Four Lessons From Two Pandemics
A historian offers takeaways from the calamitous 1918 flu pandemic as we move into an uncertain future.
As the world emerges from more than a year of pandemic lockdowns, Retro Report invited John Barry, the author of “The Great Influenza: The Story of the Deadliest Pandemic in History,” to take a look back in history for lessons from and comparisons to the convulsive 1918 pandemic, which killed between 50 to 100 million people worldwide. Barry has advised past presidents on pandemic preparedness and response.
1. Disjointed public health messaging leads to distrust.
“The №1 lesson coming out of 1918 is that public health officials and the government have to tell the truth about the disease,” Barry said. “Otherwise you kill people.” The Wilson administration was intent on keeping national morale high during World War I and failed to recognize the pandemic. Officials characterized the 1918 strain as “ordinary flu by another name,” despite reports of people dying within 12 hours of falling ill. As to the admonition for mask-wearing, “Better ridiculous than dead,” one New York health official said.
“You saw a lot more outright fear,” Barry said. “In Phoenix, rumors spread that dogs could carry influenza, and people were shooting their pets. I live in New Orleans. I can contrast that with Katrina, when people were risking their lives to save their pets. So that’ll give you a sense of the fear.”
In 2020, despite numerous conflicting statements from the White House about the pandemic, “we had entirely different messaging,” Barry said. “Most of the media [was] very good covering this. You did have local public health leaders who were telling the truth.”
2. Don’t count on a repeat of the Roaring 20s.
The 1920s were marked by rapid economic growth and vast social change in the United States. Americans had greater access to popular culture and manufactured consumer goods like automobiles. But the memorable hallmarks of the era — flappers, Prohibition, jazz — did not directly result from the post-1918 flu recovery and celebration, and the period was not a prosperous one for everyone, Barry said. “Right now you hear a lot of people talking about the Roaring 20s and linking it to the end of the 1918 pandemic,” he said. “I think those people are mistaken.”
While there is evidence of a brief recession in 1920–21, the virulent 1918 flu strain burned through communities in weeks, not long enough to affect the economy over the long term, Barry said, noting that 1919 was an especially disruptive year in other ways, with effects that lasted well into the next decade. “You had race riots in 26 cities, a huge, huge race riot in Chicago,” he said. “You had a general strike in Chicago and Seattle, a police strike in Boston. You had a Red Scare. Then you had a significant recession: 1920, 1921. Only when we recovered from that recession did we get into the Roaring 20s.”
3. Persistent symptoms aren’t new.
Scientists are studying people experiencing lingering effects from the coronavirus pandemic, so-called “long-haulers,” who show symptoms that last weeks or even months.
“You had the same phenomenon in 1918 that many people who nominally recovered from influenza had health problems into the future,” Barry said. A study by Cincinnati’s health department showed that thousands of survivors of the 1918 flu experienced health effects into 1919, many requiring care for heart problems.
Today’s long-haul patients face persistent brain fog, respiratory or cardiac problems and loss of taste and smell.
4. Airborne illnesses are here to stay.
There have been three significant flu pandemics since 1918 influenza. “We’re not going to eradicate [coronavirus] from the human population,” Barry said. “But I think our immune systems will recognize it better.” Transmissible viruses will continue to be found in mammals, but with different relationships to immunity. Barry said such viruses may remain lethal, but would likely not spread to the extent that an economy would need to be shut down again.
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