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Covid-19 vs. The Spanish Flu

Amberly E. Danks

Youngstown State University

NURS 4844: Community Health Nursing

Dr. Kim Ballone

September 27, 2021

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There are many commonly used phrases about history that people hear and tend to agree

with; one statement that works currently is history repeats itself. Why this statement is relevant

now is that currently the world is in a global pandemic due to Covid-19, and it has been for over

a year and a half now. A little more than 100 years ago the world was experiencing something

verry similar but with the Spanish Flu of 1918. Both illnesses have many similar factors like how

it was spread, causing the whole world to essentially shut down, and mask mandates just to name

a few. However, the two illnesses also have many differences that can be related to factors

including but not limited to modern medicine including vaccines, a larger total population, mass

transit and easier international travel, and social media leading to misinformation being spread

regarding the illness.

The Spanish Flu of 1918’s cause is still to be considered unknown with that said many

have speculations; some say that that it was caused by birds that came from France, sick pigs in

the United States, and even possibly from Chinese laborers during World War I (WWI) that

worked in England on the docks. Strange flu like symptoms were noted about 200 miles west of

Wichita Kansas and an increase in deaths occurred there too. The difference between this new

mysterious illness and the seasonal influenza was that this illness was not only affecting the

upper respiratory tract but was also found to be deep in the lungs and damaging its tissue which

then led to viral and bacterial pneumonias (Barry, 2017). Symptoms that were exhibited were

fever, sore throat, cough, and a headache. Many say the first official cases of the Spanish Flu

were in Camp Funston in central Kansas and spread to other Army camps in the United States

including 24 of the 36 large camps before it was carried overseas (Barry, 2017). The close

quarters of the camps led to a rapid spread of the illness. Many sources of evidence say that

American troops were the ones who spread the disease to France when coming over during the
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war. At the time of the spread there was a lot of names it was being called based on each country

for example Spain referred to it as the French Flu (Merc Docs, 2020). This pandemic of 1918

was very different because it first many people did not die from the illness even though large

numbers of people were infected daily.

The number of deaths changed quickly when the second wave began which was even

more deadly. The US Army report noted, “the influenza…occurred as an explosion.” (Barry,

2017). During the peak the Army reported that as many as 1,543 soldiers in a single day came

down with influenza and averaged 100 deaths a day which caused hospitals to become

overwhelmed. The worse the illness got those affected started having an overwhelming desire to

sleep, had a worse cough, sneezing, and signs of delirium. Poor oxygenation led to cyanosis of

the skin and mahogany spots appeared in their faces which usually meant death was not long

after. Also, another bad sign that pointed to the illness being in advanced stages was empyema in

the lungs which could lead to septicemia and death due to bacteria being in the blood (Merc

Docs, 2020). Depending on the community citizens were required to wear masks, quarantine,

and shut down public places; people were also told to avoid shaking hands and stay inside.

Covid-19 started at the end of 2019 when the World Health Organization (WHO) in

China found out about several pneumonia cases that had no known cause and all cases were

connected to a Huanan Seafood Wholesale Market in Wuhan China on December 31, 2019. On

January 7, 2020, authorities were able to identify that the causative agent was a novel

coronavirus. Within the next few weeks cases of the novel coronavirus start to spread all over the

world; the first confirmed case in the United States was confirmed in Washington state on

January 20, 2020. The first hotspot of Covid-19 was in Italy and their government issued a

lockdown to try and stop the spread on February 23, 2020. On March 11, 2020, The World
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Health Organization declared Covid-19 a pandemic. Only two days later March 13th the president

of the United States Donald Trump declared a nationwide emergency and on March 15th States

started to shut down to try and stop the spread. Covid-19 spread very fast through big cities in

the United States with New York being the hardest hit. Within less than two months of Italy

being on a lockdown and having extremely high numbers of cases and deaths the United States

surpassed their number of deaths on April 13, 2020, of 23,036 deaths. While the virus was still

rapidly spreading some states started to partially reopen despite many saying it was far too soon

to do so; those states were Alaska, Georgia, and Oklahoma. By May 28, 2020, the death toll

related to Covid-19 in the United States passed 100,000 and by September 22, 2020, the death

toll passed 200,000. The first Covid-19 vaccine was issued for emergency use by the Food and

