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Spanish Flu - a covid Lesson From History

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Introduction

The year is 1918 and millions are dying, young and old alike. However, this it is not just the war that is killing so many, illness is wiping out hundreds if not thousands a day. That illness is a new strain of influenza, now being called ‘Spanish Flu’

It is estimated that the Spanish flu killed between 17 and 50 million people world wide. In some countries mass graves were used for those who died due to the infection. It was the first known pandemic of a H1N1 strain of the flu virus.

Why was it called 'Spanish Flu'

The name ‘Spanish Flu’ derives, not from where it started, but from the first country to admit there was a country wide epidemic of it.

Why Spain? Simple, during World War one, neither side wanted to admit to having an epidemic as this would not only damage the morale in their country but also give the upper hand in the propaganda war to the other side. Spain, being neutral, had no such problems and no censorship of the press to contend with so they did go public. The first known case of this flu strain is believed to have been in Kansas in the USA.

What happened with this flu?

Well here we have to think of this as happening mainly in two different waves of the illness and follow it that way.


The first wave:

This was really seen as not being very different to normal seasonal flu, all be it a quite nasty one. As with flu even today it did kill people, but it was those in the most ‘at risk’ groups that died. The elderly, the very young, those with underlying heath problems etc.


With the war to fight very little was said publicly about it, except for the usual seasonal flu advice.


The numbers of cases with the flu went up and then back down and as expected there was a loss of life in the at risk groups. However there was nothing really all that concerning at this point.


The second wave:

Remember we are still in the war time period so everything was hush hush in the government and little was said or released about it. Also the press in the countries involved in the war were under censorship orders – on both sides.


However, something had happened with the flu virus, it had mutated. Mutations in viruses are not uncommon but through natural selection it tends to be the less serious and less deadly ones which survive. This is due to the less serious ones tend to make you a little unwell but are able to carry on with day to day life (e.g. the common cold) and so it gets passed on quite easily. The more virulent virus makes so ill you stay in bed and so it does not get passed on as easily and so it dies out. If you had the less serious strain of the virus it could make you immune to the more virulent strain as well. This is what happened with the Spanish flu.


The more virulent strain began to take hold. However, this time it was killing the young and healthy, those who would normally survive such an illness. Yet the more at risk groups were seemingly unaffected. If they had had the first wave form then they were immune to this newer more virulent strain and so did not fall ill.


Don’t underestimate just how deadly this second wave was. There were reports that seemingly young healthy people who appeared to be fine at breakfast but were dead by dinner time. One cause of death has been put down to it being a cytokine storm where the white blood cells produce a large number of cytokines which trigger more white blood cells to do the same. This can cause multiple organ failure and at the time little could be done to treat it – even if it was caught early. Others also died due to opportunistic secondary infections such as pneumonia which added to the death toll. As there were no anti-biotics to treat this infection, penicillin would not be discovered for another 10 years.

Spanish Flu Poster

US Poster used during the pandemic

US Poster used during the pandemic

Why did this new strain spread so far and kill so many?

Well it was the conditions during the war for one thing. Those who were just mildly ill were kept at the front line in the trenches so the less serious form of the illness spread here.


The very ill were sent away from the front line to hospitals where the infection could easily spread. Then we have transport ships, hundreds if not thousands aboard. If just one person went onto that ship with this new more deadly strain then very soon it could go through the entire ship. Soldiers returning home after the war, if they were carrying the virus is spread very easily through their family and neighbourhood.


We also have to consider that people's living conditions were typically far worse than they are now and even hospitals were not as hygienic as today's standards demand so again secondary infections could easily have been picked up due to the immune system trying to fight off the virus.


So what did the government get wrong?


I can only really comment on the UK government but the answer is simple, they didn’t do anything until it was too late. Except for the usual advice for seasonal flu the government did not push through any other recommendations. Social distancing, closure of big meeting places and isolation of the sick would have helped but with the war to fight and thinking about how it would damage morale little was released to the public. Even when advice posters were produced there were not enough of them. Local councils did begin to bring in their own restrictions but this was very varied up and down the county. The then secretary of state for health’s political carrier never really recovered.


By then end of the pandemic the death toll in the UK was around 228,000 people and compared to some countries the UK got off lightly. This was partially helped by the UK being an island. Whilst viruses do not respect national boarders crossing vast expanses of water in 1918-1919 was a lot harder. The mortality rate world wide was between 10 to 20% of those who were infected.

The lesson for today

The current covid-19 outbreak has the potential to be just as bad, if not worse, than Spanish flu. Despite advances in medicine and intensive care treatment as well as improvements in living conditions and better hospital hygiene when it comes to a virus we are still reliant on our immune systems to deal with it. The big problem is the utter ignorance of some people to the dangers of the illness. This is NOT just a bit of a cold as some have said this is far more serious and it is easier to spread than the flu virus.


The Spanish flu pandemic showed just what can happen if the virus is allowed to spread unchecked with no or little effort to slow it down. 50 million dead, just let that sink in. 50 Million DEAD that is the equivalent of 75% of the current population of the UK. Also remember that the 50 million is possibly an under estimate some have estimated the world wide death toll was closer to 100 million.


What we now have to do is follow the advice we have been given. If a virus can not be passed on it will eventually die out. A vaccine is still at least 18 months away but we can all do our bit by staying at home unless it is for an essential reason. If we can stop the spread we can save lives.


In some countries a second wave looks like it is taking hold. Only time will tell if this is following the same path as the Spanish flu did and become more deadly. As cases rise again, unfortunately so will the number of people who will lose their lives to the virus.

Another wave and vaccinations

So there has been a second wave and variants and vaccinations so how are things going?


Well the variants are not unusual and viruses mutate all the time the concerning things are if the new variants are more easily transmitted or more dangerous. Also will the vaccinations work against the new variants as well. This is unknown as is weather we will need booster shots every 18 months or so.

The vaccines well I had my first dose about 3 weeks ago (as of writing this) and apart for a bit of a sore arm for a day or two I had no side effects. The results are looking good and as far as the UK is concerned the roll out has gone well with over 50% of the adult population having had at least one dose. This roll out where more people are given at least some protection appears to have been the right one and things are moving, slowly in the right direction. However, we must not be complacent about this as another wave can occur as it is already taking hold in mainland Europe.

Will this become something we may have to live with as we do the flu? Only time will tell but it is looking like a possibility. The more of us who are vaccinated the more we will be able to get back to normal.


I have had my second jab and had no reaction to it except a bit of a sore arm the next day. Thankfully due to our wonderfull NHS the UK roll out is very sucessfull and at no further cost to us. Also eveyone has had to wait their turn with Prince William only just having had his first.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2020 mikec1978

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