Two pandemics: What have 100 years taught us?
Introduction
100 years apart, two global pandemics have both brought the world to a standstill. Popularly known as the Spanish flu and the COVID-19, these two “influenza-like illnesses” have many similarities and common lessons that can be learned for preparedness for a future global pandemic. Even though both the illnesses spread through respiratory droplets and aerosols, they belong to different viral families [1].
How Did The Two Pandemics Originate?
The Spanish flu (1918–1920) was caused by the H1N1 influenza virus of avian origin while COVID-19 was caused by a novel coronavirus SARS-COV-2 [2]. While the origin of Spanish flu is still unknown, COVID-19 is speculated to have originated in the seafood market in Wuhan, China and spread globally in a very short time. The symptoms for both include fever, muscle aches, headache, and respiratory symptoms — but the loss of taste and smell is unique to COVID-19.
Which Pandemic Was More Fatal?
With 500 million people infected, the Spanish flu caused approximately 50 million deaths worldwide and 675,000 deaths in the U.S. [3]. In a year since its outbreak, COVID-19 has resulted in 114 million infections, 2.54 million deaths worldwide, and 514,000 deaths in the U.S. Unlike COVID-19, where the highest mortality rate is among people aged 65 and older, a wider range of demographics including people aged 20-40 and less than five were also at high risk in the Spanish flu [4].
What Was Treatment Like?
As both pandemics are highly contagious, identical simple hygiene rules were recommended: washing hands, wearing masks and gloves, and avoiding public gatherings. One hundred years ago, there was very little understanding of the illness and, in absence of advanced medical treatments, household therapies such as vicks, aspirin (30 mg), clean linen, ventilation, and hot soup were recommended [5]. Today, as more antiviral drugs and antibiotics are available, treatment of secondary infections has improved [2].
The Heroes
Frontline workers bore the brunt of the pandemic and were the heroes in both the Spanish flu and COVID-19. Even after all this time, we globally face shortages of nurses, doctors, and hospital beds, similar to the Spanish flu. Even though the PPE has improved from gauze masks during the Spanish flu to a protective N-95 respirator today, the supply of N-95 has been very limited and has therefore resulted in severe consequences for healthcare workers [2].
Vaccination
Given that the cause of the Spanish flu was unknown (and it was misdiagnosed as a bacterial illness), there was no attempt to develop a vaccine; on the other hand, in the coronavirus pandemic, innovation led to finding new ways of developing vaccines with messenger RNA. Undoubtedly, with advancements in science, technology, and research, we’ve been able to develop a vaccine within a year of the outbreak of the disease. This is a true testament to scientific collaboration, partnership within academia, and effective global communication of information [6].
Federal Government Strategy
During the Spanish flu, the President and White House were silent about the pandemic and ignored the severity of the illness — they took no measures to contain the pandemic and protect the citizens. In contrast, during the coronavirus pandemic, the White House has held presidential press briefings; however, the message has not been consistent about wearing a mask and different states have implemented a myriad of strategies to control the spread of the disease. The federal government has also gained more power and a more active role in the last century, creating federal relief and stimulus packages that have been mobilized to support the people [3].
Leadership
Now, organizations like WHO and CDC exist to establish guidelines for safe protocol during the pandemic. Amidst the crisis, there emerged strong leaders like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, whom people look up to for advice and recommendations.
What Can We Learn?
The way we handled the COVID-19 crisis globally indicates that we could have learned much more from the prior pandemic — there was an overall lack of global preparation and planning. The pandemics have taught us critical lessons for leadership: the importance of preparedness, the need for constant innovation, and the necessity of strong, transparent, and effective communication. With these skills in hand, we’ll be ready to face the next global health emergency.
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About the Author
Saloni Shah is a senior at the Harker School in San Jose, CA.
References
- Gillespie C. How are the Spanish Flu and COVID-19 alike? Here’s what doctors say [Internet]. Health.com. Health.com; 2020. Available from: https://www.health.com/condition/infectious-diseases/how-are-spanish-flu-and-covid-19-alike
- Robinson KR. Comparing the Spanish flu and COVID-19 pandemics: Lessons to carry forward. Nurs Forum [Internet]. 2020;(nuf.12534). Available from: http://dx.doi.org/10.1111/nuf.12534
- August M. The 1918 flu pandemic killed hundreds of thousands of Americans. The White House never said a word about it. Time [Internet]. 2020 Aug 11; Available from: https://time.com/5877129/1918-pandemic-white-house/
- History of 1918 flu pandemic [Internet]. Cdc.gov. 2019. Available from: https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm
- Terry M. Compare: 1918 Spanish Influenza Pandemic Versus COVID-19 [Internet]. Biospace.com. BioSpace; 2020. Available from: https://www.biospace.com/article/compare-1918-spanish-influenza-pandemic-versus-covid-19/
- Gasparyan D. Three leadership lessons from the 1918 flu pandemic. Forbes Magazine [Internet]. 2020 Jun 11; Available from: https://www.forbes.com/sites/forbestechcouncil/2020/06/11/three-leadership-lessons-from-the-1918-flu-pandemic/
