tag:theconversation.com,2011:/ca/topics/spanish-flu-11781/articlesSpanish flu – The Conversation2022-02-25T12:49:31Ztag:theconversation.com,2011:article/1775962022-02-25T12:49:31Z2022-02-25T12:49:31ZDigital technology is helping us memorialise the pandemic – despite the government wanting us to forget about it and move on<p>As the warnings to “<a href="https://www.bbc.co.uk/news/av/uk-52012581">stay at home</a>” fade from memory and we’re told we must “<a href="https://www.reuters.com/world/uk/britain-must-learn-live-with-covid-19-it-could-be-with-us-forever-javid-2022-01-20/">learn to live with COVID</a>”, it is easy to forget the first dread-filled days of the pandemic two years ago. Then, kisses, hugs and handshakes were freighted with danger and, panicked by the <a href="https://news.sky.com/story/coronavirus-inside-the-red-zone-the-desperate-fight-italy-hasnt-seen-since-the-plague-11963915">images from Italy</a> of intensive care wards filled with elderly patients, we rushed to supermarkets to empty the aisles of bleach and disinfectant.</p>
<p>Sure, there had been precedents: in 1918, there was a similar panic when hospitals were inundated with allied troops whose lungs had been compromised by “Spanish influenza”. In response, several US cities banned large public gatherings and passed public mask ordinances, while Australia imposed quarantines on soldiers returning from Europe. But these measures were far from universal. For instance, New Zealand did not attempt to quarantine returning troops.</p>
<p>The fact is that before COVID, entire cities had never been locked down at the same time and never before had social distancing been applied at such a scale – and for such an extended period. This was a remarkable achievement, one that few experts thought possible before the pandemic.</p>
<p>But the coronavirus pandemic was also unprecedented in another way. For even as we learned to keep our distance from other people, lest they prove unwitting carriers of the virus, so there was also an explosion of virtual social connections. Thanks to Zoom, Facebook and Twitter, we could “see” friends and family and offer words of solace, even if we could not touch them and wipe the tears from their eyes.</p>
<p>How this will affect remembrance of the coronavirus pandemic is difficult to say. From the moment Prime Minister Boris Johnson grasped that COVID threatened to overwhelm the NHS, he has been at pains to present the pandemic as a crisis comparable to war. But while war memorials can draw on a familiar suite of symbols and rituals, the same is not true of pandemics.</p>
<p>For example, despite killing over 50 million people globally, there are no contemporary memorials to the 1918-19 Spanish flu anywhere in Europe or North America. Nor, with one or two notable exceptions, have those who perished in the Great Flu pandemic been memorialised since. As Guy Beiner, a historian of modern memory, puts it in a <a href="https://global.oup.com/academic/product/pandemic-re-awakenings-9780192843739?facet_narrowbybinding_facet=Hardcover&lang=en&cc=us">new collection</a> revisiting the 1918-19 pandemic, “the Great Flu is essentially a lieu d’oublie, a site of social and cultural forgetting”.</p>
<p>It is also hard to locate meaning in a natural phenomenon lacking clear heroes and villains. “Who are the perpetrators if the Flu is caused by mutations of a string of RNA?” asks the memory studies scholar <a href="https://www.memorystudies-frankfurt.com/people/astrid-erll-2/">Astrid Erll</a> in the same collection. “What could the moral of the story be if victims are claimed randomly?”</p>
<p>However, for those who have lost close family members to COVID and who will not soon forget their grief – and the government errors that contributed to their trauma - there is an urgent moral story to be told, one full of agency. This story is written in red ink on the <a href="https://en.wikipedia.org/wiki/National_Covid_Memorial_Wall">National Covid Memorial Wall</a>, an unauthorised “people’s memorial” on Albert Embankment emblazoned with 160,000 hand-drawn hearts, one for every British victim of the virus.</p>
<h2>Organised online</h2>
<p>Conceived during lockdown by COVID-19 Bereaved Families for Justice, a patient-activist group that organised online, the wall is a vivid example of how social media and connective digital technologies are enabling the remembrance of the pandemic in ways that would have been inconceivable in previous centuries. And it is not the only example. The Anglican church is also having to adapt its rituals and traditions to the digital age: hence St Paul’s Cathedral’s <a href="https://www.rememberme2020.uk/">Remember Me</a> project - an online book of remembrance containing the names of thousands of victims of COVID.</p>
<p>The result is a new politics of memory, one in which activists, with the support of religious and moral leaders, are increasingly able to dictate what form memorials to the pandemic should take, and whose memories should be accorded prominence.</p>
<p>Despite Johnson’s repeated invocations of the blitz spirit, we were not all in this together. Indeed, when most of us were observing the social-distancing regulations, the prime minister and his Downing Street staff were holding social gatherings in an apparent breach of the lockdown rules.</p>
<p>History suggests that pandemics do not end when politicians tell us they are over but when they become objects of cultural forgetting. Yet, for many of us, there can be no end to the pandemic as long as questions about responsibility for the death toll remain unanswered and the coronavirus continues to claim lives.</p><img src="https://counter.theconversation.com/content/177596/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Honigsbaum does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A new politics of remembrance emerged during the COVID pandemic.Mark Honigsbaum, Medical Historian and Lecturer in Journalism, City, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1684812021-10-10T19:09:47Z2021-10-10T19:09:47ZSchools have moved outdoors in past disease outbreaks. Here are 7 reasons to do it again<figure><img src="https://images.theconversation.com/files/425147/original/file-20211007-27-138ow3i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/coronavirus-outbreak-lifestyle-outdoor-summer-school-1751836280">Shutterstock</a></span></figcaption></figure><p>Leaders across the country – particularly in the states with the largest outbreaks, New South Wales and Victoria – have designed road maps towards reopening the states after long lockdowns. Safety in childcare, schools and universities is a core component of reopening plans.</p>
<p>Year 12 students in <a href="https://www.theage.com.au/national/victoria/schools-begin-the-slow-return-to-on-site-learning-20210924-p58uhq.html">Melbourne</a> go back to school this week, and there are staggered return plans for the rest of the year levels over the coming weeks. All students are set to return to the classroom full-time by November 5. </p>
<p>Regional <a href="https://www.premier.vic.gov.au/getting-regional-students-safely-back-classroom">Victorian students</a> have a different schedule with all students back in the classroom full-time by October 26.</p>
<p>NSW students will be <a href="https://www.abc.net.au/news/2021-10-07/nsw-introduces-major-changes-to-covid-19-roadmap/100519894">returning to class</a> in a staggered fashion too. <a href="https://education.nsw.gov.au/covid-19/advice-for-families#:%7E:text=Students%20will%20return%20to%20face,October%20%E2%80%93%20all%20remaining%20year%20groups.">Kindergarten, year 1 and year 12 students are</a> to return on October 18; all other grades will return on October 25.</p>
<p>Managing a safe return includes managing indoor classrooms via ventilation, sanitation and social distancing. But the NSW Education Department has said it will also support schools to use “<a href="https://education.nsw.gov.au/news/latest-news/preparing-classrooms-for-students-return">outdoor learning areas</a>”. And the Victorian strategy <a href="https://www.coronavirus.vic.gov.au/covidsafe-ecec">includes advice for</a> early childhood centres and services to “move to an indoor/outdoor program (shifting to as much outdoor programming as possible)”.</p>
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Read more:
<a href="https://theconversation.com/from-vaccination-to-ventilation-5-ways-to-keep-kids-safe-from-covid-when-schools-reopen-166734">From vaccination to ventilation: 5 ways to keep kids safe from COVID when schools reopen</a>
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<p>Moving classrooms outside is not a new idea. It has been done in past disease outbreaks such as tuberculosis and the Spanish flu. We can learn lessons from history and take pointers from international schools that have already made moves to learn outside.</p>
<h2>A history of outdoor education</h2>
<p>As <a href="https://www.history.com/news/school-outside-tuberculosis">tuberculosis</a> was spreading and taking a toll on children in the early 1900s, an open-air school movement was launched in Germany. In 1904, the <a href="https://en.wikipedia.org/wiki/Waldeschule">Waldschule (forest school)</a> opened in Berlin. Its success spread, with forest schools opening in Scandinavia and open-air schools in Britain. A nationwide movement for fresh-air schools was launched across the US a few years later.</p>
<p>In 1912 New York, a private school <a href="https://www.nytimes.com/2020/07/17/nyregion/coronavirus-nyc-schools-reopening-outdoors.html">moved classes onto the roof</a>. Another school took up classes in an abandoned ferry and another in Central Park. </p>
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<a href="https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Black and white historical photograph. Kids in winter clothes." src="https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=456&fit=crop&dpr=1 600w, https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=456&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=456&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=573&fit=crop&dpr=1 754w, https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=573&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/425130/original/file-20211006-27-1u94hk2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=573&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">During past disease outbreaks, many classes were held outside. This is an open-air school in South Boston, 1918.</span>
<span class="attribution"><a class="source" href="https://picryl.com/media/south-boston-mass-open-air-school">PICRYL</a></span>
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<p>Schools around the world are now using outdoor classrooms again as a key strategy to mitigate the risks of COVID while remaining open.</p>
<p>The US <a href="https://www.greenschoolyards.org/covid-learn-outside">National COVID-19 Outdoor Learning Initiative</a> has been pushing for <a href="https://www.edsurge.com/news/2021-01-04-schools-turned-to-outdoor-learning-for-safe-equitable-instruction-in-2020-they-don-t-have-to-go-back">schools to have classrooms outdoors</a> and many have done so. </p>
<p>By last October New York City officials alone <a href="https://www.nydailynews.com/new-york/education/ny-outdoor-learning-nyc-schools-20201015-6aavvz6ftzdd3dhdx2ik24lgim-story.html">approved 1,100 proposals</a> for public school students to spend at least part of their day outdoors.</p>
<p>Some wanted to use their school grounds, closed down streets or take students to local parks for lessons. <a href="https://www.nytimes.com/2020/10/27/us/outdoor-classroom-design.html">Essex Street Academy</a>, a public secondary school in Lower Manhattan, was one of these schools. Students have been taking multiple classes on the expansive roof. According to the principal of the school, the roof of the vertical schools was designed as a school yard – so nothing needed to be adjusted. </p>
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<span class="caption">École de plein air de Suresnes: a school near Paris built in a similar internal layout to that used in hospital architecture, with long window-lined hallways.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Suresnes_-_Ecole_de_plein_air_NB_10.jpg">Wikimedia Commons</a></span>
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Read more:
<a href="https://theconversation.com/physical-distancing-at-school-is-a-challenge-here-are-5-ways-to-keep-our-children-safer-168072">Physical distancing at school is a challenge. Here are 5 ways to keep our children safer</a>
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<p>Without any specific directions, many teachers around Australia have also been heading outdoors. A K-1 primary teacher in NSW told me:</p>
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<p>Since the pandemic, on the days I’m onsite, I keep the kids outside most of the day. We go into the garden and read stories, complete writing tasks, art and maths games – using the gardens as stimulus.</p>
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<p>A university lecturer in Victoria said:</p>
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<p>Last semester, to support social distancing and increase fresh air, I took classes outdoors. Our classroom was the campus grounds, a local park, the botanic gardens and the National Gallery.</p>
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<p>Here are seven reasons why schools should be moving classes outside as much as possible.</p>
<h2>1. Being outdoors supports students’ health and well-being</h2>
<p>Being outside lowers the risk of transmission of the virus by making it easier to socially distance and providing better ventilation and fresh air. </p>
<p>It also supports students’ mental well-being. Research shows being outside has many positive health, social, emotional, ecological and learning <a href="https://www.plymouth.ac.uk/uploads/production/document/path/6/6811/Student_outcomes_and__natural_schooling_pathways_to_impact_2016.pdf">benefits</a> for students and staff.</p>
<h2>2. Setting up an outdoor classroom is relatively inexpensive and easy</h2>
<p>Compared to the other options such as opening up walls or windows in classrooms, installing ventilation systems or rotating home/school attendance to ensure smaller class numbers, moving outdoors can be implemented with limited resources. </p>
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<a href="https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Empty wooden chairs and tables in forest cleaing with blackboard at the front." src="https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/425146/original/file-20211007-19-6latxd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Learning outdoors has many health and social benefits.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/empty-outdoor-classroom-forest-black-classic-1977379202">Shutterstock</a></span>
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<h2>3. Outdoor classrooms may mean schools stay open</h2>
<p>Schools could safely accommodate more students by going outside. Therefore, there is less likelihood of disruption to the lives of students and families. By lowering risks once students return, schools are more reliably able to remain open. </p>
<h2>4. What is normally taught indoors can be adapted for outside</h2>
<p>For early childhood and primary school everything can be outside. Experiences overseas have shown well-resourced roof spaces or pavilions have overcome issues of special equipment. </p>
<p>The question should be what really <em>can’t</em> be taught outside rather than what <em>can</em> – that is the shorter list.</p>
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Read more:
<a href="https://theconversation.com/children-learn-science-in-nature-play-long-before-they-get-to-school-classrooms-and-labs-166106">Children learn science in nature play long before they get to school classrooms and labs</a>
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<h2>5. Schools can use a variety of outdoor options</h2>
<p>Permanent outdoor classrooms could be set up. Students could use the outdoors for one-off classes during the day, or schools can stagger class numbers by scheduling small groups inside and out throughout the day. </p>
<h2>6. Any space outdoors can be used</h2>
<p>Around the world, we’ve seen verandahs or external corridors, decks, courtyards, roof tops, school grounds, gardens, ovals, blocked-off streets on school boundaries, nearby local parks and playgrounds, and a <a href="https://www.academia.edu/415807/Every_Experience_Matters">vast array</a> of other local community spaces, such as beaches, forests and village centres, used as outdoor classrooms. </p>
<h2>7. Educators from outside the school can be used</h2>
<p>Educators from national parks, aquariums, museums, zoos and science centres are already trained in teaching outdoors and many have had limited work due to pandemic closures.</p><img src="https://counter.theconversation.com/content/168481/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karen Malone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Moving classrooms outside is not a new idea. It’s been done in past disease outbreaks such as tuberculosis and the Spanish flu.Karen Malone, Professor, Environmental Sustainability and Childhood Studies, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1675252021-09-19T20:09:42Z2021-09-19T20:09:42ZPeople dropped whisky into their noses to treat Spanish flu. Here’s what else they took that would raise eyebrows today<figure><img src="https://images.theconversation.com/files/421762/original/file-20210917-13-13403ae.jpg?ixlib=rb-1.1.0&rect=1%2C2%2C997%2C761&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bottle-whiskey-sitting-on-barrel-1360163816">Shutterstock</a></span></figcaption></figure><p>We’re researching COVID-19 in a <a href="https://theconversation.com/have-australian-researchers-developed-an-effective-covid-19-treatment-potentially-but-we-need-to-wait-for-human-trials-161085">fast-paced world</a> with <a href="https://theconversation.com/covid-is-surging-in-the-worlds-most-vaccinated-country-why-160869">new data</a> becoming available all the time. We track which interventions work well and which ones don’t.</p>
<p>But in 1918, during the Spanish flu pandemic, the world was a different place. No one was entirely sure <a href="https://www.history.com/topics/world-war-i/1918-flu-pandemic">what caused influenza</a>. By the time health authorities began to find out, it was too late.</p>
<p>Our knowledge about viruses was limited in 1918, but we knew about bacteria. People who died of flu had bacterial infection in their lungs. However, <a href="https://www.clinicaloncology.com/COVID-19/Article/07-20/Vaccine-Efforts-In-the-1918-Flu-Pandemic/58837">this threw researchers off track</a> because these were <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291411/">secondary infections</a>, not caused directly by the flu.</p>
<p>With this lack of knowledge, it was still an anything-goes medical research world. There were <a href="https://www.clinicaloncology.com/COVID-19/Article/07-20/Vaccine-Efforts-In-the-1918-Flu-Pandemic/58837">unregulated vaccine trials</a> and lots of hype for the latest “cure”, even in respectable medical journals.</p>
<p>More than 100 years on, controversial “cures” for COVID-19, such as ivermectin, are <a href="https://theconversation.com/thinking-of-trying-ivermectin-for-covid-heres-what-can-happen-with-this-controversial-drug-167178">making the headlines</a>, being reported in <a href="https://theconversation.com/a-major-ivermectin-study-has-been-withdrawn-so-what-now-for-the-controversial-drug-164627">medical journals</a> and are being promoted by <a href="https://www1.racgp.org.au/newsgp/clinical/restrictions-placed-on-ivermectin-use-in-general-p">doctors</a> and <a href="https://www.abc.net.au/news/2021-08-25/tga-warns-people-against-using-ivermectin-for-covid-treatment/100406472">politicians</a>.</p>
<p>Here’s what we know about the Spanish flu “cures” of the day, whisky included.</p>
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Read more:
<a href="https://theconversation.com/i-asked-historians-what-find-made-them-go-wait-wut-heres-a-taste-of-the-hundreds-of-replies-167176">I asked historians what find made them go ‘wait, wut?’ Here's a taste of the hundreds of replies</a>
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<h2>Doctors, pharmacists and nurses had cures</h2>
<p>Doctors developed and used some of these cures for the flu. Sydney’s chief quarantine officer, Dr Reid, <a href="https://trove.nla.gov.au/newspaper/article/92732032?searchTerm=influenza%20cures">treated patients</a> in March 1919 with 15-grain (1 gram) doses of calcium lactate every four hours, and a “vaccine” containing influenza and pneumococcus bacteria. In 203 cases, he had no deaths. </p>
<p>Calcium lactate is used today to treat <a href="https://www.drugs.com/dosage/calcium-lactate.html">low levels of calcium in the blood</a>. But Dr Reid’s doses are well above the current recommended daily level.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=407&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=407&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=407&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=511&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=511&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421230/original/file-20210915-25-1rist46.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=511&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">J R A McAlister’s treatment ‘cures influenza at once’.</span>
<span class="attribution"><span class="source">Trove Digitised Newspapers, Guyra Argus, September 11, 1919, p2, National Library of Australia</span></span>
</figcaption>
</figure>
<p><a href="https://trove.nla.gov.au/newspaper/article/117849190?searchTerm=influenza%20cures">Chemists were also busy</a> making and selling <a href="https://trove.nla.gov.au/newspaper/article/173829607?searchTerm=influenza%20cures%20chemist#">their own influenza cures</a>. J. Reginald Albert McAlister of Guyra in regional New South Wales advertised his 1919 patented mixture as <a href="https://trove.nla.gov.au/newspaper/article/173829607?searchTerm=%22influenza%20is%20here%22%20guyra">curing influenza at once</a>.</p>
<p>People even listened to nurses — who at the time were usually the <a href="https://nursekey.com/nursing-historical-present-and-future-perspectives/">least important people in the health-care system</a> — about cures for the Spanish flu.</p>
<p>Nan Taylor, a New Zealand nurse, <a href="https://trove.nla.gov.au/newspaper/article/166914012?searchTerm=spanish%20flu%20cures%20quinine">advocated</a> whisky — lots of it, including gargling and drops up the nose. She also recommended quinine and castor oil.</p>
<p>Nurse Kate Guazzini cared for Spanish flu patients in South Africa in late 1918, and caught the flu there before moving to Sydney. She <a href="https://trove.nla.gov.au/newspaper/article/175740882?searchTerm=influenza%20cures">said</a>:</p>
<blockquote>
<p>I was kept alive on brandy and milk for six weeks […] That, with quinine and hot lemon drinks, were found to be the only effective remedies.</p>
</blockquote>
