1918 Spanish Flu

1918 is the year originally famous for the culmination of what was supposed to be the ‘The War to end all wars’. It was also a year reminiscent of the medieval Europe and Black Death. As the war-machine ground to a halt, the Spanish flu started ravaging the young adult population globally.

Published Categorized as Events
A big room lined up with patients in bed
Beds with patients in an emergency hospital in Camp Funston, Kansas, in the midst of the influenza epidemic.

Spanish Flu (Feb 1918 – Apr 1920)

It feels like dystopia these days. Coronavirus has presented extraordinary challenges to humanity.

Haunting picture have emerged on the internet of empty sports stadiums and deserted alleyways; the sort that are displayed in post-apocalyptic movies! Airports are shut, and almost all the aerial fleet is grounded. Millions have been affected by this latest development on a scale unknown to mankind so far. Millions of others have lost their jobs. Countless livelihoods are hanging in limbo as a state of uncertainty and chaos has gripped the globe. A few weeks ago, international bodies convened and officially declared that the global economy has entered an unprecedented recession.

And yet, no one seems to have an answer to the problem. The diagnosis is complete i.e. we are losing trillions of dollars every day, with trillions of dollars more at stake. But the physician’s prescription is missing, and we don’t know when the world will be able to breathe a collective sigh of relief!

Science is an objective study. Researchers make observations. They use these observations to deduce a few statements. Peer review authenticates (or negates) the validity of theses deductions. The scientific process is an evolutionary process which takes time and experimentation.

At this particular instance in the history of mankind, scientists from all walks of life seem to be a bit lost. The closest we’ve come to deducing anything is that, life will return to its normality only when the vaccine for the Coronavirus is created. And when that might be, we are still uncertain!

All this begs the question, ‘Has mankind ever known a catastrophe as big as the Coronavirus Pandemic?’ ‘Has there never been an instance in all recorded history that pitched humanity against Mother Nature in such a colossal battle for survival?’

Indeed, localized epidemics have been a constant theme throughout history. Pandemics, on the other hand, are rare. The Black Death and the 1918 Spanish Flu immediately spring to mind. This small sample size restricts observational prowess and caps a barrier on what we can deduct from the experiences of our forefathers, but I think we should take a look nonetheless, in an attempt to understand what it was like to live through such tough periods.

I will therefore take up the more recent Spanish flu pandemic, and try to educate the readers:

As to the origins of this deadly virulent strain of the influenza virus that came to be known as the Spanish Flu, and the whereabouts of the patient zero, little is known, and whatever is understood, is highly debatable and controversial. Several hypotheses exist to describe its origin, with the most popular ones listing China, the United States, and the British troops stationed in France as the likeliest sources. What is clear though, is the fact that it was one of the most (if not the most) relentless outbreak that killed almost 50 million people globally, and infected another 500 million, almost 1/4th population of the entire world at the time!

Policemen in a group, wearing masks and stationed in city.
Policemen in Seattle wearing masks made by the Red Cross, during the influenza epidemic, December 1918.

The most compelling argument has been presented by Michael Worobey who went to great lengths in an attempt to understand the complex procedure of its spread. Nowadays, everyone has access to the CDC archives. Back in the day in 1918, although there were some brilliant scientists at work, disease was considered a work of angry gods by most people! Records were, therefore, difficult to maintain and keep! Regardless of this, Worobey in his article first published in 2018 argues that the strain might be North American in its origins. The evidence though, is not conclusive, and as mentioned earlier, the difficulties are compounded by a lack of proper documentation, and sentiment clouding the judgement of the early researchers.

The symptoms, just like those exhibited by asymptomatic Coronavirus patients, included a mild case of flu in most people. In worse cases, characteristic symptoms included cyanosis (bluish skin), pulmonary failure due to mucus congestion, and right sided heart failure!

Although children and seniors were most vulnerable to its effects, the surprising fact about the virus was the high mortality rate in healthy young adults, with casualties exceeding expectations.

Viruses are on the borderline of living and non-living beings. Their status is a matter of raging debate in the scientific community. They exhibit some qualities of living beings such as reproduction, evolution, transmission of genetic information to the next generation, etc. but they are basically DNA enclosed in a protein shell!

Lytic cycle diagram showing different stages of Virus invading the host cell
Virus attaches itself to a bacterial cell and unloads its DNA inside the cell membrane. The viral DNA assimilates itself into the DNA of the original bacterial cell and starts making copies of itself. Once enough copies are made, protein coats start synthesizing. The viral DNA is enclosed in the protein coats and the cell bursts releasing hundreds of copies of the original virus. These viruses attach themselves to other cells and the cycle continues!

The mode of transmission for the influenza virus is usually coughing and sneezing, which releases millions of airborne virulent specimens. The geopolitical and socioeconomic conditions presented the Spanish Flu virus with a really good opportunity to not only spread, but mutate along the way as well, resulting in a global crisis.

