The Financial Express

Revisiting the flu pandemic of 1918-19  

| Updated: June 01, 2020 22:42:08

Chicago theatres displayed posters like this one to slow the spread of the Spanish Flu during the 1918 pandemic 	—NG Photo Chicago theatres displayed posters like this one to slow the spread of the Spanish Flu during the 1918 pandemic —NG Photo

Despite the loud claims of unprecedented scientific progress and huge technological breakthroughs for over a century, the circumstances surrounding Covid-19 or Novel Coronavirus pandemic appear to be a lot similar to that of the Spanish Flu Pandemic of 1918-19. This has been so in spite of the massive strides made in accumulated knowledge about viruses, the cures and preventions of diseases through numerous medicines and vaccines, a perennially inter-linked globalised world, and elaborate communication cum public health networks strewn all over the planet. AP correspondent Calvin Woodward wrote in a recent post, the "Virus-afflicted 2020 looks like 1918 despite science's march".  Although a century has elapsed, people are still wearing masks, taking recourse to home-quarantines, isolations, sanitisers, disinfectants and herbal remedies, and appear as powerless as ever before in halting the spread of this deadly virus, which has already infected around 5.5 million people globally and has accounted for over 350 thousand deaths.

If we look back, the naming of the Spanish Flue pandemic itself was deceptive, as it certainly did not originate in Spain. Rather, the avian virus H1N1 most probably originated in countries like the USA, France and Britain. The only reason it took such a name was because Spain was a neutral country during the First World War and its free press provided wide coverage to the havocs the flu was wreaking during 1918.

In contrast, the warring governments that included the USA as well as their complicit media were playing it down in an atmosphere of jingoism, denial, news blackouts and censorship. And because of this massive coverage by the Spanish media, the outbreak ultimately came to be known as the 'Spanish Flu Pandmic'. People worldwide believed that it originated in Spain as the Spanish news sources were the only ones widely reporting on the flu. However, the Spanish citizens called it 'French Flu' assuming that it came from France.

The pandemic killed around 50 million people and infected an estimated 500 million across the globe (about 30 per cent of the then global population) in a matter of twenty months between early-1918 and late-1919, which even surpassed the combined military cum civilian casualties in the First World War (1914-18). A significant proportion of the pandemic's victims were also military personnel, with the USA accounting for a total of 675 thousand deaths. More US soldiers died from the flu than those killed in the Great War. About forty per cent of the US Navy was hit, while 36 per cent of the US Army became sick. Troops moving around in crowded ships and trains helped spread the virus across the globe. The dead included President Donald Trump's paternal grandfather Friedrich Trump; and those who recovered after contracting the flu included the wartime leaders of Great Britain, Germany and the United States, the British and Spanish kings, as well as the upcoming US President Franklin Delano Roosevelt.

The first known case of the flu was reported in the United States in Fort Riley, Kansas, on March 11, 1918. It is believed that the infected soldiers then spread the disease to other military camps across the country, and finally carried it overseas.

About 84 thousand American soldiers travelled across the Atlantic in March 1918 followed by another 118 thousand in the following month. The first wave of this pandemic struck in the spring of 1918, which was generally mild. The sick experienced typical flu symptoms like chills, fever and fatigue, but usually recovered after several days, and the number of reported deaths was not high. But a second, highly contagious wave of flu appeared with a vengeance in the fall of 1918. Patients died within hours or days of developing symptoms, their skin turning blue and their lungs getting filled with fluid, just like the Covid-19 patients. The death rate from the flu was estimated to be 2.5 per cent, and the average life expectancy of Americans plummeted by a dozen years in a matter of one year.

Becoming known as 'Bombay Influenza' or 'Bombay Fever', the death rate in British India was as high as 5 per cent causing at least 12 million mortalities - the highest in the world.   A calamitous second wave swept through the United States in the fall, when returning infected soldiers spread the disease among the general population-especially in densely-populated cities.

As there was no vaccine or approved treatment protocol, the responsibility of decision-making for safeguarding the health of citizens fell on the local mayors and health officials. Many tragic decisions were then made amid the pressure to appear patriotic during wartime with a censored media downplaying the threat posed by the disease. On the other hand, control efforts were by and large limited globally to uneven applications of non-pharmaceutical interventions like isolation, quarantine, good personal hygiene, use of disinfectants, and restrictions on public gatherings similar to what is happening today.

One unusual aspect of the flu was that it overpowered many previously healthy, young people in the age-group of 20-40 years-a group normally resistant to this type of infectious illness-including many First World War servicemen.

When these people were infected, their antibodies went after the virus like soldiers spilling from the trenches of battlefields.  The immune system threw all weapons at its disposal against the virus; but the battlefield was the lung, and the lung was getting destroyed in the ensuing combat.

The Spanish Flu pandemic came to an end after 1919, as people infected either died or were believed to have developed immunity from the disease. But that may not fully explain the disappearance of the virus, and there might have been other evolutionary or environmental factors at work that are not yet clear to the scientific community. However, the virologists belatedly discovered in 2008 that what made the Spanish Flu virus so dangerous was the presence of a group of three genes that enabled it to weaken the victim's bronchial tubes and lungs, thereby paving the way for bacterial pneumonia. This modus-operandi bears eerie resemblance to the current pandemic caused by novel coronavirus, with viral pneumonia causing most of the fatalities.

There have been several other influenza pandemics since 1918-19. A flu pandemic killed around 2 million people worldwide, including 70 thousand in the USA, from 1957 to 1958. Another one killed about 1 million people, including 34 thousand Americans, from 1968 to 1969.

But modern day pandemics still arouse renewed interest in the Spanish Flu, which has been dubbed as the 'forgotten pandemic' because of poor record-keeping as well as cover-ups through media blackouts in the backdrop of a global war.


Dr. Helal Uddin Ahmed is a retired Additional Secretary and former Editor of Bangladesh Quarterly. hahmed1960@gmail.com

Share if you like