<p>Food manufacturers linked themselves to flu cures. In 1919 a <a href="https://web.archive.org/web/20050311025801/http://www.kraft.com.au/virtualMuseum/decades/index.cfm?Page=decades1910">brand new beef extract</a>, Bonox, had just hit the Australian market, and the flu epidemic was a great marketing opportunity. <a href="https://trove.nla.gov.au/newspaper/article/243479671?searchTerm=spanish%20influenza%20flu%20cures%20chemist">Bonox was advertised</a> as a sure way to recover your health and strength after the flu.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421100/original/file-20210914-17-1mnp2em.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This Bonox advertisement promised a robust recovery.</span>
<span class="attribution"><span class="source">Trove Digitised Newspapers, Herald (Melbourne), April 26, 1919, p9, National Library of Australia</span></span>
</figcaption>
</figure>
<h2>News of ‘cures’ spread far and wide</h2>
<p>In much of Australia just after WWI <a href="https://www.mja.com.au/journal/2014/201/1/medicine-colonial-australia-1788-1900">there were often no doctors close by</a>. So many people were used to dosing themselves with <a href="https://recollections.nma.gov.au/issues/vol_6_no_1/refereed_papers/opening_the_medicine_chest">homemade potions and remedies</a>. They shared their prescriptions in the pages of local newspapers. </p>
<p>Between 1918 and 1920, Australian newspapers were flooded with Spanish flu cures of all kinds.</p>
<p>In October 1918, a journalist at Victoria’s Bendigo Independent <a href="https://trove.nla.gov.au/newspaper/article/219787116?searchTerm=influenza%20cures">lamented</a>:</p>
<blockquote>
<p>Cures? My goodness me, the vast amount of cures on the market are positively frightening, and everyone has a favorite cure. I pin my faith to one, you to another. There’s a certain influenza mixture that, taken in the early stages, is regarded as a certain cure by one large section […] Asperin [sic] is the cry of another batch of victims, and they tell you that that drug does the trick. ‘Try whiskey and milk taken hot and taken often,’ is the advice of others who have had it. But one and all end in the same way: ‘Go to bed and stay there till the thing leaves you.’</p>
</blockquote>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421099/original/file-20210914-17-1kel86o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Aspro advertising, Telegraph (Qld), 30 July 1921, page 14.</span>
<span class="attribution"><span class="source">Trove Digitised Newspapers, National Library of Australia</span></span>
</figcaption>
</figure>
<p>Aspirin was very popular as a Spanish flu treatment worldwide. But people sometimes took it at dangerously high doses, <a href="https://www.sciencedaily.com/releases/2009/10/091002132346.htm">which may have boosted the number of deaths</a> <a href="https://academic.oup.com/cid/article/49/9/1405/301441">attributed to the flu</a>. </p>
<p>In the absence of many other treatments, government authorities <a href="http://www.gp.org.au/SpanishFlu.php">promoted aspirin</a>, along with <a href="https://trove.nla.gov.au/newspaper/article/72991015?searchTerm=spanish%20flu%20cures">quinine and phenacetin</a>. </p>
<p>The pain killer <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Phenacetin#:%7E:text=Phenacetin%20is%20an%20odorless%20fine,by%20a%204%2Dethoxyphenyl%20group.">phenacetin</a> is now banned because it’s linked to <a href="https://www.iarc.who.int/news-events/ban-on-widely-used-painkiller-significantly-reduced-incidence-of-renal-pelvis-cancer/">kidney and urinary tract cancers</a>. </p>
<p>Like aspirin, <a href="https://trove.nla.gov.au/newspaper/article/236346598?searchTerm=spanish%20influenza%20phenacetin">its overuse might have boosted</a> the Spanish flu death rate.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/100-years-later-why-dont-we-commemorate-the-victims-and-heroes-of-spanish-flu-109885">100 years later, why don't we commemorate the victims and heroes of 'Spanish flu'?</a>
</strong>
</em>
</p>
<hr>
<h2>They’re using it in America</h2>
<p>Like today, Australians were also eagerly reading about overseas experiments, and wanting to try these cures locally.</p>
<p>In June 1919, the Richmond River Herald <a href="https://trove.nla.gov.au/newspaper/article/132523415?searchTerm=spanish%20flu%20cures%20mercury">reported</a>:</p>
<blockquote>
<p>On Friday we published the following New York cable: — ‘Dr. Charles Duncan, at the Convention of the American Medical Association, said the cure for influenza was one drachm of infected mucus pasteurised and with filtered water injected subcutaneously … Yesterday (says Tuesday’s Tweed 'Daily’) a youth was seen inquiring for a chemist, having in his hand the above clipping and sixpence, his object being to secure that amount’s worth of the ‘cure.’ Several others, it is understood, have also been inquiring into the same matter, with a view to ‘having it made up’ locally.</p>
</blockquote>
<h2>Some of these cures lingered</h2>
<p>Once the Spanish flu pandemic was over, many of the cures remained. Most of them, like aspirin, incorporated the threat of influenza <a href="https://trove.nla.gov.au/newspaper/article/21556041?searchTerm=influenza%20aspirin">into regular advertising</a>.</p>
<p>Some, <a href="https://www.pennmedicine.org/departments-and-centers/otorhinolaryngology/about-us/newsletters/latest-newsletter/quinine-the-tonic-for-covid19">like quinine</a>, have made a reappearance during the COVID-19 pandemic. </p>
<p>And one of the most commonly recommended cures — <a href="https://trove.nla.gov.au/newspaper/article/232375023?searchTerm=spanish%20influenza%20whisky%20cure">whisky taken at frequent intervals</a> — <a href="https://www.wearethemighty.com/MIGHTY-SURVIVAL/whiskey-protect-against-covid-19/">hasn’t lost its popularity</a>.</p><img src="https://counter.theconversation.com/content/167525/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philippa Martyr does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Doctors, nurses, pharmacists and others all had their own cures for the Spanish flu. But some of these may have made things worse.Philippa Martyr, Lecturer, Pharmacology, Women's Health, School of Biomedical Sciences, The University of Western AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1622462021-07-07T20:09:06Z2021-07-07T20:09:06ZSardines for breakfast, hypothermia rescues: the story of the cash-strapped, post-pandemic 1920 Olympics<figure><img src="https://images.theconversation.com/files/410056/original/file-20210707-15-cgugyb.JPEG?ixlib=rb-1.1.0&rect=132%2C20%2C1190%2C999&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">British runner Albert Hill winning the 800-meter run at the 1920 Antwerp Olympics.</span> <span class="attribution"><span class="source">Bibliothèque nationale de France, département Estampes et photographie, EI-13 (727)</span></span></figcaption></figure><p>Since the global pandemic began, debate has raged over whether Tokyo should go ahead with the Olympic Games, now set to open on July 23.</p>
<p>The same heated debates were heard the last time an Olympic Games were staged following a global pandemic — the 1920 Summer Olympics in Antwerp. </p>
<p>The International Olympic Committee (IOC) strongly believed the Olympics would help bring the world back together — not just after the devastating Spanish Flu pandemic that <a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html#:%7E:text=It%20is%20estimated%20that%20about,occurring%20in%20the%20United%20States.">killed at least 50 million people</a>, but also the tumult of the first world war. </p>
<p>Only six months after the armistice that ended the conflict — and in the midst of the pandemic — Pierre de Coubertin, the founder of the modern Olympics and president of the IOC, <a href="https://fr.wikisource.org/wiki/Autour_de_la_VIIme_Olympiade">called</a> an extraordinary IOC session to award the 1920 Olympics to Antwerp in recognition of Belgium’s suffering. </p>
<p>Newspapers around the world agreed. In France’s premier sports paper, L’Auto, journalists asked “<a href="https://gallica.bnf.fr/ark:/12148/bpt6k4628326j/">Belgium – didn’t they earn the Games?</a>”. </p>
<p>Despite the IOC’s enthusiasm, worries about the resurgence of the Spanish Flu stalked the competition. Although the last wave hit Europe in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634693/">spring of 1920</a>, newspapers still reported on rumours of new outbreaks in the weeks leading up to the games.</p>
<p>Though a number of Olympic athletes died from the flu in the years leading up to the games, historical records show the virus <a href="https://www.tandfonline.com/doi/full/10.1080/01490400.2020.1773982">had no direct impact</a> on the event itself. Nonetheless, planning an Olympics in the aftermath of both a war and pandemic was far from easy for the under-resourced and overstretched Belgians.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=324&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=324&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=324&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=408&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=408&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410044/original/file-20210707-21-1crb0iq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=408&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Spanish flu outbreak in Boden, Sweden, taken in 1918.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<h2>An Olympic farce?</h2>
<p>The Antwerp Games followed closely after the <a href="https://www.worldwar1centennial.org/index.php/communicate/press-media/wwi-centennial-news/6352-june-22-july-6-marks-centennial-of-the-inter-allied-games.html">Inter-Allied Games</a>, held in Paris in 1919, which brought together soldiers from the Allied powers who were stationed in France and Belgium and had yet to be demobilised. </p>
<p>The popular event saw large crowds, despite concerns about the flu, and provided greater impetus to move ahead with the even more ambitious Olympics. British Olympic officials <a href="https://trove.nla.gov.au/newspaper/article/120303682">said in a letter</a> to The Referee newspaper in Sydney,</p>
<blockquote>
<p>By renewing her claim to this Olympiad, she [the city of Antwerp] says to her tyrants of yesterday, ‘You thought you had broken my spirit and ruined my fortunes. You have failed.’ </p>
</blockquote>
<p>The Belgian Olympic Committee refused to invite athletes from the Central Powers who fought in the war — Germany, Austria, Hungary, Bulgaria, and the Ottoman Empire. The newly created Soviet Union also <a href="https://www.britannica.com/event/Antwerp-1920-Olympic-Games">declined to attend</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=446&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=446&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=446&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410058/original/file-20210707-27-3pf7ja.JPEG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The British-winning tug of war team at the 1920 Games.</span>
<span class="attribution"><span class="source">Bibliothèque nationale de France, département Estampes et photographie, EI-13 (727)</span></span>
</figcaption>
</figure>
<p>This intrusion of politics on the games proved challenging for the IOC. During the first world war, de Coubertin had avowed Olympic neutrality, and <a href="https://www.tandfonline.com/doi/abs/10.1080/09523367.2011.554184">was quoted</a> in the Italian newspaper La Stampa in 1915 as being open to Germany hosting the games the following year. (The <a href="https://encyclopedia.1914-1918-online.net/article/olympic_games_1916">1916 Berlin Olympics</a> were ultimately cancelled due to the war.) </p>
<p>The IOC also made every effort to sell the 1920 Olympics as a celebration of peace. Antwerp was the first Olympics, for example, to feature the famed five interlocking rings designed to represent “<a href="https://olympics.com/ioc/olympic-rings">the union of the five continents and the meeting of athletes from throughout the world</a>”. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=829&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=829&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=829&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1041&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1041&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410043/original/file-20210707-13-1wb47tf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1041&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">1920 Olympics poster.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<p>But not everyone was supportive of the idea that “Olympism” could promote peace in the wake of the war. The UK assistant under-secretary for foreign affairs, Eyre Crowe, decried the Olympics as “<a href="https://www.tandfonline.com/doi/pdf/10.1080/09523369208713789">an international farce</a>” and joined a chorus of government officials arguing against funding a British Olympic team. </p>
<p>The Belgian Olympic Committee, and the athletes themselves, explicitly connected the games to the war, as well.</p>
<p>At the opening ceremonies, the organisers released doves into the air, but also held a religious service in memory of the Allied athletes who had been killed. Military officials also played a key role in organising and staging events: the American team only arrived in Europe, for instance, thanks to a last-minute military transport. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/bJw_8ppb4nI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<h2>Few fans and a financial failure</h2>
<p>Just like the Tokyo Games, De Coubertin and the IOC were under considerable pressure to ensure the Antwerp Olympics went ahead, despite the challenging circumstances.</p>
<p>After an eight-year break following the 1912 Olympics, de Coubertin realised that hosting Olympics in 1920 was essential to defending their position as the world’s premier international sporting competition. </p>
<p>He was aware that alternative games were being organised, including the <a href="https://www.history.co.uk/articles/the-1921-women-s-olympiad-one-hundred-years-of-women-s-international-sport">1921 Women’s Olympiad</a> in Monte Carlo, which was planned, in part, because of the unwillingness of the Olympics to allow a full range of women’s events. </p>
<p>On August 14, 1920, the Antwerp Games opened with more than 2,600 competing athletes. Several achieved remarkable success, including the Hawaiian-American swimmer, <a href="https://www.britannica.com/biography/Duke-Kahanamoku">Duke Kahanamoku</a>, <a href="https://olympics.com/en/athletes/duke-paoa-kahanamoku">who won gold and set a world record</a> in the 100-metre freestyle. But overall, the quality of competition had dipped significantly. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=897&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=897&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=897&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1127&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1127&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410049/original/file-20210707-25-yfwraw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1127&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Olympic swimming champion Duke Kahanamoku at the Antwerp Olympics in 1920.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<p>The war was the cause: many star athletes died or returned injured and unable to compete. The British team, for instance, lost several track and field stars — <a href="https://olympics.com/en/athletes/gerald-rupert-lawrence-anderson">Gerald Anderson</a>, Kenneth Powell and Henry Ashington — all from Oxbridge sporting clubs.</p>
<p>Other athletes <a href="https://www.seattletimes.com/sports/olympics/planning-for-olympics-in-a-pandemic-has-echoes-of-1920-games/">had died from the flu</a>, including nine-time Olympic medallist <a href="https://en.wikipedia.org/wiki/Martin_Sheridan">Martin Sheridan</a>.</p>
<p>The number of fans were also lower than organisers expected: many locals were unable to afford the high cost of tickets. The low local interest resulted in a <a href="https://www.thoughtco.com/1920-olympics-in-antwerp-1779595">loss of 600 million francs</a> for Belgium, and within three years, the Belgian Olympic Committee had <a href="https://www.nytimes.com/1996/07/14/sports/perspectives-on-the-playing-fields-of-flanders.html">gone bankrupt</a>. </p>
<p>The rush to host the games could only partially explain its financial failure. The Belgian government <a href="https://digital.la84.org/digital/collection/p17103coll8/id/9586/rec/8">set aside 4 million francs</a> to fund the competition, but quickly ran out of money and was forced to scrape up money through local fund-raising drives and by selling memorabilia. </p>
<p>American, British, and French Olympic committees similarly faced difficulty raising funds to send athletes to Belgium. In the wake of the war, amid a global economic recession, few governments had money to spend on sport. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=393&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=393&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=393&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=494&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=494&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410045/original/file-20210707-17-1rz2anp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=494&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The opening of the 1920 Olympics.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<h2>‘We were heartsick when we saw it’</h2>
<p>Cash-strapped Belgium was hardly ready to welcome athletes, let alone large numbers of fans. Walker Smith, an American track and field athlete, <a href="http://digital.la84.org/digital/collection/p17103coll11/id/236/rec/59">described</a> sleeping on cots “without mattresses” in dormitories housing 10 to 15 men per room.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1319&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1319&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1319&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1657&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1657&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410053/original/file-20210707-13-r6ixr0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1657&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Aileen Riggin during the 1920 Olympic Games in Antwerp.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<p>The food situation was similarly bleak, with athletes given only a roll, coffee and “one little sardine” for breakfast. They were forced to buy their own food — Belgium was still receiving aid because of food shortages. </p>
<p>Sporting facilities, too, were in shambles. The Olympic Stadium was barely finished when the games began — the track was incomplete and many of the races were conducted in muddy conditions. </p>
<p>Swimmers faced even tougher circumstances: the Belgians had not built a pool but instead constructed a wooden frame in an existing waterway. </p>
<p>Aileen Riggin, the gold medallist in the women’s three-meter springboard event, <a href="https://digital.la84.org/digital/collection/p17103coll11/id/604/rec/57">remembers</a> diving into a canal, part of the city’s ancient defences, and into water being shared by all the nautical sports. </p>
<blockquote>
<p>We were heartsick when we saw it. […] A 50-meter pool was not asking too much, but of course Belgium did the very best they could. This was right after the war.</p>
<p>It was so cold that many swimmers had to be rescued from hypothermia. They were unconscious, and some of them were really in a bad way and had to be dragged out.</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=436&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=436&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=436&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=548&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=548&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410052/original/file-20210707-17-1lhs8fn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=548&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Swimming competition in a canal at the Antwerp Olympics. (Duke Kahanamoku is in lane 5).</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<h2>Antwerp’s legacy</h2>
<p>Despite these hardships, Belgians reported a successful Olympiad. The IOC’s report called the games a noble cause, but admitted that “<a href="https://digital.la84.org/digital/collection/p17103coll8/id/9586/rec/8">for Belgians the success was relative</a>”. </p>
<p>According to the IOC, one of the lessons they learned was</p>
<blockquote>
<p>how expensive it was to host the games [and] that it is imprudent to undertake them without having the necessary capital in hand. </p>
</blockquote>
<p>In the rush to host the 1920 games, the IOC, local organisers, and other national committees made avoidable and costly mistakes. </p>
<p>Unfortunately, as the long history of politicised and costly Olympics has shown, some of these mistakes were doomed to be repeated.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-tokyo-olympics-are-going-ahead-but-they-will-be-a-much-compromised-and-watered-down-event-160104">The Tokyo Olympics are going ahead, but they will be a much compromised and watered-down event</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/162246/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Keith Rathbone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The IOC was under considerable pressure to host the 1920 games. While a noble goal, it resulted in significant hardships for war-torn Belgium and the athletes themselves.Keith Rathbone, Lecturer, Modern European History and Sports History, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1579252021-03-26T16:35:51Z2021-03-26T16:35:51ZVirginia Woolf: writing death and illness into the national story of post-first world war Britain<figure><img src="https://images.theconversation.com/files/391966/original/file-20210326-19-1yl4eir.jpg?ixlib=rb-1.1.0&rect=0%2C120%2C1150%2C770&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Spanish Flu spread around the world in 1918 and 1919. At least 20 million died.</span> <span class="attribution"><a class="source" href="https://www.alamy.com/1918-1919-an-epidemic-of-spanish-flu-spread-around-the-world-at-least-20-million-died-although-some-estimates-put-the-final-toll-at-50-million-its-estimated-that-between-20-per-cent-and-40-per-cent-of-the-entire-worlds-population-became-sick-image332695346.html?pv=1&stamp=2&imageid=C2EFE65B-9460-4027-9945-9717447C57D9&p=865682&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d3%26resultview%3dsortbyRelevant%26npgs%3d0%26qt%3dspanish%2520flu%26qt_raw%3dspanish%2520flu%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d367580%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3dGB%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d">Vintage_Space/Alamy</a></span></figcaption></figure><p>Illness, unlike war, as English academic and writer Elizabeth Outka brilliantly demonstrates in her book <a href="http://cup.columbia.edu/book/viral-modernism/9780231185752">Viral Modernism</a> (2019), is a story that easily slips out of cultural and historical memory.</p>
<p>In illness, the modernist writer Virginia Woolf observed, “We cease to be soldiers in the army of the upright; we become deserters.” Woolf, writing in the wake of the first world war, saw the threat that the Spanish flu of 1919 posed to the stories of national triumph. Influenza moves in invisible and unpredictable ways. It renders everyone potentially vulnerable. </p>
