The influenza pandemic of 1918, more commonly known as the Spanish flu, infected around 500 million people across the globe. It was more deadly than both World Wars combined, killing around 50 million people, according to the Centers for Disease Control. It bears some similarities to the coronavirus.
“[It] was transmitted when infected people sneezed or coughed and expelled mucus into the air or onto another person,” issue 130 of the Alabama Heritage reads, a print magazine published by The University of Alabama, The University of Alabama at Birmingham and the Alabama Department of Archives and History. “A person could be symptom-free but contagious for as long as twenty-four hours.”
The above text refers to the spread of the Spanish flu, but could easily be applied to the current COVID-19 outbreak, as people can be contagious with COVID-19 for up to 48 hours before the onset of symptoms, according to Harvard University. In the first-hit locations in the United States, like Camp Funston in Kansas, the disease spread so quickly that the sick had to be housed in a converted hangar, according to the Alabama Heritage.
While the Spanish flu had been synthesized and evaluated by the time of the outbreak, the properties that made it so devastating were not. Efforts to limit its spread were solely non-pharmaceutical.
“With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited,” the CDC’s website reads. “Non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants and limitations of public gatherings were applied unevenly.”
Yet another similarity of the two pandemics is the way in which they hurt their victims. The following quotes are taken from the paper titled, "Spanish Influenza." This paper is based on the findings of 600 cases at the Post Hospital of the then-Alabama Polytechnic Institute, now Auburn University.
“The essence of the whole pathologic picture consists, therefore, in the abundance of the hemorrhages seen in the mucus and serous membranes, in the respiratory tract and in the lungs,” the paper reads. “Hemorrhages in the lungs pave the way for a secondary infection … as the lungs are literally shot to pieces, as with bird shot, after an attack.”
In many cases, the secondary infection that came after was pneumonia. According to the CDC, a similar process can happen with pneumonia afflicting the weakened lungs of COVID-19 patients.
Other similarities in symptoms include an elevated temperature of 99–101 degrees as well as a dry and rasping cough, according to the paper based on findings from the Post Hospital. These symptoms were found by the paper to be telling signs of the Spanish flu.
In Alabama, the first wave of the Spanish flu passed through in the spring and summer of 1918, but it was not until the second wave that the outbreak became severe enough to alarm health officials. The City of Birmingham’s health inspector, Dr. J.D. Dowling, went on record to the Birmingham News on Sept. 4 insisting that the outbreak was nothing more than a case of the cooties.
Under the headline, “No Spanish Influenza Here; ‘Cooties’ Attack School Kids,” which ran in the Birmingham News, Dowling insisted that no “extraordinary disease of any kind has been reported,” saying that children starting the new school year were at risk from “cooties.”
Just three days later, on Sept. 7, Birmingham reported the first two flu deaths, and the next day, all schools in the city were closed.
According to the Alabama Heritage, Gov. Charles Henderson issued a proclamation on Oct. 7, calling on “all country and municipal authorities” to ban public gatherings and to close “schools, churches, theaters, picture shows and other places of amusement” as long as “the disease exists in their respective communities.”
The pandemic then made its way to Alabama Polytechnic Institute. In a report to the Student Army Training Corps, Tommy Fullan, instructor in mechanical drawing and machine design, stated that “thirteen persons died of approximately 700 who had this severe flu, 80 cases developing into late pneumonia.”
President Charles C. Thach reported to the trustees of Alabama Polytechnic Institute in 1918 the following statement regarding the University’s response to the pandemic:
“[The] heroic service of about forty women of the community, who at the peril of their lives, nursed the young soldiers day and night and by their spirit of self-sacrifice … contributed the chief agency in the preservation of the lives of these young men, and bringing about the highly gratifying low death rate.”
While the Spanish flu would continue to ravage the globe, the worst of the pandemic had passed in Alabama. According to the Alabama State Board of Health, 145,821 cases were reported in 1918, with 5,446 deaths, a death rate of 3.73%. There were an additional 5,882 pneumonia deaths.
This contrasts with the death rate in Alabama for COVID-19, which is 1.71% at the time of writing, according to The New York Times.
Information for this story was sourced from Auburn University's Special Collections and Archives.
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