because they believed the virus came from France.

Despite the different beliefs, it was unknown where the flu originated. Different theories pointed to France, China, Britain, or the United States. The first known case in the U.S. that was reported was from Camp Funston in Fort Riley, Kansas, March 11, 1918. It was believed by many that the soldiers were the ones that spread the disease around the world.

The 1918 flue struck down healthy, young people, which was a very unusual aspect but the reason why a number of WWI servicemen ended up contracting the flu. There were more U.S. soldiers that died from the flu than there were killed in battle. Troops helped spread the virus due to crowded ships and trains that brought them to many different countries, hitting about 40% of the U.S. Navy and 36% of the Army.

Another problem was the fact that very few locations were immune or safe from this virus, it ranged from major cities to even remote Alaskan communities. Reportedly, President Woodrow Wilson contracted the flu in early 1919 during the negotiation of the Treaty of Versailles.

Because of World War I, physicians and other health workers were in short supply in parts of the Untied States, and many of the medical personnel that were available contracted the flue themselves. Despite the rise of the need for medical personnel, there were no effective vaccines or antivirals at the time. There were many different ways that people approached fighting the Flu.

Schools, private home and other buildings were converted into makeshift hospitals because of how crowded regular hospitals were, and some had employed medical students for more workers. Officials put quarantines, ordered masks to be worn, and shut down public places (schools, churches, theaters). People were advised to avoid hand shaking and to stay inside.

An underlying factor into the huge spike of deaths was caused by accidental aspirin poisoning. Due to the lack of vaccines, doctors prescribed medications that would reduce symptoms, normally being aspirin. They advised to take up to 20 grams per day, which is highly toxic. For comparison, four-grams doses are unsafe. Aspirin poising would lead to hyperventilation and the buildup of fluid in the lungs. Now, it’s believed that many deaths in October were in relation to aspirin poisoning

In the United States, some businesses were forced to shut down because their employees were falling ill, and the illness caused great difficulties for mail delivery and garbage collection workers. Some locations didn’t have enough farm workers to harvest crops and state and local health departments closed as well.

A second wave of the flu hit America in the summer of 1918 with the return of infected soldiers. Local mayors and healthy officials improvised plans to keep the safety of their citizens as their priority.

In Philadelphia, their response was not enough and way too late. With health professionals claiming the fatalities of the city were not the “Spanish flu” but the normal flu, the city hosted a Liberty Loan parade on September 18, that tens of thousands of Philadelphians attended. Over 1,000 Philadelphians were dead and 200,000 were sick in just 10 days. Then they closed saloons and theaters. March 1919, over 15,000 citizens lost their lives.

While St. Louis, Missouri, acted oppositely of Philadelphia. They closed schools and movie theaters and public gatherings were banned. The peak mortality rate in St. Louis was one-eighth of Philadelphia’s death rate. In San Francisco, citizens were fined $5 if they were in public without masks, being charged with disturbing the peace.

In Nebraska, the flu had reached the state by October. Red Cloud reported two flu deaths on Oct. 2, Omaha had its first case reported the next day, and Scottsbluff reported its first case Oct. 15. By Oct. 7, the state closed all schools, churches, and places of entertainment or public congregation. Mail carriers wore white face masks for protection, but they continued with their jobs.

In 1918, many Nebraska communities were still relatively new. There was a lack of basic services, like supportive health care which could have been led to more deaths in counties, like Cherry and Scottsbluff that were lacking buildings like hospitals. In Lincoln and Omaha, the virus reached out-of-control proportions due to crowding, traveling, and non-compliant public gatherings. The use of social distancing and quarantines within compliant communities seemed to reduce the spread of the virus.

By Oct. 18, seven people had died in Scottsbluff County. There had been 70 cases reported in Scottsbluff, and Gering had between 25 to 30. On Nov. 1, there was more than 1,200 causes reported in Scottsbluff County and there had been at least 14 deaths. Four days later, Scottsbluff was seeing 100 new cases daily, while churches became makeshift clinics and the Red Cross created another hospital.

By summer 1919, the end of the pandemic came. People that were infected had either died or developed an immunity to the strand.

In 2008, researches announced they discovered that the reason this strand was so deadly was because a group of three genes enabled the virus to weaken a victim’s bronchial tubes and lungs and clear the way for bacterial pneumonia.

Since 1918 pandemic, there has been other influenza breakouts, but none have been as deadly. The flu pandemic from 1957 to 1958 killed around 2 million people and a pandemic from 1968 to 1969 killed about 1 million people. More than 12,000 Americans died during the H1Nr, or Swine flu pandemic that happened from 2009 to 2010, and as many know we are currently undergoing a pandemic for COVID-19.

Each of these modern pandemics brings interest to the Spanish Flu, also known as the “forgotten pandemic” because it was overshadowed by the tragedy brought by “The Great War” and covered up by news blackouts and poor record-keeping.

The Spanish Flu infected 500 million people worldwide, which was about 1/3 of the population in 1918. In general, the fatality rate of this flu was calculated to be about 2%, but still claimed more than 50 million people’s lives. COVID-19 has a confirmed 3,094,841 number of cases and fatality rate that is different for different age ranges. COVID-19 has 213,433 deaths confirmed but 938,325 people have recovered after testing positive for the virus. Nebraska has 3,358 confirmed cases, and there are reportedly zero cases in Dawes County.

Cautious steps have been taken and regulations that are happening during the current COVID-19 pandemic were similar steps taken for the Spanish Flu. Masks are suggested and social distancing is a step that many people have taken already. Schools, restaurants, movie theaters, and other nonessential locations have been closed, but in Nebraska the closing of restaurants is being lifted slightly in May. Buildings must stay under 50% of their occupation level, but this allows restaurants, salons, and other businesses to open back up to stay in business during this stressing time.

 Continue to stay updated on stipulations and regulations as they change with the pandemic, they differ from state to state on how the virus is spreading within the state. Information was found on history.com and Nebraska.history.com and all confirmed numbers regarding COVID-19 are updates given on April 28.