Picture the United States struggling to deal with a deadly pandemic.
State and local officials are enacting a series of social distance measures, collecting bans, shutdown orders and masking mandates in an effort to turn the tide of cases and deaths.
The audience responds with widespread adherence, mixed with more than a hint of grumbling, pushback and even outright resistance. As the days turn into months from weeks, the strictures become more difficult to tolerate.
Theater and dance hall owners are complaining about their financial losses.
Clergy lament church closures, while offices, factories and in some cases even saloons are allowed to remain open.
Officials argue whether children are safer in the classroom or at home.
Many citizens refuse to put on face masks in public, some complain they are uncomfortable and others argue that the government has no right to encroach on their civil liberties.
As familiar as it may all sound in 2021, these are true descriptions of the US during the deadly 1918 flu pandemic. In my research as a medicine historian, I have seen time and again the many ways our current pandemic mirrors the pandemic that has affected our lives. ancestors a century ago.
As the COVID-19 pandemic enters its second year, many people want to know when life will go back to what it was like before the coronavirus. History, of course, is not an exact template for what the future holds. But the way Americans got out of the earlier pandemic might suggest what life after the pandemic will be like this time around.
Sick and tired, ready for the end of the pandemic
Like COVID-19, the 1918 flu pandemic hit hard and fast, ranging from a handful of reported cases in a few cities to a nationwide outbreak within weeks. Many communities issued several rounds of different shutdown orders – in accordance with the ebb and flow of their epidemics – in an effort to control the disease.
These disengagement orders from society worked to reduce the number of cases and deaths. But, just like today, they often proved difficult to maintain. By late fall, just weeks after the social distance relations orders took effect, the pandemic seemed to end as the number of new infections declined.
People were screaming to get back to their normal life. Companies urged officials to reopen. Believing that the pandemic was over, the state and local authorities began to repeal public health regulations. The nation focused its efforts on tackling the devastating influenza.
For the friends, families, and employees of the hundreds of thousands of Americans who had died, life after the pandemic was filled with grief and sorrow. Many of those still recovering from their attacks with the disease needed support and care while they recovered.
At a time when there was no federal or state safety net, charities took action to provide resources to families who had lost their breadwinners, or to take in the countless children orphaned by the disease.
However, for the vast majority of Americans, life after the pandemic seemed to be a stubborn rush to normalcy. Starved for weeks in the city, sporting events, religious services, classroom interactions and family gatherings, many were eager to return to their old life.
Following directions from officials who had declared – somewhat prematurely – that the pandemic was ending, Americans were predominantly rushing to return to their pre-pandemic routines. They stopped in movie theaters and dance halls, hustled in shops and stores, and gathered with friends and family.
Officials had warned the nation that cases and deaths were likely to persist for months. However, the burden of public health no longer rested on policy, but on individual responsibility.
Predictably, the pandemic would continue and spread into a third deadly wave that lasted until the spring of 1919, with a fourth wave hitting in the winter of 1920. Some officials blamed the resurgence on careless Americans. Others downplayed the new cases or turned their attention to more routine public health issues, including other illnesses, restaurant inspections, and sanitation.
Despite the ongoing pandemic, influenza quickly became old news. Once a regular part of the front pages, coverage quickly diminished to tiny, sporadic clippings buried in the back of the national newspapers. The nation moved on, accustomed to the toll the pandemic had taken and the dead to come. People were largely unwilling to return to socially and economically disruptive public health measures.
It’s hard to stay in there
Our predecessors can be forgiven for no longer staying on course. First, the nation was eager to celebrate the recent end of World War I, an event that loomed perhaps greater in Americans’ lives than even the pandemic.
Second, death from illness was a much larger part of life in the early 20th century, and plagues such as diphtheria, measles, tuberculosis, typhoid, whooping cough, scarlet fever, and pneumonia each killed tens of thousands of Americans each year. In addition, neither the cause nor the epidemiology of influenza was well understood, and many experts were still not convinced that social distance measures had a measurable effect.
After all, there were no effective flu vaccines to save the world from the ravages of the disease. In fact, the flu virus wouldn’t be discovered until 15 years later, and a safe and effective vaccine wasn’t available for the general population until 1945. Given the limited information they had and the tools at their disposal, Americans may have made it through public health. restrictions for as long as reasonably possible.
A century later, and a year after the COVID-19 pandemic, it is understandable that people are now all too eager to get back to their old life. The end of this pandemic will inevitably come, as with all previous humans that humanity has experienced.
However, if we have anything to learn from the history of the 1918 flu pandemic and our experience so far with COVID-19, it is that a premature return to a pre-pandemic life means more cases and more deaths.
And Americans today have significant advantages over those of a century ago. We have a much better understanding of virology and epidemiology. We know that social distance and masking work to save lives. Most importantly, we have multiple safe and effective vaccines in place, with the rate of vaccinations becoming weekly.
Sticking to all of these factors fighting or reducing the coronavirus could mean the difference between another wave of disease and a faster end to the pandemic. COVID-19 is much more transmissible than flu, and several alarming SARS-CoV-2 variants are already spreading around the world. The deadly third wave of flu in 1919 shows what can happen when people relax their guard prematurely.
J. Alexander Navarro is assistant director of the Center for History of Medicine at the University of Michigan in Ann Arbor, Michigan. This was first published by The Conversation – “People gave up on influenza pandemic measures a century ago when they had had enough – and paid a price”.