Coronavirus and Spanish flu: comparison of two deadly pandemics, separated by a century

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WASHINGTON –
Despite the progress of a century in science, 2020 is very similar to 1918.

Between the two deadly pandemics, one against the ill-named Spanish flu, the other COVID-19, the world has discovered viruses, cured various diseases, made effective vaccines, developed instant communications and created public health networks elaborate.

Yet here we are again, masked to the maximum. And still unable to crush an insidious but preventable infectious disease before hundreds of thousands die.

As in 1918, people again hear hollow assurances contradicting the reality of filling hospitals and mortuaries and draining bank accounts. The old common sense of quarantine is back. The same goes for quackery: rub raw onions on your chest, they said in 1918. What about the disinfectant in your veins now? thought President Donald Trump, gasping instead of laughing at what he faintly tried to pretend to be a joke.

In 1918, no one had a vaccine, treatment or cure for the great flu pandemic that was ravaging the world and killing more than 50 million people. No one has any of that for the coronavirus either.

Modern science quickly identified today’s new coronavirus, mapped its genetic code, and developed a diagnostic test, harnessing the knowledge no one had in 1918. This gave people a better chance of fighting to avoid the dangers, at least in countries that have deployed tests quickly, which the United States has not done.

However, there has been little change in the ways to avoid getting sick and what to do in the event of illness. The inability of US presidents to take the threat seriously from the start also ties into the past and the present.

Trump almost declared his victory before the infection took root in his country and has since spread a wave of disinformation. President Woodrow Wilson’s main failure was his silence.

Not once, historians say, did Wilson speak publicly about a disease that killed Americans grotesquely and in large numbers, even if he contracted it himself and was never the same after. Wilson focused on America’s parallel combat in the First World War as “a dog with a bone,” said John M. Barry, author of “The Great Influenza.”

The suspected zero for the Spanish flu goes from Kansas to China. But it was clear to American officials even in 1918 that it had not started in Spain.

The pandemic only took the name of Spain because its free press ambitiously reported the devastation of the disease wave in early 1918, while government officials and an accomplice press in countries at war – the United States among them – downplayed it in a time of jingoism, censorship and denial.

Like COVID-19, the 1918 pandemic came from a respiratory virus that passed from animals to humans, was transmitted in the same way and had a similar pathology, Barry said by email. Social distancing, handwashing and masks were the main controls of yesterday and today.

The medical advice of the time also resonates today: “If you get it, stay at home, rest in bed, stay warm, drink hot drinks and remain silent until symptoms are resolved past, “said Dr. John Dill Robertson, Chicago health commissioner in 1918.” Then continue to be careful, because the greatest danger is pneumonia or a related disease after the flu subsides. “

In the manner of the day, there just had to be a catchy rhyme in circulation too: “Cover each cough and sneeze.” If you don’t, you will spread the disease. “

But there were also marked differences between the 1918 and 2020 viruses. The Spanish flu was especially dangerous for healthy people aged 20 to 40 – the first generation of military service – paradoxically because of their dynamic immune systems .

When such people became infected, their antibodies attacked the virus like soldiers spreading through the trenches of European battlefields.

“The immune system threw all the weapons it had against the virus,” said Barry. “The battlefield was the lung. The lung was destroyed in this battle. “

Young soldiers and sailors massed in military camps in the United States, sailed to Europe on ships full of humanity, fought side by side in the trenches and returned victorious in front of adored crowds. The results have been enormous for them and the people they have infected. The Spanish flu could just as easily have been called the flu of the United States Army or the United States Navy. Or the German or British flu, by the way.

Among those who died in the pandemic was Friedrich Trump, Donald Trump’s paternal grandfather. Among those who contracted and recovered it were the warlords of Great Britain and Germany as well as American, British and Spanish kings and the future American president, Franklin Roosevelt, when he was assistant secretary of the Navy.

But the toll was heavier on average for people and the poor, crowded with sweaty homes, trams and factories.

Not all of them could live, according to the words of 1918 American surgeon general Rupert Blue: “Stay away from crowds and stuffy places as much as possible. … The value of fresh air through open windows cannot be overstated. … Make every effort to breathe as much clean air as possible. “

An estimated 675,000 Americans died during the pandemic, which is said to have infected a third of the world’s population. Monitoring by Johns Hopkins University shows that the continuing COVID-19 pandemic has killed more than 250,000 people worldwide, more than 68,000 in the United States.

