The Walter Reed Hospital flu ward is shown circa 1918.

The Walter Reed Hospital flu ward is shown circa 1918. Library of Congress

The Coronavirus Is No 1918 Pandemic

The differences between the global response to the Great Flu Pandemic and today’s COVID-19 outbreak could not be more striking.

We have just commemorated the centenary of the Great Flu Pandemic of 1918, which lasted only a few months but claimed 50 million to 100 million lives worldwide, including 675,000 in the United States. That pandemic remains a benchmark, and many commentators have rushed to compare it to the current coronavirus outbreak. What’s most striking about these comparisons, though, is not the similarities between the two episodes, but the distance that medicine has traveled in the intervening century. Whatever happens next, it won’t be a second 1918.

 

That year, as pandemic influenza ravaged communities as diverse as California and Kolkata, no one knew what was killing them. Theories abounded. Some suggested it was a misalignment of the planets. (That’s what gave us the name influenza, from the Italian word for “influence.”) Others believed the cause was tainted Russian oats, or volcanic eruptions. Microbiologists focused on a bacterium they had discovered decades earlier in the lungs of influenza victims, and called it Bacillus influenza. But they had merely recognized a bacterium that invades lungs already weakened from influenza. Not until 1933 did two British scientists demonstrate that the cause must be a new class of disease, which today we call viruses. Finally, in 1940, the newly invented electron microscope took a picture of the influenza virus, and for the first time in history we could not only name, but also see, the culprit.

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