Drug Administration (FDA) on December 11, 2020, which was the Pfizer-BioNTech or

commonly referred to as the Pfizer vaccine. One week later the second vaccine the Moderna

Covid-19 vaccine was authorized for emergency use by the FDA. Within a little more than one

year the worldwide number of Covid-19 cases surpassed 100 million. On February 21, 2021, the

death toll in the United States has passed 500,000 citizens. The third vaccine for use in the

United States was approved by the FDA for emergency use on February 27, 2021, was the

Johnson and Johnson one shot vaccine; both the Pfizer and Moderna vaccines required two

different shots. Currently as of September 26, 2021, the number of total cases of Covid-19 in the

United States are more than 42.9 million cases and 688,000 deaths. In the world currently there

are over 219 million cases and 4.55 million deaths. Also, with the increase in the numbers the

end of this pandemic does not seem to be in the foreseeable future.

There are many similarities between the Spanish Flu and Covid-19; the first similarity is

that both pandemics caused a mask mandate, quarantine, and closure of public places and
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gathering such as schools, religious services, public entertainment, and stores. In relation to the

mask mandate for both pandemics for both the government or local officials lifted their

restrictions to early and that resulted in an uptick of cases when with the mandate in place

numbers were lower. Also, for both pandemics their origin is not known 100%; for the Spanish

Flu they say it started in Camp Funston in Kansas but do not know the exact cause and for

Coivd-19 they say that it started in Wuhan China where cases of un unknown pneumonia were

being linked back to a food market but also do not know its exact cause. Another interesting

similarity is that Italy in both the Spanish flu and Covid were hit very hard, and Australia took

prevention measures such as lockdowns very seriously. Both pandemics also caused a shortage

of nurses and medical personnel to take care of the sick patients; during the Spanish flu many

doctors were taken away to help with the war. With Covid-19 medical staff have been leaving

the profession due to burnout or simply the shortage is because of having to many sick patients.

The differences between the two pandemics are that the Spanish Flu tended to affect and

kill the young and healthy people more than the elderly population that usually was affected by

the yearly influenza. With Covid-19 the older and immunocompromised population are the most

affected and resulting in a significant number of deaths. The second difference is that the Spanish

Flu only lasted 15 months and Covid-19 has been going on for longer than that and does not

seem to be going away anytime soon. Another difference is that with Covid-19 there is modern

medicine and the development of vaccines which was not around during the Spanish Flu. During

the Covid-19 pandemic there have been multiple different vaccines developed to try and slow the

spread; in the United States they are Pfizer-BioNTech, Moderna, and Johnson and Johnson.

These vaccines are helping to slow the spread of Covid-19 even with there being multiple
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variants. Also, during this pandemic there has been a major focus on testing and contract tracing

to determine who else has been infected to try and stop the spread.

The pandemic of the Spanish Flu caused a global threat because in less than 15 months

the entire world was affected one way or another. Another threat was that without having any

proper treatment or vaccinee in place there was no cure or a way to prevent people from getting

infected besides social distancing or implementing lockdowns and wearing masks. Due to the

lack of medical knowledge this allowed the virus to spread very quickly with little way to

medically help. World War I was happening during the time of the pandemic, so a global threat

was already happening, and this also was not helping due to having hospitals overrun with sick

patients and many doctors were taken away due to the war. The war was also a threat because of

the high numbers of sick soldiers that were traveling around the globe and therefore spreading

the illness to new people from other countries very easily.