<p>This interest in illness was personal. Woolf came down with several bouts of influenza between 1916 and 1925 and needed to confine herself to bed for stretches of time. </p>
<p>She documents the experience of the Spanish flu in her diary in 1918, noting, as an aside, how “we are, by the way, in the midst of a plague unmatched since The Black Death, according to the Times, who seem to tremble lest it may seize upon Lord Northcliffe and thus precipitate us into peace.” </p>
<p>Her tone is mocking. She would later appreciate the seriousness the threat of influenza posed. But here she suggests that what illness promises to bring is the end of the profit of war that fuels the nationalist sentiments churned out by the newspapers owned by Lord Northcliffe’s vast empire of popular journalism. </p>
<p>Reading Woolf’s work, particularly her 1925 novel Mrs Dalloway, on the 80th anniversary of her death and in the midst of our own pandemic, we see how she tried to rewrite death and illness back into the national story of post-first world war glory and strength.</p>
<h2>Sidelining death</h2>
<p>I’m a lecturer in English at Cardiff University, and teaching literature in a sparsely filled lecture theatre during the pandemic has been a discombobulating experience. Mrs Dalloway provided an entry point to make sense of the business of studying and thinking while a new national emergency unfolded around us. The protagonist of Mrs Dalloway is a survivor of the Spanish flu of 1919 and the sense of life that permeates the text emerges from her experience of rediscovering the pleasures of life. We meet Mrs Dalloway as she weaves her way through London, experiencing the quiet intensity of life one morning in June. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/virginia-woolf-on-the-magic-of-going-to-the-cinema-157939">Virginia Woolf on the magic of going to the cinema</a>
</strong>
</em>
</p>
<hr>
<p>The novel’s famous opening line – “Mrs Dalloway said she would buy the flowers herself” – has taken on new resonance this year as the pandemic has made all our worlds much smaller. Clarissa wants to buy the flowers herself because she is delighted to go out – as we might appreciate – having spent so long indoors. </p>
<p>In class, the students and I thought about what it meant to see Clarissa as a character who has lived through a pandemic and come out the other side. Clarissa’s commitment to life, after a long confinement, is hopeful, though it comes at a cost.</p>
<p>At the centre of Clarissa’s party, which the novel builds to, comes the news that Septimus Smith, a young war veteran, has killed himself. In Woolf’s original plans for her novel, Septimus did not appear and Clarissa was to kill herself during the party. In creating Septimus as Clarissa’s double, Woolf is able to move death to the sidelines – as we all would like to. </p>
<p>Woolf revolutionises character by radically tunnelling inwards – giving us not a description of a character, but a map of their psychic life. We experience the protagonist intimately from within – through their stream of consciousness – but peripheral characters also proliferate in the modernist novel. </p>
<p>Woolf recognises how easy it is to cast characters to the sidelines of life. This is, after all, how national fictions work, by making space for protagonists at the expense of those who are pushed further out of view. In the case of post-war Britain, space was made for the glory of war but not for the the Spanish flu.</p>
<h2>Collective memory</h2>
<figure class="align-right ">
<img alt="Painting of Virginia Woolf." src="https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=794&fit=crop&dpr=1 600w, https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=794&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=794&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=998&fit=crop&dpr=1 754w, https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=998&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/391938/original/file-20210326-25-8esw7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=998&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Virginia Woolf painted by Roger Eliot Fry.</span>
<span class="attribution"><a class="source" href="https://artuk.org/discover/artworks/virginia-woolf-18821941-37569">Leeds Museums and Galleries</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Mrs Dalloway is a text that shows how memory and mourning work to uphold the values of the British Empire. Its attention on how emotions circulate between people allows us to understand how national structures of feeling are created through newspapers and through the orchestration of symbolic identifications. </p>
<p>“In all the hat shops and tailors’ shops strangers looked at each other,” Woolf writes, “and thought of the dead; of the flag of Empire.” Woolf is interested in showing something that is hard to pinpoint: how national communities are created and sustained; how the war’s dead continue to underpin an inexorable sense of Britishness.</p>
<p>Woolf saw that a subjective perspective was required to make sense of how death continues to inflect the mood of a generation. Mourning, as <a href="https://www.sas.upenn.edu/%7Ecavitch/pdf-library/Freud_MourningAndMelancholia.pdf">Sigmund Freud</a> also realised at a similar point, is ongoing, illusory work. What is remarkable about her writing is that Woolf draws our attention to how death pushes us beyond what we can know. In this unknowing, we are forced to admit that our lives are more fragile and dependent on the lives of others. </p>
<p>As one of her characters articulates in The Voyage Out (1915): </p>
<blockquote>
<p>“It seems so inexplicable,” Evelyn continued. “Death, I mean. Why should she be dead, and not you or I? It was only a fortnight ago that she was here with the rest of us?” </p>
</blockquote>
<p>Woolf’s ability to show how hard it is to explain death helps us understand the difficulty of living with its presence. In the face of the loneliness of death, the growing demise of its communal forms, the diminished structures of public mourning, she provides us with a language for death outside of national structures of commemoration.</p><img src="https://counter.theconversation.com/content/157925/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jess Cotton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Woolf’s writing about illness defied the establishment’s post-war story of national strength.Jess Cotton, Lecturer at School of English, Communication and Philosophy, Cardiff UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1522642020-12-22T17:56:16Z2020-12-22T17:56:16ZHow Ernest Hemingway really responded to the Spanish flu pandemic<figure><img src="https://images.theconversation.com/files/376424/original/file-20201222-23-ue7nac.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ernest Hemingway, July 1918, American Red Cross Hospital, Milan, Italy.</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Ernest_Hemingway,_1918,_American_Red_Cross_Hospital.jpg">Buckley, Peter, Ernest, Dial Press, New York, 1978</a></span></figcaption></figure><p>Earlier this year, as the world came to terms with the coronavirus pandemic, a letter purporting to have been written by F Scott Fitzgerald in the midst of the 1918 flu pandemic did the rounds on the internet. It was, of course, a <a href="https://www.mcsweeneys.net/articles/this-side-of-paradise-a-letter-from-f-scott-fitzgerald-quarantined-in-the-south-of-france">parody</a>, but the writing style and notes to his pal Ernest Hemingway meant the letter – unless you’re a Fitzgerald expert – was pretty convincing:</p>
<blockquote>
<p>At this time, it seems very poignant to avoid all public spaces. Even the bars, as I told Hemingway, but to that he punched me in the stomach, to which I asked if he had washed his hands. He hadn’t. He is much the denier, that one. Why, he considers the virus to be just influenza. I’m curious of his sources.</p>
</blockquote>
<p>Its real author, Nick Farriella, had expertly muddied the tone of Fitzgerald’s language with, some contemporary 21st century concerns, and a dash of the clichéd image of the character we’ve come to know as “Hemingway” – something of a macho bore, brawler and liar. </p>
<p>It’s an unfortunate, but sometimes well-deserved, persona, as I have come to know intimately whilst doing research for a new book examining his often ignored, shadowy time spent in London and Europe before and after D-Day. </p>
<p>This was an arguably defining time in his life and career, when he was possibly the best known living writer in the world and something of a one-man global commercial brand. Even then, I have discovered that when he was in the company of undercover spies and well-known authors (sometimes, like his friend Roald Dahl) he could be, by turns, thoughtful, loving, brilliant, brave, embarrassing, abusive and downright nasty. </p>
<p>For some, the tone of the parody pandemic letter was a brief moment of entertainment because it was the return of the cartoonish wild-eyed and comical version of Hemingway from Woody Allen’s <a href="https://www.youtube.com/watch?v=ADwLBOQRmI0">Midnight in Paris</a>. For others, who knew a little more about Hemingway, it was yet another simplistic attempt to besmirch his deeply complex legacy – fake news, you might say.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/ADwLBOQRmI0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<h2>Hemingway and the facts</h2>
<p>In fact, Hemingway’s response to the pandemic of 1918-19 – and later waves too – was very different from the parody. The truth is effortlessly stranger and more enigmatic than any fiction. Of course Hemingway was guilty of hyping facts to meet his mantra that fiction could be truer than the truth. But that didn’t change his basic respect for scientific facts and the natural world. </p>
<p>He was, after all, the dutiful son of a doctor from Oak Park, Illinois who’d witnessed first-hand his father’s work and used the experiences in his later fictional works. The Hemingway scholar <a href="https://www.kentstateuniversitypress.com/2020/the-hemingway-society-reprints-love-in-the-time-of-influenza-hemingway-and-the-1918-pandemic/">Susan Beegel</a> has shown how serious illness, disease, sudden and prolonged death were nothing new to him. He was aware, in humans and animals, of the fragility of life. </p>
<figure class="align-center ">
<img alt="A formal picture of a family." src="https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=454&fit=crop&dpr=1 600w, https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=454&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=454&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=571&fit=crop&dpr=1 754w, https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=571&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/376179/original/file-20201221-17-1u9p675.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=571&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">An early picture of Ernest Hemingway with his family, 1905. Ernest stands at the far right.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/Category:Ernest_Hemingway_Photograph_Collection_at_the_John_F._Kennedy_Presidential_Library_and_Museum#/media/File:Ernest_Hemingway_with_Family,_1905.png">John F. Kennedy Presidential Library and Museum, Boston</a></span>
</figcaption>
</figure>
<p>The GP’s son later had his own appalling experiences in the first world war, when he volunteered for the Red Cross. Bad eyesight meant normal duty was out of the question, but a determined Hemingway used the Red Cross to get to the Italian front line instead.</p>
<figure class="align-right ">
<img alt="A man in army uniform stands on crutches." src="https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=771&fit=crop&dpr=1 600w, https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=771&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=771&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=968&fit=crop&dpr=1 754w, https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=968&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/376181/original/file-20201221-17-1uvy4rk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=968&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ernest Hemingway recuperates from wounds in Milan, 1918.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/Category:Ernest_Hemingway_Photograph_Collection_at_the_John_F._Kennedy_Presidential_Library_and_Museum#/media/File:Ernest_Hemingway_with_Family,_1905.png">John F. Kennedy Presidential Library and Museum, Boston</a></span>
</figcaption>
</figure>
<p>Within hours of arriving in Italy, Hemingway was tasked with cleaning up the body parts of victims of shelling, a sight he recounted in his controversial short work “<a href="http://www.24grammata.com/wp-content/uploads/2014/08/Hemingway-A-Natural-History-oft-he-Dead-24grammata.com_.pdf">A Natural History of the Dead</a>”, that both fascinated and horrified him. Within weeks he would be pulled off a battlefield himself, a bloodied wreck more dead than alive, with 228 pieces of shrapnel embedded in his legs. Long days and painful nights of touch-and-go recuperation followed.</p>
<p>Yet later, after shadowing Red Cross nurses, Hemingway <a href="http://www.24grammata.com/wp-content/uploads/2014/08/Hemingway-A-Natural-History-oft-he-Dead-24grammata.com_.pdf">wrote</a> about the worst death he ever saw. It hadn’t been from a bomb or a bullet: “The only natural death I’ve ever seen […] was death from the Spanish influenza. In this you drown in mucus, choking, and how you know the patient is dead is; at the end he shits the bed.”</p>
<p>This horrendous scene was common amidst a global pandemic which had claimed, by December 1919, <a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html">50 million</a> people. There was no coordinated national and international research as we would know it, no effective treatment, and certainly no vaccine on the way. Soldiers and volunteers like Hemingway were literally swimming in the virus.</p>
<h2>Dodging disease</h2>
<p>Yet Hemingway dodged the peaks of the 1918-19 pandemic waves by weeks, sometimes days, as he convalesced in Italy, and then returned to the US. Once home, he discovered family and friends had perished from it. Despite youthful public insouciance, all these experiences privately scarred him, and that dying soldier in Italy was never far from his mind. </p>
<p>According to as his masterful biographer <a href="https://www.amazon.co.uk/Hemingway-American-Homecoming-Reynolds-1992-12-01/dp/B01K3KFR8G">Michael Reynolds</a>, Hemingway’s superstition about death meant that “the slightest possibility of flu often sent him scurrying for healthier conditions, for he had a particular horror of drowning in his own fluids”. Consequently, by 1926 and now living in Paris, when his son Jack, nicknamed “Bumby”, developed a “hacking cough”, Hemingway immediately sent him and his wife Hadley off to the clean air and sunshine of the Riviera to recover, while he went solo to Spain to work.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white picture of parents and a child." src="https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=884&fit=crop&dpr=1 600w, https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=884&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=884&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1111&fit=crop&dpr=1 754w, https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1111&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/376174/original/file-20201221-13-4nd83.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1111&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ernest, Hadley and Bumby Hemingway, 1926.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Ernest_Hemingway">John F. Kennedy Presidential Library and Museum, Boston</a></span>
</figcaption>
</figure>
<p>Hadley and Bumby Hemingway arrived at Antibes on May 26 1926, and the child was immediately diagnosed with the infectious – and potentially fatal – whooping cough. Quarantine was called for, so both were summarily housed by their hosts, the ever-generous patrons of the arts Sara and Gerald Murphy, in a small dwelling near their own 14-roomed Villa America. </p>
<p>One week later they were moved again, under quarantine conditions, to a hastily vacated Villa Paquita at Juan les Pins, previously inhabited by Scott and Zelda Fitzgerald, who had zipped off to the safety of another coastal retreat. To complicate matters, Hemingway’s mistress Pauline Pfeiffer, a chic Paris-based editor at Vogue magazine, arrived from Paris, and within 48 hours, they were joined fresh from Madrid by the central figure in this peculiar set-up, Hemingway himself.</p>
<p>For a while, quarantining was all very jolly. By day, Hemingway dedicated himself to editing corrections to his soon-to-be bestseller <a href="https://www.theguardian.com/books/2014/sep/22/100-best-novels-sun-also-rises-ernest-hemingway-robert-mccrum">The Sun Also Rises</a>. By evening, everyone gathered for socially-distanced cocktails with the Murphys and Fitzgeralds, who stayed outside the garden fence. Empty bottles, drained and upended, were mounted like heads on the spiked fence. Each one marked another day of quarantine for the Hemingway child.</p>
<p>It worked – to an extent.</p>
<p>Quarantine ended when his son got better, though as a precaution he and his nanny were housed nearby, leaving Hemingway in a nice hotel with the two women. He pretended he was happy but inevitably, the post-lockdown arrangement slid into emotional anarchy. Hadley Hemingway and he argued, while Pfeiffer hung on for the prize she wanted most – Hemingway himself. It stayed that way as everyone decamped from the Riviera to Pamplona, Spain for the annual fiesta.</p>
<p>Within a year of that quarantined summer, the Hemingways were divorced.</p>
<figure class="align-center ">
<img alt="A couple." src="https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=437&fit=crop&dpr=1 600w, https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=437&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=437&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/376177/original/file-20201221-57996-4lxjw5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ernest and Pauline Hemingway, Paris 1927.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/Category:Ernest_Hemingway_Photograph_Collection_at_the_John_F._Kennedy_Presidential_Library_and_Museum#/media/File:Ernest_and_Pauline_Hemingway,_Paris,_1927.jpg">John F. Kennedy Presidential Library and Museum, Boston</a></span>
</figcaption>
</figure>
<p>In 1937, 11 years later, despite quarantining in Saranac Lake, Upstate New York, the Murphy’s 16-year-old son Patrick died from tuberculosis.</p>
<p>Hemingway rose at dawn on July 2 1961 in Idaho and took his own life.</p>
<p>The child who had the whooping cough in 1926, Jack “Bumby” Hemingway, had a happier outcome than most in his family. He became a decorated second world war veteran who survived capture and imprisonment after parachuting into Nazi Germany, and died peacefully in 2000.</p><img src="https://counter.theconversation.com/content/152264/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eamonn O'Neill does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Hemingway’s response to death and disease was very different from the parody that circulated earlier this year.Eamonn O'Neill, Associate Professor in Journalism, Edinburgh Napier UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1510062020-11-27T13:45:10Z2020-11-27T13:45:10ZChristmas coming early: there’s never been a right time to put up the decorations<figure><img src="https://images.theconversation.com/files/371728/original/file-20201127-13-l3158a.jpg?ixlib=rb-1.1.0&rect=0%2C2615%2C3953%2C2556&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Adoration of the Shepherds by Guido Reni (1642).</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:The_Adoration_of_the_Shepherds_by_Guido_Reni.jpg">Wikimedia</a></span></figcaption></figure><p>In the words of Perry Como’s classic, “<a href="https://www.youtube.com/watch?v=KmddeUJJEuU&ab_channel=PerryComoVEVO">it’s beginning to look a lot like Christmas</a>”. The pandemic has got many yearning for a little festive joy earlier than usual and, for some, it started looking like Christmas <a href="https://www.theguardian.com/commentisfree/2020/nov/18/is-it-too-early-to-put-up-christmas-decorations-not-after-the-year-weve-had">in early November</a>. Trees, lights, tinsel and baubles were already appearing in streets and houses, and Christmas shopping was well underway. </p>
<p>But such early holiday spirit is not always well received by those who argue that Christmas is for, well, Christmas. It wouldn’t be Christmas though without such disagreements – they’ve been going on since early Christians started celebrating the birth of Christ. </p>
<p>There <a href="https://www.livescience.com/42976-when-was-jesus-born.html">is no indication in the Bible of the date</a> on which Christ was born, and no consensus in early Christianity. By the second century, it had become customary in the eastern churches to celebrate the baptism of Christ on <a href="http://www.accc.org.uk/cardinal-feasts/">January 6</a>. </p>
<p>By the fourth century, the early January celebration of the Epiphany had become <a href="https://www.history.com/topics/christmas/history-of-christmas">a major feast in the western European calendar</a>, associated with the arrival of the wise men who recognised the infant Jesus as the son of God. With suggestions that the birth of Christ occurred in January, March or even June, the lack of agreement about when Christmas should be celebrated is hardly surprising.</p>
<p>We have Pope Julius I in 340 AD to thank for securing <a href="https://www.jstor.org/stable/3152491#metadata_info_tab_contents">December 25</a> the day of Christ’s birth in western Christianity. A mid-winter celebration enabled the Christianisation of pre-existing winter customs. The date also aligned with ideas that Jesus died on the day of his conception in March. Nine months from March would then mean that he would have been <a href="https://www.italyheritage.com/traditions/calendar/december/december-25-why.htm">born in December</a>.</p>
<figure class="align-center ">
<img alt="Painting of the wise men travelling through desert." src="https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/371725/original/file-20201127-17-1255w81.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Journey of the Magi by Sassetta (1433–35). Early January celebrations were associated with the arrival of the wise men.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Nativity_of_Jesus_in_art#/media/File:Sassetta_004.jpg">Wikimedia</a></span>
</figcaption>
</figure>
<p>By the end of the century, the Christmas feast had been extended to include the commemoration of St Stephen (December 26), John the Baptist (December 27), and Holy Innocents (December 28). In 567, the Council of Tours established a 12-day Christmas feast. But in Orthodox churches which use the Roman Julian calendar, Christmas is still celebrated in January, and January 6 is known as “Old Christmas”.</p>
<h2>Regulating Christmas</h2>
<p>By the sixth century then, December 25 had become the date to celebrate. The feast of Christmas started at sundown on December 24, and for a long time decorations were only hung on Christmas Eve. The church tightly regulated Christmas to avoid links with pre-Christian festivals. The time between Advent Sunday (November 29, four Sundays before the nativity) and Christmas was a period of fasting and penance. It was certainly not a time for chocolate-filled advent calendars, parties and premature decoration of streets and houses. Traditional plant lore still holds that even bringing holly into a house before Christmas Eve will lead to <a href="https://www.plant-lore.com/holly/">bad luck</a>. </p>
