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Hawkins 0 Anne Arundel Community College Spanish Flu Pandemic 1918-1919 Kelli Hawkins Frank Alduino, Ph.D. HIS 212-201 October 3, 2023 Spanish Flu in the U.S.: 1918-1919

Hawkins 1 As World War I drew to a close, it could be assumed that Americans' biggest concerns were dissipating when this belief was far from the case. The Spanish flu took the world by storm from early 1918 until mid-1920. With its perplexing name derived from misunderstandings, this influenza outbreak swept across the United States with alarming speed, infecting millions, and claiming the lives of hundreds of thousands. Its profound impact extended far beyond the immediate realm of healthcare, reshaping communities, straining healthcare systems, and triggering profound social and economic consequences. There are many details that are important to understand when understanding the Spanish Flu's including: its emergence, transmission, and consequences within the United States. The name "Spanish Flu" is somewhat misleading, as it was not necessarily more severe in Spain but garnered that name due to Spain's neutral stance during World War I, allowing for more open reporting of the outbreak in the Spanish press. Other countries involved in the war downplayed their outbreak to maintain wartime morale. According to Evan Andrews, " since nations undergoing a media blackout could only read in-depth accounts from Spanish news sources, they naturally assumed that the country was the pandemic's ground zero" (Andrews). Since these countries either downplayed its effects or didn't report on it at all, all the citizens of these countries could think is that it was mostly contained to Spain. In "America's Forgotten Pandemic: The Influenza of 1918 by Alfred Crosby, he states, "no matter what they called it, the virus attacked everyone similarly. It started like any other influenza case, with a sore throat, chills, and fever. Then came the deadly twist: the virus ravaged its victim's lungs." (qtd. in Smith). The misleading name of the Spanish flu underscores the importance of getting the facts right in history and not giving past pandemics names that might lead to confusion.

Hawkins 2 The origin of the Spanish Flu is unknown and controversial. The exact origins of the Spanish Flu are uncertain, with various theories pointing to potential sources in the United States, Europe, or Asia. According to Sara Fujimura, " one of the first recorded cases was on March 11, 1918, at Fort Riley in Kansas" (Fujimura). Chandana Balasubramanian claims that I t is thought that the virus likely started close to a military base and subsequently spread to Europe, as numerous young American soldiers were sent abroad for the war effort (Balasubramanian). The influenza appeared to have a more pronounced impact on military personnel than civilians, which meant that it received comparatively less attention amid the more pressing issues of the time, like the intense battles raging across Europe. Balasubramanian also adds that “the second theory proposes that this flu originated in Etaples, France, at a British training camp for soldiers. Apart from crowded quarters housing over 100,000 soldiers, the base had several hospitals catering to sick and wounded soldiers — breeding grounds for disease” (Balasubramanian). No matter where the disease actually originated it had detrimental effects on the entire world. Millions of people were impacted by the Spanish flu. Steve Maas reports that “an estimated 40 million people, or 2.1 percent of the global population died” (Maas) in the great influenza pandemic. If this happened on the same scale today, it would've taken out nearly 150 million. Besides the literal health impacts of the outbreak, the Spanish Flu also impacted the world socially. T his epidemic led to serious social disruptions. Students and researchers at Bocconi referred to it as "a textbook case of the utter failure of health care institutions both in containing the spread of an epidemic and in providing effective care"(Aassve). by. Consequently, a climate of general mistrust emerged and appears to have permanently affected individual behaviors. A person's trust is influenced by both ongoing events and the values and traditions passed down through generations. Consequently, one can gage inherited trust by examining

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Hawkins 3 current levels of trust. After conducting a survey on immigrants whose ancestors immigrated before and after the Spanish flu, researchers found that " an increase in mortality of 1 death per thousand resulted in a 1.4 percentage points decrease in trust. Moreover, the effect is significantly more negative among countries that remained neutral during WWII. Among those countries, an increase in influenza mortality of 1 death per thousand resulted in a 2.1 percentage points decrease in trust." (Assve et al.) This shows that citizens from countries that faced more censorship ended up harboring more mistrust for the people in charge of their health and safety. The influenza virus spread in three distinct phases: the initial one occurred during the spring of 1918, followed by the second, which was the most fatal, spanning from September 1918 to January 1919, and finally, the third wave extended from February 1919 until the close of that year. The disease itself spread primarily through respiratory droplets when infected individuals coughed, sneezed, or even talked. It was highly contagious, and the virus could survive on surfaces for a period, contributing to its transmission. Crowded settings, such as military camps, urban areas, and public transportation, played a significant role in facilitating the virus's rapid spread. Additionally, the movement of troops during World War I contributed to its global spreading as infected soldiers traveled to various regions, domestically and internationally, carrying the virus. Individuals and communities employed various measures to combat the virus during the pandemic despite limited medical knowledge and resources. In the absence of effective antiviral drugs or vaccines, people resorted to practical strategies to curb the spread of the disease. Sick individuals were isolated from healthy ones, and sometimes entire households or neighborhoods were quarantined. Face masks became a common sight in public spaces, especially in crowded areas like public transportation, schools, and theaters, even though their efficacy by today's

