Analysis of Spanish Flu 1918 and COVID Pandemic 2020

Hayley Socha

Youngstown State University

NURS 4844

Dr. Kim Ballone

September 27, 2021

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Introductions

A pandemic is the term used when a disease has affected several different countries.

Some examples of pandemics are the 1889 Russian Flu, the 1918 Spanish Flu, the 1981

HIV/AIDS outbreak, and the COVID-19 pandemic we are all currently affected by. Those are

just a few pandemics throughout our history. COVID-19 has just passed up the 1918 Spanish Flu

as the deadliest disease in the United States. The Spanish Flu has been brought up a lot lately due

to the similarities of the changes it has caused across the world. This paper will go more in detail

about the similarities and differences between these two pandemics.

Respiratory System

One similarity between the COVID-19 pandemic and the 1918 Spanish Flu is that they

are both viruses that affect the respiratory system. They are both spread by respiratory droplets.

This means these diseases can be spread by someone coughing, sneezing, and even talking.

Some respiratory symptoms of COVID-19 according to the CDC are cough, shortness of breath,

sore throat, congestion, runny nose, trouble breathing, and chest pain (CDC, 2009, para.1). Some

Spanish Flu respiratory symptoms as stated by the CDC include cough, sore throat, and runny or

stuffy nose(CDC, 2021, para.1). Because both of these diseases spread by respiratory droplets,

mask mandates were put into place during both pandemics.

Shut-downs

COVID-19 caused so many things to shut down in the past two years. School went online

and teachers and students had to adapt to this new learning environment, businesses had also

closed and many people lost their jobs. The informative “Spanish Flu 1918- The Forgotten
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Pandemic” Youtube video goes into detail about shut downs that happened during this time.

When the flu spread to Philadelphia, “The city needed to take strong measures, and on October

third, the Philadelphia Board of Health closed all public schools and all indoor Liberty Loan

meetings.. Also closed all public gatherings, saloons, theatres, and churches”. (Merc Docs,

2020). All of these same restrictions were in place in America due to the COVID-19 pandemic.

Deadliest Pandemics

Another similarity between The Spanish Flu of 1918 and the COVID-19 pandemic are

the devastating number of deaths. The Spanish Flu and COVID are two of the deadliest

pandemics in history. The Spanish Flu is referred to as the mother of all pandemics. According to

the youtube video, there were more than 50,000,000 deaths worldwide and . “The 1918 Flu

killed five times the number of people globally as WW1 and ten times as many as aids have

killed globally in the last 40 years. This virus killed more Americans than died in all of the wars

America has ever fought in” (Merc Docs, 2020). Worldwide, there are around 4.5 million deaths

related to COVID-19 and according to the CDC, as of now there are “672,021 deaths related to

COVID-19 in America” (CDC, 2021, para.3).

Differences of these Pandemics

Although these two diseases may have many similarities, there are also some things that

are quite different. One of the things that may be different are symptoms that someone who is

infected can experience. Previous paragraphs explained how both diseases affect the respiratory

system, however some symptoms of COVID that differ from The Spanish Flu are the new loss of

taste and smell. Another thing that may be different is the time between being infected to the
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onset of symptoms, also known as the incubation periods. The CDC states that the incubation

period for COVID-19 is “thought to extend to 14 days, with a median time of 4-5 days”(CDC,

2021, para. 4). With the 1918 pandemic being an influenza virus the incubation period is only

1-4 days. This means someone could be unknowingly infectious for a much longer period of time

with COVID-19. Another difference is the effect that The Spanish Flu on soldiers was much

greater. Soldiers also acted as vectors for the disease as they traveled through different countries.

Global Threats

There are a few theories on how The Spanish Flu originated. It was believed that infected

birds carry the flu. This would infect bird pluckers and consumers. Historians believe the flu may

have also come from 100,00 chinese workers who came to Europe for work during World War 1.

These workers took the route through Canada to Europe which may explain the rapid spread of

the flu to North America. 90,000 workers arrive in Northern France and they are already sick and

dying. Along with COVID-19, The 1918 Spanish Flu would die down in certain areas and

reemerge in high population areas. These diseases are highly transmissible and spread quickly

around the world. Incubation periods allow people to spread the disease unknowingly. This is

why mask mandates were put in place and large gatherings came to a stop. The COVID-19

pandemic put a hold on a lot of things for us Americans. Weddings were being rescheduled,

holiday plans with family were cancelled, and there were travel bans due to the large spread of

the virus. When there is such a great threat on global health, actions have to be taken.

