How the Spanish Flu can help us in understanding COVID-19
The COVID-19 pandemic affected the world greatly and caused massive changes to society. However, it is not the first pandemic as there have been multiple epidemics in human history nor will it be the last. Other epidemics included the Black Death, Spanish Flu, Plague of Justian, and the HIV global pandemic. These diseases possess varying characteristics that make them threats to human society. They cause different symptoms and so there is no one solution for pandemics. Still, understanding and looking back at past events can help individuals find solutions for current threats. The Spanish Flu, for instance, shares a few similarities with COVID-19 which can help society understand how to address the virus and what to expect as the pandemic continues.
What is the Spanish Flu?
The “Spanish Flu” or the “1918 H1N1 Virus” was an influenza A virus that rapidly spread worldwide and affected millions of individuals. According to the Centers for Disease Control and Prevention (2018), the Spanish Flu is the most severe pandemic in history, including the current pandemic. The CDC estimated that the Spanish Flu killed about 50 million individuals and affected 500 million people. In the U.S., it lowered the average lifespan of citizens by around 12 years (Jester et al., 2018). Illustrating the impact the disease had on society. As its alternative name suggests, the Spanish Flu appeared in 1918. However, it did not originate in Spain and scientists have yet to learn its origin. Even today, scientists continue to study the Spanish Flu as the information about the virus is still lacking.
The Spanish Flu Pandemic
As mentioned earlier, the origin of the Spanish Flu remains an unknown fact. This made it difficult to understand the virus and develop solutions to mitigate its effects. Medical practitioners and scientists could not create vaccines nor prescribe medicine to cure the Spanish Flu. Instead, they insisted on the use of non-pharmaceutical methods, such as quarantine, social distancing, use of disinfectants, promotion of proper hygiene, and isolation (1918 Pandemic History, 2018). Non-pharmaceutical methods prevented the virus from spreading more rapidly but could not help improve the situation for those with Spanish Flu. The effectiveness of these methods was limited and so the Spanish Flu continued to spread and infected millions of individuals. Still, without the non-pharmaceutical methods, the pandemic could have infected more and possibly caused more severe damage to economies, livelihoods, and societies.
End of the Spanish Flu
The Spanish Flu pandemic lasted for about two years and affected millions of lives. The end of the virus, however, was not due to the development of a cure or any form of solution. The Spanish Flu mutated over time, creating a strain that became non-lethal to humans (Ries, 2021). This involved multiple waves of the virus affecting the population, leading to various mutations which eventually weakened the disease. As the Spanish Flu mutated into a non-threatening disease, the rates of infection and mortality lowered. Common medicine could cure the less-threatening virus and so the pandemic eventually stopped.
Since the Spanish Flu only mutated, it continues to infect individuals today. However, the mutated virus is significantly different from the original strain and so it could not spread and cause another pandemic. Additionally, most of the population has developed herd immunity against the Spanish Flu, limiting its detrimental effects (Ries, 2021). The different waves of infection also contributed to the mutation of the virus and limitations to its reproductive capabilities (Agrawal et al., 2021). As the virus experiences more waves, it undergoes changes that can make reproduction difficult. This can be due to the lack of new hosts after a massive wave or the development of vaccines that prevent the virus from transmitting effectively. These factors, along with the natural life cycle of a pandemic, led to the eventual end of the Spanish Flu pandemic.
Comparison Between Spanish Flu and COVID-19
The Spanish Flu and COVID-19 share various similarities that are essential in understanding pandemics and how to address the current crisis. According to Agrawal et al. (2021), the Spanish Flu and COVID-19 are both of avian origin, meaning that they come from flying animals, such as bats and waterfowl birds. Their main mode of transmission is through respiratory droplets, explaining the quick spread of the diseases. Both the Spanish Flu and COVID-19 are highly transmissible diseases that can result from inhaling respiratory aerosols, mostly during breathing, talking, coughing, and sneezing. Agrawal et al. (2021) also noted that both diseases target the lungs and no other organs. However, the infections in the lungs can affect other organs, leading to different complications from the diseases. These similarities can help scientists and other experts understand how to mitigate the effects of COVID-19 and prevent an unmanageable spread of the disease.
The two diseases differ regarding the complications that they cause to infected individuals. Spanish Flu causes bronchopneumonia and pulmonary hemorrhage while COVID-19 often leads to respiratory failures, septic shock, and multiple organ dysfunction syndrome (Agrawal et al., 2021). However, the Spanish Flu had more consistent levels of severity while COVID-19 had different levels; each with different symptoms. This is a significant difference between the two since it indicates that the Spanish Flu is easily identifiable while COVID-19 is not. For instance, a mild or asymptomatic COVID-19 case may seem like a simple throat infection and without the development of other symptoms, experts cannot evaluate whether it is a COVID-19 infection or not. This makes it difficult to assess whether an individual should stay in isolation, contributing greatly to the complexity of the crisis.