<p>But regulating Christmas was easier said than done, and preventing the appearance of Christmas decorations was nigh on an impossible. Ancient pre-Christian midwinter celebrations, such as bringing greenery into houses as soon as winter arrived, could not be stopped then either. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-christmas-was-cancelled-a-lesson-from-history-149310">When Christmas was cancelled: a lesson from history</a>
</strong>
</em>
</p>
<hr>
<p>When Christmas celebrations were banned in England in the 1640s, people decorated houses, and the wardens of St Margaret, Westminster, decked the church with holly and ivy in defiance of the law.</p>
<h2>The Christmas season</h2>
<p>Christmas today can appear in our shops as early as November 1, as Christmas items replace Halloween products. At this point, we are used to the ever-expanding Christmas season, but this is usually only seen in commercial spaces eager to make the most of the seasonal spending. However, this year it’s come earlier to many homes too, with reports of decorations <a href="https://www.independent.co.uk/life-style/christmas-decorations-tree-early-coronavirus-b1720441.html">being put up as early as Halloween</a>.</p>
<p>Festive sparkle has become a way of adding joy and warmth to the gloom of pandemic restrictions. Christmas decorations bring back happy memories, and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0272494489800106?via%3Dihub">psychologists have found</a> that those who put up their decorations early are happier than their peers and appear more sociable.</p>
<p>There are faint echoes here of <a href="http://www.worldwar1archive.com/world-war-1/decorating-a-christmas-tree-in-the-trenches/">testimony</a> from soldiers in the trenches during world war one who regarded Christmas rituals on the western front as a connection with normality.</p>
<figure class="align-center ">
<img alt="Painting of a family dancing around a Christmas tree." src="https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=478&fit=crop&dpr=1 600w, https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=478&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=478&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/371729/original/file-20201127-19-5vafuc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"><em>Glade Jul</em> by Viggo Johansen (1891)</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Christmas_tree#/media/File:Johansen_Viggo_-_Radosne_Bo%C5%BCe_Narodzenie.jpg">Wikimedia</a></span>
</figcaption>
</figure>
<p>History shows that this is not the first time that Christmas celebrations have been affected by a pandemic. <a href="https://www.nelsonstar.com/community/nelson-in-1918-christmas-shopping-starts-early-due-to-spanish-flu-epidemic/">News reports from 1918</a> point to Christmas shopping starting early during the Spanish flu pandemic, as is the case in 2020. But the “lockdown fatigue” that prompted mass celebration of Armistice Day, Thanksgiving, and Christmas in 1918, unleashed a further wave of the Spanish flu pandemic in US cities.</p>
<p>Traditional views of Christmas decorations might have been overturned in 2020, but there’s still plenty of time to argue about when they should come down. For most that is January 5, and some might argue any later than the eve of Epiphany (January 6) and you are at risk of an <a href="https://www.spiegel.de/consent-a-?targetUrl=https%3A%2F%2Fwww.spiegel.de%2Finternational%2Feurope%2Fbeware-the-kallikantzaroi-greek-goblins-run-riot-over-christmas-a-597656.html&ref=https%3A%2F%2Fwww.google.com%2F">infestation of goblins</a> – either those of the <a href="https://www.spiegel.de/consent-a-?targetUrl=https%3A%2F%2Fwww.spiegel.de%2Finternational%2Feurope%2Fbeware-the-kallikantzaroi-greek-goblins-run-riot-over-christmas-a-597656.html">Greek Kallikantzaroi</a> persuasion or those in Robert Kerrick’s <a href="https://allpoetry.com/Ceremonies-For-Candlemas-Eve">Ceremonies for Candlemas Eve</a>. Both very much unwelcome.</p><img src="https://counter.theconversation.com/content/151006/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Helen Parish does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It will always be too early, depending on who you ask, so put up your decorations whenever you want if it makes you happy.Helen Parish, Professor in History, University of ReadingLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1439942020-08-20T20:16:15Z2020-08-20T20:16:15ZFriday essay: vizards, face gloves and window hoods – a history of masks in western fashion<figure><img src="https://images.theconversation.com/files/353787/original/file-20200820-22-c50i1h.jpg?ixlib=rb-1.1.0&rect=54%2C36%2C5898%2C3971&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://image.shutterstock.com/image-photo/woman-wearing-stylish-protective-black-600w-1794076177.jpg">Shutterstock</a></span></figcaption></figure><p>Masks have emerged as unlikely fashion heroes as the COVID-19 pandemic has developed. Every conceivable colour and pattern seems to have become available, from <a href="https://www.syfy.com/syfywire/alien-facehugger-coronavirus-mask">facehuggers</a> to <a href="https://www.etsy.com/listing/800546489/star-wars-darth-vader-face-mask-with?source=aw&awc=10781_1596684726_ebd56f193b252d97cbc2ddf5fa6123f1&zanpid=10781_1596684726_ebd56f193b252d97cbc2ddf5fa6123f1&utm_medium=affiliate&utm_source=affiliate_window&utm_campaign=au_buyer&utm_content=78888&utm_term=141123">Darth Vader</a> to <a href="https://www.news.com.au/lifestyle/fashion/brides-wear-intricate-wedding-day-face-masks-amid-pandemic-photos/news-story/d821ddbfcc3c20f37ba1583fc5973bef">bejewelled bridal numbers</a>. </p>
<p>Many show how brevity and style can combine to protect the wearer, offsetting the fear the sight of a respiratory or surgical mask usually inspires. </p>
<p>Some, like those produced by not-for-profit enterprises including the <a href="https://www.thesocialstudio.org/">Social Studio</a> and <a href="https://www.secondstitch.org.au/product-page/fabric-face-mask">Second Stitch</a>, use on-trend fabrics and benefit both the wearer and the makers. Meanwhile, an Israeli jeweller has designed a <a href="https://www.independent.co.uk/life-style/coronavirus-face-mask-most-expensive-jeweller-israel-diamonds-yvel-a9665476.html">white gold, diamond-encrusted mask</a> worth US$1.5 million (A$2.1 million).</p>
<p>Yet, masks remain fundamentally unnerving. Mostly intended to either protect or disguise, they are designed to cover all or part of the face. In societies where emotions are <a href="https://www.nature.com/articles/srep22049">read through both eyes and mouth</a>, they can be disorienting. </p>
<p>In many places around the globe, masks have played an important role in conveying style, spirituality and culture for thousands of years. They have been a part of western fashion for centuries. Here are some of the highlights (and lowlights) of masks as fashion items.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-should-i-clean-my-cloth-mask-143974">How should I clean my cloth mask?</a>
</strong>
</em>
</p>
<hr>
<h2>Silenced by the vizard</h2>
<blockquote>
<p>“And make our faces vizards to our hearts/Disguising what they are”
– Macbeth </p>
</blockquote>
<p>One of the most bizarre accessories in 16th-century fashion was the vizard, an oval-shaped mask made from black velvet worn by women to protect their skin whilst travelling. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=879&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=879&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=879&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1105&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1105&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351271/original/file-20200805-22-ifinzx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1105&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A woman wearing a vizard, c.1581, France.</span>
<span class="attribution"><span class="source">Wikimedia</span></span>
</figcaption>
</figure>
<p>In an age where unblemished skin was a sign of gentility, European women took pains to avoid sunburn or significant sun tan. Two holes were cut for the eyes, sometimes fitted with glass, and an indentation was created to accommodate the nose. Disturbingly, they did not always have an opening for the mouth. </p>
<p>To hold the mask in place, wearers gripped a bead or button between their teeth, prohibiting speech. To the contemporary feminist, the mask raises associations with the <a href="http://www.historyofmasks.net/famous-masks/scolds-bridle/">scold’s bridle</a>: a method of torture and public humiliation for gossiping women and suspected witches. </p>
<p>During the following century, masks continued to be fashionable although the guise of protection gave way to mystique and desire. The small “domino” mask – seen in a 17th century Netherlands example below and still worn by superheroes from Batman to Harley Quinn – <a href="https://enacademic.com/dic.nsf/enwiki/5634899#:%7E:text=Since%20the%2018th%20century%2C%20the,lord%22%20or%20%22master.%22">covered the eyes and tip of the nose</a>. It was usually made from a strip of black fabric. For warmer months, <a href="https://lh5.ggpht.com/qLmqR1dTpPwCsQVdjeLzan_MrgarWLemmWC7rGH1726niY2jcKrLrRyG3Dj0s-fh_U7M4NRHgec_frfG7mjq5YNzdMcE=s0">a lighter veiling</a> could be substituted.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="17th century engraving of woman wearing black eye mask and period clothing." src="https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=846&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=846&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=846&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1064&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1064&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351258/original/file-20200805-493-1i3xlf0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1064&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The look for Winter by Wenceslaus Hollar (1643).</span>
<span class="attribution"><a class="source" href="https://lh4.ggpht.com/EFWFDmGMt2Fdio1emzvdfIXoO9J502nlD7b3JvZtkAPmddwg85nGbfVGqz5qGDxwYjIrJTx1Qeu12ishn30ZmWLjo-ag=s0">Rijksmuseum</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/beware-of-where-you-buy-your-face-mask-it-may-be-tainted-with-modern-day-slavery-142672">Beware of where you buy your face mask: it may be tainted with modern day slavery</a>
</strong>
</em>
</p>
<hr>
<h2>Masquerade and desire</h2>
<p>Venice has long been associated with masks, thanks to its <a href="https://www.venice-carnival-italy.com/what-is-the-venice-carnival/#/cart">history of carnival and masquerade</a>. Their theatrical nature might lead to an assumption masks were always worn to deceive or seduce. Travellers expecting a masked amoral free-for-all in the early 18th century <a href="https://www.google.com.au/books/edition/Venice_Incognito/EbUwDwAAQBAJ?hl=en&gbpv=1">were surprised</a> at how “innocent” the accessory really was in everyday life. </p>
<p>When worn at a masquerade, masks encouraged “safe” contact between the sexes – bringing them close enough to mingle but maintaining the social distance between strangers that etiquette required. In this scenario, masks also encouraged a kind of egalitarianism by allowing people of disparate <a href="https://www.jstor.org/stable/2738282?seq=1">social classes to mix</a> – a freedom never allowed in normal social gatherings. </p>
<p>The <a href="https://theculturetrip.com/europe/italy/articles/a-guide-to-the-masks-of-venice/">gnaga mask</a>, with its cat shape, allowed men to dress as women and skirt Venetian homosexuality laws. Venetian prostitutes were <a href="https://www.google.com.au/books/edition/Venice_Incognito/EbUwDwAAQBAJ?hl=en&gbpv=1">at various times prohibited from wearing or required to wear masks</a> in public, yet married women were required to wear masks to the theatre, fostering an association between masks and sex. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Venetian masks" src="https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=404&fit=crop&dpr=1 600w, https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=404&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=404&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/353116/original/file-20200817-14-1l8dfw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Masquerades encouraged contact between the sexes while maintaining acceptable social distance.</span>
<span class="attribution"><a class="source" href="https://images.unsplash.com/photo-1533022586528-2e09bde0959b?ixlib=rb-1.2.1&ixid=eyJhcHBfaWQiOjEyMDd9&auto=format&fit=crop&w=3142&q=80">Unsplash/Llanydd Lloyd</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Conversely, the infamous <a href="https://books.google.com.au/books?id=RMPZ76R-VqcC&printsec=frontcover">Harris’s List of Covent Garden Ladies</a>, published annually between 1757 and 1795, provided a catalogue of prostitutes to hire in London. One entry from 1779 described a woman who … </p>
<blockquote>
<p>by her own confession has been a votary to pleasure these thirty years, she wears a substantial mask upon her face, and is rather short. </p>
</blockquote>
<p>John Cleland’s controversial 1748 book <a href="https://www.gutenberg.org/files/25305/25305-h/25305-h.htm">Memoirs of Fanny Hill</a> describes Louisa, a prostitute, being made “violent love to” by a “gentlemen in a handsome domino” as soon as her own mask was removed. </p>
<h2>Charming possibilities</h2>
<p>“A mask tells us more than a face”, wrote Oscar Wilde in his 1891 dialogue <a href="https://www.gutenberg.org/files/887/887-h/887-h.htm">Intentions</a>, yet by the 19th century the mask as fashion accessory was <em>démodé</em>. Masks were generally only mentioned in newspapers and fashion magazines when referring to fancy dress and masked balls, which still took place in the homes of the wealthy. </p>
<p>“Society is a masked ball”, wrote <a href="https://cdnc.ucr.edu/?a=d&d=WBR18610209.2.8.6&srpos=1&e=-------en--20-WBR-1--txt-txIN-%22society+is+a+masked+ball%22-------1">one American columnist in 1861</a> mirroring Wilde’s famous quote, “where everyone hides his real character, and reveals it by hiding”. </p>
<p>Although masks were no longer recommended for maintaining a pale complexion, women’s faces were still covered by veiling in certain situations: including, for the first time, weddings. Ironically, <a href="http://nla.gov.au/nla.news-article227206624">one Australian fashion column</a> in 1897 decried the fashion, stating: </p>
<blockquote>
<p>Veils are largely responsible for poor complexions … This fine lace mask – for it is nothing else – hinders the circulation … but does far more injury by keeping the face heated.</p>
</blockquote>
<p>As if this were not enough, veils blew dust from the street into “open pores” and retained dirt, redistributing it onto the skin every time it was worn.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Advertisement for Rowley's Toilet Mask shows woman with rubber face shield." src="https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=473&fit=crop&dpr=1 600w, https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=473&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=473&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=595&fit=crop&dpr=1 754w, https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=595&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/353756/original/file-20200820-20-143sc2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=595&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A precursor to today’s sheet beauty treatments.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/sv/editorial/image-editorial/advert-for-madame-p-rowleys-toilet-mask-1895-9805233a">Shutterstock</a></span>
</figcaption>
</figure>
<p>Veiling still had some fans, who touted its health and beauty benefits, and connotations of intrigue and excitement. <a href="http://nla.gov.au/nla.news-article138628599">“It suggests such charming possibilities beneath it”</a>, a columnist in The Australasian wrote in 1897.</p>
<p>Fashionable or not, some masks were still worn behind closed doors. Enter the most bizarre masked accessory since the vizard: the toilet mask or “face glove”.</p>
<p>Devised by a Madame Rowley in the 1870s-80s, the rubberised full-face covering was <a href="http://nla.gov.au/nla.news-article102705392">advertised as an</a>: </p>
<blockquote>
<p>aid to complexion beauty … treated with some medicated preparation … the effects of the mask when worn at night two or three times in the week are described as marvellous. </p>
</blockquote>
<p>Advertisements for these <a href="https://www.beautifulwithbrains.com/beauty-history-madame-rowleys-toilet-mask/">precursors to today’s sheet mask beauty treatments</a> contained testimonials from women who claimed to be cured of freckles and wrinkles. </p>
<h2>Veils and visors</h2>
<p>The advent of the automobile in the early 20th century brought a whole new fashion range into the public arena. Motorists needed protection from weather, dust and fumes, so accessories had to be practical. For women, protection took the fashionable form of coats and face coverings.</p>
<p>Veils and hoods were wrapped around stylish large hats of the day, and fastened under the chin so that the entire face was safely covered. </p>
<p>Advertisements in the early 1920s describe a “<a href="https://cdnc.ucr.edu/?a=d&d=SDI19210814.2.115&srpos=1&e=-------en--20-SDI-1--txt-txIN-%22complete+face+mask%22-------1">complete face mask</a>” for drivers – ostensibly men as the accessory “buttoned to the cap and [is] equipped with an adjustable eye shield against glaring headlights”. </p>
<p>A design for women in 1907 was described as a <a href="https://digitalcollections.nypl.org/items/510d47e1-1ea0-a3d9-e040-e00a18064a99">“window hood”</a>, which completely engulfed the hat beneath and closed with a drawstring around the neck. It had a gauze “window” for the eyes and another smaller opening at the mouth.</p>
<p>By the swinging 1960s, the cultural and sartorial landscape couldn’t have been more different – and yet, masks made an unlikely appearance in “<a href="https://www.vogue.com/article/60s-space-age-fashion#:%7E:text=The%20space%20race%20in%20the,envisioned%20as%20the%20next%20frontier.&text=Chin%2Dstrap%20space%20bonnets%2C%20flat,for%20a%20new%20sartorial%20stratosphere.">space age</a>” fashion championed by designers such as André Courrèges and Pierre Cardin. Metallic mini dresses and one-piece suits were topped with “space helmets” that left an opening for the entire face or eyes. </p>
<p>More commonly adopted were plastic visors worn separately or as part of a hat, sometimes covering forehead to chin and taking on the appearance of a welders’ shield – or indeed, the <a href="https://www.health.gov.au/resources/publications/coronavirus-covid-19-face-shields-a-quick-guide">face shields worn by health workers</a> today. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/WoT2z14YemI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Plastic fantastic looks of the sixties.</span></figcaption>
</figure>
<p>Sunglasses, a kind of mask in their own right, were taken to the extreme by Courrèges with his infamous solid white shades with only a slit for light. Life described this as a <a href="https://books.google.com.au/books?id=8VIEAAAAMBAJ&printsec=frontcover">“built-in squint”</a> in 1965 - a design that “dangerously narrows the field of vision”. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-fashionable-history-of-social-distancing-134464">The fashionable history of social distancing</a>
</strong>
</em>
</p>
<hr>
<h2>What goes around …</h2>
<p>Discussions during the 1918-19 Spanish flu pandemic around whether masks would be a fad, how long they would be required, and how to create your own at home, seem eerily prescient now. </p>
<p>This darkly comic mask from 1918 demonstrates the same wish for ingenuity and levity that exists today: </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man wears white face mask with black skull and cross." src="https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=896&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=896&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=896&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1126&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1126&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351353/original/file-20200805-22-grtbgf.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1126&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The skulls and cross bones embellishment was a joke, rather than standard issue in 1919.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/statelibraryofnsw/3481163841/">State Library of NSW/Flickr</a></span>
</figcaption>
</figure>
<p>Lebanese fashion designer Eric Ritter has sported <a href="https://www.insider.com/most-creative-face-masks-people-have-designed-2020-5#people-have-hid-their-lower-faces-behind-graphics-like-a-skull--17">a similarly macabre aesthetic</a>. He was already thinking and <a href="https://www.instagram.com/p/B7CDivfJPZJ/?utm_source=ig_embed">writing about masks</a> on Instagram in January before coronavirus spread around the world …</p>
<blockquote>
<p>On growing up without a mask</p>
<p>On being forced to wear a mask</p>
<p>On ecstatically removing a mask</p>
<p>On picking a mask back up</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person in pink hood with decorative face covering" src="https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=601&fit=crop&dpr=1 600w, https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=601&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=601&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=755&fit=crop&dpr=1 754w, https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=755&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/353769/original/file-20200820-24-xa4cav.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=755&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Beirut designer Eric Ritter.</span>
<span class="attribution"><a class="source" href="https://www.instagram.com/p/B7CDivfJPZJ/">ericmathieuritter/Instagram</a></span>
</figcaption>
</figure>
<p>In Australia, entertainer Todd McKenney has launched an <a href="https://toddmasks.com/todd-masks-launches/">online marketplace</a> for costume designers to make and sell one-of-a-kind masks directly to the public. </p>
<p>Face masks don’t have to be created by artists, designers or couture fashion houses to make them appealing. But a look through our fashion history shows that ingenuity and humanity have long influenced our face wear – whether for the purposes of allure, space travel or pandemic protection.</p><img src="https://counter.theconversation.com/content/143994/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lydia Edwards does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Masks have a chequered history in western fashion. Some silenced women in the name of beauty, others provoked sexual desire.Lydia Edwards, Fashion historian, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1416872020-07-13T11:53:58Z2020-07-13T11:53:58ZMask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers’<figure><img src="https://images.theconversation.com/files/345886/original/file-20200706-3943-5gsic4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Policemen in Seattle, Washington, wearing masks made by the Red Cross, during the influenza pandemic, December 1918</span> <span class="attribution"><a class="source" href="https://catalog.archives.gov/id/45499339">National Archives</a></span></figcaption></figure><p>We have all seen the alarming headlines: Coronavirus cases are <a href="https://www.pbs.org/newshour/health/coronavirus-cases-are-rising-in-40-of-50-u-s-states">surging in 40 states</a>, with new cases and hospitalization rates climbing at an alarming rate. Health officials have warned that the U.S. must act quickly to halt the spread – or we risk losing control over the pandemic. </p>
