Nonessential businesses and churches forced to close. Countless students unable to attend school. Public gatherings, including sporting events, restricted to small numbers or not allowed. Face mask mandates enacted.
This describes the situation in 1918 as accurately as it does 2020.
As one of my favorite TV shows, Battlestar Galactica, reminds us, “All of this has happened before and all of this will happen again.”
Thankfully, these constructive mitigation efforts have been repeated. Unfortunately, almost in the same months and at the same rate of speed, we are seeing the mistakes of the past occur.
The flu pandemic of 1918 officially began when Albert Gitchell was diagnosed with a new strain of the flu at Camp Fuston, Kansas, on March 4. The pandemic may predate that as Dr. Loring Miner of Kansas noticed possible cases and informed the U.S. Public Health Services as early as January.
Nonetheless, confirmed cases were showing up in Queens, New York, by March 11 and as far away as Ukraine by May. World War I provided a transmission process similar to the globalized economy of 2020.
The first six months of the 1918 pandemic saw 75,000 flu-related deaths in the U.S. alone. This generated massive public outcry, criticizing government and public health officials for not doing more during the first two months of the pandemic.
Keep in mind, these restrictions were more difficult to communicate and implement. People did not have cell phones or internet access. You could not stay home and binge watch Netflix. There was no online contactless delivery from Grub Hub.
People got their local news from the paper and each other. Social interaction was all in person – no Zoom or Google Meets. Entertainment was live and public.
Unlike our time, face masks were truly a burden. Often made from multiple layers of thick cotton gauze, they were hot, heavy, thick, itchy and made breathing difficult to impossible.
All of this was taking place alongside the restrictions generated by World War I, but the greatest generation endured.
The vast majority of the public adopted the recommendation of public health officials with patriotic pride, resulting in a decline in cases by the late summer.
By the fall, sections of the public were demanding the restrictions be lifted. Religious groups began to protest the closing of churches. Church members and leaders were even arrested in defiance of the public restrictions.
Countless municipalities had developed local mask requirements by this time, with opposition groups forming in response, such as the Anti-Mask League of San Francisco.
With the rise of flu cases in October, the city imposed public restrictions, closures and a mask ordinance. The ordinance was strictly enforced such that on Nov. 9 over 1,000 people were arrested and fined at least $5, or even jailed for not wearing masks.
Due to public outcry, the ordinance was repealed on Nov. 21, 1918. Shortly after the repeal, the city saw cases of the flu skyrocket, and the city reimposed the mandate on Jan. 17, 1919.
Following the second mask ordinance, around 5,000 people showed up to a meeting to protest the mandate. This generated a petition that forced a repeal of the second mask ordinance on Feb. 1.
Scientific data on the effectiveness of masks from the 1918 flu pandemic is unreliable because masks were often not required indoors, were worn improperly or the mandates were ignored. However, there is evidence that after the imposition of public health restrictions or mask ordinances that infectious rates dropped.
Unfortunately, as the public became weary, lazy or simply ignored these mandates, infectious rates increase significantly. Public outcry forced many municipalities to roll back restrictions, which most likely had a negative impact upon the second, third and fourth wave of the pandemic.
The increase in flu cases during the second and third waves of the pandemic can often be linked to the rolling back of restrictions. Most notably were the thousands who died following the lifting of the maritime quarantine in Australia in 1919, which probably led to the virus returning in force to the U.S. and Europe.
Yes, all of this has happened before, and I fear all of this will happen again. The problem with public health restrictions is we grow tired of them.
On Oct. 17, 2020, The New York Times published an article titled “As the Coronavirus Surges, a New Culprit Emerges: Pandemic Fatigue.”
The authors detail how the public has grown weary of COVID-19 restrictions and has begun rebelling against public health efforts by not social distancing, refusing to wear face masks and returning to public gatherings.
This rejection of public health protocols has mirrored the 1918 resurgence of flu cases, as we’re seeing an increase in COVID-19 all over the world from Europe to Hong Kong to cities throughout the U.S. It is a repeating of the past almost to the date.
As we enter the fall, we need to listen to scientists and learn from lessons from the past.
What did our great grandparents do right? What are the lessons to still be learned? How can we protect each other?
We must learn from past triumphs and mistakes from 1918, translating and applying these to the era of COVID-19.
It would be a shame to ignore the lessons of history, thinking that we know better, only to witness four or more waves of COVID-19 and the lives that will be lost as a result.
By Monty Self
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