Successful and Unsuccessful Interventions- The Spanish Flu of 1918

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Some measures put into place during the Spanish Flu pandemic were more successful

than others. One big mistake was that the countries involved in WW1 didn’t want their enemies

to know they were facing such illness so the press was limited. Not a lot of attention was brought

to the virus which would cause it to spread even more. The mutated virus hits America in

September from ships brought in by the Boston Harbor. Big cities such as Boston, Philadelphia

and New York were hit hard due to one mistake that was made. The sick people from the ships

were not quarantined. According to the youtube video, Dr. Wilmer Krusen made some mistakes

that resulted in a poor outcome. Krusen was the Philadelphia Director of Health and Charities

and claimed that the Spanish Flu was the ordinary flu that wouldn’t infect the civilian population.

He was advised to cancel the Liberty Loan parade that would raise money for the Philidelphians

fighting in Europe. The parade was expected to attract over 100,000 civilians, yet Krusen refused

to cancel the parade. The Youtube video states, “Just three days after the parade, all 31 of

Philadelphia's hospitals were overrun by sick patients”. (Merc Docs, 2020). This caused

thousands of deaths and it wasn’t until then that public officials started shutting things down.

Interventions were mostly non-pharmaceutical. Some successful interventions included isolation,

masks, and good hygiene. Isolation and masks both help decrease the spread of the disease.

Hand washing is the number one safety measure we can use to prevent spread of disease.

Successful and Unsuccessful Interventions- COVID-19

Three successful interventions for COVID-19 also include isolation, masks, and good

hygiene. Isolation is when someone who is infected with a disease stays away from all other

people. It is important for someone with a highly transmissible disease to isolate. Masks are also

worn and have been mandated at certain times and places to decrease the chance of respiratory
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drops spreading. As always, washing your hands with soap and water for 20 seconds is the best

technique to stop the spread of germs. One thing that is successful in a way but also had negative

consequences is the effect that quarantining had on mental health in America. A CDC report

stated that “Elevated levels of adverse mental health conditions, substance use, and suicidal

ideation were reported by adults in the United States in June 2020. The prevalence of symptoms

of anxiety disorder was approximately three times those reported in the second quarter of 2019

(25.5% versus 8.1%), and prevalence of depressive disorder was approximately four times that

reported in the second quarter of 2019 (24.3% versus 6.5%)” (CDC, 2020, para.4). Another

negative is that as businesses shut down due to COVID, many people lost their jobs and

unemployment rates in America became very high. Lastly, some may say that something

negative was the shutting down of schools and learning virtually. Although simulations were

provided, students couldn’t be provided with the same hands-on learning as they would if they

were in the classroom or clinical setting.

Conclusion

In conclusion, history really repeated itself here. Despite some of the differences, these

two diseases are very similar in the ways they affect the human body and how they have affected

the world as a whole. Hopefully, the world will have learned from these pandemics and be able

to better manage global health threats of the future.

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References

CDC. (2009, December 5). H1N1 Virus. Centers for Disease Control and Prevention.

https://www.cdc.gov/h1n1flu/symptoms.htm

CDC. (2021, February 16). Interim Clinical Guidance for Management of Patients with

Confirmed Coronavirus Disease (COVID-19). Center for Disease Control and

Prevention.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.

html

CDC. (2021, February 22). Symptoms of COVID-19. Centers for Disease Control and Prevention.

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

CDC. (2021, April 23). COVID-19 Mortality Overview. Center for Disease Control and

Prevention. https://www.cdc.gov/nchs/covid19/mortality-overview.htm

Czeisler, M., Christensen, A., & Czeisler, C., et al. (2020, August 14). Mental Health, Substance

Use, and Suicidal Ideation During the COVID-19 Pandemic. Centers for Disease Control

and Prevention. https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

Merc Docs. (2020, April 19). Spanish Flu 1918: The Forgotten Pandemic [Video]. YouTube.

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