What Can Images of the 1918 Influenza Pandemic Teach Us About COVID-19?

Policemen in Seattle, Washington, wearing masks made by the Seattle Chapter of the Red Cross, during the influenza epidemic (all images courtesy the National Archives Catalog)

In 1918, a flu pandemic ripped through the globe, infecting one-third of the world population and killing more than 50 million people. Known as the Spanish Flu, or the 1918 Influenza Pandemic, it was caused by an H1N1 virus with genes of avian origin. Considered the worst flu pandemic in history, it was marked by exceptionally high mortality rate in otherwise healthy people. And much like today’s coronavirus pandemic, it caught the world unaware.

Photographic records of the 1918 Influenza Pandemic held at the National Archives Catalog, headquartered in College Park, Maryland, provide an illuminating overview of life in the United States while the disease ravaged the globe. The images, collected from regional archives across the country, hold striking similarities to the current COVID-19 pandemic and offer valuable lessons on how to contain it.

In the US, the virus was first identified in military personnel in spring 1918. At that early stage, few deaths were reported and people sickened by the virus recovered after a few days. But later in fall, the flu returned and quickly swelled to the scale of an epidemic, infecting more than 25% of the country’s population and killing about 675,000 people. In one year, the average life expectancy in the country dropped by 12 years.

Nurses in Boston hospitals equipped to fight influenza

Emergency hospital in Brookline, Massachusetts, to care for influenza cases

The archival images reveal marked parallels with the way the US is combatting the current pandemic: mandatory quarantine; field hospitals; mass recruitment of healthcare workers; and mask-clad civilians and essential workers.

It also appears that the strain on hospitals today is not vastly different from what it was in 1918. One archival image shows an emergency tent hospital in Brookline, Massachusetts, unable to accommodate the influx of influenza patients, with some hospitalized in the open air. A contemporary version of that hospital was recently erected in Central Park in Manhattan while some New York hospitals are reaching full capacity.

Just like today, masks were the elementary protective gear during the influenza pandemic, but with one major difference: the US led the world in mask-wearing, making face protection mandatory in many parts of the country. With a similar shortage of surgical masks, citizens back then were encouraged to craft their own masks at home. Churches, community organizations, and Red Cross chapters contributed to the effort by acquiring gauze and holding mask-making sessions.

A mask-clad street cleaner (unidentified location)

Social distancing was practiced as well, with cities like Minneapolis and Los Angeles banning public gatherings and shutting down all schools and businesses. According to a recent paper penned by Massachusetts Institute of Technology economist Emil Verner together with Sergio Correia and Stephan Luck of the Federal Reserve, these measures have not only mitigated the pandemic but also helped accelerate the economic recovery of affected areas.

“Cities that intervened earlier and more aggressively do not perform worse and, if anything, grow faster after the pandemic is over,” the economists write in their paper. “Our findings thus indicate that NPIs [non-pharmaceutical interventions] not only lower mortality; they also mitigate the adverse economic consequences of a pandemic.”

Men gargling with salt and water after a day working in the War Garden at Camp Dix, New Jersey

The archives can also teach us what measures were less effective in curbing the illness. In one lighthearted image, a group of soldiers is captured gargling with salt and water as a preventative measure against the virus. Although it has since been debunked as a medicinal remedy, the Center for Disease Control and Prevention (CDC) still recommends gargling with warm salty water as a way to soothe a sore throat.

Although there are several useful lessons to be learned from the 1918 Influenza Pandemic, the National Archives argues that it never received its due attention in American history.

“It is an oddity of history that the influenza epidemic of 1918 has been overlooked in the teaching of American history,” the National Archives says on its website. “Documentation of the disease is ample, as shown in the records selected from the holdings of the National Archives regional archives. Exhibiting these documents helps the epidemic take its rightful place as a major disaster in world history.”