What Missteps During the Spanish Flu Pandemic Can Teach Us About Celebrating Christmas Safely During COVID-19

Stay home this holiday season and save the big family reunion for after the Coronavirus vaccine next year

What the Spanish Flu Christmas Can Teach Us About Celebrating the Holidays During COVID-19

COVID-19 is the first modern pandemic since the great influenza pandemic of 1918, commonly known as the Spanish flu. While there is considerable variation in calculations of that global death toll (estimates range from 17 to 100 million) even the lowest estimates put the fatality rate at 1% of the total global population, with higher estimates at 6%. Now that we are experiencing our own (hopefully) once-in-a-century pandemic and entering into a second wave of infections, how the US government botched Christmas during that earlier pandemic can be used as a guide to make sure we don't re-make the same mistakes this millennium.

To begin with, calling it the Spanish flu is misleading as the virus did not originate in Spain but in Haskell County, Kansas. In January 1918, a local doctor in the area was so alarmed by the new outbreak of illness in the area that he alerted the US Public Health Service.

How did what began as a severe but localized flu strain end up slaughtering millions worldwide?

The answer is World War I. Haskell County’s young men were leaving home to be trained as soldiers for the war, and unwittingly taking the virus with them. On March 4, mess cook Albert Gitchell stationed at Camp Funston, Kansas called in to the infirmary complaining of a sore throat, headache, and fever. By noon, the infirmary had over a hundred such cases. Weeks later, there were so many soldiers afflicted that the chief medical officer requested a hanger in order to fit all of the patients into a makeshift medical ward.

The close quarters of army life are a notoriously ripe breeding ground for infection. But matters here were complicated by America’s entry into what was the first true world war. Camp Funston wasn’t just sending its young recruits and trainees to other American army camps, but shipping many of them directly to France. By April, infection hot spots were bubbling up throughout America’s Midwest, Eastern cities where soldiers were embarking on their European tours, and partying heavily while they were still stateside before heading off to battle, as well as in the international port cities of France where they debarked. It didn’t take long for the virus to reach the trenches of the Western front. From there, it swept Europe and then infiltrated the rest of the world. 

Given that the first known case of the virus was in America, how did it come to be called the Spanish flu? 

Upon America's entry into World War I, a morale law was passed, promising up to twenty years jail time for anyone publishing anything negative about America on the grounds that it could hurt the war effort. When influenza outbreaks started popping up all over the United States, the press either ignored the stories or downplayed their importance. Nor was it just the US. Press censorship was even stricter in Great Britain at that time. The one European nation that was neutral during the war was Spain. As a result, when the influenza reached Spain and sickened millions, reporters there covered the story first, and the name the Spanish flu stuck.

Meanwhile, in the United States and Great Britain, it was public policy to deny that there was any real problem lest it hurt public morale. Sound familiar? But that propaganda didn't stop Americans from getting sick and dying at an alarming rate. (Viruses are inconsiderate like that.) In what many medical historians consider to be one of the most irresponsible decisions of all time, Philadelphia officials ignored medical advice and held the Liberty Loan parade on September 28, even though influenza was already burning through the Philadelphia Navy Yard. Hundreds of thousands of people flocked the streets to see the two-mile-long parade, which was at the time the largest in the city’s history. Within days of the parade, every bed in Philadelphia’s hospitals was filled. By October, the city was shut down and horse-drawn carriages roamed the streets to collect decomposing bodies left on sidewalks. 

What role did Christmas play in making the Spanish flu pandemic worse?

After the massive tragedy in Philadelphia, Americans who could stayed home and out of harm's way. But on November 11, the Armistice was signed, ending four long years of war. They took to the streets and began holding social gatherings again. To make matters worse, the first post-war Thanksgiving and Christmas followed soon after. There were some half-measure attempts to curtail mass gatherings, and many churches did the right thing and canceled their usual Christmas Eve services for fear of crowding and endangering members of their congregations. 

But without an official government order to shut down and stay home, stores all over the country remained open for Christmas shopping in crowded indoor spaces. On Christmas Eve, thousands of veterans traveled to New York City to attend lavish parties and festive dances. In Hamilton, Montana, a month’s long lockdown was lifted in late December, just in time to allow churches and movie theatres to have a Christmas Day opening. The government's refusal to give Americans firm guidance and their inability to resist gathering until it was safe to do so caused a third wave of influenza infections to sweep the entire globe as soldiers worldwide left crowded barracks to participate in similar welcoming ceremonies over the holidays in their own home countries. That third wave of avoidable mass illness and death would not subside until the spring. 

Why was the Spanish flu so deadly, and how is it different from typical influenza?

With a fatality rate of approximately 2.5%, the 1918 Spanish flu strain was twenty-five times more deadly than regular influenzas. At least a fifth of the world and 28% of Americans became infected, and the death toll was staggering. In the US alone, the average life span in 1918 dropped by 12 years. To get an idea of how that would look in today’s times, adjusting for population, that would mean over 1.5 million US deaths, which is a total greater than the number of people killed each year by heart disease, cancer, strokes, AIDS, Alzheimer’s, and chronic pulmonary conditions combined.  

No one ever came up with a cure for the Spanish flu, or a vaccine. Its sudden disappearance would prove as puzzling as its origins. Did enough people become infected to bring about herd immunity?  Did the virus mutate into something less lethal? Or did it simply burn itself out, running out of new live hosts to infect? Most importantly, now that there is another equally contagious and deadly pathogen in the world, will we learn from the pandemics of the past and make better choices to stay home for Christmas this time around? 

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