We can learn from the past. And 102 years is a long time to prepare for the next pandemic. So what did we learn in hindsight from the 1918 Pandemic Flu, and is it too late to keep history from repeating itself in 2020?
A New York City typist wears a flu mask while at her desk, October 16, 1918 National Archives and Records Administration
Influenza Encyclopedia, University of Michigan Library
I’ll admit it. When our schools closed before there were any known cases in the community and before any neighboring cities closed theirs, I questioned whether there was any science that justified my kids being home (and invading my office). Well, I dug up some evidence and it turns out that preemptive school closings during the 1918 flu pandemic was a key social distancing ingredient that saved tens of thousands of lives, if not more.
In St. Louis, schools closed within about 2 weeks of the first flu case to be identified, and about two weeks before the virus began to peak in the community. In Pittsburgh, schools closed about 6 weeks after its first case and almost 2 weeks after the flu began its peak in the city. What we saw was a sizable difference in the number of deaths in St. Louis compared to Pittsburgh, where the rate was 2.25 times higher.
Seems like Pennsylvania as a state was slow to react to the pandemic. Philadelphia, much like Pittsburgh, waited weeks after the first known cases before it implemented any social distancing measures. St. Louis, as we know, took much quicker action. The result, a dramatic “flattening of the curve” in St. Louis and, again, the cumulative death rate was cut in half.
Looks familiar, right? So we did learn something from the 1918 flu pandemic. The question now is whether we’ve acted on it soon enough.
As Long as it Takes
Now something you wont want to hear. We actually want the spread of COVID-19 to last as long as possible. It sounds counter-intuitive, but it is true. We need to stretch it out as long as possible if we want to save as many lives as possible.
Take a look at St. Louis versus Philadelphia again. Before, we were so interested in the death rate (the y-axis) that we forgot to look at the timeline (the x-axis). The Philadelphia outbreak was all said and done by early November, whereas the St. Louis outbreak lasted 2 more months, until the end of the year. However, for every 1 person that died in St. Louis over the course of the pandemic, more than twice that number died in Philadelphia. The city had more than 12,000 deaths in total.
The US as a whole lost 675,000 lives to the 1918 pandemic.
Lets hope we learned our lesson and that the measures we are taking to slow the spread of COVID-19 started soon enough and last long enough. Then again, we always could have started sooner. Hindsight is 20/20…
Want to learn more about the 1918 flu pandemic in America? Visit the Influenza Encyclopedia by the University of Michigan.
