However, this pandemic is not without its precedent: the last time we dealt with such a mysterious, uncontrolled, and far-reaching pandemic was in 1918, when influenza devastated populations around the world.
The 1918 flu killed 50 to 100 million people by 1919. There are eerie parallels between the 1918 flu and the 2020 coronavirus pandemic: a disease with an astounding array of symptoms for which there is little treatment, human behavior as a public health barrier, and cluster outbreaks that are widespread are to name a few.
For 102 years, influenza scientists and infectious disease experts have tried to educate the masses in hopes of preventing future pandemics. And yet we are here.
The coronavirus, which is responsible for the current pandemic, is not a flu virus. And yet, the 1
918 and 2020 pandemics have similarities in terms of their foundation on a novel, massive virus that has taken the world and every aspect of society by storm. To learn the lessons from the 1918 flu, the missteps we’ve made since then, and our post-pandemic future, CNN spoke to three experts on the matter.
These conversations have been edited and condensed for the sake of clarity.
CNN: What are the lessons from the 1918 pandemic?
John M. Barry: Number one tell the truth Number two, non-pharmaceutical interventions work. The Asian countries New Zealand, Germany and Senegal have done an incredibly good job due to the transparency. However, we’ve shown that you can actually control the outbreak by performing non-pharmaceutical interventions (social distancing and masks). We didn’t do it in the United States. We didn’t stick to them; We played with them.
Dr. Jeremy Brown: In late 1918 and early 1919 there was a backlash against wearing masks in San Francisco. People were essentially fed up. There was a group of libertarians who claimed it was a violation of their rights and freedoms to be forced to wear masks and in fact prevented the health authority there from renewing a mandate to wear masks.
What happened was another surge in influenza cases in San Francisco in early 1919, and they wore masks again. The message, perhaps, is that things are not as new as they may seem, and that human behavior in response to pandemics of this magnitude is actually quite predictable.
Gina Kolata: While we know exactly what the 1918 virus looks like, we still don’t know why it was so deadly.
And here we have the coronavirus, and we know so much more, and we still don’t really know why it’s so deadly or what it does. I think this is a very important lesson for you to think, “I know molecular biology, I know viruses, I know how they replicate,” and yet there can be these diseases that you do not understand.
CNN: 1918 experts and infectious diseases stressed history to help prevent future pandemics. Where have we been wrong since the 1918 flu?
Brown: We have to be very careful and say, “Well, it was obvious, do that, do that.” But I think it was pretty clear that the next pandemic threat was going to be a virus, not a bacterium, fungus, or parasite. Most people thought it was going to be a pandemic influenza, and I was one of them.
I think we had to spend more time thinking that it could be influenza and other things. It doesn’t matter because if we had planned well in advance how we would deal with a pandemic influenza, we would also have set up a game plan for how we would deal with a different virus pandemic.
Unfortunately, we know that funding for these things comes in waves. The allocation of funds is essentially based on what is going on today. Very little attention is paid to what can happen later, and we have become complacent with our belief that we are able to control everything. We are all exposed to extreme weather conditions, but also to nature.
If we had kept the planning and the center of pandemic planning, I believe we would have been in a much, much better place. But every year when you fund pandemic planning, say no to fund something else. If there’s no pandemic on the horizon, it’s very easy to say, “Why don’t we take these many millions of dollars and put them into curing Alzheimer’s disease?”
CNN: How did the 1918 pandemic end, and how do you think the current pandemic will end?
Brown: The influenza of 1918 disappeared in early 1919. The influenza viruses circulating today include a descendant of the original H1N1 virus from 1918. So we are actually exposed to a descendant of this initial pandemic.
Generally, an infectious disease ends when people run away until it goes away and when all of the people exposed to it have died from it, so there is no one else. And when other exposed people survive and gain immunity, it offers some protection.
We saw these three effects in history in 1918, and we’re going to see a variant of them today. There is no doubt that we will see an end to Covid-19. The big question is what the cost will be and when it will be.
CNN: Given your knowledge of the 1918 flu, what are you particularly concerned about now?
Barry: Most worryingly, we know that the virus damages the heart and lungs, even when people have no symptoms at all. It’s likely to damage other organs, even in people who don’t have symptoms. So we don’t know what long-term effects this damage will heal and whether it will haunt them and affect their lives in 10 or 25 years.
Brown: What I’m most concerned about is people’s selfishness and I thought, “If I’m fine, that’s all that matters.” I think the message we saw is that people are selfish to a remarkable extent that I believe we have never seen. People’s selfishness and their inability to show empathy for others who are not like themselves is one of the very, very worrying aspects the disease has highlighted. I think this is a deeply ingrained part of American society.
Kolata: I worry about society, employment, people who have lost everything and people who don’t have enough to eat. I’m worried about the kids at school because distance learning doesn’t work. And college kids who need to go to college from afar. People who have just graduated cannot get jobs. They are like a lost generation when they should start their careers. I worry about people who are long distance drivers – they just never recover. I worry about people losing family members.
CNN: Is there anything about the current pandemic that gives you hope?
Barry: Trump is right about one thing: this virus won’t go away; it will be here forever. But I think at some point people’s immune systems, with or without a vaccine, will adapt to it. It probably won’t be as dangerous in the future as it is now. At least there is a good chance of that.
Brown: First, people seem to return to normal very quickly. I think that’s because infectious diseases were so common around the turn of the century – we didn’t have any vaccines for diphtheria, measles, hepatitis or meningitis, so waves of these diseases were very common in Europe and the United States. People have been dealing with infectious diseases in their lives for centuries. In 1918 they recovered relatively quickly.
With Covid-19, I think an open question remains as to whether there will be an economic boom and, above all, an emotional boom – where we are reminded in a way that we have never been reminded before that we are subject to the whims of nature when it comes to diseases.
Kolata: Societies have somehow got through, recovered, and survived some pretty terrible pandemics in the past that were much worse than we are going through now. At least now we have a chance to get a vaccine that could actually stop this virus before it penetrates the entire population and affects everyone affected. So I have hope.