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A Tale of Two Pandemics

influenza_1918.jpg
The National Archives
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It was just over a hundred years ago that this country found itself in the midst of a global pandemic that claimed 50 million lives.  Today, historians report some surprising similarities in how the disease spread, and how people in Virginia responded. 

As the former editor of a journal called Academic Medicine and a retired faculty member at UVA’s medical school, Addeane Calleigh has written a lot about the influenza epidemic of 1918 and 1919.  She studied death certificates from that time – then took the virtual stage at the Albemarle Charlottesville Historical Society to describe the devastation.

“Almost 700,000 Americans died of influenza," she says. "If we compare that to today, given our population growth, that would be two million people!  Today we would have 2,000 deaths here in Charlottesville and Albemarle County alone, and right now we’re in the70’s in the whole health district.”

Today’s lower death count aside, there were surprising similarities.  Calleigh notes, for example, that the president’s actions were not helpful.

“Because of the war effort, President Woodrow Wilson would not stop sending troops to Europe, and so that led to a high death count on the ships.”

And he barred the federal government from releasing the number of flu cases recorded or the death toll.  Like his 21st century counterpart, Woodrow Wilson caught the disease according to Dr.  Mike Dickens – a retired physician from Charlottesville.

“One of the things I had the opportunity to do was to read the medical records and private correspondence of Wilson’s private doctor. Wilson very likely had influenza in the spring of 1919 while he was negotiating the Paris peace accords, and during that time he was hallucinating, an effect of having  a very severe case of influenza.”

President Trump was taken by helicopter to the hospital on live TV, but the public never learned that Wilson was ill. Trump, of course, blamed COVID-19 on China where it may have jumped from live bats to humans.  Medical historian Addeane Calleigh says the 1918 pandemic may actually have started in Kansas – spreading from pigs to people, but it was Spain that got the blame.

“This was at the height of the First World War, and there was censorship in all of the countries that were at war, but Spain was a neutral, and so they published stories in their newspapers about this epidemic, and so people began to call it the Spanish flu.” 

And both pandemics spread with the help of large gatherings – political rallies, concerts and the annual bikers convention in 2020, military training camps in 1918.

“Hundreds of thousands of American soldiers in military installation all over the country meant that when the epidemic got to them it spread rapidly.”

“My mother’s older sister had been 18 when the war broke out, and she had been engaged to one of those doughboys who went off.  He went to the training camp – Camp Gordon – outside Atlanta, and he died from influenza before he event went overseas.”
Civilians also caught the flu while showing support for the war.

“One of the worst things that happened in Philadelphia was that they did not cancel a huge parade for war bonds, and the disease exploded.  Philadelphia is the only place in the United States where they had to do mass burials.”

In our next report, we’ll tell you how the public responded to mask mandates in 1918, share surprising claims of a cure and tell you why rural counties in southern Virginia were hit hard by the influenza pandemic .  

PART TWO

You might expect that after a hundred years Americans would have learned some lessons about coping with a pandemic, but Virginia faced many of the same issues in 2020 as they saw when a new strain of influenza hit in 1918.  

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A Tale of Two Pandemics: Part 2

influenza_two.jpg
Credit The National Archives
In 1918, some cities made masks mandatory in an attempt to stop the spread of influenza.  Those who refused could be arrested and jailed.

Both  pandemics started in cities according to Virginia Tech Professor Ron Fricker, who joined historian Tom Ewing in studying the outbreak of a new strain of influenza.

"It started in the metropolitan areas – so Northern Virginia, Richmond and out in the east, so Norfolk" Fricker says.

The deadly diseases eventually got to rural areas, and Ewing  says some counties in southern Virginia were devastated.

"Dickinson County, Wise County, Tazewell had really high death rates, and I suspect it was because of underlying conditions.  This was coal country. These were people who may have had compromised health conditions.”

Ewing, who devoted a decade to study of what happened a hundred years ago, says masks – like those worn today -- were an important way to prevent the spread of disease, and they were briefly mandated in San Francisco and several other cities.

But Fricker says many people decided to go maskless.

“Back in 1918 they were really just as controversial as they are today.”

It wasn’t a political thing.  Ewing’s research suggests some people did not know about the benefits of masks or couldn’t be bothered.

“People just got tired of wearing masks.  They didn’t remember the mask.  They didn’t think it was important, or what you see a lot of in 1918 is people would wear masks incorrectly.” 

