Imagine the United States struggling to cope with a deadly pandemic.
State and local officials adopt a list of social distancing measures, compiling bans, closure orders, and mask warrants in an effort to curb the tide of cases and deaths.
The audience responds with widespread compliment mixed with more than a touch of ruminating, recoil, and even direct defiance. As the days become weeks they become months, the stretches become more difficult to tolerate.
Theater and ballroom owners complain about their financial losses.
Clergy lament the closure of churches while offices, factories and, in some cases, even halls are allowed to open.
Officials argue whether children are safer in classrooms or at home.
Many citizens refuse to wear masks when in public, some complain that they feel uncomfortable and others argue that the government has no right to infringe on their civil liberties.
As familiar as it may seem in 2021, these are real descriptions of the U.S. during the deadly flu pandemic of 1918. In my research as a medical historian, I have seen over and over again the many ways in which our current pandemic it has reflected what our ancestors experienced a century ago.
When the COVID-19 pandemic reaches its second year, many people want to know when life will go back to how it was before the coronavirus. The story, of course, is not an exact template for the future. But the way Americans came out of the previous pandemic could suggest what post-pandemic life will be like this time.
Sick and tired, ready for the end of the pandemic
Like COVID-19, the 1918 flu pandemic quickly affected and went from a handful of cases reported in some cities to an outbreak across the country in a matter of weeks. Many communities issued several rounds of various closure orders, corresponding to the ebbs and flows of their epidemics, in an attempt to control the disease.
These social distancing orders worked to reduce cases and deaths. Just like today, however, they were often difficult to maintain. In late fall, a few weeks after social distancing orders came into force, the pandemic seemed to end as the number of new infections dwindled.
People demanded a return to their normal lives. Companies pressured officials to reopen it. Believing the pandemic was over, state and local authorities began revoking public health edicts. The nation focused its efforts on fighting the devastation the flu had caused.
For the friends, family, and co-workers of the hundreds of thousands of Americans who had died, post-pandemic life was filled with sadness and pain. Many of those still recovering from their attacks with the disease required support and care as they recovered.
At a time when there was no federal or state safety net, charities began to act to provide resources to families who had lost food winners or to take in the countless children who were orphaned by the disease.
However, for the vast majority of Americans, life after the pandemic seemed to be a breakthrough toward normalcy. Many hungry for weeks of nights in the city, sporting events, religious services, classroom interactions and family reunions, many were eager to get back to their old life.
Taking the cues from officials who had declared, somewhat prematurely, the end of the pandemic, the Americans were quick to return to their pre-pandemic routines. They packed up in movie theaters and dance halls, crowded into shops and stores and gathered with friends and family.
Officials had warned the nation that cases and deaths would likely continue over the coming months. However, the burden of public health did not depend on politics, but on individual responsibility.
Predictably, the pandemic continued and spread in a third deadly wave that lasted until the spring of 1919, with a fourth wave hitting the winter of 1920. Some officials blamed the resurgence of neglected Americans. Others downplayed the new cases or focused their attention on more routine public health issues, including other illnesses, restaurant inspections and sanitation.
Despite the persistence of the pandemic, the flu quickly became old news. Once it was a common feature on the front pages, the report was quickly reduced to small sporadic clippings buried in the back of the country’s newspapers. The nation continued, settled on the toll that had suffered the pandemic and the deaths to come. People were not very willing to go back to socially and economically harmful public health measures.
It’s hard to hang on to
We may be forgiven for our predecessors for not staying longer. First, the nation was eager to celebrate the recent end of World War I, an event that perhaps stood in the lives of Americans rather than the pandemic.
Second, death from disease was a much more important part of life in the early twentieth century, and scourges such as diphtheria, measles, tuberculosis, typhoid, whooping cough, scarlet fever, and pneumonia they killed tens of thousands of Americans every year. Furthermore, neither the cause nor the epidemiology of influenza was known, and many experts were not convinced that social distancing measures had any measurable impact.
Finally, there were no effective flu vaccines to rescue the world from the ravages of the disease. In fact, the flu virus would not be discovered for another 15 years and a safe and effective vaccine was not available to the general population until 1945. Given the little information they had and the tools at their disposal, the North -Americans may have endured public health restrictions for as long as reasonably possible.
A century later, and a year after the COVID-19 pandemic, it is understandable that now people are eager to return to their old lives. The end of this pandemic will inevitably come, as has happened with all the previous ones that humanity has experienced.
However, if we have anything to learn from the history of the 1918 influenza pandemic, as well as from our experience so far with COVID-19, it is that a premature return to pre-pandemic life leads to more cases and more dead.
And today’s Americans have significant advantages over those of a century ago. We know virology and epidemiology much better. We know that social distancing and masking work to save lives. The most critical thing is that we have multiple safe and effective vaccines that are being deployed, with an increasingly weekly vaccination rate.
Respecting all these anti-coronavirus factors or suppressing them could mean the difference between a new disease and a faster end to the pandemic. COVID-19 is much more transmissible than influenza and several worrying SARS-CoV-2 variants are already spreading around the world. The deadly third wave of flu in 1919 shows what can happen when people prematurely relax their guard.
J. Alexander Navarro is deputy director of the University of Michigan Center for the History of Medicine in Ann Arbor, Michigan. It was first published by The Conversation: “People gave up on pandemic flu measures a century ago when they got tired of them. – and I paid a price ”.