Hawkins 4 standards was limited. Personal hygiene gained prominence, with public health campaigns stressing the importance of frequent handwashing and proper coughing and sneezing etiquette. The army even had requirements for soldiers. Kathleen Fargey relays that they "required all soldiers in units having disease outbreaks to gargle twice a day and sprayed their noses and throats with an unspecified liquid. Medical staff sterilized mess kits, clothing, and bedding, and sprayed bunks and floors with disinfectants" (Fargey 24). Many communities temporarily closed schools, churches, theaters, and other public gathering places to reduce transmission opportunities, while some regions restricted travel. People relied on home remedies such as “fried onions and sugarless, hot lemonade” (Duffy et al) and rest to alleviate symptoms, as medical understanding of viruses and infectious diseases was less advanced. These collective efforts, however simple, played a crucial role in slowing the virus's spread and mitigating the pandemic's impact on society. The devastating impact of the Spanish Flu prompted significant reforms in public health and healthcare infrastructure in the United States and around the world. In the aftermath of the pandemic, governments and healthcare systems recognized the urgent need for a more robust response to infectious diseases. This recognition led to the establishment of public health agencies and expanding research into viruses and vaccines. The groundwork for the future Centers for Disease Control and Prevention (CDC) was laid in the United States, emphasizing the importance of centralized disease monitoring and control. Additionally, the Spanish Flu underscored the need for improved healthcare access and infrastructure, leading to the expansion of hospital facilities and the professionalization of nursing and medical care. These reforms marked a pivotal moment in the evolution of public health practices, shaping how nations would

Hawkins 5 respond to future pandemics and epidemics and ultimately contributing to the development of modern healthcare systems. The Spanish Flu of 1918-1919 and the COVID-19 pandemic of the 21st century share several notable similarities while also exhibiting significant differences. Both pandemics were caused by respiratory viruses and spread globally, affecting millions. However, there are key distinctions between the two. The Spanish Flu had a disproportionately severe impact on young, healthy adults, whereas COVID-19 has generally posed a higher risk to older individuals and those with underlying health conditions. Scientific and medical advancements since the early 20th century allowed for faster development of COVID-19 vaccines, while the Spanish Flu occurred in an era with limited medical interventions. Additionally, the response to the two pandemics has varied significantly due to advances in healthcare infrastructure, communication technology, and global cooperation. COVID-19 prompted swift and coordinated international efforts, including lockdowns, mass testing, and vaccination campaigns, contrasting with the more limited public health measures available during the Spanish Flu. Nevertheless, both pandemics serve as stark reminders of the ongoing challenges of infectious diseases and the importance of preparedness, public health, and medical research in safeguarding global health. In conclusion, the Spanish Flu pandemic of 1918-1919 stands as a reminder of the intense and far-reaching impact that infectious diseases can have on societies. Its rapid spread, the high mortality rate among young adults, and disruptions to daily life left a mark on the 20th century. The Spanish Flu reshaped public health practices, spurred the establishment of critical institutions like the Centers for Disease Control and Prevention (CDC), and paved the way for advancements in medical research. Additionally, it highlighted the importance of preparedness, communication, and international cooperation in the face of global health crises. As we reflect on

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Hawkins 6 the lessons learned from the Spanish Flu, particularly considering more recent pandemics like COVID-19, it becomes evident that vigilance, scientific inquiry, and collective action remain our strongest defenses against the ever-present threat of infectious diseases.

Hawkins 7 Works Cited Aassve, Arnstein, et al. Bocconi Knowledge , Bocconi, April 14 2020, www.knowledge.uniboc- coni.eu/notizia.php?idArt=21729. Andrews, Evan. "Why Was It Called the 'Spanish Flu?'" History.Com , A&E Television Net- works, January 12 2016, www.history.com/news/why-was-it-called-the-spanish-flu. Balasubramanian, Chandana. "The Spanish Flu of 1918: An Influenza Pandemic." GIDEON , February 15 2023, www.gideononline.com/blogs/spanish-flu/?gad=1&gclid=CjwKCAjw9- 6oBhBaEiwAHv1QvA_x65FhJpCf3ls0dG0wKmZTyQYdiOGMTHMs8qrIoerQhH4- FAHUniRoCOrwQAvD_BwE. Duffy, Sean, and Erin Rothenbuehler. “Unconventional Treatments Were Attempted during Span- ish Flu Pandemic.” Theintelligencer.Net , The Intelligencer, 7 Apr. 2020, www.theintelli- gencer.net/news/top-headlines/2020/04/unconventional-treatments-were-attempted-during- spanish-flu-pandemic/#:~:text=Home%20remedies%20included%20fried%20onions,the %20desperate%20myth%2Dmaking%20continues. Fargey, Kathleen M. "The Deadliest Enemy: The U.S. Army and Influenza, 1918–1919." Army History , no. 111, 2019, pp. 24–39. JSTOR , https://www.jstor.org/stable/26616953. Fujimura, Sara Francis. "Purple Death: The Great Flu of 1918." PAHO/WHO | Pan American Health Organization , 2003, www.paho.org/en/who-we-are/history-paho/purple-death- great-flu-1918. Maas, Steve. "Social and Economic Impacts of the 1918 Influenza Epidemic." NBER , May 5 2020, www.nber.org/digest/may20/social-and-economic-impacts-1918-influenza-epidemic.

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