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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.”

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Hakim Bishara

Hakim Bishara is a staff writer for Hyperallergic. He is also a co-director at Soloway Gallery, an artist-run space in Brooklyn. Bishara is a recipient of the 2019 Andy Warhol Foundation and Creative Capital...

4 replies on “What Can Images of the 1918 Influenza Pandemic Teach Us About COVID-19?”

  1. I wish the article covered the parallel of how racially unequal the healthcare system was then and how very little has changed since then. The bias against Black and Brown patients then is definitely worth pointing out as there are an overwhelming amount of Black people filling many of the hospitals today.

  2. Fantastic. My grandmother died in this. Great pics.
    …Just read comment below … good point, very true. Probably it would take more real research than they wanted to do to dig up pics and records … as non whites may not even have been treated in white hospitals, or at all. But I bet there is something there.

    1. If the photographers worked for a white audience, are there even ANY photos of POC during that pandemic?

  3. Alas, the 1918 pandemic has more in common with our era than most imagine. Still unrecognized by most contemporary commentators, it started not in Spain, or Kansas, but in China. It was taken to North American and Europe on ships and trains carrying over 100,000 Chinese workers brought in to relieve the wartime labor shortage. They traveled in close quarters with American and Canadian soldiers. And leaders of the allied nations suppressed information about the spreading virus lest it reveal vulnerabilities to the Germans. See historian Mark Humphries’s pathbreaking research in The Last Plague, 2013, and also the fascinating accounts by historian James Higgins on how different PA cities coped with the pandemic. In short, China has been exporting pandemics for over a century, and democratic leaders have been trying to ignore their early threats for political reasons. Which one is easier to remedy: fondness for eating wild animals full of viruses that jump easily to people in an information-suppressing autocracy, or investing heavily in expensive preparations for the next one? As long as so many are afraid to offend the powerful and economically resourceful China, I guess we’ll have to spend billions on hospitals, masks, ventilators, and economic compensation for the pandemic-disadvantaged.

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