<p>There’s a <a href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprevent-getting-sick%2Fcloth-face-cover.html">clear consensus</a> that Americans should wear masks in public and continue to practice proper social distancing. <a href="https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/">While a majority of Americans</a> support wearing masks, widespread and consistent compliance has proven difficult to maintain in communities across the country. Demonstrators gathered outside city halls in <a href="https://www.12news.com/article/news/local/valley/anti-mask-rally-to-protest-mask-mandate-held-in-scottsdale/75-94cd29b2-9630-457d-8116-a6a6d32af281">Scottsdale, Arizona</a>; <a href="https://www.statesman.com/news/20200628/alex-jones-leads-anti-mask-protest-at-capitol">Austin, Texas</a>; and other cities to protest local mask mandates. Several <a href="https://www.washingtonpost.com/nation/2020/06/26/sheriffs-mask-covid/">Washington state and North Carolina sheriffs have announced they will not enforce their state’s mask order</a>.</p>
<p>I’ve <a href="https://www.researchgate.net/scientific-contributions/38950136_J_Alexander_Navarro">researched</a> the <a href="http://www.influenzaarchive.org/about.html">history of the 1918 pandemic</a> extensively. At that time, with no effective vaccine or drug therapies, communities across the country instituted a host of public health measures to slow the spread of a deadly influenza epidemic: They closed schools and businesses, banned public gatherings and isolated and quarantined those who were infected. Many communities recommended or required that citizens wear face masks in public – and this, not the onerous lockdowns, drew the most ire.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=526&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=526&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=526&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=661&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=661&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345895/original/file-20200706-3980-1euqqs7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=661&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Officials wearing gauze masks inspect Chicago street cleaners for the flu, 1918.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/chicago-illinois-inspecting-chicago-street-cleaners-for-news-photo/514910726">Bettman/Getty Images</a></span>
</figcaption>
</figure>
<p>In mid-October of 1918, amidst a raging epidemic in the Northeast and rapidly growing outbreaks nationwide, the <a href="https://www.usphs.gov/">United States Public Health Service</a> circulated leaflets recommending that all citizens wear a mask. The Red Cross took out newspaper ads encouraging their use and offered instructions on how to construct masks at home using gauze and cotton string. Some state health departments launched their own initiatives, most notably California, Utah and Washington.</p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p>Nationwide, posters presented mask-wearing as a civic duty – social responsibility had been embedded into the social fabric by a massive wartime federal propaganda campaign launched in early 1917 when the U.S. entered the Great War. San Francisco <a href="https://quod.lib.umich.edu/f/flu/1620flu.0009.261/1/--proclamation-of-mayor-asks-masks-for-all?rgn=full+text;view=image;q1=conscience%2C+patriotism+and+self-protection+demand+immediate+and+rigid+compliance">Mayor James Rolph announced</a> that “conscience, patriotism and self-protection demand immediate and rigid compliance” with mask wearing. In nearby Oakland, <a href="https://quod.lib.umich.edu/f/flu/8540flu.0007.458/1/--wear-mask-says-law-or-face-arrest?rgn=full+text;view=image;q1=Face+Arrest">Mayor John Davie stated</a> that “it is sensible and patriotic, no matter what our personal beliefs may be, to safeguard our fellow citizens by joining in this practice” of wearing a mask.</p>
<p>Health officials understood that radically changing public behavior was a difficult undertaking, especially since many found masks uncomfortable to wear. Appeals to patriotism could go only so far. As one Sacramento official noted, people “must be forced to do the things that are for their best interests.” The Red Cross <a href="https://quod.lib.umich.edu/f/flu/1440flu.0007.441/1/--wear-a-mask-and-save-your-life?rgn=full+text;view=image;q1=wear+a+mask">bluntly stated</a> that “the man or woman or child who will not wear a mask now is a dangerous slacker.” Numerous communities, particularly across the West, imposed mandatory ordinances. Some sentenced scofflaws to short jail terms, and fines ranged from US$5 to $200. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=479&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=479&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=479&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=601&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=601&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345891/original/file-20200706-4000-1ruwuu5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=601&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Collage of newspaper headlines related to the previous year’s influenza pandemic, Chicago, Illinois, 1919. Headlines include ‘Police Raid Saloons in War on Influenza,’ ‘Flu Curfew to Sound for City Saturday Night’ and ‘Open-Face Sneezers to Be Arrested.’</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/collage-of-various-newspaper-headlines-related-to-the-news-photo/1219167361">Chicago History Museum/Getty Images</a></span>
</figcaption>
</figure>
<p>Passing these ordinances was frequently a contentious affair. For example, it took several attempts for Sacramento’s health officer to convince city officials to enact the order. In Los Angeles, it was scuttled. A draft resolution in Portland, Oregon led to heated city council debate, with <a href="https://quod.lib.umich.edu/f/flu/2510flu.0008.152/1/--decline-in-flu-cases-expected?rgn=full+text;view=image;q1=Decline+in+Flu+Cases+Expected">one official declaring</a> the measure “autocratic and unconstitutional,” adding that “under no circumstances will I be muzzled like a hydrophobic dog.” It was voted down. </p>
<p>Utah’s board of health considered issuing a mandatory statewide mask order but decided against it, <a href="https://quod.lib.umich.edu/f/flu/9830flu.0009.389/1/--dr-beatty-makes-plain-his-position-on-mask-question?rgn=full+text;view=image;q1=makes+plain+his">arguing</a> that citizens would take false security in the effectiveness of masks and relax their vigilance. As the epidemic resurged, Oakland tabled its debate over a second mask order after the mayor angrily recounted his arrest in Sacramento for not wearing a mask. A <a href="https://quod.lib.umich.edu/f/flu/3360flu.0007.633/1/--flu-masking-ordinance-is-turned-down?rgn=full+text;view=image;q1=Flu+Masking+Ordinance+is+Turned+Down">prominent physician in attendance commented</a> that “if a cave man should appear…he would think the masked citizens all lunatics.”</p>
<p>In places where mask orders were successfully implemented, noncompliance and outright defiance quickly became a problem. Many businesses, unwilling to turn away shoppers, wouldn’t bar unmasked customers from their stores. Workers complained that masks were too uncomfortable to wear all day. One Denver salesperson refused because she said her “nose went to sleep” every time she put one on. <a href="https://quod.lib.umich.edu/f/flu/6190flu.0003.916/1/--masks-not-popular-many-people-ignore-health-board-rules?rgn=full+text;view=image;q1=many+people+ignore">Another said</a> she believed that “an authority higher than the Denver Department of Health was looking after her well-being.” As <a href="https://quod.lib.umich.edu/f/flu/2290flu.0003.922/3/--new-orders-are-issued?page=root;rgn=full+text;size=200;view=image;q1=New+Orders+are+issued">one local newspaper put it</a>, the order to wear masks “was almost totally ignored by the people; in fact, the order was cause of mirth.” The rule was amended to apply only to streetcar conductors – who then threatened to strike. A walkout was averted when the city watered down the order yet again. Denver endured the remainder of the epidemic without any measures protecting public health.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=823&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=823&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=823&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1034&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1034&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345897/original/file-20200706-4008-zh4ckj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1034&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Precautions taken during the 1918 flu pandemic would not allow anyone to ride street cars without a mask. Here, a conductor bars an unmasked passenger from boarding.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/precautions-taken-during-spanish-influenza-epidemic-would-news-photo/1223011380">Universal History Archive/Getty Images</a></span>
</figcaption>
</figure>
<p>In Seattle, streetcar conductors refused to turn away unmasked passengers. Noncompliance was so widespread in Oakland that officials deputized 300 War Service civilian volunteers to secure the names and addresses of violators so they could be charged. When a mask order went into effect in Sacramento, the police chief instructed officers to “Go out on the streets, and whenever you see a man without a mask, bring him in or send for the wagon.” Within 20 minutes, police stations were flooded with offenders. In San Francisco, there were so many arrests that the police chief warned city officials he was running out of jail cells. Judges and officers were forced to work late nights and weekends to clear the backlog of cases.</p>
<p>Many who were caught without masks thought they might get away with running an errand or commuting to work without being nabbed. In San Francisco, however, initial noncompliance turned to large-scale defiance when the city enacted a second mask ordinance in January 1919 as the epidemic spiked anew. Many decried what they viewed as an unconstitutional infringement of their civil liberties. On January 25, 1919, approximately 2,000 members of the “Anti-Mask League” <a href="https://quod.lib.umich.edu/f/flu/1320flu.0009.231/1/--new-cases-of-influenza-at-low-record?page=root;rgn=full+text;size=150;view=image;q1=New+Cases+of+Influenza+at+Low+Record">packed the city’s old Dreamland Rink</a> for a rally denouncing the mask ordinance and proposing ways to defeat it. Attendees included several prominent physicians and a member of the San Francisco Board of Supervisors.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/346412/original/file-20200708-3978-bycckm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Poster of a Red Cross nurse wearing a gauze mask over her nose and mouth – with tips to prevent the influenza pandemic.</span>
<span class="attribution"><a class="source" href="https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101580385-img">The National Library of Medicine/NIH</a></span>
</figcaption>
</figure>
<p>It is difficult to ascertain the effectiveness of the masks used in 1918. Today, we have a <a href="https://doi.org/10.1038/s41591-020-0843-2">growing body of evidence</a> that well-constructed cloth face coverings are <a href="https://doi.org/10.1377/hlthaff.2020.00818">an effective tool</a> in slowing the spread of COVID-19. It remains to be seen, however, whether Americans will maintain the widespread use of face masks as our current pandemic continues to unfold. Deeply entrenched ideals of individual freedom, the lack of cohesive messaging and leadership on mask wearing, and pervasive misinformation have proven to be major hindrances thus far, precisely when the crisis demands consensus and widespread compliance. This was certainly the case in many communities during the fall of 1918. That pandemic ultimately <a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html">killed about 675,000 people in the U.S</a>. Hopefully, history is not in the process of repeating itself today.</p>
<p><em>This article was updated to correct the location of sheriffs mentioned.</em></p><img src="https://counter.theconversation.com/content/141687/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The University of Michigan Center for the History of Medicine received funding from the US Centers for Disease Control and Prevention for a portion of its research on the 1918 influenza pandemic. J. Alexander Navarro was a member of that team of researchers.</span></em></p>As the US battled the 1918 influenza pandemic, some communities staged contentious battles against wearing masks. Sound familiar?J. Alexander Navarro, Assistant Director, Center for the History of Medicine, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1407012020-07-12T11:25:44Z2020-07-12T11:25:44ZComparing COVID-19 to past world war efforts is premature — and presumptuous<figure><img src="https://images.theconversation.com/files/345918/original/file-20200706-3953-1sm6t6x.jpg?ixlib=rb-1.1.0&rect=35%2C70%2C4661%2C2894&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Donald Trump is no Winston Churchill and the coronavirus pandemic is not like a world war.</span> <span class="attribution"><span class="source">(AP Photo/Tim Ireland)</span></span></figcaption></figure><p>The collective effort to fight the coronavirus pandemic has been called the defining moment of the 21st century, or <a href="https://www.forbes.com/sites/kenrapoza/2020/04/01/battling-coronavirus-is-pushing-world-growth-to-zero-requiring-a-world-war-approach/#5b4016825007">this generation’s Second World War</a>. </p>
<p>There may be some truth to these analogies, but it’s premature — and even presumptuous — to put the present into a historic context.</p>
<p>Pandemics have always shaped human history. Starting in the year 541, <a href="https://www.pnas.org/content/116/51/25546">the Plague of Justinian</a> killed 50 million people — possibly half the world’s population — in just a few years. In the mid-14th century, <a href="https://www.livescience.com/what-was-the-black-death.html">the Black Death</a> claimed approximately 200 million lives with massive political, social and economic impacts.</p>
<p>Plagues resurfaced dozens of times over the next 300 years. Smallpox haunted Europe and Asia for centuries and <a href="https://www.cdc.gov/smallpox/history/history.html">then went with colonizers to the New World</a>, <a href="https://www.macleans.ca/news/canada/how-a-smallpox-epidemic-forged-modern-british-columbia/">wiping out Indigenous populations</a>. </p>
<p>Just over a century ago, influenza claimed between 50 and 100 million lives — roughly five per cent of the population — while the world fought the Great War. It’s debatable how much the pandemic affected the war, but there’s little doubt the war shaped the flu by putting millions in close proximity and providing the means for quick global transmission. </p>
<h2>Flu claimed as many as the Great War</h2>
<p>Just like today, Canada was not spared. About 55,000 Canadians died in the 1918-19 flu, nearly the same <a href="https://www.warmuseum.ca/firstworldwar/history/after-the-war/legacy/the-cost-of-canadas-war/">as the losses in what became known as the First World War</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=551&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=551&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345921/original/file-20200706-27824-15i802k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=551&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A burial scene in France during the First World War. The 1918 flu killed almost as many Canadians as were lost in the Great War.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/ (National Archives of Canada</span></span>
</figcaption>
</figure>
<p>Montréal and Toronto were particularly hard hit. Schools, businesses and public places closed. Debates raged about the efficacy of wearing masks. People practised social distancing, while physicians urged quarantine. Eaton’s and other stores <a href="https://earlycanadianhistory.ca/2020/03/23/killer-advertising-how-canadians-were-sold-the-1918-1919-influenza-pandemic/">advertised cure-alls</a>. When the worst passed, there were phased reopenings. A federal department of health was created. The economy rebounded.</p>
<p>We have learned many lessons from 1918 — about basic sanitation, quarantine, drugs, immunizations and more. But we still have much to learn. </p>
<p>COVID-19 has taken an enormous toll. With 12 million confirmed cases and more than 550,000 dead, it could remain a serious global threat for years, maybe decades.</p>
<p>Fears of a virulent “second wave” are acute, especially with the first wave still wreaking havoc. The economic costs might prove incalculable. Political and social instabilities are rising, <a href="https://www.thestatesman.com/opinion/covid-threat-imrans-regime-1502891466.html">even threatening some regimes</a>.</p>
<h2>A limited analogy</h2>
<p>But while the pandemic might seem like a “war,” there are serious limitations to the analogy.</p>
<p>Leaders invoke comparisons to bolster their images: <a href="https://www.bbc.com/news/av/world-us-canada-52915972/white-house-likens-trump-to-churchill-in-ww2">likening themselves to Winston Churchill</a> or Franklin D. Roosevelt, even if they don’t fully understand what either did in response to crisis.</p>
<p>Curiously, some have talked about COVID-19 having <a href="https://www.bloomberg.com/opinion/articles/2020-03-24/coronavirus-recession-it-will-be-a-lot-like-world-war-ii">the same impact on the economy as a world war</a> when in fact <a href="https://www.veterans.gc.ca/eng/remembrance/history/historical-sheets/industry">the Second World War required total production</a>, not the paring down to an essential economy that has happened during the coronavirus pandemic.</p>
<p>COVID-19 is also not bombing cities. It does not have a political ideology. It does not harbour <a href="https://www.cambridge.org/ca/academic/subjects/politics-international-relations/international-relations-and-international-organisations/irredentism-european-politics-argumentation-compromise-and-norms?format=HB&isbn=9780521895583">irredentist claims</a>, or seek to “right” historical “wrongs.” It is not exterminating millions in concentration camps.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/345922/original/file-20200706-22-c3su36.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Donald Trump has likened himself to a war-time president as his administration struggles with its response to the coronavirus pandemic. Here, Trump and First Lady Melania Trump visit the Second World War memorial in Washington last May to commemorate the 75th anniversary of Victory in Europe Day.</span>
<span class="attribution"><span class="source">(AP Photo/Evan Vucci)</span></span>
</figcaption>
</figure>
<p>Although disconcerting, business closures and social distancing are not akin to living under enemy occupation. Aside from front-line workers, most of us have endured inconveniences, not sacrifices. Soldiers are not dying in trenches or on the beaches. Ordering from Amazon and binge-watching Netflix cannot be compared to Stalingrad, Iwo Jima or <a href="https://www.iwm.org.uk/history/what-was-the-battle-of-verdun">Verdun</a>, let alone Auschwitz. </p>
<h2>Building unity</h2>
<p>Likening the pandemic to war, however, can convey a sense of urgency to those who don’t understand the consequences of inaction. It can push reluctant leaders to put public health ahead of politics. It can build a sense of collective responsibility and unity. As part of our collective memory and identity, wars can represent inspirational virtues. We might aspire to the fortitude of those who persevered through two world wars and the Great Depression.</p>
<p>But outright comparisons to the suffering and sacrifice of millions in vastly different contexts is disrespectful and doesn’t help the current fight against COVID-19. What we are living through now is important, but it’s not war. </p>
<p>It will be a long time before we might consider anything about COVID-19 history, but historical perspective can help us better understand this pandemic — and potentially better manage it. Understanding the magnitude of wars would help too.</p>
<p>German philosopher <a href="https://www.goodreads.com/quotes/12801-we-learn-from-history-that-we-do-not-learn-from">Friedrich Hegel famously said</a>: “We learn from history that we do not learn from history.” Thinking in historical terms might help us better understand ourselves: what we have endured and what we need to do, together, in future crises. In the case of this current crisis, let’s hope Hegel was wrong.</p><img src="https://counter.theconversation.com/content/140701/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Arne Kislenko does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It’s always dangerous to put present-day events into historic perspectives. That’s especially true when political leaders have compared the coronavirus pandemic to a war effort.Arne Kislenko, Associate Professor of History, Toronto Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1405192020-07-06T12:13:43Z2020-07-06T12:13:43ZLessons from the 1918 pandemic: A U.S. city’s past may hold clues<figure><img src="https://images.theconversation.com/files/342022/original/file-20200616-23276-1gja8tr.jpg?ixlib=rb-1.1.0&rect=184%2C109%2C3484%2C4267&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A list of rules from the U.S. Public Health Service in 1918 to reduce the chances of contracting or spreading the devastating flu pandemic. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/rules-to-reduce-the-spread-of-spanish-flu-posting-by-the-us-news-photo/699913383?adppopup=true">Getty Images / Fototeca Storica Nazionale</a></span></figcaption></figure><p>Coronavirus infection rates continue <a href="https://coronavirus.jhu.edu/us-map">to rise</a>, with the number of new cases climbing in <a href="https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html#states">dozens of states</a> and the U.S. reporting <a href="https://www.nytimes.com/2020/07/01/world/coronavirus-updates.html">record numbers of cases on individual days</a>. Hospitalization across the U.S. has dramatically jumped; some cities are <a href="https://www.cnn.com/2020/07/02/health/coronavirus-hospitalizations-rates-rise/index.html">seeing surges</a> that threaten to <a href="https://www.cbsnews.com/video/overwhelmed-houston-hospitals-transfer-coronavirus-patients-to-other-cities-as-cases-spike/">overwhelm</a> their health care systems. </p>
