In late 2019, a mysterious disease began spreading in the city of Wuhan in the province of Hubei in China. The new disease appeared to affect the respiratory system of those infected, causing signs and symptoms such as fever, cough, weakness, and difficulty breathing. But more than this, the disease appeared to be fatal among vulnerable populations, particularly those who are of advanced age or diagnosed with a chronic health condition. By the second quarter of 2020, the disease has spread to almost every country around the world in six continents, making it a pandemic of staggering proportions. Scientists were able to determine that the disease is caused by a new type of coronavirus known as the severe acute respiratory syndrome coronavirus 2 (also known as SARS-CoV-2). The disease itself came to be known as COVID-19. With millions of people infected and thousands of lives lost, the pandemic effectively brought the world to a standstill. The events that unfolded in the last six months have reminded the world of another pandemic that took place just a century ago: the Spanish flu. Although the COVID-19 pandemic of 2019 is an entirely different event caused by a different virus, the influenza pandemic of 1918 provides valuable lessons that can be used to address current and future pandemics.
The Spanish flu
The Spanish flu was a pandemic that occurred between 1918 and 1920. It was a cause by the influenza A virus subtype H1N1, otherwise known as the A/H1N1 virus. This virus remains today and occasionally causes epidemics as well as flu seasons. However, a particularly deadly strain of the virus appeared in 1918—one which the global population had little to zero immunity. It is uncertain where exactly the Spanish flu originated, although researchers believe that it may have come from France, China, the United States, or the United Kingdom. In a matter of months, the flu spread around the globe and wreaked havoc in almost every country. The rapid spread of the virus can be attributed to its mode of transmission. Researchers believed that the virus was transmitted through droplets generated through coughing, sneezing, and talking. The cramped camps in the warzones and heavy use of transportation also didn’t help, as these conditions were favorable to the spread of the virus.
Like other cases of flu, the disease caused signs and symptoms like fever, fatigue, headache, and sore throat among others. Infection usually lasted for days to weeks. Most of the deaths were caused by bacterial pneumonia, a type pneumonia that occurs when the respiratory system becomes severely infected by bacteria that overwhelm damaged tissue. But what made the Spanish flu different was that it killed people who were otherwise healthy. It is usual for flu to cause death among the elderly and people with chronic health conditions. But in the case of Spanish flu, even young people in the peak of their health succumbed to death. Studies show that people in the 20-40 years old age group suffered high mortality rates, which is highly unusual since this group has the highest chances of survival when it comes to other infectious diseases.
Even after a century of research, scholars are still having difficulty determining the extent of the Spanish flu’s impact. The pandemic ravaged economies around the world. Millions of people were left unemployed as businesses were shuttered to prevent contagion. Public places such as schools, churches, and theaters were closed down, while mass gatherings were prohibited. By the time the pandemic ended, 500 million people or a third of the world’s population at the time had been infected. Estimates put the death toll between 50 million and 100 million people. More people died from the Spanish flu than from Word War I.
Similar to the Spanish flu, COVID-19 primarily attacks the respiratory system. The causative agent, however, is a virus that comes from the coronaviridae, a family of viruses which includes the viruses that cause the common cold, SARS (severe acute respiratory syndrome), and MERS (middle east respiratory syndrome) among others. Since its emergence in late 2019, SARS-CoV-2 has been studied by researchers in a bid to better understand it and ultimately create a vaccine. However, much remains unknown including the most effective treatment for the disease. It is known, however, that this virus almost certainly jumped from bats or pangolins to humans. It has also been determined that the virus can be transmitted through respiratory droplets generated by coughing, sneezing, and talking.
The signs and symptoms of COVID-19 vary, but the most common include fever, fatigue, shortness of breath, cough, loss of appetite, and diarrhea among others. Complications of COVID-19 include pneumonia, acute respiratory distress syndrome, shock, multi organ failure, and death. Similar to other diseases, severe cases are most common among vulnerable populations such as people of advanced age and those with chronic health conditions such as heart disease and diabetes.
