In 1918, a deadly virus swept across the globe, infecting one-third of the world’s population and killing tens of millions in its wake. But where did this mysterious illness come from? How did it spread so fast? And most importantly, what lessons can it teach us about the pandemics of today and tomorrow? In this video, we’ll learn how the Spanish Flu pandemic continues to shape how we fight global outbreaks, despite occurring more than 100 years ago.
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Welcome home, doughboy! You survived the Great War. Despite spending months in wet trenches dodging German bullets and cannon shot, you have finally made it home to your beloved New York City. You march proudly through the streets with your fellow veterans as American men, women, and children crowd the sidewalks to cheer you on.
They drop confetti. They shake your hand. Heck, some of the women even let you sneak a kiss or two.
But the celebration doesn’t last long. You wake up in your apartment the next day, safe and sound. However, you don’t feel well at all. A few too many drinks? No, this is something else. A high fever. A pounding headache. Chills that cause you to shake down to your bones. You figure you better head to the local infirmary.
Just two days later, you’re lying in a hospital bed, unable to breathe and watching as your arms, face, and fingers turn blue. In less than 24 hours, you’ll be dead. You may have dodged the Kaiser, but you couldn’t dodge…the flu.
The Spanish Flu Epidemic of 1918 and 1919 was the deadliest global illness since The Black Death. But where did it come from? How did it spread? Most important of all, how can we keep it from happening again? In this video, we’ll answer all these questions and so much more…
What “The Flu” Was Before Vaccines
Influenza, often referred to as “the flu,” is an infectious disease caused by influenza viruses. Depending on the type of flu, how new or “novel” it is, and what tools are available to fight it, the flu can either be a mild inconvenience or a severe, life-threatening illness.
Nowadays, we only think about the flu when we get our yearly shots or, in the event those vaccines don’t work, when we get a mild illness requiring a few days off work. However, the first of these treatments only dates back to around 1940.
Before then, the flu was serious business.
Physicians lacked antiviral drugs, which meant they really only worked to make the infected comfortable while simply hoping they didn’t die. Secondary bacterial infections like pneumonia commonly followed the flu, and without antibiotics – which weren’t available until after 1928 – these complications were frequently fatal. Poor hygiene and a limited understanding of germ theory further exacerbated the spread. If you were sick, young, or old, you were pretty much written off the moment you demonstrated a fever. If you did survive, you could take comfort in knowing you now had some limited immunity to the virus.
Today, we know that there is more than one “flu.” In fact, the flu virus exists in several forms: types A, B, C, and D—each targeting different hosts. Long before the modern era, we humans knew to expect seasonal flu epidemics, which varied in their deadliness. In the U.S., the flu generally killed around 20 to 50,000 people a year. But once the flu season ended, most people accepted that they were generally safe.
Pandemics, however, are different.
These global outbreaks occur when a new strain of the virus emerges. This means anyone who had immunity to previous variants were vulnerable again. As a result, new strains spread quickly, leading to millions of deaths and striking the ill, healthy, old, and young in equal measure. In the past few centuries of recorded history, we have been aware of ten such pandemics. The 11th and deadliest would eventually become known as the Spanish Flu. Contrary to popular belief, it did not originate from Spain, so how did it then end up with that name?
A New Kind of War
Earth had never seen anything quite like World War I. Millions of soldiers from dozens of countries had been mobilized, armed with the latest killing machines, and turned loose upon each other in a global conflict that killed up to 16 million people.
But just as the war finally began to draw to a close, a new threat emerged – one that would kill at least three times as many people, but possibly up to six times or more. The worst part? There were no shiny new weapons with which to fight this new menace.
Despite still being referred to as the “Spanish” flu today, this illness most likely did not originate in Spain. In fact, many historians now agree that it started in the good old U S of A – specifically, the Midwest.
The pandemic’s first documented case occurred on March 4, 1918, at Camp Funston, a U.S. Army training camp located near Manhattan, Kansa. On that day, an army cook named Albert Gitchell came to the infirmary to report flu-like symptoms. Days later, logs at the base reported as many as 500 soldiers had fallen ill.
