Why We Can’t Compare the “Spanish Flu” Waves to This Pandemic

The 3 Waves of the “Spanish Flu”
Most people had no idea that the first wave was happening, thus a faulty comparison to now.
Centers for Disease Control and Prevention / Public domain

We’ve heard the predictions of multiple COVID-19 waves for months. Our current stage is being disputed, with some people calling this the 2nd wave, while others argue that we’ve haven’t left the first. Regardless, the comparison between this pandemic and the “Spanish Flu” has been ongoing throughout this crisis. This focus on the waves of the 1918-19 influenza pandemic has particularly been used as a PSA of what not to do now. However, as I wrote in my post “Your Wise Friend Was Wrong” about a “Spanish Flu” meme that was circulating, this ahistorical comparison assumes too many similarities between then and now. Yes, we can and should learn from historical outbreaks, but we have to first understand what was known about disease at the time and what was communicated to the public.

Influenza (also called “la grippe”) was a familiar disease in 1918, predictably seasonal and usually mild. Doctors were not required to report deaths from influenza to the U.S. Public Health Service, even though it became epidemic in several years, including 1915-16. Influenza was not usually fatal, at least not for those outside of vulnerable populations.

The First Wave (from a contemporary understanding)

The H1N1 virus that attacked in 1918-19 was unique in its frequent complication of a deadly pneumonia and its high mortality among young adults. Outbreaks of this influenza/pneumonia likely first occurred in Kansas, at Camp Funston and the nearby Haskell Institute. Throughout the next two months, other military camps experienced high numbers of cases. These clusters of disease and death received almost no media coverage, other than a few stories that presented the outbreaks as isolated incidents, downplaying the severity of this new threat.

This article appeared at the bottom of page 2 of the Topeka State Journal on April 4, 1918. Coverage of (what we now identify as) the first wave was limited.

By the end of May, the outbreaks dwindled in the U.S.

Looking back, we now recognize these Spring outbreaks as the “first wave” of the influenza pandemic. However, in the moment, the lack of media coverage meant that most Americans had no knowledge of the rising cases. Most attention was directed to supporting the soldiers in World War I.

For the people of 1918, the influenza pandemic appeared to begin in June. Stories in The New York Times, Washington Post, and other U.S. papers reported on June outbreaks in China, Madrid, Morocco, India and Berlin and then throughout Europe in July. While cases appeared back in the U.S. at the end of the month, American media outlets only covered the epidemics elsewhere.

The Second Wave (but it seemed like the first)

It wasn’t until an eruption of U.S. cases in mid-September that the government and press publicly acknowledged that the epidemic had arrived. From September through November, the “Spanish Flu” raged throughout the United States. Quarantine was imposed at various degrees, as stores, public venues, and schools closed for 1-2 months. The people felt and lived this wave, as it affected the everyday lives of even the healthy.

The Third Wave

A third wave followed in the Spring, much of which was attributed to the mass transport of troops following the end of the war. Life didn’t shut down for this reemergence, however, at least not on a mass scale.

Why we can’t compare the pandemics

Outside of their available newspapers and magazines, the people of 1918 had very little media access. Information beyond what was in print simply wasn’t conveyed to the public, including the prevalence of influenza in Spring of 1918. To them, as presented in media, the first wave didn’t exist, the “Spanish Flu” began overseas, and even at the height of the epidemic, the war dominated all news.

With our abundant media outlets and individual-created content, we are in a different world than 102 years ago. We have known about COVID-19 since 2019, tracking its spread and watching its devastation. In other words, we cannot compare the notion of waves in 1918 as applying to this pandemic, at least not in the response of the public back then to now. What we can take away, however, is that the “Spanish Flu” eventually did subside, as will COVID-19.

Why We Need Journalism More Than Ever

Until the number of U.S. cases and deaths recently skyrocketed, many people have been dismissive of encroaching pandemic. A Pew Research survey from the week of March 10-16 showed that 37% of the 8,914 adult participants believed that media greatly exaggerated the risks of coronavirus. Perceptions of media coverage have varied by the amount of news and the specific source primarily consumed. As the tides are tragically turning, with cases skyrocketing in the U.S., this is not a time to criticize or dismiss messages, nor clump all outlets and content into a faceless “Big Brother” media entity.

I’m not advocating that we heed all advice, especially the (mis)information spread by social media. What I mean is that we need to stop demonizing journalists and recognize that we have never needed them more. If we’re lucky enough to be stuck at home, professional and citizen journalists are our link to local, national, and international information. Without our own eyes and ears in the world, we must rely on others to tell us what is going on, especially when the stakes are so high.

