The Spanish Influenza Pandemic of 1918-1919 disappeared from everyone’s memory as soon as it was over. Nobody seemed willing to address it, not even historians. Yet, it had lasting effects on the population that lived through it and has become relevant today once more in our new pandemic times. 

Scientists have a hard time explaining the Spanish Influenza Pandemic of one hundred years ago, even today. Imagine how difficult it was for doctors and the general population to understand it back then. 

Viruses had been identified only a few decades earlier. By the 1910s, people understood that microbes caused infectious diseases. But during the pandemic flu, even doctors thought they were dealing with bacterial infection, not a virus. This shaped how the flu spread across the world and how people tried to fight it. 

If this were not enough, there were many reasons why whole sections of the population wanted a different explanation. The flu seemed a kind of lottery. Nobody could explain why a person died and another survived, so many people looked for their own answers and tried to find their own protections. 

Then, in a matter of two years, the flu disappeared, and everybody did their best to just erase that experience from their minds. 

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The Spanish Influenza hits

The most recent historiographic research shows that the Spanish Flu outbreak was tightly connected with WWI. The first cases probably emerged in the trenches. But the pandemic isn’t linked to the war by historical causes alone. There were also political reasons behind the spread of the flu. 

The name itself is revealing. Today we know fully well the Spanish Flu didn’t arise in Spain. We also know that we still call it that because it was in the Spanish press that the news first appeared. Spain was a neutral country during WWI, and its censorship was less pressing. All other countries simply passed the news to silence even while field camp hospitals across the Great War battlefields recorded flu cases every day. 
Soldiers knew nothing about the flu as it spread in the spring of 1918. When they went home on leave, they took no precautions because they didn’t know they should, and so they spread the virus to their family and friends, which is probably how the flu left the trenches and filtered in on the different home fronts.
Meanwhile, governments were underplaying the danger of the epidemic for the same reasons they kept silent: bad-interpreted patriotism. 
If the news of a pandemic had come out, it would have caused fear and anxiety on the home front, weakening the morale. It could also have emboldened their enemies. Therefore, the governments involved in the war chose to ignore the news. The press was advised to keep quiet, and in fact, there was surprisingly little coverage, even when the number of cases started to rise. 
It was even worst in the fall when the Armistice took effect, and millions of soldiers went home. 

But governmental choices were only part of the ‘problem’. 
It was a world where news travelled slowly. The primary means of transportations were train and ship. Telephones were still relatively new and rare in households. Newspapers were the chief method of learning news, and apart from the fact that governments tethered the press, many people couldn’t read and would have missed the information anyway. 
The population learned about the epidemic very slowly, and only when cases hit their community – at which time it was already too late to do anything effective. 

The Spanish Flu basically encountered very few barriers as it spread worldwide. 

It was an enemy that revealed itself when it was already too late.

The pandemic spreads

Whether they had no opportunity to learn about the pandemic or were hindered from learning about it, most populations were unprepared to face it and fight it. 

It was chaotic and frightening. 
The situation would escalate swiftly after the first case appeared, frequently swiping away entire communities. 
Though it has been seen from archival researches that the virus hit harder in Asia and Africa, it reached and wreaked havoc on communities everywhere, even the most remote. The Inuit village in Alaska, where decades later scientists would recover samplers that allowed the virus to be sequenced, was a far away, isolated place. Yet, the flu swiped away 90% of its population. 

In the US and Europe, the most basic services failed as significant numbers of people started to get ill, and simply not enough people remained to carry them on. Due to flu-stricken workers, goods and mail delivery, garbage collection, and public transport were limited or downright suppressed. Many farms could not harvest their crops because they had not enough workers. 

Even places that would have been natural presides against the flu had to cope with the shortage of workers. The press was hindered by this, in addition to all the limitations imposed by censorship. Hospital personnel were mowed down as doctors and nurses fell ill. 

It was a catastrophe.

Could it have been handled better? As always in historical matters, it’s hard to say. But it is true that nations mostly avoided giving national direction, and there was very little – if any – international collaboration – a consequence of the recent war. 
Most everywhere, finding solutions and imposing limitations fell on the single community, be it a city hall or a village government. As a result, the pandemic situation could vary widely in communities mere kilometres away when they adopted different strategies against the epidemic. The use of masks, for example, was left to the single local authorities – which sometimes was the school heads or the hospital direction, depending on how small that community was.
But then, nobody liked restrictions, and no public official liked to impose them. Therefore, on many occasions, no restriction was put in place. 

Besides, the situation was extremely confused. Even doctors didn’t know what to do. There was no proven – let alone official – cure. Nobody could say how exactly someone got infected. There were all kinds of strategies, more or less effective – or even reasonable – to try and avoid dangerous situations. But often, even this was left to the common sense of the single individual. With the knowledge of the time, even giving a diagnose with any certainty became difficult, if not impossible, because the flu was often mistaken for something else with similar symptoms. Doctors were left each to their own devise and experience. 

It was often a battle to fight alone when it would have been a war to fight together. 
But in a world where people had just left the battlefields, nobody was prepared for this kind of collaboration. 

Pandemic coping strategies

They said the flu was democratic because it could hit indiscriminately. In fact, the flu was everything but egalitarian. 

Firstly, some continents were hit harder than others, with Asia and Africa suffering the most, North America, Europe and Australia the less. Secondly, even in the countries that fared a little better, there were areas where the flu was more vicious. For example, it tended to be worst in the cities than in the countryside. And in the cities, the flu struck harder and with a higher likelihood to kill where people crowded together in less cleaned, airy environments. A condition that would lower their immune systems because of higher exposure to diseases and malnourishment, just like it had happened in the WWI trenches. 
These conditions were more often found among the immigrants and ethnic communities and generally among minority groups in the cities. 

