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History Repeats in Real Time

By Emma Christley

Similarities between the 2020 and 1918 pandemics reveal three lessons to be learned

In 1945, long-awaited vaccinations for the Influenza virus, which created a worldwide pandemic in 1918, were first administered to military personnel, before going out to the general public.

In December 2020, the Food and Drug Administration approved Pfizer’s COVID-19 vaccine in record time and will be first administered to the frontline and essential workers before being released to the general public.

Given the high efficacy rate of the vaccine for how quickly it was developed, Dr. Anthony Fauci was pleased, saying“I’d like to say I would have predicted it, but I would not have,”

With the advent of the internet, social media, and other technologies, the world looks very different in 2020 than in 1918, but in some ways, this COVID-19 pandemic has shown how much is still the same in how large outbreaks are handled.

In both cases, a lack of concrete information at the initial outbreak led to an early lifting of restrictions, which may have prolonged the pandemic. Election years have seen politicization to the outbreaks, which has caused people to refuse to wear masks in public claiming a violation of their freedoms.

Influenza in Pittsburgh, 1918-1919

During the height of the Influenza pandemic, initial attempts at fighting the disease included antibiotics, which they later learned was ineffective as the disease was viral rather than caused by bacteria. When the vaccine was being developed at the University of Michigan in the 1940s, the head researchers on the project were Dr. Thomas Francis Jr. and his doctoral student Jonas Salk. Salk would later be known for his work developing the polio vaccine at the University of Pittsburgh in the 1950s.

Nearly 30 years before a vaccine would be invented, the first case of Influenza in the United States was at Fort Riley, Kansas in March 1918, where soldiers were experiencing symptoms of headaches, sore throats and fevers.

By noon on March 11, there were over 100 cases and by the following week, over 500. 48 would die by the end of that spring. The virus then spread to other cities and the general public in Fall 1918, killing 675,000 Americans between 1918 and 1920.

According to Forbes, the Influenza outbreak was mistakenly labeled the “Spanish Flu” after it was thought to have originated in Spain. On the contrary, Spain was one of the only countries with a large outbreak that was uncensored in their coverage of the devastation caused, thus being incorrectly labeled as the center of the outbreak.

In Pennsylvania, specifically in Pittsburgh, the city imposed a public gathering ban on October 4, 1918, to combat the spread. The ban, issued by Pennsylvania Health Commissioner Dr. Benjamin Franklin Royer closed “all public places of entertainment, including theatres, moving picture establishments, saloons and dance halls,” until further notice.

By October 10, local businesses were itching for restrictions to be lifted and called upon Mayor Edward Babcock to do so. A week before the statewide ban was to be lifted, Babcock lifted restrictions for Pittsburgh and allowed bars and other businesses to reopen.

Eric Jaffee, who writes about the intersection of science, history, and urban life for Sidewalk Talk, warns in his article about the 1918 pandemic in Pittsburgh that the early lifting of restrictions was a major contributor to the deadly second wave of Influenza later that year.

Having studied the 1918 pandemic in Pittsburgh and now living through the 2020 pandemic with history happening in real-time, Jaffee finds the similarities to be “striking”.

“We knew from 1918 that tough local restrictions flattened the epidemiological curve, so long as they were kept in place for a sufficient length of time. We also knew that local political interests would push hard to loosen restrictions in the name of liberty or economic survival (even though there was additional evidence that restrictions did not necessarily dampen economic recovery long term).” Jaffee said via email.

In addition to lifting the restrictions too soon, Jaffee also writes in his article about the politicization of the Influenza virus, particularly by Mayor Babcock.

Before lifting the ban himself, Babcock met with Royer to end the ban, but the state declined. Against the backdrop of an upcoming November election, Babcock accused Royer of “taking drastic measures ‘for political effect’” writes Jaffee.

Dr. James Higgins, who has studied extensively the effects of the 1918 pandemic in Pittsburgh, wrote that on September 29, 1918, during the ban on public gathering, Babcock led a parade of 40,000 people through Forbes Field in Oakland to encourage the purchasing of war bonds. Paling in comparison to the rise in cases caused by the now-infamous Philadelphia war bond rally the day before, the cases were doubling nearly every 24 hours in the days following the parade until October 4.

Because little was known at the time how to combat the Influenza virus, medical professionals of the day relied on other methods to stop the spread, including isolation and face coverings.

Unlike today, in 1918 anti-mask rhetoric wasn’t centered around a political figure, but rather a city. San Francisco was the hub of mask slackers, as they were known at the time. The San Francisco Anti-Mask League was formed in January 1919 following a second mask-wearing ordinance. The league was short-lived, but reportedly 2,000 people appeared at a protest organized by the group as reported by CNN.

Nancy Bristow, a professor at the University of Puget Sound was quoted by the History Channel saying “Some people argue against [masks] because they say that they create fear in the public and that we want to keep people calm; which I think is really an excuse to critique them because someone doesn’t want to wear them.”

While the enforcement of mask-wearing was not universal across the country, one man in San Francisco was shot by a health officer for not complying with the masking law.

Hindsight is not 20/20

Over 100 years later, COVID-19 began rising in alarming rates in the United States. Just as March 11 saw the first cases of Influenza hit Fort Riley, March 11, 2020, saw the shutdown of the NBA due to the alarming rise of COVID-19 cases. The NHL and Broadway followed suit the next day.

