By Alessia Anderson
It’s a grim comparison. As the COVID-19 contraction rate exponentially increases, some are drawing parallels between our current pandemic and the Spanish influenza of 1919. While this makes sense to the general population however, are these comparisons accurate?
After the end of WW1, around 500 million people were infected with H1N1. Popularised as the Spanish flu, it is actually unknown where the flu first broke out. However, due to restricted wartime censorship in other countries, it received widespread press attention in Spain first. In Australia, which had a population of 5 million, ~15,000 people died.
Andrew Miller, WA head of the Australian Medical Association recently said, “The truth is, we probably haven’t seen a virus like this one since 1918, with the Spanish flu”.
The Spanish influenza and COVID-19 are both infectious respiratory illnesses, sharing the same symptoms of fever, coughing and aches, and can both lead to pneumonia. Nevertheless, the two diseases are very different biologically – but comparison persists because novel viruses are rare.
Ian Mackay, a virologist from the University of Queensland, states “Whenever we see a pandemic, we are seeing something similar to other pandemics so that’s a fair enough comparison to make” suggesting there are limited similarities beyond their common title of pandemic. He goes on to say that COVID-19 “is a very different virus to a pandemic influenza. It is a totally different virus and it spread differently; it causes a different disease; it seems to target different groups.”
During 1919, medical knowledge was obviously far less revolutionary from our current society. “People had never even heard of influenza as a virus” says Kirsty Shot, an influenza virologist. However, governments knew enough to introduce travel bans, quarantine rules and social distancing measure… sound familiar? “Cinemas and festivals were closed down, people were asked to not congregate in shops” and “widespread efforts to limit contact among people… were highly successful in reducing transmission” (Professor McCaw).
Evidence from China indicates their reproduction rate (that is, the number of people each infected person passes it onto) under one. If people hadn’t changed their behaviour and implemented measures kindred to the Spanish influenza, Professor McCaw argues “we would have expected somewhere around the millions of cases in China by now instead of the comparatively small number around 100,00”. By saying this, McCaw is aiming to highlight the pivotal impact of social distancing and good hygiene in the transmissibility of coronavirus. Despite these measures, Australia’s no. of cases now surpasses 4,000, hence the government's further action.
A clear difference between COVID-19 and the Spanish flu, possibly meaning our current pandemic will be less detrimental, is that people do not appear to be as infectious before they develop symptoms. Furthermore, the pandemics seem to target different age groups, the Spanish flue particularly hitting those “in the middle ages of life – so around 35-40” (Dr Short). Whereas, our current outbreak causes mild illness for most people, with mainly elderly and very young people being severely affected. Similarly, the clinical outcomes for the two diseases have stark contrasts in children. “For influenza, children are a hub for infection” Professor McCaw writes, whereas “strangely and surprisingly perhaps, for coronavirus, children seem to be largely unaffected”.
Interestingly, majority of those who died in 1919 were not killed by the Spanish flu, rather secondary bacterial infectious which the virus makes them more susceptible to. We have not yet seen the same thing happen at present. Nevertheless, if this were to occur with coronavirus, modern medicine has developed we would be much better prepared, as the Spanish flu occurred “in the pre-antibiotic era” (Dr Short).
Ultimately, while there are many similarities between these two pandemics, Dr Maru Dobson, Historian of Medicine reveals the Spanish flu “killed more people in the first 25 weeks than HIV/AIDS has killed in 25 years. Horrendous! Those morality statistics are staggering.” That level of mortality was driven by the social context of the outbreak, including the culmination of a world war and lacking medical knowledge. Our current governments and medical associations reassure that we are in much safer hands one century later and corona virus will unlikely reach the staggering calamity that 1919 is define with.
There is no need to compare the Spanish Flu to Covid-19, as this only increases public panic (which as we know manifests in bulk buying). It is best during this time for us to take proper precautions, and support each other as we live through this unprecedented pandemic. So long as we do, our community will emerge on the other side.