Since its detection, there have been around 10 million confirmed cases of COVID-19, around 500,000 of which have resulted in death. However, the impact of the disease is far from over. As a vaccine is yet to be developed, with some researchers estimating that it will not be available until 2021, there will certainly be more infections to come. The pandemic’s impact on the economy has also been staggering. Many countries around the world have been forced to implement widespread lockdowns. Borders have been closed and non-essential travel has been banned. Countries with severe cases have also experienced social unrest as various groups protest against the inefficient handling of the crisis by national governments. Economies have also greatly suffered. As people are advised to stay at home, small businesses and multinational corporations alike have seen declining revenues. Thousands of these small and large companies have already closed or downsized, resulting in record rates of unemployment. Even if a vaccine is developed by next year, it will still take years to undo the damage done to the global economy by the pandemic.
Lessons from the 1918 pandemic
While there are significant differences between the 1918 influenza pandemic and the current coronavirus pandemic, there are important lessons that can be learned from the past. First of all, the dissemination of factual information is vital to combatting the disease. Researchers have found out that one of the reasons the Spanish flu reached such devastating proportions was the lack of information on its spread. The Spanish flu emerged during World War I, a time when countries involved in the fighting imposed stringent policies on the types of information released to the public. Though evidence of a looming pandemic was mounting, many countries were slow to report the details due to fear that such news would negatively impact public morale. In fact, the 1918 pandemic became known as the Spanish flu not because the virus was detected in this country but because the Spanish were the first to openly report about it since Spain was neutral. Many people have not heard of this pandemic, and when they do it is usually because they have been asked to read about it or write an essay or a research paper about this topic. Had information been made public and countries collaborated early on, many deaths would have been prevented. The Spanish flu demonstrated the importance of timely information dissemination. Exercising transparency and honesty will enable governments to utilize facts in the formulation of sound policies that can save lives and address various problems.
Another important lesson taught by the Spanish flu is the importance of prioritizing public health. The Spanish flu came at a time when public health was not the priority, considering how the world was just emerging from four years of war. But as it became apparent, comprehensive steps were necessary to address the population’s health. It was not enough to approach the pandemic by treating individual cases; instead, it was essential to see the bigger picture and find innovative ways to address problems in their entirety. For example, as difficult as it was, closing down public places helped curb the disease during the 1918 pandemic. The widespread use of masks also contributed to preventing infection. The same can be said today. The countries that are winning the war against COVID-19 are those whose policies are proactive and designed to address public health needs. For example, Taiwan is one country praised for its rapid response to the pandemic. Vietnam is another. So are Iceland and New Zealand. These countries response curbed the disease by preventing rapid spread of the virus. Some of the most effective practices observed by these countries are conducting mass testing, implementing strict isolation and treatment protocol, and encouraging social distancing, all of which are of course on top of a strong and effective health system.
Individuals also have a role to play. The 1918 pandemic would have been worse if people did not cooperate with the government or follow health guidelines. Even the simple act of wearing a mask and washing hands frequently can help prevent transmission of the virus. Being more mindful of practicing hygiene and sanitation can prevent further loss of life. The same tips for avoiding getting sick that college students receive are valuable guidelines in disease control and prevention that anyone can follow. Taking care of mental health is also an essential component of fighting the pandemic. As people are separated from one another due to social distancing and lack of socialization, rates of anxiety and depression are increasing. Knowing the ways to maintain mental health is therefore vital in preventing a public mental health crisis.
As COVID-19 continues to spread across the world, the future remains uncertain. Scientists are yet to come up with a vaccine against the disease, which means more people will become infected in the coming months or years. Hope is not lost, however, as the response to this pandemic has also been impressive for a number of reasons. Publication of the virus’ full genome, for instance, was accomplished in a matter of months, whereas such a feat once took years. More than a hundred vaccines are also under various phases of clinical trials. Vaccines once took years to develop, but scientists are hopeful that one or more will be available as early as 2021 since research has been ramped up in the past months. For now, the most that governments can do is to strengthen the health system, implement best practices and innovative approaches to curbing infection, and learn the lessons from the past.