People abandoned the flu pandemic protocol a century ago when they were fed up – and paid the price



Give a picture of the United States struggling to cope with a deadly epidemic.

State and local authorities create a slate of social-distance measures, cumulative bans, closure orders, and mask orders in an effort to prevent the length of cases and deaths.

The response has been mixed with more than a sign of widespread adherence, disturbance, pushback and outrage. As the days change from week to month, the difficulty becomes harder to bear.

Theater and dance hall owners complain about their financial loss.

Churches are closed when offices, factories and in some cases even salons are allowed to remain open.

Officials argue that children are safe in the classroom or at home.

Many citizens refuse to wear face masks even when in public, some complain they are uncomfortable and others argue that the government has no right to infringe on their civil liberties.

As familiar as it may be in 2021, during this deadly 1918 influenza pandemic the U.S. There are no real descriptions. In my research as a medical historian, I have seen again and again many of the ways that our ancestors experienced a century ago and often our current epidemic.

As the Covid-19 epidemic enters its second year, many want to know how life will go back to when it was before the coronavirus. History, of course, is not a precise model for what the future holds. But the way Americans emerged from the epidemic could indicate what life would be like after this time of disease (epidemic).

Sick and tired, ready for the end of the epidemic

Like COVID-19, the 1918 influenza pandemic hit hard and fast, with a handful of cases in a few cities spreading the disease nationwide in a matter of weeks. Many communities issued different phases of different commands – tailored to the adaptive flow of different epidemics and the course of its disease, so that the disease could be maintained.

These social-distance commands served to reduce cases and deaths. As of today, however, they have often proved difficult to maintain. By the end of autumn, weeks after the implementation of the social-distance orders, the epidemic was found to be on the rise as the number of new infections decreased.

People negotiated to get back to their normal lives. Businesses pressed officials allowed to reopen. Believing the epidemic was over, state and local officials began defending public health instructions. The nation struggled to cope with the devastating influenza.

For the friends, families and colleagues of the hundreds of thousands of Americans who died, life after the epidemic was full of sadness and grief. People who are still healthy need support and care to recover from their conflicts.

At a time when there was no federal or state security, charities worked to provide resources for their families or to take countless children orphaned by the disease.

For most Americans, however, life after an epidemic seems to be on the rise. Performing his nightly weeks at the city, sporting events, religious services, classroom interactions and family gatherings, many were eager to return to their old lives.

After taking their cues from officials announcing the end of the epidemic somewhat prematurely, Americans hurried to return to the routine of the epidemic. They filled movie theaters and dance halls, crowded stores and shops and gathered with friends and family.

Officials warned the nation that the possibility of a case and death would continue for months to come. The burden of public health, however, now rests on personal responsibility, not policy.

Predictably, the epidemic spread to the third deadly wave, which lasted during the spring of 1919, with the fourth wave hitting the winter of 1920. Some officials blamed the resurgence on careless Americans. Others rejected new cases or focused on more hygienic matters, including other diseases, restaurant inspections and sanitation.

Although the epidemic was not constant, influenza quickly became old news. Once a regular front-page feature, the report quickly dwindled toward small, scattered clippings buried in the backs of the nation’s newspapers. The toll plagued by the epidemic across the country was injured and will still die. People were mostly unwilling to return to socially and economically disordered public health measures.

It’s hard to hang there

Our predecessor may be forgiven for not keeping this course for a long time. First, the nation was eager to celebrate the recent end of World War I, an event that became even bigger than an epidemic in the lives of the American people.

Second, in the early 20th century, death from disease was a major part of life, and diseases such as diphtheria, measles, tuberculosis, typhoid, whooping cough, scarlet fever, and pneumonia regularly kill thousands of Americans each year. Moreover, neither the cause of the influenza nor the epidemic was well understood, and many experts did not agree that social distance measures had any measurable effect.

After all, there was no effective flu vaccine to save the world from the scourge of disease. In fact, the influenza virus could not be detected for another 15 years, and until 1945 a safe and effective vaccine was not available to the general population. Given the limited information they have and the means of their disposal, Americans may have tolerated public health restrictions as far as they could reasonably.

A century later, and a year into the COVID-19 epidemic, it is understandable that people are now all too eager to return to their old lives. This epidemic will inevitably come to an end, as it has been experienced with every previous man.

If we are to learn from the history of the 1918 influenza pandemic, as well as from our experience so far with Covid-19, it is that premature return to pre-epidemic life carries the risk of more cases and more deaths.

And today’s Americans have significant advantages over a century ago. We have a better understanding of virology and epidemiology. We know that social distance and masking work to save lives. Most seriously, we have multiple safe and effective vaccines that are being deployed, the pace of vaccination is increasing weekly.

Sticking to or getting rid of all these coronavirus-fighting factors means the difference between the growth of a new disease and the rapid end of an epidemic. COVID-19 is more transmissible than influenza, and many troubled SARS-Co-2 variants are already spread around the world. The terrible third wave of influenza in 1919 shows what can happen when people prematurely rest their guards.

J. Alexander Navarro, Assistant Director of the Center for the History of Medicine, University of Michigan

This article is republished from the talk under the Creative Commons license.