A Tale of Two Pandemics

Eberts Field in Lonoke was one of 32 U.S. Air Service training camps established during World War I. "Eberts Field, Lonoke, Arkansas - Convalescing influenza patients are isolated from sicker patients ... unit set up when hospital overflowed." (November 7, 1918, National Archives)

"Fighting Influenza in the United States - To successfully combat the influenza which has stricken a number of our Army and Navy boys, a special camp has been fitted up on the grounds of the Correy Hill Hospital in Brookline, Mass. Nurse wearing a mask as a protection against the disease, which is contagious, is filling a pitcher from the water hydrant." (September 16, 1918, Western Newspaper Union, National Archives)

By J.B. Hogan

Arkansas author and historian J.B. Hogan shares a portrait of the 1918 flu pandemic, the nearest medical phenomenon to the current SARS-CoV-2 pandemic our world has recently experienced. Like the pandemic of 1918, COVID-19 attacks the world’s nations in waves, and as people move from country to country, the virus spreads. More than a year after its appearance, COVID-19 continues its unrelenting march around the world. As of this writing, the nations of India and Brazil are under intense attack by this mutating, devastating disease.

Just over 100 years ago, a vicious pandemic spread across the globe, striking the oldest and youngest among us, but disproportionately attacking younger adults (aged 20-40), many of whom were heading off to war. Improperly labeled the Spanish Flu, this virus broke out during the final year of World War I and advanced through military units and then into the civilian population with extraordinary rapidity.

HISTORY REPEATS

With today’s SARS-CoV-2 (COVID-19) pandemic, there’s a sense that history is repeating itself. Historians and data show us that both the 1918 and 2020 pandemics attack with flu-like symptoms and involve the upper respiratory system. In both times, physical distancing was – and continues to be – used to bring transmission rates down. Masking, closures, and other enforced public health measures have proven key to discouraging both the viruses. Yet both pandemic events are responsible for tremendous loss of human life.

Unlike its common name implies, the Spanish Flu didn’t originate in Spain, or even in Europe. Most historians now point to rural southwest Kansas – Haskell County to be exact – as the most likely source of the 1918 influenza.

In January of that year, a local doctor named Loring Miner reported to the U. S. Public Health Service a severe outbreak of flu with pneumonialike symptoms. It is supposed that a young soldier from Haskell County brought the novel (new) influenza with him to Camp Funston, a part of Camp Riley (now Fort Riley) near Junction City, Kansas.

WAVE I – MARCH-SUMMER 1918

On the morning of March 4, 1918, a Camp Funston cook, Private Albert Gitchell, went on sick call with flulike symptoms. By noon, more than

We provide peace of mind

so you can, too.

We’ve been addressing the legal needs of the Arkansas healthcare industry for 120 years. • Medicare/Medicaid Reimbursement • Stark I and II & Anti-Kickback Compliance • Contracts & Business Transactions • Government Regulations • Operations & Management • Medical Device & Pharmaceutical Products Defense • Licensure Matters & Board Hearings • Employment Issues • Privileging & Peer Review • HIPAA Compliance & Training • Medical Malpractice Defense • Drug Diversion Prevention

Your Central Arkansas Health Law Team

EST. 1900

Rogers Little Rock wlj.com one hundred more soldiers were sick, and by day’s end some five hundred had reported to the sickbay exhibiting similar symptoms – fever, sore throat, and headache.

It was wartime, and soldiers were on the march. Because of constant troop movements both stateside and to overseas deployments, influenza swept through the United States military like a prairie fire. Within weeks, camps all over the country reported disturbingly large numbers of men sick with those same symptoms, and many ended up contracting pneumonia as well.

Because the nation was primarily preoccupied with the war, the epidemic did not garner the amount of newspaper attention one might expect. During the war, most countries (including the U.S.) imposed censorship of the press to keep weaknesses hidden. In fact, the most comprehensive coverage of the disease occurred in Spain, which remained neutral in World War I. Its press was not censored, and wide reporting on the flu made people incorrectly assign Spain as the country of origin (Spanish Flu).

We can see, in hindsight, how the movement of our troops domestically, then overseas, caused the U.S.-based epidemic to spread rapidly and become a full-fledged pandemic.

"Emergency Hospital, Brookline, Massachusetts, set up to care for the influenza patients." (October 1918, The Boston Globe, National Archives)

WAVE II – AUGUST-FALL 1918

The second wave of the 1918 flu began in late summer and was the largest and most deadly wave of the pandemic. The flu’s virulence

is exemplified by cases stemming from a September 28, 1918, Liberty War Bond rally held in Philadelphia, Pennsylvania. This one-time event was blamed for a huge spike in the epidemic there – the rally alone responsible for the loss of 750 lives.

Here in Arkansas, a statewide quarantine was issued in October 1918, lasting until November of that year. All theaters, restaurants, schools, and churches were completely closed down. Yet, overall, the second wave proved to be the most virulent and deadly of all the waves, striking civilian populations in the United States and around the world with vengeance. Some 200,000 deaths are attributed to Wave II in the U. S. alone.