While doctors and scientists studying COVID-19 agree that it originated in Wuhan, China, its genetic origins and exactly when it appeared are still unclear. Theories span everywhere from a cooked bat, which is rooted in racist stereotype, to biomedical warfare, for which there is simply no evidence. Similarly, the CDC is still unclear where the Influenza virus originated from, but have gleaned that it was likely of “avian origin” based on the genes of the virus.

There have been reports of illnesses late in 2019 that sound synonymous with the symptoms of COVID-19, leading researchers to believe that the virus first made its appearance late last year.

To help stop the spread, Pennsylvania Governor Tom Wolf and PA Secretary of Health Dr. Rachel Levine announced a statewide stay-at-home order on April 1, 2020. On April 20, a group of protesters gathered, largely unmasked, at the stops of the City-County Building in Pittsburgh to call for the reopening of businesses. On that day, Governor Wolf extended the stay-at-home order which was supposed to end on April 30 to May 8.

Governor Wolf did start to lift restrictions in parts of Pennsylvania in late May through a red, yellow and green phase system, which he wrote in a tweet posted May 11“prioritizes health and public safety.”

“The politicians who are encouraging counties to reopen prematurely are putting all of us at risk of resurgence,” Wolf wrote.

But in September, six months into dealing with the pandemic, a Pennsylvania Federal Judge found Wolf’s restrictions “unconstitutional” in a suit filed against both Wolf and Dr. Levine by small business owners and Pennsylvania Republicans.

2020 was a divisive Presidential election year, which may have played more a role in the COVID-19 pandemic than in 1918 as the division down party lines also meant a division in reactions to the pandemic. By downplaying the severity of the virus, supporters of President Trump’s felt emboldened to ignore mask-wearing protocols in grocery stores and other public businesses.

In an interview with esteemed journalist Bob Woodward for his upcoming book entitled Rage, President Donald Trump admitted to knowing about the seriousness of the virus in late January and purposefully downplaying it because he “didn’t want to create a panic.”

Along the campaign trail, rallies for Trump became super-spreader events as spikes were seen in cities Trump visited. Cases had been dropping in Douglas County, Nevada before President Trump’s campaign held an event on September 12. But four weeks after the event saw a 225% increase in cases in the county compared to the 74% increase throughout the rest of the state in the same period of time.

CNBC reported on October 31 that 18 Trump rallies occurring between June 20 and September 22 led to over 30,000 confirmed COVID-19 cases and around 700 deaths.

In addition to the President himself testing positive for COVID-19, many of President Trump’s closest advisors have been seen without masks and have later tested positive for COVID-19. Most recently afflicted has been President Trump’s personal lawyer, former New York City Mayor Rudy Giuliani. Giuliani is among an estimated 53 reported cases in Trump’s inner circle, including his chief of staff Mark Meadows and press secretary Kayleigh McEnany.

Supporters of the President have also taken his words about the virus to heart, calling the pandemic a hoax and accusing Democrats of creating the virus to make the President look bad.

Comparatively, at the start of the 1918 pandemic at the height of World War I, wearing a mask was a symbol of patriotic duty. Now in 2020, with 76% of Democrats willing to wear a mask in public compared to 56% of Republicans, it’s a symbol of political division.

Nathan Raabe, a Master’s degree student at the University of Pittsburgh studying infectious diseases, says that in 2020, social media has changed how people look at the pandemic in terms of how media has contributed to writing a specific narrative.

“It’s hard for people to see disinformation and immediately debunk it.” Raabe said.

In October, Raabe published an article featured in a student medical journal titled Covid-19: Predatory Conspiracy Theories and American Prey in which he looks at how specifically online conspiracy theories have contributed to the anti-mask rhetoric.

“It’s easy to just look at someone who is spewing nonsense and say ‘Okay, you’re not worth talking to’, but the fact is that the people who believe conspiracy theories are, statistically, the people most likely to be infected by COVID[-19]…so it is a public health crisis,” Raabe said.

When thinking about how the two pandemics relate, Raabe finds the biggest similarity to be leadership’s lack of understanding about the two illnesses which then led to reactions that were “largely either based on total fear or complete denial and disinformation.”

“It is disappointing to see that sort of failure the second time around, and in much the same way,” Raabe said.

If the 1918 pandemic is any indicator, there will be several spikes before the COVID-19 pandemic is declared over. There’s already been another large spike in early November, and many states including California and New York are considering another lockdown.

By the end of the Influenza pandemic in 1920, an estimated 50 million people died worldwide. As of mid-December 2020, 1.6 million deaths have been reported worldwide since December 2019.

On December 14, the first vaccine doses were administered in the United States to healthcare workers in New York City. Doses are expected to go to healthcare workers and elderly patients in residential care first before being released to the general public in 2021.

Dr. Fauci hopes to be vaccinated publicly “so that people can see that I feel strongly that this is something we should do, and hopefully that will encourage many more people to get vaccinated,” he said.

This piece is from Multiplatform Magazine Reporting Digital Magazine FALL 2020 Issue “Good Trouble – The New Normal.” 

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