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[Robert J. Fouser] Lessons from the Spanish flu

Since March began, the new coronavirus that causes COVID-19, has spread rapidly around the world, causing broad disruption in its wake. The speed of the spread has caught leaders and public health officials off guard and has forced them to scramble to contain the spread of the disease. Fear has set in as the public search for answers amid conflicting messages from leaders and the media.

The world has been through global pandemics before. The worst on record remains the Spanish flu from early 1918 to early 1920. At its peak in the fall of 1918, it infected 27 percent of the world’s population and caused 20 to 50 million deaths worldwide. Responses to the pandemic 100 years ago offer insight into how to deal with COVID-19.

The origins of the flu are unknown, but it did not start in Spain. During World War I, the nations at war censored reports of the flu because they did not want to appear weak in the eyes of the enemy. Spain was a neutral power at the time, and the media was free to report on the spread of the disease. King Alfonso XIII also got the flu, which raised awareness of the severity of the problem and giving it the name “Spanish flu.”

The flu spread rapidly among troops who lived in close quarters on the front line. Movements of troops, both locally and around the world, exacerbated the spread. Wartime censorship made it difficult for local communities to get accurate information and take quick action. In the US, cities, such as St Louis, that implemented quarantines and restricted large gatherings were able to contain the spread better than those that did not.

The lessons from the Spanish flu are clear. First, leaders should assume the worst, but instill confidence to prevent panic. They should follow advice of public health experts who can make informed hypotheses about the future direction of the spread. They should focus their efforts on persuading the public that disruption of daily life is required to overcome the disease in the end.

This should be obvious, but with COVID-19, too many politicians are downplaying the severity of the situation or assuming the best-case scenario. US President Donald Trump, for example, has not only downplayed the severity of the spread, but he has also tried to influence the media narrative to report his stance.

Second, swift actions to contain the spread of the disease and treat the sick instill confidence in the response. This includes mass testing and quarantining individuals is critical to preventing the spread. Depending on the health care system, some may, for personal reasons, avoid getting tested even if they exhibit symptoms of the disease. Leaders and public health officials need to use a variety of tools to encourage testing. At the same time, they need to encourage preventive measures such as frequent hand washing.

Social distancing consists of a variety of actions that keep people from gathering in large groups. Workplace shutdowns, school closings, and the cancellation of events are examples of social distancing. The rapid spread of the COVID-19 on the “Diamond Princess” cruise ship and among Sincheonji Church of Jesus members in Daegu shows that the virus is particularly infectious in crowded and confined spaces.

The rapid spread of a disease can overwhelm the medical system, making it difficult to treat the sick. Leaders and public health officials need to develop contingency plans for treating a surge in COVID-19 patients. The surge in cases in Wuhan overwhelmed the medical system, requiring a massive response from the Chinese government.

Efforts to develop a vaccine for COVID-19 are gaining momentum quickly. Public investment is not only important for development, but also for production and distribution. If current efforts succeed, a vaccine should be available in 12 to 18 months, but to be effective, it needs to be available on a mass scale. In an interconnected world, nations will need to work together to develop common guidelines governing vaccination and treatment of COVID-19.

All of this will require significant public investment as the sharp drop in consumption begins to drag on the economy. Quarantines and social distancing can cause entire cities to shut down and travel to come to a standstill. These shocks ripple through the economy, raising the risk of an economic slowdown. Public stimulus will help arrest the decline, but that too costs money.

The Spanish flu was bad, but it passed. The fear surrounding COVID-19 will fade as we learn more about the disease and vaccine development advances. To assuage our fears now, we need honest leaders who take decisive and informed action.


Robert J. Fouser

Robert J. Fouser, a former associate professor of Korean language education at Seoul National University, writes on Korea from Pawtucket, Rhode Island. He can be reached at robertjfouser@gmail.com -- Ed.
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