BAD SCIENCE

In 1918, the surgeon general noted in a prospectus that “a person who has only a slight attack of the disease can himself give a very serious attack to others”. The warning is equally applicable to the coronavirus, especially since scientists have learned that a large number of people with COVID-19 can spread it despite no obvious symptoms. The exact frequency with which the new virus kills cannot be determined without a better count of those infected; some estimates place the 1918 flu death rate at 2.5%.

Blue’s public advisory also warned people to avoid charlatans and only get drugs from doctors.

Doctors, however, did not always know what they were doing. Medical journals at the time described an eruption of unusual treatments, some in the league of Trump’s amateur theories about the disinfectant, light blasts, and an unapproved drug that has both potential benefits and risks.

A doctor in 1918 recommended that people sniff a powder of boric acid and sodium bicarbonate (baking soda) to rinse the nasal passages. Others have prescribed quinine, strychnine, and a poisonous garden plant called Digitalis to aid circulation, as well as iodine-derived drugs for “internal disinfection,” according to Laura Spinney, who wrote the book. from 2017 “Pale Rider: The Spanish Flu of 1918 and How it changed the world. “

Popular theories say that warming the feet would prevent infection, or gobble up brown sugar, or get onion rubbing. A “pure heart” was said to be preventative, although it is unclear whether it meant the organ or the heart of love.

“There was no Tony Fauci at the time,” said Barry in a remote interview with the Library of Congress in April.

We now have Fauci – a federal immunologist who has been seen as revealing the White House briefings, singularly immune to the positive effects and lies of Trump. In addition, we know much more than people did in 1918.

Yet we still hear a lot of nonsense from the dark ages.

Conspiracy theorists have accused COVID-19 of developing 5G networks, just as they say radio waves caused the 1918 flu. Arsonists recently torched more than a dozen British cell towers after spreading this lie .

In the months of this pandemic, the Associated Press debunked a series of false remedies that have spread to Facebook, Twitter and others. No, blowing hot air into the nose of a hair dryer will not protect you. No more than drinking tonic water, eating highly alkaline foods, stuffing an antibiotic ointment in the nose, drinking vodka or any other household elixir.

No, it’s not true that if you can’t hold your breath for very long, you have COVID-19. Or that a laboratory vaccine only works on a disease created by a laboratory.

Social distancing did not come with social media distancing. Over a century of science, we have not returned to the future, but to the past.

LESSONS FROM 1918 (and 1919)

In September 1918, as the second and far deadliest wave of the Spanish flu hit the United States, the Philadelphia chief of public health ignored councilors and allowed a massive parade of war bonds to unfold in the city center. The H1N1 virus has crossed the masses in what has been called the world’s deadliest parade. As the authorities insisted that there was nothing to fear, people saw the sick neighbors and die at an astonishing speed and mass graves were dug.

“It’s just the flu” had been thin as the administration’s mantra.

At the end of November, sirens roared in San Francisco to clear after six weeks of lockdown and tell people they could take off their masks. San Francisco, like many western cities, had been largely spared from the first wave and had spent the interval preparing for the second round, imposing masks and imprisoning people who did not comply.

They also had a rhyme for it, of course: “Obey the laws and wear gauze. Protect your jaws from septic feet. “

The precautions paid off with a lower mortality rate than in the cities affected elsewhere. But the city relaxed too early.

In December, thousands of new cases broke out. A wave pouring into the New Year was underway. The death toll in San Francisco has risen by more than 1,000. It was the last boost from the Spanish flu, and less deadly.

The brutal lessons of 1918 and 1919? Barry, who was enlisted 15 years ago in a Bush administration campaign to prepare all levels of government for pandemics, said they must react early, relax with caution, tell the truth.

Instead, he saw denial followed by a chaotic federal response and a leadership vacuum as Washington and the states competed for the same essential medical care and were now heading for reopening.

“Now we have plans, even war plans, spent billions to prepare for what’s going on, federal agencies have been put in charge of managing all of these things, and we get … almost nothing,” he said. .

Not even a jingle.

Associated Press editors Colleen Long and Lauran Neergaard in Washington, Amanda Seitz in Chicago and Karen Mahabir in New York contributed to this report.

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