I was researching the Spanish Flu of 1918-1919 for Orphan Rock [Transit Lounge, forthcoming March 2022], when reports of a new pandemic – COVID-19 – hit the news headlines.

SARS-CoV-2 virus which causes COVID-19

It was first identified in December 2019 in Wuhan, China, and the World Health Organization declared the outbreak with an ‘Emergencies Preparedness, Response’  on 5 January 2020, calling it  ‘Pneumonia of unknown cause – China’, then another on 12 January 2020, naming it ‘Novel Coronavirus – China’. It declared it a pandemic on 11 March 2020. By April 2020, more than half of the world’s population had been ordered into lockdown by their governments.

And as I read these headlines over the following months, I became interested in the similarities and differences in these two pandemics, and in particular how people responded to these crises, which prompted me to then research other pandemics throughout history and how people reacted to these as well. The French have a saying: ‘Plus ça change, plus c’est la même chose’, [‘the more things change, the more they stay the same’]. So true! Here is what I discovered:

Differences between Spanish Flu and COVID-19

The incubation period is different. Spanish Flu had an incubation period of only a day or two, while the incubation period of COVID-19 can be up to a fortnight. Because of this, COVID-19 can spread by what is known a ‘stealth transmission’ [ie: during this incubation period, people have very mild or no symptoms, and so do not realise they are spreading the disease].

Update: COVID-19 is now also known to remain infectious on different surfaces for up to 28 days, as shown by this chart from the CSIRO:

H1N1 influenza A virus which caused the Spanish Flu

The two viruses mutate differently. The virus of the first wave of the Spanish Flu was far less lethal than that of the second wave. As far as can be determined, this mutation immediately penetrated deep in the victims’ lungs, triggering what is known as a ‘cytokine storm, which is when the immune system goes into overdrive and releases a surge of antibodies into the lungs, which results in inflammation and fluid build-up, ‘drowning’ the victim, and making the victim susceptible to bacterial pneumonia. And while the COVID-19 has mutated, it has not, at the time of writing this [September 2020], developed into one that immediately penetrated deep into the lungs, thus giving the body’s immune system a chance to fight it.

Update: COVID-19 can, in fact, ‘drown’ the victim. It is now known that COVID-19 is a two-phase disease. In phase one, there is rapid virus propagation in tissues of the respiratory and gastrointestinal tract. This is followed by phase two, where there are uncontrolled inflammatory immune responses by the body, which drive aggressive inflammation, cytokine storm, collateral tissue damage and failure of bodily systems.

In addition, since the first cases of coronavirus in China in December 2019, the virus has undergone numerous changes. Whilst most changes have little or no impact on the virus’ properties, and so are reclassified, some changes do affect the virus’ properties, such as how easily it spreads, the severity of the resulting illness, or the performance of vaccines, etc.    The World Health Organisation, in collaboration with scientists, institutions and researchers, have been monitoring and assessing the evolution of SARS-CoV-2 since January 2020. With the emergence of variants posing an increased risk to global public health, mutations were classified as Variants of Interest [VOIs] and Variants of Concern [VOCs], in order to prioritise global monitoring, research, and response to the COVID-19 pandemic.  Since December 2019, there have been the following variants:

Current designated Variants of Concern (VOCs) are Alpha – first detected in United Kingdom, September 2020; Beta – first detected in South Africa, May 2020; Gama – first detected in Brazil, November 2020; and Delta – first detected in India, October 2020.

Current designated Variants of Interest (VOIs) are Lambda – first detected in Peru, December2020, and Mu – first detected in Colombia, January 2021.

Update 27 November 2021: A new coronavirus variant –  named Omicron – has been detected in southern Africa. It was detected in Botswana on 11 November 2021. At this time, cases of Omicron have also been detected in London, Berlin, and Amsterdam.This new variant causes serious concern amongst researchers because a number of the mutations may help the virus evade immunity. As yet, it is not know how easily transmissible this variant is, nor is there any information on whether the variant leads to a change in Covid symptoms or severity. As a results, several countries have close their borders to a number of South African countries, with some making an exception for their own people to return, but with imposed quarantine regulations. Countries that have closed their borders at the time of writing this include the United States, Canada, Brazil, Britain, the European Union, Saudi Arabia, Japan, Russia and Australia.

