While “ pandemic” may be a new word for some people, pandemics have been around for a long time. The most devastating pandemic of the 20th century was the Spanish flu pandemic of 1918 and 1919, and there are definitely parallels between then and now.
Spanish flu and COVID-19 — many similarities
By Pete Gawda
No one knows where the Spanish flu disease originated. During the winter of 1918, it was all over Europe. It was called the Spanish flu, according to the History Channel, because the Spanish media sources were the first to publicize the disease. It was brought to North America by Canadian and U.S. troops returning from World War I.
According to the Centers for Disease Control and Prevention, there were an estimated 500 million deaths worldwide from the Spanish flu, or one-third of the world's population at that time. The CDC stated there were 675,000 deaths in the U.S., or about 6.4% of the population at that time.
It has been widely reported that COVID-19 deaths in the U.S. have reached more than 300,000. Since the pandemic has not run its course, it is still to be determined what percentage of the current U. S. population of about 331 million will be fatalities related to the virus.
As with COVID-19, there were high mortality rates among those 65 years of age and older with the Spanish flu. However, unlike COVID-19, the mortality rate for Spanish flu for those under 5 years of age and those 20 to 40 years of age was also high. More people died as a result of Spanish flu than were killed in World War I, according to the National Archives and Records Administration. The Spanish flu afflicted 25% of the U. S. population.
While a vaccine for COVID-19 is currently being distributed; in 1918 and 1919, there was no search for vaccines or antibodies. No one knew that a virus caused the disease.
The CDC noted that the Spanish flu and COVID-19 shared many of the same practices, including isolation, quarantine, use of disinfectants, limitation of public meetings, face masks and good personal hygiene. Photographs of the era showed people like office workers, policemen and letter carriers wearing masks. Public meetings were canceled. People were encouraged to walk to work instead of using public transit, and stores and factories were encouraged to stagger their opening and closing hours.
“Like COVID-19, no one had immunity; it was highly infectious and spread through coughing and sneezing,” said Berkeley Lovelace Jr., CNBC.com health care reporter, on Sept 28.
Lovelace said several U. S. cities had mask mandates; and, like today, there were objections in some areas. He said both pandemics were highly politicized. In 1918, people called the masks “dirt traps,” and some people punched holes in them in order to smoke cigars. A lawyer in San Francisco called a city mask ordinance “absolutely unconstitutional” because it was not legally enacted.
“The most important lesson was the inability of people to realize the severity of the disease,” wrote Furruhk Malik, a cardiovascular specialist in Knoxville, Tennessee, in a Nov. 29 guest column in the Tennessean. “According to virologists, the present COVID-19 is more aggressive and lethal than the Spanish flu of 1918,” Furruhk said. Then, as now, Furruhk said people objected to social distancing and wearing face masks.
In the case of the Spanish flu, there was no CDC or national public health agency. The pandemic was dealt with on local and state levels. Lovelace said the Spanish flu had a greater impact on the economy than COVID-19 because no one was able to work from home or work remotely.
According to Encyclopedia Britannica, the Spanish flu hit in three waves. But by the spring of 1918, it had run its course and fizzled out. Those exposed to the disease had either died or developed immunity.
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On Jan. 9, 2020, the World Health Organization announced a coronavirus-related pneumonia in Wuhan, China; by Jan. 31, WHO issued a global health emergency. The pandemic has been wreaking havoc for almost a year. With numbers continuing to rise, a condition called COVID fatigue is beginning to take its toll on many people.
By Leslie Sheley
In the article, “5 tips for handling ‘pandemic fatigue,’” published Oct. 30 in “UCHealth Today,” writer Katie Kerwin McCrimmon reported that national data from the Census Bureau’s Household Pulse Survey show that the health crisis is causing a parallel mental health pandemic.
Denver psychologist Dr. Justin Ross said in the article that about 35% to 40% of people in Colorado and the U.S. report experiencing symptoms of anxiety and depression as they deal with the pandemic; up from a baseline closer to 25% before the start of the pandemic.
Ross said anxiety, depression and fatigue are the three biggest impacts on people’s mental health because of the pandemic. “Anxiety is being fueled by uncertainty, lacking a sense of control and having a number of important values in our lives threatened all at once,” Ross said. “Loss is the greatest driver of depression, and this pandemic has led to all kinds of losses: important events, connection to family, friends and community, travel, opportunities, finances, and career. The list is nearly endless.” He said the fatigue piece comes from juggling multiple demands all at once, constantly trying to figure out how to keep safe and worrying that every sniffle or scratchy throat might be COVID.
Nicole Weis, peer support program manager and clinical therapist at the National Institute for Human Resilience, Colorado Springs, said, “This past year has been unprecedented. We were not prepared for a worldwide pandemic, much less the thought that we would still be in the pandemic almost a full year later.” Weis said along with the pandemic, there has been economic fallout and stress, civil and social injustice, natural disasters across the country and a polarizing political year. “To put it simply, we’re tired. We are in cognitive overload and mental exhaustion,” she said. “We need to remember we are not alone in this and there are small things we can do to cope through the ongoing stress and fatigue.”
The National Institute for Human Resilience offers an online training program called GRIT or Greater Resilience Information Toolkit, which is meant to provide individual and community empowerment. GRIT training provides foundational education on stress, trauma and resilience, as well as key steps in reaching out and making meaningful connections in the community while focusing on strengths in self and others. Weis shared a few suggestions that GRIT encourages individuals to practice during this time:
- Move your body; this can be an exercise goal, or just intentionally moving your body throughout the day. Some of these activities can also include calming or relaxing movements, such as yoga, mindful walking or meditation.
- Refuel your social connections; social support and connections are positively associated with recovery from stress and trauma. Have a video coffee date with a friend, play virtual games with family who don’t live nearby, talk on the phone to an older relative and ask about their favorite memories.
- Talk it out; there is healing behind getting things out of the body. Talk to a friend or family member about the stress you are experiencing, as well as the good things going on. It can be calming and a relief to share similar experiences; thus, normalizing a situation. Journaling is also a great tool to get things out of your body and onto paper.
- Reframe the situation; it’s important to validate one’s stress and emotions, but to avoid spiraling into only negative thoughts, take time to think about and consider positive things in your life as well. We forget how powerful positive thoughts can be.
- Focus on what can be controlled; oftentimes when we feel stressed, we also feel a sense of hopelessness and helplessness. Focus on what can be controlled in your life instead, like what time to wake up, what to eat, how much exercise to engage in that day, breathing, etc. By giving our brain something to focus on and control, we feel more power and control over our lives.
- Be compassionate; take time to be compassionate to yourself and those around you. You may find yourself being critical about how you have managed the pandemic or other difficulties this past year. Remember, no one expected to be in a pandemic this long. Take time to show compassion to yourself and while you’re at it, find ways to show compassion to others around you as helping others boosts our own resilience.