WWI was a cagey affair with stalemates usually the main characteristic of nearly every front. Trench warfare was the predominant strategy on both sides, and the muddy, wet, and humid environment definitely played its part.

Apart from the fronts not being very mobile, the health and immunity of the average soldier was further compromised by malnutrition, lack of sleep, and tiredness. All this resulted in massive outbreaks in the trenches, with more than 500 soldiers calling in sick in a single week at times.

The treaty of Versailles was signed in 1919, prompting mass demobilization. When entire divisions, battalions, and armies were uprooted from their lairs, the troops carried the virus back home, transmitting it to sailors along the way, who carried it further to distant parts of the world. Troopers were jam packed in crowded trains, freighters, and carriers, and then transported to crowded hospitals who were unable to cope with the mass influx. Furthermore, no proper machinery was in place for sterilization of medical equipment. We are talking about a time period when disposable plastic syringes were nonexistent. A single metal syringe would be used for countless infusions!

6 beds with patients in a army hospital war during the pandemic
Influenza pandemic ward during World War I, U.S. Army Camp Hospital No. 45, Aix-Les-Bains, France

Technological advancements had been exponential in the days of the War, owing to mass military spending, and the race to be crowned the most modern and the most well-equipped army was at its height. This resulted in an increased demand for labor, which gathered in hordes near factories, facilitating the spread.

Advancements in the transportation industry also meant that it was easier for people to travel than ever before! Unbeknownst to the common folk, this ease of travel was probably the biggest cause of the global exposure of the virus. (The situation is very similar to Coronavirus. Travelling from one part of the world to the other has never been easier. What started in Wuhan, should’ve stayed in Wuhan if we were living in an era before the Wright Brothers!)

There’s a rather clichéd doctrine that, Wars are won by numbers. Although they caught up a bit late, by the end of the War, the WWI generals came to realize that a well-trained and well-equipped company with the advantage of terrain on its side could successfully hold off the advance of a battalion. There was also the realization that wars are fought as much at home, as on the battlefields. To keep the supply of equipment, clothing, food, medicine, ammunition, etc. going, and to maintain the logistical lines of supply open, it became extremely necessary to keep the morale high.

To do this, governments on both sides, Allied and Axis, were involved in mass cover ups of data, falsifying the actual claims made by the doctors and victims of the virus. (It feels like an insult to the regular soldier who sweat blood for his country, but I personally think that disinformation and propaganda are vital tools in waging wars successfully. You can of course disagree!)

The name Spanish Flu originated because only the Spanish newspapers in Europe were reporting deaths from a new and incurable disease! Other countries had put a ban on reporting anything related to it.

It is the youth that carries the burden of the society. The vigor and enthusiasm of youth is vital for improvisation and ultimately advancement. Pensioners won’t enjoy the luxuries if it weren’t for the younger generations paying taxes! Sadly, the most devastating effects of the pandemic were felt by fit and healthy adults.

Numerous studies have been carried out to explain this disproportionately high fatality rate in the 20-35 years age group. Conclusive evidence was found which suggests that the flu resulted in a ‘Cytokine Storm’. Think of it like the immune system going in hyper drive, triggering a response much intense than is required by the body! There’s an old saying that, excess of everything is bad, and the immune system on afterburners isn’t a really healthy sign, so much so that, it can lead to death.

With masks over their faces, members of the American Red Cross remove the deceased.With masks over their faces, members of the American Red Cross remove the deceased.
Influenza epidemic in United States. St. Louis, Missouri, Red Cross Motor Corps on duty, October 1918.

No cure was discovered at the time, and none has been found yet. The standards procedures for trying to nip the evil in the bud is social distancing, quarantine, and isolating the patients from the rest of the society. This doesn’t always work but is the only practical solution to halt the spread of the virus.

As is the case with most pandemics, the effects of the Spanish Flu were felt across the board. Everyone suffered. Not just the victims and their families, but people from all walks of life had to reshape their style and manner of living. It took a long time to replenish the adult population which is so crucial to the process of manufacturing and development of infrastructure. Skillful labor became a commodity not every firm could afford, and those who could, paid hefty sums to hire the expertise. Enlistment no longer remained as lucrative a career option as it was at the start of the war.ie. The survival instinct superseded the patriotic spirit.

Dr. Michael Nyberg jokingly remarked, ‘Potentially the only thing we’ve learned from the last year of the War is that, don’t forget your flu shots!’ (So much for the Anti-Vaxxer movement!)

Seriously though, there were a lot of lessons learnt, chief among which was that the practice of isolating the affected individuals was the principal exercise that needs to be employed in order to stop the spread of the virus. This practice is still relevant today as humanity seeks to defeat the COVID-19.

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