Highline College

Thursday, September 24, 2020

Pandemics of 1918 and 2020 have similarities, differences

Policemen in Seattle wearing masks made by the Red Cross, during the Spanish influenza epidemic in December 1918.
Wiki Commons photo

Ally Valiente Staff Reporter April 14

One-hundred years ago a deadly flu swept the globe, killing millions of people and sickening many more.

But while there are some similarities between COVID-19 and the misnamed Spanish Flu, there are also some important differences, a Highline professor said.

The United States currently has the highest number of coronavirus fatalities with 21,912, out of and 557,488 cases nationwide.

It has forced stay-at-home orders all over the world, and moved classes at schools and colleges nationwide to be conducted online.

The COVID 19 pandemic is often compared to the H1N1 pandemic of 1918 – also known as the “Spanish Flu.”

Highline Respiratory Care professor Dr. Ann Korn said, “Spain had nothing to do with any of it. H1N1 occurred in the waning days of World War I, and Spain had been neutral in the war. This neutrality allowed reporters from Spain to report freely on this new influenza. The governments of the countries fighting the war suppressed much of the negative information about the flu.”

Since the United States implemented “sedition laws,” which made it unlawful to say or write anything disloyal, the pandemic was dubbed the Spanish flu, because they were the only reporters and news stories providing the truth.

“Somehow reporting on a horrible pandemic and warning people seemed disloyal [in the U.S.],” Dr. Korn said.

Other groups targeted and blamed during the 1918 pandemic included every country who the US fought during the war; immigrants; the poor; and sometimes women in general.

Similarly, due to the COVID19 pandemic, Asian communities have been targets of racism and prejudice.

“I think prejudice and ignorance go hand in hand. When people are afraid, that seems to make behaviors even worse,” Dr. Korn said.

“COVID 19 is not the fault of any country, any people, any belief or culture. COVID 19 is a virus, pure and simple. Viruses were here long before us and they will be here long after us. Viruses don’t pick and choose.”

Dr. Korn said, “It is also prudent to note that H1N1’s origins are a bit murky. Many researchers believe it originated in Kansas; others believe France in a hospital camp during the war.”

The first documented case in the US was in Kansas by a local country doctor, Dr. Loring Miner, who tried sounding the alarm. Unfortunately, Dr. Miner was ignored by the US Public Health Service.

“In March, a soldier from Kansas reported to a Kansas military hospital very ill. He died shortly after he was admitted. Within days, 522 men at the camp reported to the hospital with the same illness,” Dr. Korn said.

H1N1 was considered a novel virus, much like COVID 19.

Because both were first introduced as completely brand new viruses, humans did not have immunity to either one.

“Humans need exposure for the body to recognize a virus as something that doesn’t belong and then a series of events occurs inside of the body to kill the virus,” Dr. Korn said. “This is part of the problem with both pandemics: the newness.”

Dr. Korn describes COVID 19 virus as a moving target. Without adequate testing, there is no accurate estimation as to how many have been infected or how many currently have it.

“Much of the coming death rates will depend on our behaviors. The current seasonal flu fatality rate is 0.1 percent. COVID 19 is 10 times that, and again it is very early days of COVID 19,” Dr. Korn said.

H1N1 killed more people, at least so far, Dr. Korn says.

There have been estimated totals now from the H1N1 pandemic. And most deaths occurred during H1N1’s second wave.

“The second wave was far worse for a variety of reasons,” Dr. Korn said. “At its worst, H1N1 infected about 500 million people worldwide. Estimates are about 50 million deaths. A lot of disagreement exists because of period reporting problems. H1N1 is considered to have about a 2.5 percent fatality rate, though some estimates are higher at 6 percent.”

Dr. Korn said,“Many of the patients contracted bacterial and fungal infections on top of H1N1. And there weren’t really any antibiotics to treat them. Much like today, the medical community was completely overwhelmed.”

Dr. Korn said that H1N1 had three distinct waves, the second wave in the fall of 1918 being the worst by far.

By the third wave, many more people were immune because of exposure during the first two waves. Because no vaccinations existed people, either had H1N1, taken care of people who had it or were exposed by other means.

One of the distinct differences between the two viruses were the age groups that were affected.

While COVID 19 seems to run more characteristically with fatalities in the elderly population higher than other groups, initially H1N1 killed adults, under 40 years old, though it spread out over age groups as time went on.

“Many had been malnourished during the war and many, many were in very poor physical shape. And H1N1 had been spread during the war with many young men being infected first. Pregnant women had one of the highest fatality rates, with fatality estimates around 23 to 71 percent,” Dr. Korn said.

Symptoms of H1N1 include violent headaches, severe body aches with severe shaking, high fevers, and unproductive coughing.

Oftentimes a patient who made it to the hospital would be covered in mahogany spots, caused from bleeding under the skin, and spitting blood. At times, they bled from their ears and eyes.

“So many people died, the life expectancy dropped from 50 years in 1916 to 36 years in 1918,” Dr. Korn said.

“Far more people died from H1N1 than died in the war. Many who survived were left with permanent debilitating lung damage and cognitive deficits.”

Although many began to wear masks, the spread was so vast by then that any hope of containment disappeared.

“Folks really didn’t know to protect themselves or how to protect themselves. The governments didn’t tell them the truth, didn’t provide any warning or education and when confronted with actual events, lied repeatedly. As is often the case, there were many who didn’t think H1N1 was a big deal. This approach did not work out well for the public,” Dr. Korn said.

Unfortunately, a large group of people continue to downplay the intensity of the virus and merely compare it to the seasonal flu.

Dr. Korn says that now is not the time to think of COVID 19 as a seasonal flu.

“COVID 19 is far more severe than the seasonal flu, though the seasonal flu is nothing to ignore. It is best not to think of COVID 19 as a flu, maybe then we will take it more seriously.”

Dr. Korn says that COVID 19 is part of the coronavirus family of viruses, which “by and large come around fall and winter” although it can last longer into the spring and summer.

One of the good things to come from H1N1 were universal health programs and consistent regular visits to doctors.

Dr. Korn says that people began to think of their health as something they needed to take care of and be responsible for.

“Germs theories and far better antiseptic practices began. These practices were scarce before 1918 in the US. Doctors in Europe had long been practicing antiseptic techniques during surgery,” Dr. Korn said. “In the US before 1918, doctors often were skeptical of wearing masks, gloves or soap.”

The most important thing now is to stay home and, if possible, avoid going out.

Dr. Korn says that although masks may help, nothing compares to social distancing and washing your hands.

“Sadly, a lot of things we could have learned didn’t seem to stick. Officials need to tell the truth, have solid factual and consistent messaging. Leadership is essential. Nothing helps more than planning for the inevitable and for that we need leaders who think ahead and know that pandemics come, they are a part of life,” Dr. Korn said.

“You may get through COVID 19 ok, but the woman you give it to may not. COVID 19 is so contagious. Now is the time to understand that our behaviors can make this pandemic last longer and with terrible outcomes. Or we can do our part. We all need to be part of this.”