1918 Spanish Flu Pandemic: FACT vs. FICTION

The current COVID-19 pandemic has often been compared to the 1918-1919 pandemic of the H1N1 flu, known in history as the “Spanish Flu.” The pandemic killed 675,000 Americans and millions around the world, perhaps as many as 50 million, in three waves in 1918 and 1919. In the United States, social distancing regulations and “lockdowns” have been implemented, with similar rules during the 1918 pandemic pointed to as justification. 

But in the world of memes and fake news, its important to keep a tab on what is true and not true about the Spanish Flu as history is used, and often rewritten, to justify actions today. 

The Spanish Flu Pandemic lasted two years and came in three waves 

TRUE

It actually lasted two and a half years, but the worst of the pandemic took place entirely within 12 months, between March 1918 and March 1919, with the vast majority of deaths occurring in October and November 1918. The flu remained an ongoing nuisance until the middle of 1920, but no more “waves” occurred after March 1919. 

The end of the pandemic may have come through herd immunity, in which the majority of the population in hard hit areas grew immune to the virus, making it hard to travel from host to host. It is also possible it mutated to a more mild form and settled into seasonal rotation.

The second wave was deadlier than the first wave because major cities lifted lockdowns too soon

MOSTLY FALSE

The first wave of the Spanish Flu hit in March-May 1918, and was quite mild with a low death toll and low infection rate (though it did kill many people, among them President Donald Trump’s grandfather who died in New York in May 1918). Very few social restrictions, or “lockdowns” were put in place at the time. The second wave did not start until September 1918, three and a half months after the first wave, and it was then that “lockdowns” were introduced. Philadelphia, which has become a popular case study in support of social distancing, never had any restrictions on public life previous to the infamous September, 1918 parade – although there were public bans on coughing, sneezing and spitting enacted a week or so before. The city did not go into its first lockdown for a week after the parade. 

What is true is that cities like San Francisco. St. Louis and Seattle that instituted social distancing measures early, then eased them before the second wave had passed, did see a rise in deaths. However, this occurred during the second wave period, which lasted from late September 1918 until around New Years 1919, not the “third wave,” which struck in early 1919 and didn’t hit the United States as hard. 

Hard-hit Philadelphia, however, which lifted is lockdown after only four weeks when hospitalizations were still high, saw the second wave end quickly. By mid-November, when other cities were still at peak and St. Louis temporarily lifted their restrictions, the flu had disappeared from Philadelphia and never returned outside of isolated cases. 

The Spanish Flu’s second wave was deadlier because the virus mutated to a deadlier strain. 

MOSTLY FALSE 

Scientists are not really certain why this second wave was more deadlier than the first, but it is possible the virus mutated to a more deadly strain. However, it is widely accepted that the virus that caused the second wave was brought back to the United States from the battlefields in Europe in the waning days of World War I. Mitigating circumstances, such as the weakened state of soldiers returning from war, the lack of immunity from the milder earlier outbreak and an overuse of aspirin on patients that caused poisoning, all led to the second wave being the deadliest.

Another factor was the second wave’s deadly effect on younger people. The first wave seemed to only effect the older population, many of whom self-isolated without any government order. The second wave however saw a huge uptick in the amount of young people who died. Aspirin poisoning and soldiers suffering war injuries and the tendency for young people to gather in big parties are seen as a major reason for this. 

Also, previous to the second wave, the first wave was mostly confined to the United States and was localized, as the First World War and expense of traveling far from home, made it hard for the flu to move around the country quickly and easier to confine locally. 

The Spanish Flu got its name because it came from Spain 

FALSE

There are many theories about where the Spanish Flu began, but its accepted that it didn’t start in Spain. It is likely to have started in Kansas, as the United States was where the first reported cases in the first wave were located. 

Another theory suggest the flu existed for years before the pandemic in Europe and may have came from Britain, while a less likely hypothesis was that it came from China, then a mostly isolated society. This theory lies in the fact that China was not hard hit by the pandemic in 1918, despite it affecting colonial populations there, so the Chinese population may have developed immunity from an earlier outbreak that had been unknown to the outside world. 

The Spanish Flu got its name because Spain was hardest hit 

FALSE

Another falsehood is that the flu got its name because Spain was the hardest hit country.

It is likely France was hardest hit country in the West, and tens of millions may have died in India, but the pandemic became historically linked to Spain because the country was neutral during World War I and the only hard-hit nation to report honestly about its statistics.

Other European countries hard hit, including France, Germany, Austria, Italy, Belgium and the United Kingdom, suppressed the severity of the illness from the media to keep morale up during the war. Russia, which may have also been exceptionally hard hit, was in the midst of a civil war, making it hard to correctly gather data. 

The flu came to Spain from France and hit the Spanish capital of Madrid hard. Spain’s King Alfonso XIII, who was only 32 years old at the time, came down with a severe case, and became a key human face attached to the pandemic, further cementing the image that his country was hardest hit.

Cities that had extended lockdowns saw their economies bounce back faster than those who didn’t socially distance for as long. 

SELECTIVELY TRUE 

It has been often shared on social media that St. Louis, despite having suffered through months of lockdowns, bounced back better economically than Philadelphia, which was the hardest hit city in the United States. While this is true, there is little direct evidence the two things are correlated, and it is only a fact when you specifically compare those two cities. Other economic factors played a role. 

Philadelphia did take longer to bounce back then St. Louis or Seattle, but other hard hit cities like New Orleans, Baltimore and New York City did not – their economies were roaring again pretty quickly. One reason behind this is thought to be how hard the flu hit Philadelphia’s immigrant population, who worked in the dockyards and train yards, a key part of the city’s economy. Many of the survivors left the city, perhaps because of the flu or perhaps because of the end of the war, for jobs in places like New York, Baltimore and San Francisco – a city also exceptionally hard hit by the virus and one that also suffered a devastating second wave after easing social restrictions too early – that further saw its economy soar in the years after the virus. One aspect of St. Louis’ economic growth post-pandemic had to do with the end of World War I and the city becoming a hub of river and train traffic, due to its central location. As cross-country trips became more common, St. Louis became a popular place to meet (there was even a movie about it) and business, universities and industry began moving there, attracting recent war veterans from the East Coast. 

Other cities that “flattened the curve,” such as Cincinnati, which saw its place as Midwest commercial capital replaced by St. Louis, struggled just as much as Philadelphia.