Another significant comparison between the two is their infection and mortality rates. As mentioned earlier, the Spanish Flu affected about 500 million individuals and caused 50 million deaths. For COVID-19, the World Health Organization has recorded 584,065,952 cumulative cases and 6,418,958 cumulative deaths as of writing. The data shows that the infection rate of COVID-19 is similar to the Spanish Flu, however, there is a significant difference in the deaths they caused. This can be due to various factors, such as innovations in the medical fields, better pandemic management, and the quick development of vaccines. Since medical science has improved since 1918, governments are more prepared to handle pandemics and so while COVID-19 affected economies and society, it did not cause damage that set human progress backward.
Lessons from the Spanish Flu
The earlier discussions, especially the comparison between the Spanish Flu and COVID-19, provide information regarding the expectations as the current pandemic continues. For instance, the Spanish Flu ended after two years due to the mutation of the virus into a less-threatening disease (Ries, 2021). In the case of COVID-19, this may also be the case. There have been reports of the COVID-19 virus mutating and becoming more dangerous. However, according to Dr. Armitage, a professor of medicine at Case Western Reserve University, viruses tend to mutate in a way where they do not kill the host (cited in Ries, 2021). Since viruses want to spread, they will need to keep their hosts alive to spread the disease. For COVID-19, mutated viruses that are more lethal are likely to kill the host, reducing the likelihood of reproduction. Alternatively, COVID-19 mutations that do not kill the host are likely to spread, causing them to reproduce and turning the disease into a less-threatening one.
The Spanish Flu waves also indicate that the COVID-19 pandemic will involve multiple waves of infection. The 1918 pandemic had its first wave during the summer of 1918 and then two more waves followed it during the preceding months. The first wave involved a less lethal form of the Spanish Flu while the next waves, especially the second, were more lethal (Agrawal et al., 2021). This was again due to the mutation of the virus; wherein the first wave did not kill the hosts, promoting the spread. The next waves were more lethal due to the mutations, however, this also contributed to the decline of infections. Today, medical practitioners promote vaccinations and booster doses to prepare the population for the next COVID-19 waves (Yadav & Moon, 2022). Looking at the events of the Spanish Flu, as more waves of COVID-19 come, the higher the likelihood that the virus will mutate and become less threatening.
Lastly, and perhaps the most important lesson from the Spanish Flu, is the continuous study of diseases and the possibility that it could take decades before scientists develop a cure for COVID-19. The Spanish Flu appeared in 1918 but it was not until the late 1900s and early 2000s that scientists learned more about the disease (Jordan, 2019). The study of the Spanish Flu had various hindrances, including access to a viable virus sample. Researchers, such as Johan Hultin, had to dig through grave sites to find viable samples of the virus for study. Others, however, collected and preserved samples during the 1918 pandemic, allowing later scientists to study the virus. With regards to the current crisis, the pandemic could end with COVID-19 becoming a non-threatening virus that would eventually lose its original genetic characteristics. Since it may take years for scientists to understand the COVID-19 virus fully, preservation of its genes is necessary.
Conclusion
Learning about the Spanish Flu and the events during the 1918 pandemic can help society prepare for the different stages of the COVID-19 pandemic. The similarity between the Spanish Flu and COVID-19 can provide insights into effective methods for managing the spread of infections. The end of the Spanish Flu, which was due to the virus’ mutation, suggests that COVID-19 will eventually evolve into a less threatening disease and naturally stop the current crisis. Other information about the Spanish Flu, especially the long-term studies, indicates that the COVID-19 virus will spark decades of research before scientists can fully understand the nature of the virus and develop a cure.
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References
Agrawal, A., Gindodiya, A., Deo, K., Kashikar, S., Fulzele, P, & Khatib, N. (2021). A Comparative Analysis of the Spanish Flu 1918 and COVID-19 Pandemics. The Open Public Health Journal, vol 14. Available at https://openpublichealthjournal.com/VOLUME/14/PAGE/128/FULLTEXT/. Accessed: August 9, 2022.
Cdc.gov. (2018). 1918 Pandemic History. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm . Accessed: August 9, 2022.
Covid19.who.int. (2022). WHO Coronavirus (COVID-19) Dashboard. World Health Organization. Available at https://covid19.who.int/. Accessed: August 11, 2022.
Jester, B., Uyeki, T., Jernigan, D., & Tumpey, T. (2019). Historical and Clinical Aspects of the 1918 H1n1 Pandemic in the United States. Virology. Available at https://pubmed.ncbi.nlm.nih.gov/30453209/. Accessed: August 9, 2022.
Jordan, D. (2019). The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/flu/pandemic-resources/reconstruction-1918-virus.html . Accessed: August 9, 2022.
Liang, S., Liang, L., & Rosen, J. (2020). COVID-19: A Comparison to the 1918 Influenza and How We Can Defeat It. Postgraduate Medical Journal. Available at http://dx.doi.org/10.1136/postgradmedj-2020-139070. Accessed: August 9, 2022.
Ries, J. (2021). What We Can Learn from the 1918 Flu Pandemic as the Omicron Variant Spreads. Healthline. Available at https://www.healthline.com/health-news/what-we-can-learn-from-the-1918-flu-pandemic-as-the-omicron-variant-spreads. Accessed: August 11, 2022.
Yadav, R. & Moon, S. (2022). Opinion: Is the Pandemic Ending Soon? World Health Organization. Available at https://www.who.int/philippines/news/detail/11-03-2022-opinion-is-the-pandemic-ending-soon. Accessed: August 9, 2022.