Pandemic in Peace Time vs. Public Health Crisis of World War I

COVID-19 is once in a century public health storm. The only comparable event is the Spanish Flu from a century ago that coincided with World War I. As the world enters a winter with a resurgence in cases, there are waves of record COVID cases popping up in major urban centers as society deals with the challenges of reopening the economy and fatigue from social distancing. If current trends persist, the coronavirus could take the worst toll on society for a public health crisis during peace time.

As of Q4 2020, there are 242 thousand deaths and 10.5 million COVID cases in the United States alone. A Stanford study at the end of Q3 2020 found that fewer than 1 in 10 Americans have antibodies to coronavirus. Based on this study of nationally representative analysis of virus antibodies, it means that at least 9 percent of the U.S. population been infected with COVID-19.

Cumulative deaths from COVID-19
Total Reported COVID-19 Cases

Major drivers of virus transmission are public events and spaces where people interact, such as restaurants, shops, places of worship and other social gatherings. Those infected persons can then transmit it to people in their family and close circles. Important to note is we’re living in peace time in 2020.

There is no major war like what we faced a century ago when there were massive movements of troops. What we do have today is constant movement of people, not so much for the battlefield, but traveling for business and leisure, in an interconnected world with opened borders marked by globalization. Our modern economic life is much busier, have diverse needs and encompasses human collaboration and interaction in connected spaces. It’s what the economist Alfred Marshall referred to as the “ordinary business of life.” But these are extraordinary times.

The Center for Disease and Control Prevention estimates that 675,000 people in the United States contracted the Spanish Flu during the 1918 pandemic (HN1N virus). It infected about 28 percent of all Americans.

The biggest driving factor for transmission were urban density and troops mobilizing for World War I. President Wilson faced the challenge of the deadly Spanish flu while committing U.S. forces to fight the war. Like any commander in chief, President Wilson did not make decision lightly (Wilson would later suffered from the flu during post-WWI peace. negotiations in Paris).

In April 1917 had officially entered World War I with 378,000 in the armed forces. It wasn’t long until the draft established 32 large recruiting camps, each housing 25,000-55,000. The first cases of the Spanish Flu were detected in the spring of 1918. There were a few reported severe cases and a handful of deaths in rural Haskell, Kansas. The nearest military training ground, Camp Funston in Fort Riley, Kansas, about 100 soldiers had contracted the flu. Within a week, that figure shot up to a few hundred. With the “war to end all wars” at stake, there was no turning back. In May 1918, hundreds of thousands of U.S. troops would be deployed to the war front in Europe.

Massive movement of troops would be a key contributor to the deadly spread of the Spanish Flu. There was no social distancing. But unlike today’s peace time, soldiers were not dining at restaurants or at their local pubs. They were largely ground troops fighting conventional warfare, situated in crowded quarters and foxholes. On the aggregate, the Spanish Flu is thought to claim more lives than troops dying from the battlefield.

The Journal of the American Medical Association posted the following eerie observation on December 28, 1918:

“The 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man’s destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all–infectious disease” 

 Cots set up in gymnasium for flu patients
Military hospital for Spanish Flu patients