They target different age groups. Spanish Flu targeted those from their 20s to 40s as well as children. The elderly weren’t as susceptible, and it’s believed to be because they may have received partial immunity from previous infections. COVID-19, on the other hand, targets the elderly more than younger people, and children are either unaffected or have much less severe illness.

Many who died after getting the Spanish Flu died of secondary bacterial infections such as pneumonia [in an era when antibiotics were unavailable], whereas with COVID-19, people die from COVID-19.

Update: The elderly – and in particular those over 80 – have had the most severe health issues from COVID-19, partially due to the number of underlying health conditions such as diabetes, heart disease, and other chronic illnesses present in older populations. However, the past year has shown that COVID-19 targets all age groups, including young children. At the time of writing this [November 23, 2021], there have been 258,437,036 confirmed cases worldwide – of which 21,420,180 are currently infected – and 5,174,857 deaths from the coronavirus COVID-19 outbreak. We now know that children are affected by COVID-19 – a report by UNICEF, which looked at 3.3 million COVID-19 deaths, found that of those, 11,700 occurred in under 20-year-olds, with 58% being amongst 10-19 year olds, and 42% of those deaths being in children 0-9 years old. [When statistics are being quoted, please note that these are only confirmed cases, and therefore lower than the actual number of cases, which is not known. This is because not everyone that should have been tested, is tested – sometimes because a person may not be exhibiting any symptoms, at other times it may be the country that lacks facilities, or people being too frightened or too isolated to report their symptoms. So no government or organization knows the exact number of COVID cases, or COVID related deaths, at any one time.]

Similarities between the Spanish Flu and COVID-19

Both diseases are the result of ‘zoonotic spillover, which means the transmission of a virus from an animal reservoir [ie: an animal which carries the disease but is not affected by it] to humans [who do become ill from it].

Both are highly infectious diseases of the respiratory system.

These diseases are caused by viruses, so do not respond to antibiotics.

Both are spread though droplet infection [ie: through the air by coughing or sneezing], or by touching infected surfaces.

They share similar symptoms: fever, coughing, sneezing, aches and pains, difficulty breathing, and can lead to pneumonia.

Both viruses spread in waves

The first wave of Spanish flu begun in March 1918, and was relatively mild. The second, more deadly wave started in the second half of August 1918, and was over by December of that year. But by January 1919, a third wave hit Australia and quickly spread through Europe and the United States, ending in June 1919. In the Northern hemisphere spring of 1920, a fourth wave occurred in the US, Switzerland, Peru, Scandinavia, Japan, Spain, Denmark, Finland and Germany.

COVID-19 is also spreading in waves. Though first reported to the WHO on 31 December 2019, it was not declared a pandemic until March 2020, and soon governments placed their countries into lockdown in an attempt to control the disease. But as restrictions eased, many countries experienced a second wave. On 20 July 2020, an article in the Sydney Morning Herald identified Australia, India, Japan, Israel, Italy and the United States all experiencing a second wave, then a third wave hit Hong Kong and Singapore in July 2020. On the 15th July 2021, the World Health Organization warned that the Covid-19 pandemic has entered the early stages of a world-wide third wave as the fast-spreading Delta variant of the virus caused cases to spike, wiping out progress made through vaccines.

Update: In April and May 2021, another wave of infections hit India, and the Delta variant identified. At the peak of this wave, India reported more than 400,000 new cases and 4,000 deaths a day. In mid-April, Delta was detected in the UK – two months later a third wave hit the country. A second wave in Europe starting in September–October 2021. The U.S. experienced two waves – in April it mainly involving New York and New England, and in July–August it spread over the remaining states. It is now experiencing a third wave. On 15 June 2021, it was reported that cases were surging in Latin America, particularly in Brazil. And in August, Iran experienced another wave of the Delta variant. In early June 2021, Africa faced a third wave of COVID infections with cases rising in 14 countries.

