Many health officials and academics are comparing the novel coronavirus outbreak to another pandemic more than 100 years ago. The Spanish Flu of 1918 killed at least 50 million people worldwide, and its symptoms are similar to those of COVID-19.


What You Need To Know


  • Historian Carla Bittel said while the Spanish Flu and COVID-19 aren’t the same virus, there are a lot of similarities to how health officials and the public reacted

  • They are both respiratory illnesses and have some similar symptoms such as cough and fever

  • People were encouraged to quarantine, wear masks and wash their hands

Carla Bittel, associate professor of history at Loyola Marymount University, told Inside the Issues the two are different types of viruses. Still, they are both respiratory illnesses, which is likely why there are similarities.  

“One thing about 1918 that was surprising was that it hit young people so hard. Flus before that had really been most dangerous for children and also for the elderly, but this hit a lot of soldiers who were preparing to go off to World War I and never made it because they died in training camps in Kansas,” she said. 

According to Bittel, doctors reported that the influenza had symptoms such as fever and cough, like symptoms of COVID-19, but there were other, very different symptoms as well.

“There were these mysterious symptoms of people becoming very blue in the face and also suffering from a type of delirium,” she said. “It was very confusing for physicians at the time.”

The actions that health officials have taken with the COVID-19 outbreak, asking people to stay at home, wash their hands, wear masks when leaving the house, isolate the sick and track cases, are also quite similar to those suggested by officials in 1918. 

“They also closed large venues and stopped public gatherings,” she said. “There was also this huge campaign about personal acts of prevention, so washing hands, also avoiding crowds, sneezing [or coughing] into a handkerchief, sanitizing and then there was this huge anti-spitting campaign that comes out of the way in which tuberculosis had been fought for a long time.” 

She said many people generally followed the rules, but those who didn’t were looked down upon.

“The term ‘slacker’ was used to describe people who didn’t actually follow the rules,” she said.

But at the same time, some resisted. For example, in Los Angeles an ordinance was passed that closed movie theaters and churches. 

“The Theater Owners Association really did not like that and protested,” she said. “The Christian Science churches also protested that. In San Francisco, there was a mandatory mask ordinance that faced a lot of resistance, actually, and it led to people not abiding by it, it led to fines and arrests, even.”

As the cities began to reopen in 1918 and people started to venture out, there was a second wave of Spanish Flu cases, which the Centers for Disease Control and Prevention said was “responsible for most of the U.S. deaths attributed to the pandemic.”

According to Bittel, one of the most interesting similarities she has seen between the two viruses is the spread of information and misinformation, especially during the early days of the pandemics.

“In 1918, a lot of historians look at how public health officials were not really straightforward with people about the real dangers of the pending epidemic. In our own time, of course, we have a lot of concerns about knowledge and getting the right information when there is a lot of misinformation,” she said.

Another comparison she made has to do with preparedness and supplies. 

“During 1918, most attention and supplies went to supporting the war effort and that led to [not being ready] for what was coming,” she said. “I think, in our own time, even though we've been warned for decades that novel viruses were a huge threat, it feels like we were not as prepared as we could have been.”

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