To keep reporting and producing media content during an outbreak is an act of bravery. In 1793, Andrew Brown was the only printer to keep producing his daily newspaper throughout the yellow fever epidemic. In an era centuries before computers, the Federal Gazette became the only means of informing and connecting the people of Philadelphia.

While we certainly have an abundance of choices now, it doesn’t make the work less dangerous. Journalism is an essential service. As Chris Kieffer wrote in this letter of appreciation to the staff of the Daily Journal of Tupelo, Mississippi, “Great reporting and photography can’t be done from a safe ‘social distance.’” Reporters have already become sick on the job. And yet, our focus has largely been on criticizing this risky work.

Instead, we should be supporting journalists and producers of media content at this critical time. We need to recognize the value of all people who continue to work to make our society function. Without credible media sources to turn to, we won’t know how the pandemic is impacting lives outside of our own bubbles (which are quite small these days). We won’t know who needs help or ways to help from afar. We won’t know what to do if we have symptoms or where to go. And, without news, we won’t know when the crisis finally subsides and life can return to our new normal.

Social media is great for connecting with friends and family, but it is not a substitute for local, national, and international news content. Recognize the value of those producing content so that most of us can have the luxury of staying home and the benefit of learning through media channels when it is once again safe to experience life first-hand once more.

What the Archives Didn’t Teach Me About Life in a Pandemic

In researching my book, I spent months studying primary sources: newspaper articles, pamphlets, public health records, personal correspondence, diary entries and other materials. I never expected that I would see first-hand what a global contagious threat would look like in my life time. I had an idea of the progression of quarantine and the pattern of media coverage. At the same time, no book or microfilm prepared me for a number of aspects in this experience.

  • The Waiting Game: Nothing that I’ve read addressed what it is like to feel fine, have your family feel fine, but know that the danger is coming. . .for months and is not a matter of if, but when. I’m sure the people in the army camps of 1918 that got hit with the March/April wave of influenza felt similarly–just no one wrote about it.
  • Balancing Crisis Mode with Everyday Life: In the yellow fever epidemic of 1793, townsperson Elizabeth Drinker made daily notes in her diary that combined mundane activities like taking a walk with notes about the latest death toll and friends who had passed. I never imagined how strange it would be to do the basic things we have to do, like buy dog food, within the context of the COVID-19 cloud. Everything is the same, yet it’s not the same.
  • Some people are fools. Newspapers of the past occasionally mentioned individuals that broke quarantine and were then arrested. Since they didn’t have social media in 1925, for example, there weren’t Instagram photos capturing crowds flaunting their poor choices and lack of consideration for others.
  • Parenting in a pandemic: This is a big one that NO ONE talked about in the past. Children were part of past epidemics, of course, and were mentioned when they became ill and died, but the stories of active parenting during such a time were not documented and a preserved. As parents, it’s a tricky time. Not only are we juggling childcare and work, but we are also trying to balance crisis and despair with making sure our kids are fed, engaged, and have pretty good days. We have the added challenge of explaining and demonstrating this new reality without terrifying them and inciting panic. At the end of the day, our kids deserve to think that the world is good, they are safe, and this will pass.
  • How much I would miss the world during social distancing. I am certain that the groups of students quarantined at the University of Kansas and other schools felt lonely, bored, and isolated. However, we don’t have their personal testimonies about the experience. We are privileged to be safe here as a family. Yet, I will fully admit that I mourn our normal reality.
    Being extra-extroverted, I knew that I would have these feelings. But it’s not just my friends that I miss. I love being part of a community–like a normal one, in which you see the same faces at stores, parks, karate, and on campus. I miss teaching to human students sitting in front of me, even if they fall asleep sometimes. I want maskless faces to slightly breech the six-foot distancing just to chat for fun, comment on the weather, or to just return a “hello.” Someday we’ll get back to a new version of that world.

What does this all mean, aside from my own lamenting? We need to be writing our stories and recording the diverse experiences of others so that future generations can better understand what living at this time was like.

Nothing is normal. We’re in a pandemic. Shifting Expectations in the Midst of Crisis

In 1751, George Washington’s diary entries stopped for 24 days because he was ill with smallpox. Forty-two years later, the yellow fever epidemic in Philadelphia forced President Washington to relocate to Mount Vernon. Disruption due to disease was frequent and expected.

This pattern continued with other epidemic moments as well. When influenza hit in 1918, Kansas, like many states, canceled all group meetings and conferences, closed businesses and schools, and prohibited public loitering. The University of Kansas canceled all classes and mandated quarantine. Even though students were stuck on campus, they were not expected to continue their studies. Healthy male students practiced drills and smuggled cigarettes into the makeshift hospital for their ailing friends. Female students cared for the sick, but were also encouraged to go on hikes and roast hot dogs.