 Both viruses can kill

Spread of COVID-19 – 19 July 2021 Image: Johns Hopkins University

Worldwide, the Spanish Flu is estimated to have killed between 50 to 100 million people [depending on the record], with around a third of Australia’s population being infected. In Australia, losses were estimated at between 12,000 to 15,000 deaths. Note, however, that because many died from secondary infections, researchers cannot attribute a definite number to the deaths caused by the Spanish Flu. A constantly updated world map by the Johns Hopkins University showed, at the time of updating this [19 July 2021], that there were 190,375,116 confirmed cases of COVID-19 worldwide, with 4,088,328 deaths. In Australia, the figures were 32,015 confirmed cases, with 914 deaths.

Update: 23 November 2021 – there have been 258,281,783 confirmed cases of COVID-19 worldwide, with 5,159,493 deaths. In Australia, the figures are 200,651 confirmed cases, with 1,968 deaths.

Update: Vaccines

The race to develop a vaccine for the Spanish Flu continued all through the 1918 and beyond, and many drug companies claimed vaccines already developed for other diseases were effective against the Spanish Flu. But these vaccines were effective against bacteria, not viruses. It wasn’t until the 1930s that researchers realised that influenza was caused by a virus, and not a bacterium. By 1933 were able to isolate the influenza A virus, and in 1936 were scientists able to grow the virus inside a fertilised chicken egg [a vital step in vaccine development]. In 1938, Jonas Salk and Thomas Francis were able to developed a vaccine against influenza A, which was given to soldiers in WWII and approved for civilians in 1946. In 1942, a single vaccine was developed against both influenza A and influenza B.

Image: U.S. Army photo by Maj. Bonnie Conard

When COVID-19, caused by the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus, was first identified in December 2019, scientists realised a pandemic was imminent and that the development of an effective vaccine was crucial. Unprecedented collaboration between multinational pharmaceutical industries, university research groups, health organizations and governments occurred, whose aim was to quickly develop a suitable vaccine against the SARS-CoV-2 virus, and tens-of-billions of dollars were provided to make multiple vaccines on shortened timelines. Luckily, research into other coronaviruses – such as four that cause the common cold and the one which causes SARS [severe acute respiratory syndrome] and MERS [Middle East respiratory syndrome] – had been going on for years, and this provided the groundwork for the development of the Covid-19 vaccines. Scientists shared their research globally, and thanks to advances in genomic sequencing, researchers were able to successfully uncover the viral sequence of SARS-CoV-2 by January 2020. This enabled them to be able to use the virus’s genetic blueprint and tweak their vaccine to target COVID-19. As of 24 November 2021,  more than 7.76 billion doses have been administered across 184 countries.

Other developments in the past year include:

  • To date [November 2021], there have been twenty-five approved vaccines against COVID-19 worldwide and another ninety-one are under development.
  • There is emerging evidence for the need of a booster dose for the currently available COVID-19 vaccines.
  • Research has shown that natural immunity is not better than vaccine-acquired immunity – COVID-19 vaccines are five times more effective in preventing hospitalization than a previous infection of the disease.
  • On 29 October 2021, the U.S. Food and Drug Administration authorized the use of the Pfizer COVID-19 Vaccine for children from 5 years of age, and clinical trials are underway for children age 6 months to under 5 years old. At the time of writing this [November 2021], Australia has not yet authorised vaccines for children under 12 years of age.
  • On 31 March 2021, the Russian government announced that they had registered the first COVID-19 vaccine for animals, including dogs, cats, Arctic foxes, mink, foxes and other animals. Named Carnivac-Cov, it is aimed at preventing mutations that occur during the interspecies transmission of SARS-CoV-2.


So did people behave differently in 1919, when the Spanish Flu reached their shores, compared to how people are behaving during COVID-19? Click here to find out #pandemic  #covid-19  #SpanishFlu #Omicron