But there was a war on, and wars don’t stop because of one little outbreak. As a result, those soldiers healthy enough to fight were given orders and shipped off to bigger bases at home and abroad. By March 11, the virus had spread to the other Manhattan. By April, it was already overseas, where it used the crowded trenches and military camps to breed with unheard of efficiency.
In fact, medical historians often say that the pandemic might not have happened at all without World War I. The malnutrition, poor sanitation, and physical exhaustion that accompanied this new form of warfare weakened the immune systems of grunts and officers alike, but wartime media censorship prevented many nations from reporting on the outbreak in an attempt to maintain morale.
Only Spain, which was neutral in the conflict, reported on the fast-spreading pandemic. As such, people began to erroneously believe it must have originated there.
Hence, “Spanish flu.”
For the last few months of the war, several armies reported that more soldiers were put into infirmaries for breathlessness and fever than bullet wounds. And when the war ended in November of 1918, all of those men were sent home with their germs in tow. The same flu had already started wreaking havoc in places like New York, Paris, London, and Berlin. However, things hadn’t gotten bad enough to stop citizens from welcoming the returning soldiers with parades, drinks, and more than a few public make-out sessions.
Before long, the illness quite literally went viral. Little did they know, it was just the beginning.
The Second Wave
Truth be told, the first wave of the Spanish flu was relatively mild. The United States reported around 75,000 flu-related deaths in the first six months of 1918, only around 12,000 more than the year before.
But the second wave, which began in August of 1918, was CATASTROPHIC.
Where the initial outbreak resembled typical flu epidemics, primarily affecting the sick and elderly, the second wave was an equal opportunity infector. Military parades for brave troops became superspreader events, with one Philadelphia procession being linked to 12,000 deaths in just a few weeks. In the U.S., nearly 292,000 people died between September and December alone, 1023% more than the 1915 figures. The figures were the same in other towns and cities around the world.
The worst part? There wasn’t much that anyone could DO about it.
At the time, medical science was completely ill-equipped to combat the virus. Scientists hadn’t even discovered the influenza virus yet. As far as they knew – and some believed – the flu was caused by ghosts, leprechauns, or an angry God. Those secondary bacterial infections that tend to make the flu more deadly went untreated due to the lack of antibiotics, and public health measures were rudimentary at best.
Efforts to control the spread primarily relied on non-pharmaceutical interventions like isolation, quarantine, and social distancing. Gauze masks were worn by some but shunned by many. Moreover, these Victorian PPE measures may not have been that helpful in the first place. Across the world, the dreaded “second wave” proved to be one of the deadliest public health crises in history – and there were still two more waves to go.
Causes, Responses, and General Insanity
You might be asking yourself: given the lack of medical knowledge in the early 1900s, there must have been some rather insane reactions and theories associated with the Spanish Flu. Well, you’d be right!
But to truly understand the pandemic, you need to get a good idea of just how many people were dying and how fast it was happening. Because while the virus spread the fastest in crowded urban areas, it did some of the most complete damage in rural ones. This was especially true of indigenous communities, whose isolation had previously kept them safe from such events. In fact, newspapers of the era reported entire Native villages being either wiped out or losing the majority of their adult population.
Still, urban areas fared no better. In the first few weeks of the second wave, New York City buried over 33,000 victims, and Philadelphia lost nearly 13,000 people. The sheer volume of deaths overwhelmed infrastructure, forcing cities to use streetcars as makeshift hearses while thousands of bodies remained unburied in homes for days. As is the case with all pandemics, some entrepreneurial types saw the opportunity to make a few bucks.
Prices for coffins and burial services skyrocketed, with reports of price hikes as high as 600%. In some cases, families were charged exorbitant fees only to be told they had to dig their own loved ones’ graves.
But there were also plenty of people doing their part to stop the virus’ spread – or at least trying to – often with hilarious or terrifying results.
