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History has lessons on a pandemic; are we condemned to repeat it?

Last year, just before Memorial Day, a few dozen people attended a ceremony in Devens to dedicate a memorial to the more than 800 soldiers and caregivers there who died when the 1918 flu raged through the camp. It was an effort to honor those who fell far from the battlefield in a pandemic that had largely faded from public memory.

 As this Memorial Day approaches, the nation is reliving the experience of a pandemic, and the 1918 influenza is widely cited as the closest parallel to COVID-19. News reports refer to the 1918 pandemic almost daily. Historian John M. Barry’s “The Great Influenza,” published in 2005, has been on The New York Times bestseller list for weeks, first as a book and now as an audiobook, and Barry himself is regularly interviewed on radio and TV. 

Current concerns about recurring waves of COVID-19 are based on the pattern followed by the 1918 disease. After a mild outbreak in the spring of 1918, the flu returned in far deadlier form in the fall, and then another wave struck in early 1919.

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The influenza of 1918 was met with an aggresive, nationwide, public-health campaign. (Courtesy photo)

By 1920, that pandemic had infected a third of the world’s population and killed at least 50 million people worldwide. In the United States, more than a quarter of all Americans were infected, and about 675,000 died, according to the Centers for Disease Control and Prevention. Towns across the country reported desperate shortages of doctors, nurses, coffins, and gravediggers. When the statistics for 1918 were computed, the average lifespan for Americans had fallen by 12 years.

Like COVID-19, the 1918 flu was a zoonotic disease—that is, it spread from animals to humans. (Some modern flu outbreaks have reflected that connection in their popular nicknames like “swine flu” and “bird flu.”)

Scientists still have not determined exactly where the 1918 flu originated or how it became so deadly. Although the 1918 flu was called “the Spanish flu,” that name had nothing to do with the disease’s country of origin. It got that name because Spain had stayed out of World War I, and therefore its newspapers were not subject to any wartime censorship of bad news. Spanish journalists freely reported the flu outbreaks in their cities, especially after King Alfonso XIII contracted the disease. Meanwhile, newspapers in Britain, France, Germany, and the United States played down the worst of the news to keep up public morale in wartime.

A leading hypothesis

Until recently, a leading hypothesis was that the 1918 flu first jumped from animal to human on a pig farm in Kansas, whence the disease spread to the Army’s nearby Camp Funston. That was the theory Barry accepted in his 2005 book, saying American troops carried the flu from this country to Europe. But in an NPR interview this month, Barry said more recent research suggests several other possible points of origin for the 1918 flu. Barry said he is now inclined to think it likely began in China, as COVID-19 appears to have done, although other places in Asia are also possibilities. 

The 1918 flu reached the Army camp at Devens in August 1918. In her 1999 book about the pandemic, science reporter and author Gina Kolata wrote, “Overnight, Fort Devens became a scene out of hell.” In one day, more than 1,500 soldiers reported sick. Within a few weeks, some 15,000 men came down with the disease. 

In the end, more American soldiers died of flu than in battle. Of the 116,000 Americans who perished in World War I, about 53,000 were killed in combat, while 63,000 died of disease, according to Devens Museum board member and historian Marcia Synnott, who spoke at last year’s dedication.

Amazingly, the vital records for Harvard itself (separate from Devens) show little difference from year to year over the time of the outbreak. The newspaper for the area, Turner’s Public Spirit, reported only one death from the flu in Harvard, that of Grace E. Tooker, aged 24. The paper also listed several local people who were recovering from the disease: Chester Willard, John Bigelow, Mrs. W.A. Beadle, and Miss Anna Abbot.

Grace Tooker’s death exemplifies an unusual feature of the 1918 influenza. Most such outbreaks are dangerous for the very young, the elderly, or those with weakened immune systems. The 1918 flu was most lethal for healthy young adults, while mortality for those over 60 was low.

In an interview on WBUR, Barry said the reason older people fared comparatively well was probably that some closely related but much milder influenza virus had spread widely in the United States in the late 1800s. Those who had lived through that outbreak carried immunities that helped them survive in 1918.

Much like the response to the current pandemic, responses to the 1918 flu varied from place to place. Philadelphia went ahead with a massive Liberty Loan parade in late September, after the first cases of flu had appeared there, and also kept its schools open; the city’s eventual death toll was around 12,000. St. Louis canceled its planned parade and many other public events, keeping its death toll to about 700. Photographs from the time show people across the country wearing face masks similar to those in use today.

By late September 1918, Harvard was also taking safety measures, canceling church services and military drills, closing the schools, postponing Grange meetings, and even shutting down the picture show. The Oct. 12 Public Spirit reported that all public gatherings in Harvard had been postponed, and the library reading room was shut.

Perhaps because of those precautions, the paper stated, “The influenza epidemic is well in hand, only a few new cases, and none of a serious nature. Dr. Royal is working early and late, covering five towns in his circuit.”

A week later, on Oct. 19, the paper signaled the beginning of a return to normal. The schools would reopen on Monday; the Baptist church in Still River would resume services after a three-week hiatus; the Warner Free Lecture would be held in a few days; and the Woman’s Club would meet Oct. 28.

After another week it was clear that any quarantine was over. The Public Spirit reported that two Harvard women were giving a supper “to over 100 soldier boys from Camp Devens.” Social and civic life resumed, with canning club meetings, musical performances, and efforts to gather clothing and blankets to send to war-ravaged Belgium.

And then the terrible plague faded from memory, merged with the overall horror of World War I. Calling it “the Spanish flu” made it sound as if it had happened someplace else. But, for the following century, as each new variety of swine flu or avian flu appeared, researchers asked, “Has it come back?” COVID-19 is not the same deadly virus as in 1918, but this Memorial Day, while the new plague continues to take its toll, the answer seems to be “Yes.”

 
Editor’s Note: Some material in this article previously appeared in articles on the influenza epidemic in Devens and Harvard published in the July 6, 2012, and May 23, 2019, issues of the Press.

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