The Spanish Flu of 1918: How Lessons Learned Apply to the Current COVID-19 Pandemic


The 1918 H1N1 flu pandemic, also known as the Spanish flu, was the most serious pandemic in modern history. About 675,000 deaths have been reported in the United States. Although we are only a few months into the COVID-19 pandemic, there are currently many similarities to what we saw at the time. Not only with the controversy over the wearing of masks and the closing of churches, but also in the community’s response to the pandemic.

“We have to be patient,” said David Sloane, history professor at the USC Price School of Public Policy. “It’s not that we can’t open a little, or slowly, or go back to work, but we have to think about social distancing, masks and gloves. “We have to be careful about how we do this because this thing is mean and it didn’t go away. “

The Spanish flu pandemic started in the United States on a military base in Kansas in March 1918. Sloane said it started slowly because it spreads slowly and is not very deadly. But as the soldiers went into battle during the First World War, the virus exploded.

“Somehow, in the amazing things that viruses do, it does what is called genetic change, and that change makes it much more virulent and much more dangerous. “

“It begins to spread quickly in these closed and dense spaces in which the soldiers are, and it kills people rather quickly. And when he comes home, it’s a very different virus than the one who left. “

Around September 1918, the virus returned home. Not on jumbo jets as we see today, but on ships full of soldiers returning to Baltimore, Philadelphia, Boston, New York and Los Angeles.

“They come to San Pedro and try to quarantine them after five or six days, and it is too late. It’s an incredibly contagious flu, so it’s among dockers, in communities and in Los Angeles. And that’s how it goes. Across the country. “

And just like the way health officials closed public spaces like theme parks and beaches in 2020, the same thing was done in September 1918.

“Concerts, large gatherings, processions and parades. They also closed controversial dance halls and churches. But not so controversial, they also closed schools. “

Many cities have ordered people to wear masks. A photo shows a person with a sign that says “Wear a mask or go to jail”.

“They distributed hundreds, if not thousands, of tickets to people who did not want to wear a mask. You always had freedom: you could stay at home. It’s your freedom. You could choose not to go out and infect people. But if you are going to go outside and join the public, then you are part of the responsibility of the public, as it is today. “

But while large public gatherings have been closed, many industries have not closed completely.

“They were worried about the workplace, but they didn’t take the same type of draconian effort that we have today. “

The photographs show hair salons open outside and courtrooms also moving around the city squares. But the one thing Sloane said you didn’t see happen in 1918: the physical distance.

“Institutionally, they practiced social distancing because they closed churches, schools, ballrooms and dance halls. But on a personal level, if you look at the photo, all the people with masks, they are swept together. This is partly because they don’t understand the flu. “

The Spanish flu of 1918 occurred in three waves: the first in March, which did not spread as quickly. The second wave in September, with countless soldiers returning from the battlefield, was the deadliest and the one that led to the closure of large rallies.

But as we can see now, the public got tired of the closings of 1918 and started to reopen in November. Later that winter, the third and final wave hit the United States.

What lessons have we learned? Sloane said that bringing about changes in the workplace was something that was effective at the time – and may still be today.

“It is possible that we can learn something from the 1918 flu, that there is this idea of ​​staggered work schedules. Maybe not hours, but staggered workstations. Maybe half of the people return to work on Monday, Wednesday or Friday, and half of the people return on Tuesday, Thursday and Saturday. “

“I think we have to be innovative in our social thinking as well as in our medical thinking. “

While there are certainly differences between the Spanish flu and the current COVID-19 pandemic – such as the availability of antibiotics and epidemiological advances – there are things we need to keep in mind.

“We have always said that those who forget history are bound to repeat it,” said Dr. Cameron Kaiser, public health officer for Riverside County. “And human nature is remarkably consistent, unfortunately. “

But Kaiser said there were reasons to be optimistic.

“There is certainly a lot of controversy as to whether there will be a second wave of COVID-19 and what it will look like and how it will work. But everyone agrees that you can’t stay locked up forever, ”he said. said.

“If we do the right things and do what we know it works: we are able to maintain social estrangement, face coverings and by ensuring that our most vulnerable members of the population are protected, we could possibly – be reopen safely and we could just pass through. “

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