Spanish flu to Covid-19: Lessons from past pandemics
22 January 2021 | Opinion
In late September 1918, Philadelphia prematurely ended its quarantine from the February 1918-April 1920 Spanish flu pandemic to throw a parade to boost morale for the war effort. About 200,000 people lined the streets. Within 72 hours, every bed in Philadelphia's 31 hospitals was filled and the city ended up with 4,500 people dying from the pandemic or its complications within days.
This was an unusually deadly influenza pandemic caused by the H1N1 influenza A virus that infected 500 million people – about a third of the world's population at the time – in four successive waves. In the spring of 1918, just as the human-made horrors of World War 1 were finally starting to wind down, Mother Nature unleashed the deadliest strain of influenza in modern history. The virus infected as many as 40% of the global population over the next 18 months. Of these, an estimated 20 million to 50 million died – more than the roughly 17 million people killed during WW1.
The pandemic's grasp stretched from the US and Europe to South Africa and the remote reaches of Greenland and the Pacific islands. Its victims included President Woodrow Wilson, who contracted it while negotiating the Treaty of Versailles in early 1919.
As the pandemic reached epic proportions in the spring of 1919, it became commonly known as the Spanish flu or Spanish Lady in the US and Europe. Many assumed this was because the sickness had originated on the Iberian Peninsula, but the nickname was the result of a widespread misunderstanding.
Spain was one of only a few major European countries to remain neutral during WW1. Unlike in the Allied and Central Powers nations, where wartime censors suppressed news of the flu to avoid affecting morale, the Spanish media were free to report on it in gory detail. News of the sickness first made headlines in Madrid in late May 1918, and coverage only increased after King Alfonso XIII came down with a nasty case a week later.
Since nations undergoing a media blackout could only read in-depth accounts from Spanish news sources, they naturally assumed the country was the pandemic's ground zero. The Spanish, meanwhile, believed the virus had spread to them from France, so they took to calling it the French flu.
While it's unlikely that the Spanish flu originated in Spain, scientists are still unsure of its source.
Those who cannot learn from history are condemned to repeat its mistakes. The current Covid-19 pandemic mutation variant seems to have up to 70% transmissibility (more contagious), affecting higher socioeconomic groups/levels, though with up to 25% less mortality now that frontline staff know how to treat it much more effectively.
Back home, data from the Department of Health, University of the Witwatersrand, the National Coronavirus Command Council and medical schemes seem to confirm that deaths are probably understated by up to 100% when looking at “excess mortality”. Estimates are that up to 40% of the adult population could already be infected.
It is unfortunate that the second wave coincided with, and was aided by, our major annual holidays in December, with the majority of our people going back home to be with their loved ones, mostly to villages, and those who can afford it, going on holiday to Cape Town, Plettenberg Bay, Knysna and Hermanus in the Western Cape, and Ballito, Umhlanga and elsewhere in KwaZulu-Natal.
Unfortunately, the same people had to go back to work in major cities in the middle of January, thereby being exposed at least twice. The annual migration from neighbouring countries, with our highly porous borders and high levels of corruption, can only exacerbate a dire situation. January has already presented the highest Covid-19 admissions, giving us one of the highest daily infection tracking in the world.
Major areas of concern remain KwaZulu-Natal, the Eastern Cape and Gauteng. Limpopo could still be better prepared and better equipped. The biggest concern must surely be the perception that vaccines will be the silver bullet. Our only salvation and best defence for some time will still be working from home, self-quarantine, physical distancing, wearing masks, and regularly washing hands with running water and soap.
The president has set us a herd immunity national target of 67%. That's 40 million people at 100,000 per day! Our social partners – government, business, labour and the Solidarity Fund specifically – having gained access to the Covax facility, are, like most countries, going about it in an integrated, coordinated, moral and ethical manner.
It is in the country's enlightened self-interest to take care of those most at risk first – frontline workers, essential workers, people in old age homes, teachers, people in descending order of age ( >75 years, >65 years, and so on) and people with comorbidities – to stand the slightest chance of ultimately defeating this unusually deadly virus and maintaining a modicum of hope. Daily Maverick
· Bonang Mohale is Chancellor of the University of the Free State.