Covid-19 also caused a global threat since it started in china and spread around the world

in a very short time span. With more advancements in international and still national travel

compared to the Spanish Flu the virus easily spread while mass amounts of people were traveling

together on airplanes, boats, subways, and trains due to the close proximity of people. Across the

globe people in most of the countries have been severely affected due to economies being

destroyed and hospitals being overrun and being over capacity. The Global Health Security

(GHS) Index has shown a positive correlation with morbidity and mortality in 178 of 193

countries relating to Covid-19. With hospitals being overrun and people in lockdowns people did

not seek medical attention for proper care and treatment; people who were needing surgeries or

chemotherapy had to wait due to Covid-19 taking over the entire heath care system globally.

Hospitals around the world were and still are experiencing shortages of supplies and medical
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equipment needed to properly treat patients. Many hospitals have experienced a shortage of

ventilators for patients, and this caused many problems being the demand for them was very high

due to the severe cases of the virus. Another global threat caused by the Covid-19 pandemic was

that the global economy was in the worst recession since World War II (CDC Museum COVID-

19 Timeline, 2021). Also, what caused a threat was in America alone many people had faced

food insecurity because of very high unemployment numbers; the number of people that were

dealing with food insecurity on October 6, 2020, was 52 million which was 17 million more

Americans than before the pandemic (CDC Museum COVID-19 Timeline, 2021).

Successful measures that occurred during the Spanish Flu were that in San Francisco

before the illness even reached the west coast the chief of the board of health took preventative

measures such as closing all public gatherings, divided the city into districts to better handle any

outbreaks that occurred, and instated a mask mandate for whenever the citizens were going out

into public. The mask mandate even became a law and if caught not wearing a mask citizens

were arrested and charged with disturbing the peace and fined. (Merc Docs, 2020). Another

success was in St. Louis before the first case was reported a health commissioner wrote to local

physicians about why it was important to stay home and be avoiding large crowds. After the

letter he quickly closed the public and even when business owners were wanting the restrictions

lifted, he did not listen to them. The actions Dr. Starkloff took early on is what helped St. Louis

not have the number of cases skyrocket like in other parts of the country. This fact about the

Spanish Flu was grim and unfortunate but, in a way, could be classified as a success because it

let people passing on the streets that people inside were either infected or dead and to not come

near; this was when residents knotted a white scarf to their door. With citizens knowing this

information they knew to avoid that specific residence.

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The Spanish Flu had many different failures that occurred one of them is that on

September 28th in Philadelphia a big Liberty Loan parade was scheduled despite many people

urging it to be cancel due to spread of the disease since it would be the largest parade ever in

Philadelphia. Within days after the parade all public gathering and schools closed in the area due

to the influenza. The health director of the city was downplaying the severity of the situation and

to not panic. At the worst of the pandemic Philadelphia had 759 deaths in a single day and many

people were buried in mass graves; within six weeks more than 12,000 people have died as a

result (Barry, 2017). This parade let the illness spread massively due to the large amount of

people in attendance and all in close proximity to one another. The next mistake that happened

during the Spanish flu was that in San Francisco they lifted their restrictions on masks and

opened the public for gathering on November 21st and it caused an increase of cases and deaths

as the third wave appeared in January of 1919. Many people fought the order of outlawing public

gatherings and social distancing and so resulted in more than 6,000 deaths in the third wave

which was said to be less severe than the first two (Merc Docs, 2020). Another failure or mistake

that happened was that misinformation was spread regarding aspirin it was said that it caused the

pandemic and was told to not take it; when in all reality it most likely would have helped the

people, who were infected by lessening their symptoms if a proper nontoxic dose would have

been taken.

Successful measures so far during the Covid-19 pandemic have been that with the use of

modern medicine and better knowledge of past pandemics that occurred measures to try and

control and minimize the spread were implemented quickly. With this pandemic another success

is that there are testing protocols in places to detect and tract patterns of infection. Relating to

testing mass sites are in place all over the world so people have many sites available to take a test
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when needed. To travel places internationally during the pandemic testing was also required to

be allowed into some countries. Also, vaccines were developed to stop the spread of the virus

and prevent severe illness. The vaccines available in the United States are Pfizer, Moderna, and

Johnson and Johnson. The Moderna and Pfizer vaccines have two doses; Moderna is given four

weeks apart and Pfizer doses are given three weeks apart. The Johnson and Johnson vaccine is

only one dose but recently has been recommended that people get a second dose for better

protection.