<p>Meanwhile, the demonstrations over the police killing of George Floyd brought tens of thousands into the streets, congregating shoulder-to-shoulder. Many are the victims of tear gassing by police, potentially increasing the risk of transmission and infection. The latest models indicate COVID-19’s U.S. death toll could <a href="http://www.healthdata.org/covid/updates">reach 170,000 by October</a>. A second wave this fall – or the continuation of an unabated first wave – could make that number even higher. </p>
<p>But these are not unprecedented times. </p>
<p>As a <a href="http://chm.med.umich.edu/about/j-alexander-navarro-phd/">historian of medicine</a> at the University of Michigan, I am a student of the 1918 influenza pandemic. It remains the deadliest public health event in recorded history. There are lessons to be learned from what happened a century ago. True, there are differences between then and now. Then we were a nation at war, with an economy led by manufacturing and a male-dominated workforce. We had far less medical and scientific knowledge. And it was an entirely different virus. But striking similarities exist between how we reacted to the pandemic in 1918, and how we’re responding now.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/342026/original/file-20200616-23231-1vfuz7v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In the U.S., 675,000 died from the 1918 influenza pandemic.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/red-cross-house-at-u-s-general-hospital-during-influenza-news-photo/1223011438?adppopup=true">Getty Images / Universal History Archive</a></span>
</figcaption>
</figure>
<h2>Lessons from the last century</h2>
<p>The city of Denver, Colorado, is perhaps the most relevant case study. As the epidemic skyrocketed, officials ordered the immediate closure of schools, churches, and places of public amusement. Indoor public gatherings were banned. Such action, it was argued, would save lives and money.</p>
<p>The business community agreed. <a href="https://quod.lib.umich.edu/f/flu/6200flu.0004.026/1/--denver-closes-churches-and-theaters?rgn=full+text;view=image;q1=Denver+Closes+Churches+and+Theaters">One theater owner put it this way:</a> “I shall sacrifice gladly all that I have and hope to have, if by so doing I can be the means of saving one life.” </p>
<p>That noble sense of civic duty quickly faded as townspeople took to congregating outdoors. They met in the busy downtown shopping district and at outdoor church services and lodge meetings. Business owners and those thrown out of work by the closure orders decried these gatherings; they were bearing the brunt of the closures, they said, while the public shirked its duty. Denver’s health officer, calling out the <a href="https://www.influenzaarchive.org/cities/city-denver.html#">“criminal neglect”</a> of those at the open-air assemblies, added outdoor gatherings to the prohibitions. </p>
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<p>Within just two weeks of the closures, residents grew restless. As records of new cases leveled off, many demanded an end to both the closure order and gathering ban. Giving in to the pressure, the mayor and health officer announced the measures would be lifted on Nov. 11, 1918. That day – in a horrible twist of fate – turned out to be Armistice Day. Thousands thronged the streets, hotels, theaters, and auditoriums of Denver to celebrate both the end of World War I and the pandemic. But only one of them was truly over. </p>
<p>Health authorities realized a new surge of influenza deaths were likely but acknowledged there was little they could do. “There is no use trying to lay down any rules regarding the peace celebration,” <a href="https://quod.lib.umich.edu/f/flu/7900flu.0004.097/1/--big-increase-in-flu-feared-as-result-of-packed-city-streets?rgn=full+text;view=image;q1=Big+Increase+in+Flu+Feared+as+Result+of+Packed+City+Streets">said one official</a>, “as the lid is off entirely.”</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=363&fit=crop&dpr=1 600w, https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=363&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=363&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=456&fit=crop&dpr=1 754w, https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=456&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/342301/original/file-20200616-23261-1sr22px.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=456&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Patients with the Spanish flu at a barracks hospital in Fort Collins, Colorado, 1918.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/view-of-victims-of-the-spanish-flu-cases-as-they-lie-in-news-photo/906330984?adppopup=true">Getty Images / Photo Quest</a></span>
</figcaption>
</figure>
<h2>The next wave hits</h2>
<p>The surge came hard and fast. Within a week, physicians reported hundreds of new cases and dozens of deaths per day. Officials responded with another set of closure orders and gathering bans. Theaters, bowling alleys, pool halls, and other places of public amusement were shut down. Affected business owners, complaining they were singled-out, formed an “amusement council,” and demanded the city close all places of congregation or issue a mask order. City officials acceded. They put a mask order in place.</p>
<p>Enforcement was an issue. Residents routinely refused to wear masks even when threatened with arrest and hefty fines. The mayor soon realized the futility of the order. “Why, it would take half the population to make the other half wear masks,” <a href="https://quod.lib.umich.edu/f/flu/0210flu.0004.120/1/--police-will-enforce-flu-masking-order?rgn=full+text;view=image;q1=Police+Will+Enforce+Flu+Masking+Order">he said</a>. “You can’t arrest all the people, can you?” Officials then backed off again: they would recommend mask use, not require it.</p>
<p>Except for streetcar conductors. They still had to wear them, said the city. Bristled at being singled out, the conductors threatened to strike. A walkout was averted when city officials again watered down the order. Conductors only had to wear them during rush hour commutes. The new provisions were all but useless, and a few days later the mask rule was abolished. </p>
<p>Denver’s epidemic continued for several months. It was unchecked by any public health orders, save for isolation and quarantine for those with the illness. The result: a second spike of deaths higher than the first, and one of the <a href="https://jamanetwork.com/journals/jama/fullarticle/208354">nation’s largest per capita death tolls</a>.</p>
<h2>History could repeat itself</h2>
<p>Surely at least some of this sounds familiar. If Denver’s story tells us anything, it is that we must do better than in 1918. All of us must continue to combat COVID-19 with face masks and social distancing in public. <a href="https://royalsocietypublishing.org/doi/10.1098/rspa.2020.0376">Recent studies</a> show <a href="https://www.pnas.org/content/early/2020/06/10/2009637117">face masks</a>, along with hand sanitation and social distancing by a majority of the population, can quickly bring this pandemic under control. </p>
<p>Those levels of compliance, however, might become increasingly difficult. In 2020, we are bristling much the same way they did in 1918. A century ago, masks were widely despised; many today feel the same way. Yet if we don’t take these measures seriously, we will likely face a resurgence of the virus.</p>
<p>If the past offers us any perspective into the future, it is this: returning to the sweeping closures and stay-at-home orders that we’re emerging from may be difficult. It proved all but impossible to do so a century ago. It very well may prove impossible today.</p><img src="https://counter.theconversation.com/content/140519/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>J. Alexander Navarro receives funding from The US Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the National Endowment for the Humanities. </span></em></p>How politicians and the public in Denver, Colorado handled the 1918 flu epidemic is relevant to today.J. Alexander Navarro, Professor of History of Medicine, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1409412020-07-02T04:11:59Z2020-07-02T04:11:59ZBorder closures, identity and political tensions: how Australia’s past pandemics shape our COVID-19 response<p>Tensions over border closures are in the news again, now states are gradually lifting travel restrictions <a href="https://www.abc.net.au/news/2020-06-30/sa-delays-victorian-border-reopening-amid-coronavirus/12405632">to all</a> <a href="https://thenewdaily.com.au/news/coronavirus/2020/06/30/queensland-border-victoria/">except Victorians</a>.</p>
<p>Prime Minister Scott Morrison says singling out Victorians is an overreaction to Melbourne’s coronavirus spike, <a href="https://www.theage.com.au/national/victoria/get-some-perspective-pm-calls-out-premiers-for-closing-borders-to-victoria-20200630-p557q4.html">urging</a> the states “to get some perspective”.</p>
<p>Federal-state tensions over border closures and other pandemic quarantine measures are not new, and not limited to the COVID-19 pandemic.</p>
<p>Our new <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/puar.13224">research</a> shows such measures are entwined in our history and tied to Australia’s identity as a nation. We also show how our experiences during past pandemics guide the plans we now use, and alter, to control the coronavirus.</p>
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Read more:
<a href="https://theconversation.com/national-and-state-leaders-may-not-always-agree-but-this-hasnt-hindered-our-coronavirus-response-136152">National and state leaders may not always agree, but this hasn't hindered our coronavirus response</a>
</strong>
</em>
</p>
<hr>
<h2>Bubonic plague, federation and national identity</h2>
<p>In early 1900, <a href="https://www.nma.gov.au/defining-moments/resources/bubonic-plague">bubonic plague</a> broke out just months before federation, introduced by infected rats on ships.</p>
<p>When a new vaccine was available, the New South Wales government planned to inoculate just front-line workers. </p>
<p>Journalists called for a broader inoculation campaign and the government soon faced a “melee” <a href="https://www.griffithreview.com/articles/learning-from-forgotten-epidemics/">in which</a>:</p>
<blockquote>
<p>…men fought, women fainted and the offices [of the Board of Health] were damaged. </p>
</blockquote>
<p>Patients and contacts were quarantined at the <a href="https://www.qstation.com.au/our-story.html">North Head Quarantine Station</a>. Affected suburbs were quarantined and sanitation commenced.</p>
<p>The health board <a href="https://hekint.org/2017/02/01/plague-sydney-1900/">openly criticised</a> the government for its handling of the quarantine measures, laying the groundwork for quarantine policy in the newly independent Australia.</p>
<p>Quarantine then became essential to a vision of Australia as an island nation where “island” stood for immunity and where non-Australians were viewed as “diseased”. </p>
<p>Public health is mentioned twice in the Australian constitution. <a href="http://classic.austlii.edu.au/au/legis/cth/consol_act/coaca430/s51.html">Section 51(ix)</a> gives parliament the power to quarantine, and <a href="http://classic.austlii.edu.au/au/legis/cth/consol_act/coaca430/s69.html">section 69</a> requires states and territories to transfer quarantine services to the Commonwealth.</p>
<p>The <a href="https://www.legislation.gov.au/Details/C2016C00597">Quarantine Act</a> was <a href="https://www.jstor.org/stable/40111469?seq=1">later merged</a> to form the <a href="https://www.legislation.gov.au/Details/C1901A00017">Immigration Restriction Act</a>, with quarantine influencing immigration policy. </p>
<p>Ports then became centres of immigration, trade, biopolitics and biosecurity.</p>
<h2>Spanish flu sparked border disputes too</h2>
<p>In 1918, at the onset of the Spanish flu, quarantine policy included border closures, quarantine camps (for people stuck at borders) and school closures. These measures initially controlled widespread outbreaks in Australia.</p>
<p>However, Victoria quibbled over whether NSW had accurately diagnosed this as an influenza pandemic. Queensland closed its borders, despite only the Commonwealth having the legal powers to do so.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/this-isnt-the-first-global-pandemic-and-it-wont-be-the-last-heres-what-weve-learned-from-4-others-throughout-history-136231">This isn't the first global pandemic, and it won't be the last. Here's what we've learned from 4 others throughout history</a>
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</em>
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<hr>
<p>When World War I ended, many returning soldiers broke quarantine. Quarantine measures were not coordinated at the Commonwealth level; states and territories each went their own way.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344957/original/file-20200701-54182-1xi9yxt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Quarantine camps, like this one at Wallangarra in Queensland, were set up during the Spanish flu pandemic.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/hwmobs/33951814795/in/photolist-TJcVFa-YhgcRx-atsaix-XTKch7-UaKNVR-V9MpKW-UP7JCA-MLhyLw-LRP6K1-MLhndw-HCnkAZ-HzYnQ7-HCmst8-GP2158-HCn2kF-Hjh81L-HCn4qH-GP1U5H-HFEyxo-GNWKdo-GNWpWY-bYHyHs-VzVoWC-WS74kD-MPhwS2-MFUxbv-azS5yy-aWj2ht-2eHp2Cd-iK4YSS-iK6XWw-js1RoA-2iRKFBT-2iErL2N-do1pQW-2iPBTMC-2iPxv95-dJogXQ-dJhQ6D-gaEtvV-wZtUUa-gYh1Qz-gaDNYg-gaDNsr-cN1cWE-cN1bV9-cN1cQS-cN1c6h-cN1d6C-gaDVZw">Aussie~mobs/Public Domain/Flickr</a></span>
</figcaption>
</figure>
<p>There were different policies about state border closures, quarantine camps, mask wearing, school closures and public gatherings. Infection spread and hospitals were overwhelmed.</p>
<p>The legacy? The states and territories ceded quarantine control to the Commonwealth. And <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-8500.1952.tb01591.x">in 1921</a>, the Commonwealth created its own health department.</p>
<h2>The 1990s brought new threats</h2>
<p>Over the next seven decades, Australia linked quarantine surveillance to national survival. It shifted from prioritising human health to biosecurity and protection of Australia’s flora, fauna and agriculture. </p>
<p>In the 1990s, new human threats emerged. <a href="https://wwwnc.cdc.gov/eid/article/5/2/99-0202_article">Avian influenza in 1997</a> led the federal government to recognise Australia may be ill-prepared to face a pandemic. <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cditech-influenza.htm">By 1999</a> Australia had its first <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-cditech-influenza.htm/$FILE/influenza.pdf">influenza pandemic plan</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/todays-disease-names-are-less-catchy-but-also-less-likely-to-cause-stigma-131465">Today's disease names are less catchy, but also less likely to cause stigma</a>
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</em>
</p>
<hr>
<p><a href="https://www.cdc.gov/sars/about/fs-sars.html">In 2003</a>, severe acute respiratory syndrome (or SARS) emerged in China and Hong Kong. Australia responded by discouraging nonessential travel and started health screening incoming passengers.</p>
<p>The next threat, <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a1.htm">2004 H5N1 Avian influenza</a>, was a dry run for future responses. This resulted <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-ahmppi.htm">in the 2008</a> Australian Health Management Plan for Pandemic Influenza, which included border control and social isolation measures.</p>
<h2>Which brings us to today</h2>
<p>While lessons learned from past pandemics are with us today, we’ve seen changes to policy mid-pandemic. March saw the formation of the <a href="https://theconversation.com/explainer-what-is-the-national-cabinet-and-is-it-democratic-135036">National Cabinet</a> to endorse and coordinate actions across the nation. </p>
<p>Uncertainty over border control continues, especially surrounding the potential for <a href="https://www.smh.com.au/national/australia-covid-19-death-toll-reaches-100-20200519-p54uhb.html">cruise</a> and <a href="https://www.theguardian.com/australia-news/2020/may/26/wa-premier-fears-more-covid-19-infections-after-six-test-positive-on-live-export-ship-in-fremantle">live-export ships</a> to import coronavirus infections.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-has-seriously-tested-our-border-security-have-we-learned-from-our-mistakes-134794">Coronavirus has seriously tested our border security. Have we learned from our mistakes?</a>
</strong>
</em>
</p>
<hr>
<p>Then there are border closures between states and territories, creating tensions and a potential <a href="https://www.theguardian.com/australia-news/2020/may/28/clive-palmer-launches-high-court-challenge-to-queensland-coronavirus-border-closure">high court challenge</a>.</p>
<p>Border quibbles between states and territories will likely continue in this and future pandemics due to geographical, epidemiological and political differences.</p>
<p>Australia’s success during COVID-19 as a nation, is in part due to Australian quarantine policy being so closely tied to its island nature and learnings from previous pandemics.</p>
<p>Lessons learnt from handling COVID-19 will also strengthen future pandemic responses and hopefully will make them more coordinated.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/4-ways-australias-coronavirus-response-was-a-triumph-and-4-ways-it-fell-short-139845">4 ways Australia's coronavirus response was a triumph, and 4 ways it fell short</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/140941/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Susan Moloney is Past President, Paediatrics & Child Health Division, The Royal Australasian College of Physicians (RACP).</span></em></p><p class="fine-print"><em><span>Kim Moloney does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Australia’s island identity and attitude to border security was forged from handling pandemics since the time of federation. Here’s what we’ve learned along the way.Susan Moloney, Associate Professor, Paediatrics, Griffith UniversityKim Moloney, Senior Lecturer in Global Public Administration and Public Policy, Murdoch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1412542020-06-26T13:32:32Z2020-06-26T13:32:32ZPast pandemics exacerbated disadvantages – what we can learn from them about the coronavirus recovery<p>Societies of the past were often better at dealing with problems than those of the present. It’s a sign of our complacency that <a href="https://theconversation.com/coronavirus-governments-knew-a-pandemic-was-a-threat-heres-why-they-werent-better-prepared-136857">early warning systems were not in place</a> before COVID-19 struck. This was despite the fact that the past century witnessed four major respiratory pandemics – the 1918-19 Spanish flu, 1957-58 Asian flu, 1967 Hong Kong flu and the 2009 H1N1 outbreak – each of which infected many tens of millions of people around the world and killed in large numbers.</p>
<p>Centuries ago, states understood the risks of infectious disease and had containment measures in place to make sure cases were quickly identified and prevented from spreading. Milan, for example, which had been badly hit by plague in the 1360s, <a href="https://scholarworks.wmich.edu/tmg/vol1/iss1/8/">put in place extensive networks</a> of agents tasked with paying particular attention to reports of outbreaks of disease and monitoring trade routes and mountain passes for signs of infections.</p>
<p>The health authorities in the Ottoman Empire likewise fought a long-running battle over the course of many centuries against regular outbreaks of plague in Constantinople, Damascus and Aleppo in the 15th and 16th centuries. This resulted in <a href="https://www.cambridge.org/core/books/plague-and-empire-in-the-early-modern-mediterranean-world/D35B6A9462B1E2849AA2F9A75048DF69">the introduction of steps to identify</a> and respond to cases rapidly and efficiently. It was the same story in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660681/">Ionian islands under the Venetians</a> in the 17th and 18th centuries, and no coincidence that when measures failed, as they did twice in this period, it was because of misdiagnosis or delayed notification.</p>
<p>The aftermath of COVID-19 will presumably see a return to such levels of alertness. However, it is the long-terms effects of the disease that may have the greater impact on the world we live in. </p>
<h2>Increased disadvantage</h2>
<p>New research on the health, educational and productivity of Brazil in the early 20th century has revealed that despite directly killing few people there, the <a href="https://www.nber.org/papers/w26929">Spanish flu led to a marked increase</a> of still births and infant mortality in the country into 1920. There were sharp changes, too, in sex ratios of new-born children, with a spike in the number of births of girls relative to boys, largely because female foetuses are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119278/">less vulnerable</a> than male foetuses to disease in general.</p>
<p>Over the next two decades, there was also a noticeable improvement in male literacy levels in Brazil, alongside a deterioration in female literacy levels in districts with greater influenza exposure. This was presumably because greater efforts went in to educating young boys, at the expense of girls. Such gendered educational imbalance is often seen in distressed communities, such as in Indonesia <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144011/">following the tsunami of 2004</a>.</p>
<p>It’s these sort of lessons from the past that will be so important to apply when it comes to developing policies in the wake of the current pandemic, which should correct for disadvantages. Another example comes from data from US censuses conducted in 1960, 1970 and 1980. Those conceived or in gestation during the 1918-19 flu crisis in the US had reduced educational attainment, lower lifetime incomes, and disability rates that were <a href="https://www.jstor.org/stable/10.1086/507154?seq=1#metadata_info_tab_contents">20% higher compared</a> to those in other birth cohorts. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=498&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=498&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=498&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=626&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=626&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344240/original/file-20200626-104484-y9nn7b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=626&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A nurse treats patients with Spanish flu in Washington DC.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/walter-reed-hospital-flu-ward-during-242820250">Everett Collection/Shutterstock</a></span>
</figcaption>
</figure>
<p>Devising ways to compensate for such long-term disadvantages is crucial because pandemics correlate closely with violence, intolerance and racism. This is something shown most strikingly in the <a href="https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr921.pdf">case of cities in Germany a century ago</a>. Cities and areas that suffered the most deaths during the Spanish flu spent on average less per person on their inhabitants in the decade that followed than those cities with lower mortality rates, especially on areas affecting young people – most notably school funding.</p>