WAVE III – JANUARY 1919

The Third Wave of the 1918 influenza was hardly distinguishable from the second, as it came right on its heels, lasting from late winter 1918 until the spring of 1919. In April 1919, it struck U.S. President Woodrow Wilson who was visiting Paris, France to engage in peace talks. Wilson became gravely ill, and although he recovered, he suffered a stroke that autumn. His death in 1925 at age 67 has been at least partially attributed to his bout with pandemic influenza. Not all historians agree, but many consider the limited influenza outbreak of early 1920 to be a Fourth Wave of the 1918 pandemic. Some towns were hit hard, and their populations were forced to quarantine again – although for a shorter time – to combat the new wave.

Here in Arkansas, around February 1, 1920, at least five cities, including Fayetteville, Fort Smith, Clarksville, Lincoln, and Stuttgart, once again issued at least partial quarantines, although most were lifted just two weeks later.

SIMILARITIES AND DIFFERENCES

The influenza of 1918 occurred more than 100 years ago, but there are similarities, as well as some

MANAGE WELL

WITH OUR HEALTH CARE ATTORNEYS

• Regulatory Compliance • Corporate & Real

Estate Transactions • Information Security & Privacy • Risk Management • Investigations &

Reporting • Employment & Labor

THE POWER OF EXPERIENCE

LITTLE ROCK | ROGERS | JONESBORO | AUSTIN

Megan Hargraves Ben Jackson 425 W. Capitol Ave., Ste. 1800 | Little Rock, AR 72201 | (501) 688-8800

differences, between that historical event and the present-day COVID-19 outbreak.

VACCINES: We’re grateful that there has been a century of scientific and medical advancement since 1918 to improve the care of those infected with the COVID-19 virus. Perhaps most crucial, the vaccines being developed today are making a difference as their worldwide distribution grows.

Did you know that a vaccine was also utilized in 1918? Unfortunately, it was for fighting bacterial infections only and quickly proved ineffective as a treatment for the viral influenza.

PUBLIC HEALTH MEASURES: Newspapers and advertisements from 1918-1920 show that many recommendations for combating the influenza were pretty much the same public health measures recommended for COVID-19. Maintaining good hygiene, distancing from others, and wearing masks were suggested as ways to avoid the 1918 Flu, just as these same practices are applied to fight COVID-19 in today’s world.

Keeping one’s person and one’s home clean was a key public health approach in 1918-1920, and folks were encouraged to breathe fresh air and get outside in the sunlight as much as possible. A five-foot distancing between people was called for in those days, and throughout much of 2020 the CDC recommended people maintain at least 6 feet of distance from others.

Masks were important during the 1918 pandemic as well, although they were often made of a thin gauze or cheesecloth. Today, specific types of respirators or multiple layers of masking material are recommended. During the 1918 flu pandemic there was less resistance to masking than we have seen in our time, but it did exist. In early 1919 an Anti-Mask League briefly sprung up in San Francisco. The issuance of significant fines and jail time were punishments that kept most people maskcompliant during that early pandemic.

QUININE: There was confusion in the early days of COVID-19 surrounding the possible effectiveness of the drug hydroxychloroquine, a synthetic form of quinine, to fight the virus. During the earlier pandemic, quinine itself was the drug primarily recommended to combat the 1918 influenza. Both treat malaria, symptoms of which include high fevers and chills, common to the influenza as well. Though proven ineffective in treating either virus, quinine remains effective in the treatment of the Plasmodium parasite, which causes malaria.

COMPASSIONATE CAREGIVERS: One thing that is without doubt common to the two pandemics: the dedication and care of virus patients by the world’s medical professionals and caregivers.

Stories of doctors, nurses, and volunteers working unimaginable hours and placing themselves in harm’s way to treat the afflicted abound in both eras. Without such

"Masks for Protection Against Influenza - Red Cross workers making antiinfluenza masks for soldiers in camp, Boston, Massachusetts." (May 12, 1919, International Film Service Co, N.Y., National Archives)

remarkable professionalism and diligence, the numbers of deaths and/or lasting injuries caused by these historic pandemics might have been even worse.

AFTERMATH

When it finally ran its course, the 1918 influenza had lasted nearly two years. It ravaged our nation and our world, at last ending in early 1920. The final death numbers for it are staggering. Deaths are estimated at between 50 and 100 million worldwide, with an estimate of 675,000 dying here in the United States. With the much smaller U.S. population at that time, that was 0.64% of the total population at the time (a little more than six per every 1,000 people). Though that number appears most often in historical accounts, estimates of between 500,000 and 850,000 U.S. deaths have been attributed to the 1918 pandemic.

One hundred years later, we are experiencing a similar outcome: More than 590,500 deaths have been attributed to COVID-19 in the United States, as of this writing. In terms of duration, COVID-19 has so far matched the length of the first three waves of the 1918 influenza. But as more U.S. citizens are vaccinated and as more work is done to develop vaccine boosters to protect from variants, we can begin to hope that the COVID-19 pandemic will soon join the 1918 influenza as part of our history, rather than our present.

J. B. Hogan has published more than 270 stories and poems and 10 books, including "Bar Harbor," "Time and Time Again," "Mexican Skies," "Tin Hollow," "Living Behind Time," "Losing Cotton," "The Rubicon," "Fallen," and "The Apostate." His nonfiction book, "Angels in the Ozarks," is the history of local area professional baseball. You can find his author's page on Amazon.com and link to his "Did You Ever Wonder..." series through his channel on YouTube. He lives in Fayetteville, Arkansas.