COVID-19 recently surpassed the Spanish Flu as the deadliest pandemic in American history with more than 675,00 deaths.
Even though history is not repeatable, there are haunting patterns between the two pandemics.
In both, misinformation and denial spread among the population. Public officials hid the flu’s severity, prioritizing World War I. In fact, President Woodrow Wilson refused to acknowledge the pandemic even after he caught the flu, fearing it would dispirit the American people. Likewise, President Donald Trump downplayed the pandemic multiple times, believing in American exceptionalism even as the pandemic loomed and the virus spread.
As public distrust grew, so did misinformation. During the 1918 pandemic, the Anti-Masker League of San Francisco formed, protesting the mask mandate based on one study that concluded masks did not help combat the pandemic.
This trend resurfaced during the COVID-19 pandemic as the abundance of social media platforms allowed users to warp information and misinformation together and allow fictitious information to spread quickly. In both pandemics, the public fashioned controversies of the virus’ inception, some believing that COVID-19 is a plot devised by China.
Most eerily, the demographics most impacted were nearly identical. Even after 103 years of progress, Native Americans and Alaska Natives, Black people, and Hispanic and Latinos are hospitalized at rates much higher than their white counterparts. Professor Nancy Bristow, Chair of the Department of History at The University of Puget Sound, said those were the same groups impacted by the 1918 pandemic. COVID-19 uncovered the racial, socioeconomic and ethnic healthcare disparities — again.
In both pandemics, the federal government delegated the efforts of combating the flu to states who, in accordance with the Tenth Amendment, had reserved rights that included police powers, the power to regulate citizens for the public good, health and safety. Because there was no federal government oversight, some cities in the 1918 pandemic, such as Pittsburgh and Philadelphia, rescinded the safety measures quickly after observing a decline in deaths — only to face a more severe second wave. Cities that enacted restrictions early experienced almost half the mortality rates as the cities that adopted the restrictions later.
In many of those cities, the safety measures against the flu were like those of the COVID-19 pandemic: closing schools and churches, banning public gatherings, preventing public coughing and sneezing and enacting mask mandates. But the most enduring legacy was social distancing, the most effective tool for combating the disease in a time devoid of antivirals and vaccines.
Even with its devastating outcomes, the 1918 pandemic was quickly forgotten. The United States Public Health Service had no oversight or decision-making power, and it remained so. The health system barely accommodated the sickly and minorities, and it remained so. Racism was entrenched within healthcare disparities, and it remained so.
In fact, literature about, and effects of, the 1918 pandemic is limited.
Professor Elizabeth Outka at The University of Richmond said in Viral Modernism: The Influenza Pandemic and Interwar Literature, writing about the flu pandemic was seen as disloyal and unpatriotic; the war was more important. As the pandemic ended, the suffering and memories remained personal and intimate with no public memorials to immortalize the lives or agony of the victims.
Today, we have all the information people lacked in the 1918 pandemic. We have studies detailing the modes of transmission, pathophysiology and prevention all under our fingertips. So why do we still have vaccine and mask-wearing hesitancy?
Perhaps the fear of diminishing civil liberties. Some anti-maskers believe wearing masks undermines American individualism and classical liberalism, moving toward communism. Others believe mask mandates target their religion.
Time has come to reconsider those ethical frameworks. Individual freedoms can and should be abridged in times of wars and emergencies when the general welfare depends on it. The individual and collective interests must be balanced, although the restrictions must never “go so far beyond what was reasonably required for the safety of the public,” as Justice John Marshall Harlan articulated in Jacobson v. Massachusetts (1905), which upheld the constitutionality of compulsory vaccination laws.
Religion is not an excuse for refusing the COVID-19 vaccine or wearing masks, either. A religion requiring strict adherence to practices whose harms outweigh the benefits for oneself and others cannot stand as moral. Furthermore, Justice Antonin Scalia said in Employment Division v. Smith (1990), laws that are “neutral, generally applicable, and not motivated by animus to religion” are, indeed, constitutional — which presumably includes masks mandates and vaccine laws.
Even with our progress since the 1918 pandemic, we can still improve, from harmonizing the public-scientist dichotomy and increasing transparency between the government officials and the public to embracing a more collectivist ethical framework and narrowing the healthcare disparities.
Let us strive toward a more just, humane society by which we can commemorate each life, full of meaning and aspirations, lost during the pandemics, present and past.