Two pandemics a century apart

Since the beginning of the coronavirus pandemic in the United States in February, there have been many comparisons to the Spanish Flu pandemic that swept across the country in 1918.

According to the Centers for Disease Control, the Spanish Flu was caused by an H1N1 virus with genes of avian origin. It spread worldwide in 1918-1919 although it is unknown where the virus actually originated. The number of deaths was estimated to be at least 50 million worldwide. Although there is some debate by some researchers in recent years that the number of worldwide deaths was actually more than double the reported number.

The first known case of COVID-19 was traced back to Wuhan, China in November 2019. Since then, there have been over 3.5 million cases worldwide.

Arrival in United States

The Spanish Flu first appeared in the United States in the spring of 1918 when it was identified in military personnel. It is estimated that about 500 million people, then one-third of the world’s population, became infected with this virus with about 675,000 deaths occurring in the United States.

On Jan. 20 of this year, the first case of COVID-19 in the United States was confirmed in Washington State. Since then nearly 1.2 million cases and 70,000 deaths have occurred in the United States.

“Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic” the CDC website states about the Spanish Flu.

The mortality rate of COVID-19 is highest in those 65 years and older, many with other contributing health factors.

With the Spanish flu, like the coronavirus, there was no vaccine nor effective course of pharmaceutical treatment. Worldwide efforts to control it were the same as those being used during the current pandemic, such as isolation, quarantine, good personal hygiene, use of disinfectants and limitations of public gatherings.

Businesses and public gatherings were ordered to close or cease, much like those in the current crisis.

The first wave of the Spanish flu in the spring of 1918, was considered mild with those infected suffering from typical flu symptoms. Patients usually recovered after several days. It was the second wave that struck in the fall that appeared to be more contagious with a higher death rate.

Viruses in Kentucky

According to the Influenza Archive website produced by the University of Michigan, the state of Kentucky was hit hard by the Spanish flu.

According to the site, Camp Zachary Taylor, a military training camp in Louisville with over 45,000 enlistees and officers, reported over 100 soldiers had contracted the flu on Sept. 24, 1918. A day later that number had more than doubled to 262. By the end of that month, it was reported the camp hospital was caring for more than 2,100 cases of the flu. In order to stop the spread to the city of Louisville, camp officials ordered a partial quarantine.

To further assist with containing the Spanish Flu, the city agreed to try to prevent overcrowding and deal with the poor ventilation in the city’s streetcars and public places. Movie house managers were asked to prevent congestion and to ventilate thoroughly their theaters between films. The Street Railway Company was asked to keep windows in their streetcars open at all times. City Health Officer T. H. Baker issued a prohibition against public funerals in order to prevent an assembly of people, several of which would likely have had contact with the disease. Residents were also advised to walk rather than take public transportation, to stay home if they felt ill and to avoid crowds. Local Boards of Health across the state were ordered to report any cases to the state board of health and to placard and quarantine any infected households for a minimum of 10 days, according to the Influenza Archive website.

The city-wide ban in Louisville ended in November 1918 when churches began worshiping after five weeks on Nov. 10 with businesses and other entities opening Nov. 11. In December, the city saw a second spike in cases, particularly in schoolchildren. Schools were closed and there was a two-week ban on children under the age of 14 from going to the theater or public gatherings.

A milder third spike in cases appeared again in late February 1919 but did not result in any closures. According to that University of Michigan website, it was spring of that year before “things returned to normal.”

The Kentucky Press Association recently shared on social media a proclamation published in Middlesboro and shared with KPA by Jeanna Cornett, the executive director of the Bell County Public Library District.

The proclamation read: “As Mayor of the City, I have received information of the existence of a number of cases of Spanish Influenza in the territory outside of Middlesboro, and there being a few cases in the city, and in order to prevent an epidemic in the City, it is hereby ordered and directed, that the Schools in the City of Middlesboro, the Churches, Picture Shows and Pool Rooms be suspended and closed and all persons are warned and forbidden to assemble in these various places from the morning of Oct. 8 until the morning of Oct. 21, 1918.

“The Health Officers and Physicians will make a complete canvas of the situation from day to day and should it develop that conditions warrant, this order will be revoked at the very earliest possible date if we believed that all danger of an epidemic has passed. We hope that all persons will cooperate with the authorities and Physicians to the end that the disease shall not make any headway in this community. E.S. Helburn, Mayor.”

The first case of COVID-19 was confirmed in Kentucky on March 6. As of Tuesday, there are 5,245 confirmed positive cases and 261 deaths statewide.

On March 16, Gov. Andy Beshear announced that all bars and restaurants would close to in-person business. Child care facilities were closed statewide and local schools and college campuses began suspending in-person classes. Additional business closings were announced in the following days. Mass gatherings were prohibited.

There are pictures from media sources throughout the country that shows citizens during the time of the Spanish flu wearing cloth masks to protect them, much in comparison to current photos.

Arrival in Ohio County

In Ohio County newspapers from 1918, the first mention of the Spanish Flu was in March 1918, in just one issue. In October and November 1918, every edition lists cases and deaths related to the flu.

The Oct. 11, 1918 issue of the Hartford Republican had a headline, “Entire country in grip of flu” followed by a headline two weeks later, “How to prevent the dreaded Spanish Flu.”

The Hartford Herald had reports in its Oct. 20, 1918 edition from communities throughout the county who reported closing “schools, prayer meetings, churches and public gatherings on account of the Spanish Flu.”

The Nov. 27, 1918 issue of the Hartford Herald reported, “No jury trials on account of the flu epidemic.” In that same issue, a story states, “The flu epidemic seems to have taken on new life in Hartford and there are at present several cases in the city. The malady, however, seems to have lost some of its force, and those who have it now are not in so much danger as when the epidemic first started.”

The Spanish flu was still specifically mentioned by name in issues of local papers up to the spring months of 1919.

The first case of COVID-19 was confirmed in Ohio County on April 1. There have been 74 confirmed cases and no deaths from the virus reported in the county as of Tuesday morning.

Canceled events

Gov. Andy Beshear has often used a graph of the cases of the Spanish Flu in his daily press conferences which shows how St. Louis and Philadelphia dealt with the virus.

The graph shows a high spike in cases in Philadelphia causing an overrun in the healthcare industry while St. Louis’ graph showed a flatter curve with a later spike in cases.

With pressure to appear patriotic at wartime, Philadelphia planned a Liberty Loan Parade in September 1918 to promote the government bonds that were being issued to pay for World War I. Approximately 600 sailors at the local shipyard were believed to have contracted the flu, but the parade went ahead as scheduled. According to the University of Pennsylvania, it brought approximately 200,000 people to the city’s streets. The parade is believed to have caused the severe spike in Spanish Flu in the city creating a healthcare crisis at area hospitals. Within six weeks of the parade there were at least 47,000 additional cases and 10,000 in the area.

With the pandemic at its peak, St. Louis decided to cancel its parade. The cases of the flu in that area did not rise above 700, according to the CDC.

During the current worldwide pandemic, local and national sporting events including the NCAA Basketball tournament in March, portions of NBA and Major League Baseball seasons as well as the Kentucky Derby and its festivities were canceled or postponed as well as events such as parades and commencement ceremonies.

The Spanish Flu pandemic seemed to dissipate in the summer of 1919 when it is believed people developed a high immunity to the virus.

Doctors have pointed out while there are some comparisons to the two pandemics, especially in the way in which the country has responded to it, it is important to note that they are two different types of viruses that impact the body differently. COVID-19 is not an influenza, it affects the body like a type of acute pneumonia.