During this Covid-19 pandemic there have been some failures that have occurred and the

first one is that just like the Spanish Flu the government did not want people to know about the

seriousness of the current situation and were downplaying everything. The president at the time

Donald Trump was saying that the number of cases were not going to get high and that

everything would be back to normal by Easter on Sunday April 12, 2020, which was only a few

weeks away from when he declared a nationwide emergency on March 13, 2020. If action would

have been taken immediately the spread could have been slowed down and not have escalated as

much as it did. Also, another failure was that many people did not want to believe that Covid-19

was real, and it was just a made-up thing; this increased the viruses spread because people were

not listening to the mask mandates and stay at home orders that were in place starting March 15th,

2020. The same thing is happening with the vaccines that are in place many people are getting

them but about half of the country has not been vaccinated and is now causing an increase of

cases due to unvaccinated people easily spreading the virus. Another failure was allowing people

to be back in person in schools this fall because some places mandated masks and others did not.

Within just days of the start of the school year in Florida a school district around Tampa had

5,599 students and 316 staff members in isolation or quarantine from Covid-19 (Ushe, 2021).
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Part of the problem specifically in Florida is that Governor Ron DeSantis put a ban on mask

mandates. Florida is not the only state that is having this problem because since school has

started the number of covid cases have increased drastically across the country.

Overall, both the Spanish flu of 1918 and Covid-19 have shown to have many similarities

and differences but ultimately changed the entire world due to how quickly the illness spread and

the high mortality rates. From having knowledge of the Spanish Flu from a little more than 100

years ago when Covid-19 appeared there was some information regarding how to try and slow

the virus from spreading. In the future when people are looking back at history both pandemics

will hopefully show what not to do and what can be done better so history hopefully will not

repeat itself as it usually does.

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References

1918 Pandemic Influenza Historic Timeline | Pandemic Influenza (Flu) | CDC. (2018, March

20). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/pandemic-

resources/1918-commemoration/pandemic-timeline-1918.htm

All About History, A. A. (2020, March 12). Spanish flu: The deadliest pandemic in history.

Livescience.Com. https://www.livescience.com/spanish-flu.html

Barry, J. M. (2017, November). How the Horrific 1918 Flu Spread Across America. Smithsonian

Magazine. https://www.smithsonianmag.com/history/journal-plague-year-180965222/

CDC Museum COVID-19 Timeline. (2021, August 4). Centers for Disease Control and

Prevention. https://www.cdc.gov/museum/timeline/covid19.html

Cuffari, B. M. (2021, May 18). How has the COVID-19 Pandemic Impacted Global

Health? News-Medical.Net. https://www.news-medical.net/health/How-has-the-COVID-

19-Pandemic-Impacted-Global-Health.aspx#:%7E:text=The%20COVID

%2D19%20pandemic,with%20reduced%20social%20contact.

History.com Editors. (2021, June 2). Spanish Flu. HISTORY.

https://www.history.com/topics/world-war-i/1918-flu-pandemic

Merc Docs. (2020, April 20). Spanish Flu 1918: The Forgotten Pandemic [Video]. YouTube.

https://www.youtube.com/watch?v=Zvt0ldtJFIM

Roos, D. (2020, May 27). How U.S. Cities Tried to Halt the Spread of the 1918 Spanish Flu.

HISTORY. https://www.history.com/.amp/news/spanish-flu-pandemic-response-cities
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Ushe, N. (2021, August 17). Over 5,000 Students in Florida School District Are in Isolation or

Quarantine Due to COVID. PEOPLE.Com. https://people.com/health/over-5000-

students-and-300-staffers-in-one-florida-school-district-are-in-isolation-due-to-covid/