And in both pandemics, African Americans suffered a disproportionate number of deaths according to historian Addeane Calleigh.

"About 29% of the population in Charlottesville and also just about that same number in the county were African-American, but 40% of the death certificates were for African-Americans."

Then, as now, retired physician and history buff Mike Dickens says there were people making false claims of treatments and  cures.

“The commissioner in Richmond sent a warning out to the newspapers that some man was engaged in selling a preparation which is called quinine, which is alleged to be a cure for the disease which is raging.  Now quinine, of course, is the molecular precursor of hydroxychloroquine.”

That’s right – the drug that President Trump touted to prevent COVID-19.  You might wonder why Americans know so little about the influenza pandemic and its parallels with today. Dickens says Americans – who were distracted from COVID by a presidential election – were preoccupied in 1918 by the First World War.

“That was exactly the time that the American army launched the great offensive in the battle of Meuse Argonne.  It was the single largest ever fought by the United States Army in any war ever.  The doughboys are going over the top.  They’re going to free Europe.  People paid attention to that."

Of course there were many differences between the two pandemics.  Scientists actually reconstructed the virus from frozen bodies buried in Alaska to understand more about the illness in 1918.  We’ll tell you what they found and why Woodrow Wilson’s communications strategy was wildly different from that of Donald Trump in our next report.  

PART THREE

As the nation continues its battle with COVID-19, historians here in Virginia are finding interesting parallels between the pandemic now and the influenza epidemic that hit just over a hundred years ago.

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A Tale of Two Pandemics: Part 3

COVID-19 is most dangerous to older people, but the pandemic of 1918 was an equal opportunity infection that most often killed healthy young adults. Addeane Calleigh is a historian from Charlottesville and a former faculty member at UVA’s school of medicine.

“People in their 20’s and 30’s died in larger numbers than either end of the spectrum, and it left orphans.”

In fact, the first orphanage in Charlottesville opened because of the 1918 pandemic. Dr. Mike Dickens, a retired pediatrician, has studied records from that time and believes senior citizens may have had some immunity.

“We would experience, as a society, influenza epidemics on a regular basis, and there was a fairly significant epidemic in the late 1880’s, and one theory is that people who were born prior to that epidemic caught that form of the flu, so that now -- when they were in their later years in 1918 -- they already had a partial immunity.”

Another big difference – the lack of treatment options for those who fell ill.  Today doctors have respirators and several medications that may help the sickest patients.  In 1918 they could only offer aspirin for fever.

The disease occurred in waves, but Virginia Tech historian Tom Ewing says the worst of the pandemic then was relatively short.

“There were two or three weeks where the cases were accelerating at the peak, and then it quickly diminished.”

In the 21st century, COVID made headlines as it spread on board luxury cruise ships, but the pandemic of 1918 moved from town to town on trains. 

“They used to have 17 passenger trains a day between Charlottesville and Orange up toward Alexandria and D.C.”

And Dickens says the new strain of influenza was even more dangerous than COVID – a fact confirmed not only by statistics from the time but by modern day scientists.

“They did actually isolate the 1918 virus from some frozen bodies in Alaska, in a native American village, and one of the things I read was that it had the ability to multiply and divide in your system very rapidly.”

Today, it’s easy to get information about the spread of the pandemic and the mounting death toll.  Governors and, for a time, the president hosted daily briefings.  A hundred years ago, historian Addeane Calleigh says that was not the case.

“The President and some of the leadership were so concerned about wartime morale that the President made no statements about influenza of any kind.”

Virginia’s governor was also silent, and while public health officials today knew COVID could be bad, Tom Ewing says, experts were caught off guard in 1918.

“The Surgeon General of the United States says, ‘This is a three- day fever.  You may feel bad for a couple of days, but you’re going to be fine.  Don’t worry!’  A number of city health officials put our statements saying, ‘It’s not going to be bad. Don’t panic.’ and they were wrong.”

Tech Professor Ron Fricker adds that many universities shut down, among them UVA, but today many universities are open for business. 

“Universities have had issues and we’ve had quite a few cases, but by and large it’s gone far better than anyone imagined back in the summer.” 

One other important difference: nobody criticized the response of government to the influenza pandemic, because there was a law on the books – the Sedition Act of 1918 – that barred citizens from complaining . It established fines and jail terms of up to 20 years for anyone who did.