1918 pandemic similar in many ways to today's COVID-19

As the novel coronavirus spreads locally and across the globe, it brings to mind another major pandemic: the Spanish flu in 1918, which generally is considered to be the most severe pandemic of the 20th Century.

Very similar.

Just 102 years after the 1918 Spanish flu (H1N1) virus caused the deadliest pandemic of the 20th Century, a retired teacher says we are seeing another “very similar” influenza pandemic spreading throughout the world.

“Everything we are seeing today: social distancing, school closings, church closings, non-essential businesses closing, all occurred during the 1918-1919 Spanish flu pandemic,” said Michael Kimmel, who taught biology for 35 years at Conneaut High School, and who lectured at the Conneaut Public Library on the 100th anniversary of the 1918 flu pandemic.

To demonstrate the similarities of the COVID-19 and H1N1 pandemics, Kimmel shows a newspaper clipping from Oct. 29, 1918 which appeared in the Conneaut Herald and reads: “Children must stay off the streets or get arrested.”

The 1918 disease was called the Spanish influenza because the first newspaper reporting of the flu appeared in May 1918 in Spain, a neutral country in World War I and not subject to wartime censorship.

Kimmel said there is not universal consensus regarding where the virus originated, but it spread worldwide during 1918-1919.

In the United States, it was first identified at a Midwest military camp in spring 1918, so he believes it originated in North America.

While COVID-19 originated in bats, H1N1 virus was avian in origin, according to the Centers for Disease Control (CDC) website.

It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States, according to researchers with the CDC.

“In many ways it’s 1918 all over again,” Kimmel said. “We have better medicine now, but there are many similar happenings.”

The 1918 H1N1’s mortality was high in people younger than 5 years old, 20-40 years old and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was its unique feature.

The COVID-19 seems to be the hardest on the elderly and people with underlying medical conditions.

It took city officials in Cleveland until Oct. 4, 1918 to investigate flu conditions in the city. By Oct. 7, there were 500 cases in Cleveland and action was taken to limit the spread. Then, as now, isolation was seen as the best preventative. On Oct. 14, theaters, movie houses, dance halls, churches and night schools were ordered to close. Schools closed on Oct. 15. 

One of the more distressing things to both parishioners and clergy at the time was the ban on public funerals. Priests told their flocks that the dead could be blessed privately and funeral Masses could be celebrated when the ban on public gatherings was lifted, according to the Catholic Diocese of Cleveland. 

Without television and social media, newspapers were instrumental in helping to spread the message.

By Oct. 21, 1918, there were 1,000 people hospitalized with the deadly flu. A concern of a shortage of beds soon arose. The operating hours of businesses were shortened, but industry continued to work.

“For two-and-a-half months, the flu killed people,” Kimmel said. “If COVID-19 is anything like it, we are in for a long haul.”

The ban on public gatherings, including church services, was lifted on Nov. 13, 1918.

“We may now return to God full of confidence in his love and thanksgiving for his mercy,” The Catholic Universe, a newspaper which provided the faithful updates on the virus, reported in its Nov. 8, 1918 issue.

Pittsburgh had the highest death rate of any major U.S. city. The flu killed at least 4,500 people there — more than one in every 100 people. Nearly 24,000 received treatment at city hospitals.

With no vaccine to protect against influenza and no antibiotics to treat secondary bacterial infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants and limitations of public gatherings, Kimmel said.

The 1918 flu was even more of a mystery than COVID-19, and Americans turned to a number of questionable remedies, such as drinking a pint of whiskey or eating raw onions.

Doctors prescribed aspirin for the fever and epinephrin for pneumonia. Many doctors and nurses wore gauze masks when with flu patients, just like surgical masks are used today.

Conneaut’s hospital was filled to capacity. The former Lakeview Hotel was transformed into a relief hospital, operated by the American Red Cross, where influenza patients could be isolated, according to the Conneaut Herald.

Obituary pages were filled with residents who had succumbed to influenza or pneumonia. 

In a brief timespan, from Oct. 21 to Nov. 6, 1918, more than 650 cases of influenza were reported, according to the Conneaut City Health Department.

Effects of the flu lingered into 1919. Nearby Kingsville kept schools closed into January. Monroe Township closed its schools for three weeks in mid-December, partly because of colds and mild cases of flu and also parents’ fear of exposing their students to serious illness, according to a newspaper account.

Just like today’s COVID-19, the Spanish flu pandemic showed the world how a respiratory virus could create a major disruptive event. 


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