Because of how little people knew and understood the flu at the time, this kind of explanation was unavailable to them. Yet, the fact that the flu hit harder ethnic and minority communities was noted, and some sections of society went about giving their own explanation. 
Eugenics was a mainstream current of thoughts both before and after the pandemic. According to this theory, the fact that the flu struck harder on the immigrants and minority communities was proof of the inferiority of those groups. 
When Charles Darwin laid out his theory of evolution by natural selection in 1859, he didn’t intend it to be applied to human social clusters – but that’s what eugenicists did. They believed that humanity included many ‘races’ competing among themselves, and of course, according to the theory of evolution, some races were fitter than others to survive. When eugenicists noted that the poorer, more ethnic strata of society had higher death rates, they concluded that the pandemic was a natural selective factor and, of course, ‘inferior races’ were dying faster. Never mind that this theory was belied by the fact that anybody could come down with the flu, no matter the social strata they pertained to. 
The Eugenic thinking mixed viciously with the germ theory. Pasteur had taught that infections could be prevented, so eugenicists thought that if the poorer and diverse were dying in greater numbers, it was because of their laziness. 

It was a strange time in history where science still mingled with a more ‘magic’ idea of reality. Science was in its infancy (at least for the way we understand it today), and many traditions were still practised, especially by some strata of the population. 
Facing such faceless, apparently mindless enemy as the Spanish Flu encouraged many people to find reasons anywhere. And this probably reveals more about their anxiety and fears than the real phenomenon. 

For example, many people believed that the pandemic was God’s punishment for society’s sins. They thought that they were more likely to escape the disease by being pious. So – sometimes in scorn of the regulation against big gatherings – these people assembled in churches to pray, which more often than not increased the number of cases. But it seemed it never occurred to them the gathering was to be blamed. 
In rural China, many people still believed that demons and dragons caused illnesses. So they paraded with figures of dragon kings in the streets to try and appease these powerful spirits. The results were very similar to the above. 

The pandemic aftermath

In a two-year time, the pandemic was over. After its pick between the end of 1918 and the beginning of 1919, it started to subside, and by 1920, it had disappeared. At least as a ‘real’ danger. 

Its after-effects were often not acknowledged, but they are quite visible and recognisable when looked for. 
There were, for example, very relevant effects on the structure of families. The flu had hit harder men between 20 and 40, who were normally family breadwinners and the pillars of their community. Entire families were left without support. In the 1920s, armies of parentless children would crowd the streets of many inner cities and hoards of older people were left to fend for themselves. 

These sections of the population didn’t have any help since health care didn’t exist yet. But it was precisely the pandemic that caused a meaningful shift in how public health should work. 
The pandemic had revealed that nobody was immune. As the quarantines that dotted all the countries showed, when the community acted together, the individual was best protected, not the contrary. 
From the 1920s, a change started in public health strategies as many countries reorganised their ministries and embraced the concept of socialised medicine. Not a new concept, but the pandemic accelerated the application of the idea, though, in many places, it took decades to come to fruition. Yet the change in point of view was huge. 

But the ‘social’ aftermath of the flu doesn’t stop here. Most after-effects happened at an individual level, even if seldom acknowledged. 

Though a neglected matter in the past, research has recently revealed that the flu left durable signs on people’s health and mental health. 
Historical demographer Svenn-Erik Mamelund’s research on asylum hospitalisation in Norway between 1872 and 1929 shows that first-time hospitalised patients with mental disorders attributed to influenza increased by an average annual factor of 7.2 in six years following the pandemic. He also discovered that Spanish Flu survivors suffered from sleep disturbances, depression, mental distraction, dizziness, and difficulty coping at work. Other researchers have pointed out that the pandemic seems to have produced and increased neurological diseases. In the US, some researches showed that suicide rates rose in the two post-pandemic years. In the United Kingdom, there was a marked rise in nervous symptoms and illnesses among the patients recovering from influenza. 
Historical records also show that the pandemic, like the war, took its toll on the emotional resilience of those who were not in immediate harm. Many fell in a chronic state of helplessness and anxiety. The experience left a lasting feeling of guilt, anger, confusion and abandonment. 

This affected living people as well as people still to be born. The flu had always hit men more often than women, unless the woman was pregnant, in which case she was at significant risk. But even if she survived, her baby could be affected. It has been seen that the generation who was born after the pandemic was physically and cognitively slightly reduced. They were more likely to suffer from heart attacks and less likely to graduate. 

Social attitudes also changed. There was a turning away from science in many Western countries due to disillusionment in its true abilities. For example, in America, alternative medicine took off after the pandemic. 

The forgotten pandemic

It’s a strange destiny that the Spanish Influenza Pandemic should disappear from history. Busy in trying to cope with all that WWI had left behind, people seemed unwilling to think about the flu too. Its effects were kind of incorporated into overcoming the after-effects of war, in many ways, very similar.

The Spanish Influenza Pandemic seemed to disappear from any public discourse soon after it ended. In the 1920s, nobody talked about it, and it was going to be so for many decades. 

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RESOURCES

History – Spanish Flu
Discover – 10 Misconceptions About the 1918 Flu, the ‘Greatest Pandemic in History’
World Economic Forum – A science journalist explains how the Spanish flu changed the world
University of Birmingham – A Review of the Impacts of the 1918 Spanish Flu Pandemic
History Extra – Spanish flu: the virus that changed the world
Psychiatric Times – The Spanish Flu Pandemic and Mental Health: A Historical Perspective
Berkeleyside – Berkeley shut schools, required masks in 1918: Read a woman’s letters from that pandemic
New York Times – Memories of the 1918 Pandemic From Those Who Survived

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