Bridging the Gap - Health Equity for all

The Monumental Response to COVID has its Roots in the Spanish Flu

Of the many images circulating during COVID-19, a standout one illustrated a bunch of people wearing masks just like we were, only the grainy, murky picture was taken 100 years ago during the Spanish flu. The image of healthcare workers struggling to contain a global pandemic was eerily close to what we were seeing in front of our eyes in 2020. The Spanish flu showed us that COVID wasn’t the first time that humanity had gone through a world-changing pandemic. Echoes from the past. The Spanish flu remains one of the all-time deadliest pandemics in human history, and it transformed the global mentality on infectious diseases. The innovations and dramatic shifts in culture and mindsets during the Spanish flu laid the groundwork for our response to COVID. It illustrated the importance of preparedness, international cooperation, and pushing scientific advances to combat infectious diseases. What was the Spanish flu? The H1N1 influenza pandemic that infected millions across the world from 1918 to 1919 involved an especially virulent strain of the influenza A virus. The first wave of infections featured typically mild cases, but the second wave later in 1918 was far more lethal. What did the Spanish have to do with it? Contrary to the name, this flu didn’t start in Spain and its exact origins remain unclear. Some of the leading hypotheses suggest it began in World War I camps or came from China or the US. The “Spanish flu” moniker is believed to be the result of a Spanish news service cable that reported early on about a “strange new form of disease”. Ripping through populations. Whatever its true origin, once the Spanish flu hit in 1918, it spread rapidly across the world. Overcrowded military camps and urban zones made for prime breeding grounds in which the virus could facilitate its swift transmission. Our medical ignorance and lack of effective public health control measures meant the situation became drastic in a short space of time, and millions of lives were taken. <figure><img alt="The 1918 Pandemic | Source: National Museum of Health and Medicine, Armed Forces Institute of Pathology" class="img-responsive" src="https://cdn.storymd.com/optimized/Nq4Oa6f7dK/thumbnail.jpg" /> <figcaption>Emergency hospital during the 1918 pandemic. Source: National Museum of Health and Medicine, Armed Forces Institute of Pathology</figcaption> </figure> Deaths from the Spanish flu. Over 50 million people worldwide are thought to have died from the Spanish flu, and 33% of the global population were infected. In the US, around 675,000 died. A famous yet puzzling aspect of this pandemic was that the mortality rate among young adults was particularly high. A common line of reasoning is that this was because of an overreaction of these people’s immune systems (a “cytokine storm”). This theory has been disputed as an insufficient explanation by other researchers, however. Societal impact of the virus. The monstrous scale of the 1918 pandemic overwhelmed healthcare systems and caused shortages of medical supplies, beds, and personnel. Just like in March 2020, businesses shut down, schools closed, and public gatherings were forbidden to contain the spread. Fear, paranoia, and uncertainty gripped people’s minds. Lessons learned. The Spanish Flu catapulted us forward in learning how to conduct disease prevention and control. From this experience, we learned about the importance of timely detection, having robust surveillance systems, and employing coordinated responses. We recognized that we couldn’t beat such viruses alone, and since that time, organizations like the WHO were established to facilitate collaboration on global health issues. <figure><img alt="Corona Test, Pandemic, Corona | Source: Kollinger/Pixabay" class="img-responsive" src="https://cdn.storymd.com/optimized/6qy0yvt5d1/thumbnail.jpg" /> <figcaption>Healthcare worker administering test during COVID pandemic. Source: Kollinger/Pixabay</figcaption> </figure> Relevance during COVID. The factor of international cooperation rose to much greater heights during COVID, which happened in a world too interconnected for borders to stop pathogens. Global collaboration and the pooling of data, resources, and expertise proved essential in containing the virus and developing and distributing vaccines. Vaccines during the Spanish flu. Immunization efforts were made during the 1918 pandemic, but they were based on a false understanding of the flu. For many years, the flu was thought to be caused by a bacterial infection (a 19th-century German scientist dubbed it “bacillus influenzae”). Early attempts to develop a vaccine during the Spanish flu era were therefore flawed. It wasn’t until the 1930s — when we realized the flu is the product of a virus, not bacteria — that progress toward an effective vaccine really began. Genesis for vaccine research. Despite the fumbled start, the devastating effect of the Spanish flu spurred unprecedented levels of scientific inquiry into the nature of viruses and the vaccines that could stop them. Research efforts were galvanized, and the subsequent breakthroughs in vaccine technology and antivirals have transformed our ability to prevent and control infectious diseases. That legacy lives on today with the landmark COVID-19 vaccine, which has returned our world to near-normality. <figure><img alt="How do vaccines work? | Source: Vaccines.gov" class="img-responsive" src="https://cdn.storymd.com/optimized/koX324fEA8/thumbnail.gif" /> <figcaption>How do vaccines work? Source: Vaccines.gov</figcaption> </figure> Enjoying the fruits of success. It doesn’t often feel like it these days, but being born at a time after all that painstaking development and research was conducted makes us very lucky. As much as COVID blindsided us, we were still able to respond and overcome it based on what we had learned in the past. The Spanish flu was a different story altogether. The world had never seen anything like it, and we were totally unprepared to handle it. The horrors endured by that generation fueled the advancements that allowed us to overcome many other infectious diseases since. <h2>More on the Influenza Pandemics</h2><ul><li><a href="https://soulivity.storymd.com/journal/yj5dopkinm-pandemic-influenza" target="_blank">Influenza Pandemics</a></li><li><a href="https://soulivity.storymd.com/journal/bmp8k5q06j-influenza-flu-vaccines" target="_blank">Understanding the Different Types of Influenza (Flu) Vaccines</a></li><li><a href="https://soulivity.storymd.com/journal/6weypnqi5j-social-distancing-quarantine-and-isolation" target="_blank">Social Distancing, Quarantine, and Isolation for Contagious Diseases</a></li></ul>

storymd