<p>These urban centres in Germany that experienced the most deaths and the lowest investment subsequently were also significantly more likely to vote for extremist parties during the federal elections of 1932 and 1933 that ultimately propelled Hitler to power. This is the case even after controlling the data for factors such as demographics, war-related change and unemployment.</p>
<p>This echoes research that suggests that places badly affected by the authorities’ responses to disease <a href="https://ideas.repec.org/p/igi/igierp/661.html">require higher levels of trust-building</a> to compensate and to re-calibrate how citizens respond to government advice in the future. Such places may also need greater levels of intervention to ensure that social and political polarisation do not take root and lead to intolerance and xenophobia in years to come.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=150&fit=crop&dpr=1 600w, https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=150&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=150&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=189&fit=crop&dpr=1 754w, https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=189&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/339451/original/file-20200603-130917-1phwlgk.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=189&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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</figure>
<p><em>Listen to Recovery, a series from <a href="https://theconversation.com/uk/topics/the-anthill-podcast-27460">The Anthill Podcast</a>, to hear more about how the world recovered from past crises, including an episode on the <a href="https://theconversation.com/the-slow-recovery-after-the-combined-shock-of-spanish-flu-and-the-first-world-war-recovery-podcast-part-3-140877">recovery after the Spanish flu</a>.</em></p>
<hr>
<h2>Roots of prejudice</h2>
<p>The deep roots that pandemics have with extremism, violence and xenophobia can span centuries. During the Black Death in the 1340s, Jews were often accused of being responsible for a disease that, like COVID-19, also came from Asia. </p>
<p>Under torture, <a href="https://books.google.co.uk/books?id=1O_PX2wVD0sC&pg=PA207&lpg=PA207&dq=herman+gigas+on+well+poisoning&source=bl&ots=HODzGMbJQr&sig=ACfU3U37fW-iooB_XomGX9NgwEWowwasnA&hl=en&sa=X&ved=2ahUKEwiQnt_nyZrqAhWSWRUIHbrXDe4Q6AEwA3oECAcQAQ#v=onepage&q=herman%20gigas%20on%20well%20poisoning&f=false">wrote the friar Herman Gigas</a>, many Jews were forced to confess to breeding “spiders and toads in pots and pans” and to poisoning wells to kill Christians. The antisemitic persecutions were worst in Germany, where Jewish communities in some towns <a href="https://www.jstor.org/stable/25096679?seq=1">were burnt alive inside synagogues</a> where they had taken refuge.</p>
<p>Antisemitism persisted in Germany in the intervening centuries. When expressions of violence against Jews became normalised in the 1920s, attacks were <a href="https://www.nber.org/papers/w17113">six times more likely</a> to take place in towns and cities where Jews had been murdered 600 years earlier. </p>
<p>Support for the Nazi party was also significantly higher in these urban locations. Places where there was a high level of persecution of Jews during the Black Death correlate closely with places where most damage done to synagogues on Kristallnacht in 1938. Levels of deportations of Jews to concentration camps between 1933-44 were as much as 15% higher in cities that held pogroms during the 14th century than those that did not. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/epidemics-have-often-led-to-discrimination-against-minorities-this-time-is-no-different-140189">Epidemics have often led to discrimination against minorities – this time is no different</a>
</strong>
</em>
</p>
<hr>
<p>Failure to learn from the past is a key part of the COVID-19 story. There are <a href="https://cepr.org/sites/default/files/news/CovidEconomics15.pdf">remarkably similar patterns</a> when you look at how US cities have fared during the current pandemic compared to during Spanish flu. Cities like San Francisco that performed well in 2020 also did so a century earlier because they had mayors who took drastic action. Those like New York, which took a more <a href="https://twitter.com/BilldeBlasio/status/1234648718714036229?s=20">laissez-faire approach</a> on both occasions, paid a heavy price each time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=517&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=517&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344234/original/file-20200626-104510-1qlhv5o.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=517&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Comparing the 1918-19 flu with COVID-19 in US cities.</span>
<span class="attribution"><a class="source" href="https://cepr.org/sites/default/files/news/CovidEconomics15.pdf">Zhixian Lin & Meissner, Covid Economics, CEPR Press May 2020</a></span>
</figcaption>
</figure>
<p>As history can show us if we ask the right questions, the impact of COVID-19 will have consequences that stretch decades, perhaps centuries, into the future. But to look to tomorrow, it’s important to understand the past – and to apply the valuable lessons it can teach.</p><img src="https://counter.theconversation.com/content/141254/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Frankopan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Plagues and flu pandemics of the past have led to long-term disadvantages for those affected, and increased prejudice.Peter Frankopan, Professor of Global History, University of OxfordLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1381062020-06-14T12:29:02Z2020-06-14T12:29:02ZVaccinations skipped during COVID-19 shutdown may lead to outbreaks of other diseases<figure><img src="https://images.theconversation.com/files/341306/original/file-20200611-80789-1p00yas.jpg?ixlib=rb-1.1.0&rect=641%2C0%2C7279%2C5379&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The World Health Organization estimates that 117 million people worldwide may have missed a vaccination during the COVID-19 pandemic.</span> <span class="attribution"><span class="source">(Shutterstock))</span></span></figcaption></figure><p>Although COVID-19 is a new illness caused by a new virus, the fallout from the COVID-19 shutdown may put the world at risk for outbreaks of old illnesses: ones that were practically eradicated through vaccination.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&rect=181%2C0%2C4204%2C2711&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/341120/original/file-20200611-114118-1bpoksw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Children may be falling behind on scheduled vaccinations during the COVID-19 shutdown.</span>
<span class="attribution"><span class="source">(Shutterstock))</span></span>
</figcaption>
</figure>
<p>The World Health Organization estimates that <a href="https://www.who.int/immunization/diseases/measles/statement_missing_measles_vaccines_covid-19/en/">117 million people worldwide</a> will miss out on vaccinations for preventable diseases due to COVID-19. Closer to home, the Canadian Paediatric Society is worried that Canadians will <a href="https://www.cbc.ca/news/health/covid-19-child-immunizations-1.5543286">fall behind</a> on their vaccination schedules. Vaccines are one of the most important public health tools at our disposal. Ignoring vaccinations can have dire consequences. </p>
<h2>Lessons from 1918</h2>
<p>I am a historian of medicine. I study the history of infectious diseases and vaccination. In recent months, I have focused my research on the understudied effects of the 1918 flu pandemic on public health in Canada. </p>
<p>The experience of the 1918 influenza should act as a warning for provincial public health programs. My research shows that in the years after the 1918 flu, Canada suffered a series of outbreaks of <a href="https://www.cpha.ca/sites/default/files/assets/history/book/history-book-print_all_e.pdf">smallpox and typhoid</a> after vaccination took a backseat to the pandemic.</p>
<p>Provincial governments need to have a plan to get children back on track when COVID-19 subsides, or run the risk of creating an environment ripe for outbreaks of vaccine-preventable diseases such as measles.</p>
<h2>Establishing public health measures</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=498&fit=crop&dpr=1 600w, https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=498&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=498&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=626&fit=crop&dpr=1 754w, https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=626&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/339995/original/file-20200605-176564-1gfhlrk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=626&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Walter Reed Hospital flu ward in Washington D.C. during the flu epidemic of 1918-19.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Before the 1918 flu, local public health programs were temporary, and workers were volunteers. In 1923, the Health Board of Québec provided financial support to create <a href="https://utorontopress.com/ca/public-health-in-the-age-of-anxiety-2">permanent public health units</a>. As part of this, it instituted a hygiene week, when the government educated communities about the importance of public health measures, including vaccination. Ontario followed suit, in 1924, when the chief officer of health helped develop full-time public health units for the province. </p>
<p>Though it may seem that the 1918 flu directly spurred the development of permanent public health units and sophisticated routine vaccine programs, the truth is more complicated. My study of public health reports shows that after the 1918 flu, cases of smallpox and other preventable diseases spiked. </p>
<p>In 1920, Canada had 2,553 cases of smallpox, compared to a baseline of a couple hundred a year. Cases continued climbing to a peak of <a href="https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/smallpox.html">3,300 in 1927</a>, before declining to near zero in the 1940s. In 1923, Cochrane, Ont. had an outbreak of typhoid with <a href="https://www.cpha.ca/sites/default/files/assets/history/book/history-book-print_all_e.pdf">800 cases and 50 deaths</a>. With a population of 3,400, cases represented almost a quarter of the population. </p>
<h2>Outbreaks in the wake of 1918 flu</h2>
<p>It is difficult to track vaccination uptake in the early 1900s, because records of vaccination during this period were spotty at best. Nonetheless, these lapses in public health expose failures to maintain adequate vaccination levels in communities across Canada in the wake of the 1918 flu, which interrupted many aspects of life including <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862334/">commerce, religion and vaccination</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-taming-of-polio-and-the-challenge-of-the-flu-116100">The taming of polio and the challenge of the flu</a>
</strong>
</em>
</p>
<hr>
<p>After the 1918 flu, however, public health officers did not take measures necessary to make up for lost time and missed vaccinations. It was not until several outbreaks had occurred, such as the one in Cochrane, that public health authorities regained control over preventable diseases. </p>
<p>Getting infectious diseases under control meant ensuring shots were administered as part of routine vaccination programs. This was a messy process and it did not happen all at once. However, by 1940 Toronto acheived the distinction of being the first city with a population over 500,000 to report <a href="https://utorontopress.com/ca/public-health-in-the-age-of-anxiety-2">no cases of smallpox</a>. Toronto achieved this by tracking vaccinations closely and by advertising smallpox vaccination at the same time every year.</p>
<h2>Vaccine misinformation</h2>
<p>Today, Canadian vaccination programs are threatened by vaccine misinformation, rejection and apathy. At the same time, a growing number of Canadians are <a href="https://www.cfp.ca/content/65/3/175">hesitant to vaccinate</a>. These factors leave Canada with slim margins on maintaining herd immunity, which refers to the point at which the percentage of people immunized ensures protection of the whole community from disease. Even before COVID-19, Canada has had outbreaks of measles in under-vaccinated communities. In 2019, Canada reported <a href="https://www.canada.ca/en/public-health/services/publications/diseases-conditions/measles-rubella-surveillance/2019/week-52.html">113 cases of measles</a>. </p>
<p>The COVID-19 pandemic has created many problems that will need attention. Already provinces are creating step-by-step plans to <a href="https://globalnews.ca/news/6920122/coronavirus-heres-how-provinces-plan-to-emerge-from-covid-19-lockdown/">reopen their economies</a>. What is needed now is for provinces to create step-by-step plans for identifying and contacting those who have fallen behind on their vaccinations.</p><img src="https://counter.theconversation.com/content/138106/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Derek Cameron received funding from the Social Science and Humanities Research Council. </span></em></p>Children may have fallen behind on their vaccination schedules during the pandemic, increasing the risk that COVID-19 may be followed by outbreaks of once-eradicated diseases.Derek Cameron, PhD Candidate in History, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1384292020-05-22T01:27:29Z2020-05-22T01:27:29ZLockdowns, second waves and burn outs. Spanish flu’s clues about how coronavirus might play out in Australia<figure><img src="https://images.theconversation.com/files/336285/original/file-20200520-152320-118x264.jpg?ixlib=rb-1.1.0&rect=217%2C29%2C1163%2C737&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">National Museum of Australia </span></span></figcaption></figure><p>In a remarkable coincidence, the first media reports about Spanish flu and <a href="https://www.theguardian.com/world/2020/feb/03/timeline-how-australia-responded-to-the-coronavirus-outbreak">COVID-19 in Australia</a> both occurred on January 25 – exactly 101 years apart. </p>
<p>This is not the only similarity between the two pandemics. </p>
<p>Although history does not repeat, it rhymes. The story of how Australia - and particular the NSW government - handled Spanish flu in 1919 provides some clues about how COVID-19 might play out here in 2020.</p>
<p><a href="https://theconversation.com/newsletter"><img src="https://images.theconversation.com/files/320030/original/file-20200312-116261-a6ugi0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=90&fit=crop&dpr=2" alt="Sign up to The Conversation" width="100%"></a></p>
<h2>Spanish flu arrives</h2>
<p>Australia’s first case of Spanish flu was likely admitted to hospital in Melbourne on January 9 1919, though it was not diagnosed as such at the time. Ten days later, there were 50 to 100 cases. </p>
<p>Commonwealth and Victorian health authorities initially believed the outbreak was a local variety of influenza prevalent in late 1918. </p>
<p>Consequently, Victoria delayed until January 28 notifying the Commonwealth, as required by a 1918 federal-state agreement designed to coordinate state responses.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fleas-to-flu-to-coronavirus-how-death-ships-spread-disease-through-the-ages-137061">Fleas to flu to coronavirus: how 'death ships' spread disease through the ages</a>
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</em>
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<p>Meanwhile, travellers from Melbourne had carried the disease to NSW. On January 25, <a href="http://nla.gov.au/nla.news-article222637341">Sydney’s newspapers</a> reported that a returned soldier from Melbourne was in hospital at Randwick with suspected pneumonic influenza. </p>
<h2>Shutdown circa 1919: libraries, theatres, churches close</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1482&fit=crop&dpr=1 600w, https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1482&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1482&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1863&fit=crop&dpr=1 754w, https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1863&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/336334/original/file-20200520-152338-ce12rr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1863&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The NSW government quickly imposed restrictions on the population when Spanish flu first arrived.</span>
<span class="attribution"><span class="source">National Library of Australia</span></span>
</figcaption>
</figure>
<p>Acting quickly, in late January, the NSW government ordered “everyone shall wear a mask,” while all libraries, schools, churches, theatres, public halls, and places of indoor public entertainment in metropolitan Sydney were told to close. </p>
<p>It also imposed restrictions on travel from Victoria in breach of the federal-state agreement.</p>
<p>Thereafter, each state went its own way and the Commonwealth, with few powers and little money compared with today, effectively left them to it.</p>
<p>Generally, the restrictions were received with little demur. But inconsistencies led to complaints, especially from churches and the owners of theatres and racecourses. </p>
<p>People were allowed to ride in crowded public transport to thronged beaches. But masked churchgoers, observing physical distancing, were forbidden to assemble outside for worship. </p>
<p>Later, crowds of spectators would be permitted to watch football matches while racecourses were closed.</p>
<h2>Spanish flu subsides</h2>
<p>Nevertheless, NSW’s prompt and thorough application of restrictions initially proved successful. </p>
<p>During February, Sydney’s hospital admissions were only 139, while total deaths across the state were 15. By contrast, Victoria, which had taken three weeks before introducing more limited restrictions, recorded 489 deaths.</p>
<p>At the end of February, NSW lifted most restrictions. </p>
<p>Even so, the state government did not escape a political attack. The Labor opposition accused it of overreacting and imposing unnecessary economic and social burdens on people. It was particularly critical that the order requiring mask-wearing was not limited to confined spaces, such as public transport.</p>
<p>There was also debate about the usefulness of closing schools, especially in the metropolitan area.</p>
<h2>But then it returns</h2>
<p>In mid-March, new cases began to rise. Chastened by the criticism of its earlier measures, the government delayed reimposing restrictions until early April, allowing the virus to take hold. </p>
<p>This led <a href="https://trove.nla.gov.au/newspaper/article/106079765">The Catholic Press</a> to declare</p>
<blockquote>
<p>the Ministry fiddled for popularity while the country was threatened with this terrible pestilence.</p>
</blockquote>
<p>Sydney’s hospital capacity was exceeded and the state’s death toll for April totalled 1,395. Then the numbers began falling again. After ten weeks the epidemic seemed to have run its course, but as May turned to June, new cases appeared.</p>
<p>The resurgence came with a virulence surpassing the worst days of April. This time, notwithstanding a mounting death toll, <a href="http://nla.gov.au/nla.news-article239595355">the NSW cabinet decided against reinstating restrictions</a>, but urged people to impose their own restraints. </p>
<h2>The government goes for “burn out”</h2>
<p>After two unsuccessful attempts to defeat the epidemic - at great social and economic cost - the government decided to let it take its course.</p>
<p>It hoped the public by now realised the gravity of the danger and that it should be sufficient to warn them to avoid the chances of infection. <a href="https://trove.nla.gov.au/newspaper/article/15847083">The Sydney Morning Herald concurred</a>, declaring</p>
<blockquote>
<p>there is a stage at which governmental responsibility for the public health ends.</p>
</blockquote>
<p>The second wave’s peak arrived in the first week of July, with 850 deaths across NSW and 2,400 for the month. Sydney’s hospital capacity again was exceeded. Then, as in April, the numbers began to decline. In August the epidemic was <a href="http://nla.gov.au/nla.news-article222512358">officially declared over</a>.</p>
<p>Cases continued intermittently for months, but by October, admissions and deaths were in single figures. Like its predecessor, the second wave lasted ten weeks. But this time the epidemic did not return. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-australias-response-to-the-spanish-flu-of-1919-sounds-warnings-on-dealing-with-coronavirus-134017">How Australia's response to the Spanish flu of 1919 sounds warnings on dealing with coronavirus</a>
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</em>
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<p>More than 12,000 Australians had died. </p>
<p>While Victoria had suffered badly early on compared to NSW, in the end, NSW had more deaths than Victoria - about 6,000 compared to 3,500. The NSW government’s decision not to restore restrictions saw the epidemic “burn out”, but at a terrible cost in lives.</p>
<p>That decision did not cause a ripple of objection. At the NSW state elections in March 1920, Spanish flu was not even a campaign issue.</p>
<h2>The lessons of 1919</h2>
<p>In many ways we have learned the lessons of 1919. </p>
<p>We have better federal-state coordination, sophisticated testing and contact tracing, staged lifting of restrictions and improved knowledge of virology.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/336878/original/file-20200521-102647-izcgt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Australia’s response to coronavirus has seen sophisticated testing and contact tracing.</span>
<span class="attribution"><span class="source">Dean Lewis/AAP</span></span>
</figcaption>
</figure>
<p>But in other ways we have not learned the lessons.</p>
<p>Despite our increased medical knowledge, we are struggling to <a href="https://theconversation.com/what-the-phase-1-trials-of-the-first-covid-19-vaccine-really-mean-139020">find a vaccine</a> and effective treatments. And we are debating the same issues - to <a href="https://theconversation.com/should-everyone-be-wearing-face-masks-its-complicated-135548">mask or not</a>, to <a href="https://theconversation.com/other-countries-are-shutting-schools-why-does-the-australian-government-say-its-safe-to-keep-them-open-134538">close schools or not</a>. </p>
<p>Meanwhile, <a href="https://www.abc.net.au/7.30/scott-morrison-discusses-the-governments-approach/12155546">inconsistencies</a> and <a href="https://www.theguardian.com/australia-news/2020/mar/24/australia-is-crying-out-for-clearer-messaging-on-coronavirus-rambling-politicians-told">mixed messaging</a> undermine confidence that restrictions are necessary.</p>
<p>Yet, we are still to face the most difficult question of all.</p>
<p>The Spanish flu demonstrated that a suppression strategy requires rounds of restrictions and relaxations. And that these involve significant social and economic costs. </p>
<p>With the federal and state governments’ current suppression strategies we are already seeing signs of social and economic stress, and this is just round one.</p>