Boston officials shut down public schools, saloons, and soda shops. Chicago police arrested anyone caught sneezing or coughing in public. Nashville prohibited gatherings in movie theatres, dance halls, and churches, even ordering ministers to forgo services. Mask mandates became widespread in places like San Francisco.
However, the crackdown spurred some people to rebel, allowing them to turn everyday activities like going to church or walking around maskless into acts of defiance against governmental overreach. There was even an Anti-Mask league, which decried being forced to wear face coverings as an act of tyranny.
Even though people were dying in droves, every step toward containment was met with ardent resistance.
Some so-called doctors promoted miracle cures or prevention methods, which varied from useless and harmless remedies, such as aspirin or quinine, to the deadly and extreme, such as drinking arsenic. We will cover more such extreme remedies in future articles, so make sure to bookmark this page.
In India, offerings were made to appease the goddess Sitala, believed to be behind the plague, while Spaniards wore garlic necklaces in hopes of warding off illness. Equally harmful were the assumptions about the virus’ origins, with some blaming the noxious gases used during WWI. Others claimed the pandemic was a secret weapon unleashed by the Germans in a last-ditch attempt to prevent their defeat.
The Flu’s Impact on the World
Between February 1918 and April 2020, approximately one-third of the entire global population contracted the Spanish Flu. Healthcare systems were overwhelmed to the point of breakdown, with many people having to rely on makeshift facilities constructed in schools, homes, and other buildings. Nurses and doctors were in short supply, which meant that these hastily-constructed facilities were often staffed by medical students and untrained volunteers.
Globally, the toll was staggering. India alone reported 12.5–20 million deaths. Many island nations sealed their borders completely in order to stymie the spread of the virus, with varying success. Less populated islands like Iceland and Samoa fared quite well, while places like Australia still suffered heavy infection rates, though casualties were low.
But the pandemic had other effects as well, including a wave of cultural and social adaptations. Churches were among the first to adapt, with many turning to outdoor or drive-in services where worshippers listened from carriages or cars. Even though most people didn’t even believe in germ theory, many adopted obsessive cleaning practices. Public spaces were fumigated, personal belongings were disinfected, and people developed a newfound love of handwashing.
Around the world, millions of citizens did their best to prevent the spread of the virus while others unknowingly did their worst to contribute to it. As people split into factions, governments struggled to maintain control. In some cases, violence erupted. Meanwhile, economic chaos ensued as panic buying and hoarding depleted supplies. Inflation soared, and labour unrest followed in many nations.
Fortunately, by mid-1920, the worst of the pandemic seemed to have subsided. The virus itself, H1N1, didn’t disappear, but simply evolved into a more familiar seasonal flu. To this day, its descendants continue to circulate, occasionally causing significant outbreaks and deaths, but nothing like what was seen during 1918 and 1919.
The Spanish flu’s legacy is all around us.
Most notably, it served as a catalyst for advancements in medical science, including vaccines, antiviral drugs, and antibiotics to combat secondary infections. It also underscored the importance of early intervention, access to healthcare, and global cooperation alongside information sharing.
But if you’re watching this right now, you know that pandemics are still a very real threat. In fact, many of the stories related in this video could easily have been taken from the 2020 COVID-19 pandemic. Though different in many ways, both of these viral events exposed societies’ vulnerability to novel infectious diseases, a problem that is not going to go away anytime soon. In fact, depending on which medical research you read, we could be on track for MORE pandemics in the near future.
Globalization, urbanization, climate change, and the increasing frequency of zoonotic spillovers from wildlife to humans make future outbreaks more likely and potentially deadlier. The challenge now is to ensure that these lessons are not forgotten, but rather used to build a world better equipped to confront whatever comes next.
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The content on the blog “Medical History Book” is for informational and entertainment purposes only. It is not intended to provide medical advice, diagnosis, or treatment. Readers should not rely on the information provided in the articles for medical decisions. Always consult a qualified healthcare professional for any medical concerns or questions. The authors and creators of this blog are not responsible for any actions taken based on the information provided herein. Use this blog at your own discretion.