In the midst of an epidemic, historical precedent suggests that life dramatically shifts to revolve around the outbreak itself. We are in that moment. For months, we’ve seen it coming. Videos and images from other countries have been showing us what will happen, how bad it will become.

I’m not advocating that we completely shut down working from home, online learning, or virtual activities. However, we do need assume that everything we do, task we assign, and decision we make is shaped by the current and future reality of this global pandemic. Our expectations in our normal, pre-social distancing world do not directly carry over.

Even if we are fortunate to not be sick, the current situation dramatically influences all of our routines. A month ago, this was my typical Friday morning: Wake up, care for dogs, make breakfast, wake up kids, get kids and husband off to school, exercise dogs, do some writing or other work, drive to campus, hold office hours, teach, stop at the grocery store, eat lunch. Now my Friday morning consists of juggling parenting, attempted home-schooling, attempted online teaching, and attempted writing. Added to the mix are my worries and concerns unique to this time: Will the kids get to see their teachers or friends? Am I doing enough to help them through this? And then, the questions plaguing all of us: Will the stores have milk? What about people who are less fortunate than we are? How will local businesses survive? What will happen to the economy? Does it make sense to plan anything in the next 6-8 months?

At the same time, our face-to-face outlets for dealing with stress and working through situations have been cut-off. Without lunches with friends, gym workouts, or (gasp) in-person meetings, it’s hard to emotionally process it all. I’m glad that we can have online classes, connect over social media, and take virtual karate. But let’s not pretend it is the equivalent of the real experiences that we all crave right now.

My point is that we need to adopt a communal understanding about this time. Our standards and goals, even for daily productivity, should not be the same because our lives are not the same. What we do now will inevitably affect the future, but it doesn’t mean we are setting the bar (or lowering the bar) for next year and beyond. In other words, we need to asterisk * the things we think, decide, do, and communicate with the pandemic grain of salt.

This * is already happening for many people. If you are sick or care for someone who is, or if you work in healthcare, you are already there, where the details of a pandemic are all that concern you. A month into the yellow fever epidemic, every article in the Federal Gazette mentioned disease–even those that talked about a local fire. Every poem and parable printed focused on the epidemic. Ads only addressed “remedies” and other related goods and services. Even if we are lucky enough not to be in this place and can play with the kids, teach our online classes, and do “regular things,” we need to remember that not everyone shares our fortune.

This is a strange time full of uncertainties. Enjoy the moments that feel a bit normal, especially if they bring hope and optimism. But let’s also give ourselves permission to take a breath and just try for average, not exceptional, since every accomplishment is extraordinary right now. If Washington could ease up multiple times because of disease, then so can we.

Stop Telling People to Wash Their Hands: The Myth of Responsibility in the Pandemic

Image may contain: one or more people, possible text that says 'Exhibit A...Coronavirus swab. Yes that is where the swab goes. So unless you'd like this done to you... u...stay home and wash your hands!!! Please. Facebook/MedicalMemes'
Meme going viral right now

This meme is going around social media. Along with these:

Plus parody songs that time washing hands, instructional videos on how to get that lather, and a shortage of anti-bacterial soap that demonstrates people are listening.

So I don’t seriously think you should stop washing your hands. It should have been standard practice. And yes, we could all use a little reminder to linger at the sink and up our thoroughness.

That said, I have several issues with this message as the dominant one we’re still reciting, meming, and sharing. Back in January, this “wash your hands” campaign was a good introduction to the escalation about to come. And yet we’ve spent more time repeating this phrase than sharing vital information from the CDC, World Health Organization, public health departments, and other sources.

We are past the initial stage of the crisis and should be focusing on identifying symptoms, where to go for testing, how to protect yourself from infecting others, and what to do for yourself if you don’t need hospitalization. This is the information we should be spreading online.

Using risk language (like in the meme above) simplifies disease transmission into a Magic Bullet Model. Under this falsely-conveyed causation, if you test positive for COVID-19, then you must have failed at washing your hands or not touching your face. This is not how disease works. Transmission, susceptibility, and immunity are complicated. We don’t know exactly how each person got infected so we need to stop assigning blame for those yet to be infected. And with that, stop blaming people from other countries too. It won’t protect you. Instead, treat everyone like they are Tom Hanks, Rita Wilson, or Idris Elba.

Here’s the deal: We need regular people to feel comfortable coming forward and sharing their personal experiences so stop stigmatizing individuals who have tested positive (and the many who likely have the disease but aren’t being tested). It is helpful to hear about the varied unfolding of this disease and how it affects different people. We should be thinking about how we can best be prepared and help out, not accusing others of improper hand washing. The when is here. It’s time to shift our own messages accordingly.

(And, yes, we wash our hands).