<h2>Would Australians today tolerate a “burn out”?</h2>
<p>The Spanish flu experience also showed that a “burn out” strategy is costly in lives – nowadays it would be measured in tens of thousands. Would Australians today abide such an outcome as people did in 1919? </p>
<p>It is not as if Australians back then were more trusting of their political leaders than we are today. In fact, in the wake of the wartime split in the Labor Party and shifting political allegiances, respect for political leaders was at a low ebb in Australia.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=442&fit=crop&dpr=1 600w, https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=442&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=442&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=556&fit=crop&dpr=1 754w, https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=556&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/336899/original/file-20200522-102637-1ytb0wh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=556&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Australians today may not tolerate the large numbers of deaths we saw in 1919.</span>
<span class="attribution"><span class="source">James Gourley/AAP</span></span>
</figcaption>
</figure>
<p>A more likely explanation is that people then were prepared to tolerate a death toll that Australians today would find unacceptable. People in 1919 were much more familiar with death from infectious diseases. </p>
<p>Also, they had just emerged from a world war in which 60,000 Australians had died. These days the death of a single soldier in combat prompts national mourning.</p>
<p>Yet, in the absence of an effective vaccine, governments may end up facing a “Sophie’s Choice”: is the community willing and able to sustain repeated and costly disruptions in order to defeat this epidemic or, as the NSW cabinet decided in 1919, is it better to let it run its course notwithstanding the cost in lives?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-is-a-sliding-doors-moment-what-we-do-now-could-change-earths-trajectory-137838">Coronavirus is a 'sliding doors' moment. What we do now could change Earth's trajectory</a>
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<img src="https://counter.theconversation.com/content/138429/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jeff Kildea does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are many similarities between Spanish flu and coronavirus, from school closures to mask debates. The story of 1919 also shows governments face choices that can have a terrible cost in lives.Jeff Kildea, Adjunct Professor Irish Studies, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1382202020-05-17T08:50:17Z2020-05-17T08:50:17ZWhy more must be done to fight bogus COVID-19 cure claims<figure><img src="https://images.theconversation.com/files/334628/original/file-20200513-156637-1qlwfz7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A bottle of Covid Organics, a herbal tea that authorities in Madagascar gave to students.</span> <span class="attribution"><span class="source">Photo by Rijasolo/AFP via Getty Images</span></span></figcaption></figure><p>Fake and bogus cure claims are a longstanding, but neglected <a href="https://www.sciencedirect.com/science/article/pii/S016561470900203X">public health problem</a>. Throughout recorded history, plagues have inspired anxiety and desperation. Time and again, this public nervousness has proved a fertile ground for false cures and claimants to thrive. In this sense, recent claims of COVID-19 cures and antidotes are no exception.</p>
<p>During the Spanish flu, cure claims <a href="https://link.springer.com/chapter/10.1007/978-3-030-15346-5_8">generated a false sense of safety</a> that drove hundreds to defy closures and isolation. In the US, <a href="https://www.politico.com/news/magazine/2020/03/17/spanish-flu-lessons-coronavirus-133888">scores of bogus remedies</a> alleging to cure the flu were sold under upbeat labels that undermined preventive action. One ad boasted:</p>
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<p>When Vick’s VapoRub is applied over the throat and chest, the medicated vapors loosen the phlegm, open the air passages and stimulate the mucus membrane to throw off the germs.</p>
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<p>Fake and bogus cures caused the death of many as HIV swept around the world. In Nigeria, for instance, as early as the 1990s, Jeremiah Abalaka, a surgeon with fringe training in immunology, startled the world with his <a href="https://www.sciencedirect.com/science/article/pii/S0264410X04005018?via%3Dihub">HIV cure claim</a>. Many of the HIV patients who flocked to his private clinic reportedly died, including dozens of soldiers referred for treatment by the Nigerian government. </p>
<p>More recently, during both the Ebola and SARS epidemics, fake cure claims also circulated freely, with lethal consequences. For <a href="https://www.npr.org/sections/health-shots/2014/10/23/358318848/fda-cracks-down-on-fake-ebola-cures-sold-online">example</a>, salt solution, snake venom, vitamin C, Nano Silver and some herbs were all touted as cures for Ebola. At least two people died in Nigeria and about 20 more were hospitalised after drinking excessive amounts of salt solution to prevent Ebola infection.</p>
<p>Sadly, history is repeating itself in the context of COVID-19. False claims range from US president Donald Trump’s touting of anti-malaria drug <a href="https://theconversation.com/chloroquine-and-hydroxychloroquine-no-proof-these-anti-malarial-drugs-prevent-novel-coronavirus-in-humans-134703">hydroxychloroquine</a> as a miracle cure to Madagascar’s herbal <a href="https://www.sciencemag.org/news/2020/05/unproven-herbal-remedy-against-covid-19-could-fuel-drug-resistant-malaria-scientists">“cure”</a> promoted by President Andry Rajoelina. </p>
<p>In Ghana, a Pentecostal pastor launched and sold “Coronavirus Oil”, telling a packed church that it was effective against COVID-19. An American pastor also recently directed viewers to buy Optivida Silver Solution to prevent COVID-19. Its promoter had <a href="https://www.theguardian.com/us-news/2020/mar/09/jim-bakker-letitia-james-coronavirus-product-stop-promoting">falsely claimed</a> that the product was government-approved and has the ability to kill every pathogen it has ever been tested on, including SARS and HIV.</p>
<p>With growing global anxiety, many people are easy targets for cure scams and hucksters. Victims of fake cure claims are often among the world’s poorest and most vulnerable. Fighting these cure claims is integral to containing the COVID-19 pandemic. </p>
<p><a href="https://www.who.int/health-topics/coronavirus#tab=tab_1">Authorities</a> across the world are working hard to ensure that correct information and messages on the pandemic reach everybody. But there is room to do more. </p>
<h2>Why we must act now</h2>
<p>Cure claims are dangerous. They delay treatment-seeking and promote reckless behaviour that may result in deaths. At least 300 Iranians have <a href="https://academic.oup.com/alcalc/advance-article/doi/10.1093/alcalc/agaa036/5827425">died</a> from methanol poisoning after consuming alcohol to prevent COVID-19. Hours after Trump declared <a href="https://www.washingtonpost.com/business/2020/04/21/anti-malarial-drug-trump-touted-is-linked-higher-rates-death-va-coronavirus-patients-study-says/">hydroxychloroquine</a> as a miracle cure for COVID-19, people overdosed on it in Africa and Asia. In Arizona, a man died after <a href="https://www.livescience.com/coronavirus-chloroquine-self-medication-kills-man.html">reportedly</a> treating himself with a COVID-19 home therapy derived from the same anti-malarial drug that the US president touted as a wonder drug.</p>
<p>Health literacy – the ability of patients to read, comprehend and act on
medical instructions – remains weak in many contexts. Several millions of health-seekers around the world rely on informal or inexpert sources for their health information needs. Hard-to-reach and vulnerable groups and communities must be targeted through bespoke health promotion strategies.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/false-information-fuels-fear-during-disease-outbreaks-there-is-an-antidote-131402">False information fuels fear during disease outbreaks: there is an antidote</a>
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<p>Online and traditional media offer immense potential to intensify public health education. They must maintain vigilance on COVID-19 cure scams and claimants as they emerge in diverse forms and places. However, merely identifying bogus COVID-19 cure claims or alerting the public about them is no longer enough.</p>
<p>Targeted seizure and destruction of unproven cures can deliver important results. In 2015, a global <a href="https://www.interpol.int/en/News-and-Events/News/2015/INTERPOL-coordinated-operation-strikes-at-organized-crime-with-seizure-of-20-million-illicit-medicines">crackdown</a> by Interpol seized nearly 21 million fake and illegal drugs, including fake cancer “cures”. </p>
<p>Governments must also implement community health outreach programmes that communicate clearly and accurately. Such programmes should have fit-for-purpose feedback systems to enable lay persons in multiple contexts to raise concerns, ask questions and swiftly receive answers. One size will not fit all at this time. Part of the success recorded in Nigeria during the Ebola outbreak has been attributed to the use of different media, including government-sponsored TV and radio messages, town-criers, social media campaigns, and experts to communicate health information to its citizens.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/three-key-drivers-of-good-messaging-in-a-time-of-crisis-expertise-empathy-and-timing-135866">Three key drivers of good messaging in a time of crisis: expertise, empathy and timing</a>
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<p>Countries and national health bodies must integrate traditional healers, faith leaders and community principals in their COVID-19 response strategies. Several studies have documented proven <a href="https://theconversation.com/busting-coronavirus-myths-will-take-more-than-science-lessons-from-an-aids-study-136521">strategies</a> for effectively engaging lay and faith healers to offer correct support and <a href="https://theconversation.com/comics-and-cartoons-are-a-powerful-way-to-teach-kids-about-covid-19-137910">information</a> on epidemics. This is the time to bring these strategies to scale. </p>
<p>Robust mechanisms for holding scam COVID-19 cure claimants and hucksters accountable are also urgently needed. Currently, few countries have such mechanisms. But a good precedent exists in Australia, where a <a href="https://www.theguardian.com/australia-news/2020/may/13/healing-church-fined-150000-in-australia-over-selling-bleach-as-coronavirus-cure">“healing church”</a> that touted a bleach-based solution as a COVID-19 cure has been fined more than $150,000. Politicians and other thought leaders must also realise that their utterances and actions during this pandemic will have far-reaching health, social and economic consequences.</p><img src="https://counter.theconversation.com/content/138220/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Chimaraoke Izugbara receives funding from the Hewlett Foundation, IDRC and the Ford Foundation</span></em></p><p class="fine-print"><em><span>Mary Obiyan receives funding from the Consortium for Advanced Research Training in Africa (CARTA). </span></em></p>Authorities around the world can do more to ensure that correct information and messages on the pandemic reach everybody.Chimaraoke Izugbara, Director, Global Health, Youth and Development, International Center for Research on Women (ICRW), USA & Visiting Professor, University of the WitwatersrandMary O. Obiyan, Senior Lecturer, Department of Demography and Social Statistics, Obafemi Awolowo UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1370612020-05-10T20:09:00Z2020-05-10T20:09:00ZFleas to flu to coronavirus: how ‘death ships’ spread disease through the ages<figure><img src="https://images.theconversation.com/files/333549/original/file-20200508-49556-lbapfs.jpg?ixlib=rb-1.1.0&rect=184%2C206%2C4503%2C3191&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Cushing/Whitney Medical Library</span></span></figcaption></figure><p>One of the haunting images of this pandemic will be stationary cruise ships – deadly carriers of COVID-19 – at anchor in harbours and unwanted. Docked in ports and feared. </p>
<p>The news of the dramatic spread of the virus on the <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> from early February made the news real for many Australians who’d enjoyed holidays on the seas. Quarantined in Yokohama, Japan, over 700 of the ship’s crew and passengers became infected. To date, <a href="https://www.cruisemapper.com/accidents/Diamond-Princess-534">14 deaths</a> have been recorded. </p>
<p>The Diamond Princess’s sister ship, the Ruby Princess, brought the pandemic to Australian shores. Now under <a href="https://www.smh.com.au/national/nsw/police-to-probe-second-ruby-princess-voyage-as-part-of-criminal-investigation-20200417-p54kpo.html">criminal investigation</a>, the events of the Ruby Princess forced a spotlight on the petri dish cruise ships can become. The ship has been <a href="https://www.theguardian.com/australia-news/2020/may/05/ruby-princess-was-initially-refused-permission-to-dock-over-coronavirus-fears-inquiry-told">linked to 21 deaths</a>. </p>
<p>History shows the <a href="https://www.ncbi.nlm.nih.gov/pubmed/29737663">devastating role ships can play</a> in transmitting viruses across vast continents and over many centuries.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/this-could-be-the-end-of-the-line-for-cruise-ships-135937">This could be the end of the line for cruise ships</a>
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<h2>Rats in the ranks</h2>
<p>Merchant ships carrying rats with infected fleas were transmitters of the <a href="https://academic.oup.com/past/article-abstract/244/1/3/5532056?redirectedFrom=fulltext">Plague of Justinian</a> (541-542 AD) that devastated the Byzantine Empire. </p>
<p>Ships carrying grain from Egypt were home to flea-infested rats that fed off the granaries. Contantinople was especially inflicted, with estimates as high as <a href="https://www.history.com/news/microbe-behind-black-death-also-caused-devastating-plague-800-years-earlier">5,000 casualties a day</a>. Globally, up to 50 million people are estimated to have been killed – half the world’s population.</p>
<p>The <a href="https://www.historyextra.com/period/medieval/plague-black-death-quarantine-history-how-stop-spread/">Black Death</a> was also carried by rats on merchant ships through the trade routes of Europe. It struck Europe in 1347, when 12 ships docked at the Sicilian port of Messina. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=361&fit=crop&dpr=1 600w, https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=361&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=361&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=454&fit=crop&dpr=1 754w, https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=454&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/333526/original/file-20200507-49579-nu1bmm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=454&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The people of Tournai bury victims of the Black Death.</span>
<span class="attribution"><span class="source">Wikimedia Commons</span></span>
</figcaption>
</figure>
<p>Subsequently called “death ships”, those on board were either dead or sick. Soon, the Black Death spread to ports around the world, such as Marseilles, Rome and Florence, and by 1348 had reached London with devastating impact. </p>
<p>The Italian writer, poet and scholar, Giovanni Boccaccio, <a href="https://www.historyextra.com/period/medieval/black-death-oh-father-why-have-you-abandoned-me/">wrote</a> how terror swept through Florence with relatives deserting infected family members. Almost inconceivably, he wrote, “fathers and mothers refused to nurse their own children, as though they did not belong to them”. </p>
<p>Ships started being <a href="https://www.historyextra.com/period/medieval/plague-black-death-quarantine-history-how-stop-spread/">turned away</a> from European ports in 1347. Venice was the first city to close, with those permitted to enter forced into a 40-day quarantine: the word “quarantine” derives from the Italian <em>quarantena</em>, or 40 days. </p>
<p>By January 1349, mass graves proliferated outside of London to bury the increasing numbers of dead. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/this-isnt-the-first-global-pandemic-and-it-wont-be-the-last-heres-what-weve-learned-from-4-others-throughout-history-136231">This isn't the first global pandemic, and it won't be the last. Here's what we've learned from 4 others throughout history</a>
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</em>
</p>
<hr>
<p>Army and naval ships, as well as travellers around the globe, also carried cholera pandemics throughout the 19th century. In the first pandemic <a href="https://www.history.com/topics/inventions/history-of-cholera">in 1817</a>, British army and navy ships are believed to have spread cholera beyond India where the outbreaks originated.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=447&fit=crop&dpr=1 600w, https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=447&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=447&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=562&fit=crop&dpr=1 754w, https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=562&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/333572/original/file-20200508-49546-1k9d43i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=562&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Egyptians boarding boats on the Nile during a cholera epidemic, drawn by CL Auguste (1841-1905.)</span>
<span class="attribution"><span class="source">Wellcome Collection</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>By the 1820s, cholera had spread throughout Asia, reaching Thailand, Indonesia, China and Japan through shipping. British troops spread it to the Persian Gulf, eventually moving through Turkey and Syria. </p>
<p>Subsequent outbreaks from the 1820s through to the 1860s relied on trade and troops to spread the disease across continents. </p>
<h2>At war with the Spanish Flu</h2>
<p>The Spanish influenza of 1918-1919 was originally carried by soldiers on overcrowded troop ships during the first world war. The rate of transmission on these ships was rapid, and soldiers died in large numbers. </p>
<p>One New Zealand rifleman <a href="http://dx.doi.org/10.3201/eid1811.AD1811">wrote</a> in his diary in September 1918: </p>
<blockquote>
<p>More deaths and burials total now 42. A crying shame but it is only to be expected when human beings are herded together the way they have been on this boat.</p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=364&fit=crop&dpr=1 600w, https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=364&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=364&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=457&fit=crop&dpr=1 754w, https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=457&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/333566/original/file-20200508-49542-1gfwrmz.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=457&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The SS Port Darwin returned from Europe, docked at Portsea, Victoria. Soldiers are waiting to pass through a fumigation chamber to protect Australia against the Spanish Flu.</span>
<span class="attribution"><span class="source">Australian War Memorial</span></span>
</figcaption>
</figure>
<p>The flu was transmitted throughout Europe in France, Great Britain, Italy and Spain. Three-quarters of French troops and over half of British troops fell ill in 1918. Hundreds of thousands of US soldiers travelling on troop ships across the Atlantic and back provided the perfect conditions for transmission. </p>
<h2>The fate of cruising</h2>
<p>A new and lethal carrier in the 21st century has emerged in the pleasure industry of cruise ships. The <a href="https://www.forbes.com/sites/joemicallef/2020/01/20/state-of-the-cruise-industry-smooth-sailing-into-the-2020s/#364b397665fa">explosion</a> of cruise holidays in the past 20 years has led to a proliferation of luxury liners plying the seas. </p>
<p>Like historical pandemics, the current crisis shares the characteristic of rapid spread through ships. </p>
<p>The unknown is in what form cruise ships will continue to operate. Unlike the port-to-port trade and armed forces that carried viruses across continents centuries ago, the services cruise lines offer are non-essential. </p>
<p>Whatever happens, the global spread of COVID-19 reminds us “death ships” are an enduring feature of the history of pandemics.</p><img src="https://counter.theconversation.com/content/137061/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joy Damousi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some 1,500 years ago, the Plague of Justinian spread via ships from North Africa to Europe and Asia, killing up to 50 million people.Joy Damousi, Director, Institute of Humanities and Social Sciences, Australian Catholic UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1376482020-05-01T15:03:59Z2020-05-01T15:03:59ZFace masks: what the Spanish flu can teach us about making them compulsory<figure><img src="https://images.theconversation.com/files/331959/original/file-20200501-42913-1f48dqp.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Red Cross nurses in San Francisco, 1918. </span> <span class="attribution"><span class="source">Wikimedia</span></span></figcaption></figure><p>Should people be forced to wear face masks in public? That’s the question facing governments as more countries unwind their lockdowns. <a href="https://www.theguardian.com/commentisfree/2020/apr/24/face-masks-mandatory-spread-coronavirus-government">Over 30</a> countries have made masks compulsory in public, <a href="https://www.aljazeera.com/news/2020/04/countries-wearing-face-masks-compulsory-200423094510867.html">including</a> Germany, Austria and Poland. This is despite <a href="https://theconversation.com/should-everyone-be-wearing-face-masks-its-complicated-135548">the science</a> saying masks do little to protect wearers, and <a href="https://annals.org/aim/fullarticle/2764367/effectiveness-surgical-cotton-masks-blocking-sars-cov-2-controlled-comparison">only might</a> prevent them from infecting other people. </p>
<p>Nicola Sturgeon, the Scottish first minister, has nonetheless announced new guidelines <a href="https://www.theguardian.com/uk-news/2020/apr/28/sturgeon-urges-scots-to-wear-coronavirus-face-masks-for-shopping-and-travel">advising Scots</a> to wear masks for shopping or on public transport, while the UK government <a href="https://metro.co.uk/2020/04/30/uk-get-new-guidance-face-masks-next-week-12636404/">is expected to</a> announce a <a href="https://www.dailymail.co.uk/news/article-8247407/Government-tell-Brits-wear-facemasks-work-shops-public-stop-coronavirus-spread.html">new stance</a> shortly. Meanwhile, US vice president Mike Pence has controversially <a href="https://www.theguardian.com/us-news/2020/apr/28/mike-pence-face-mask-mayo-clinic-visit-coronavirus">refused to</a> mask up.</p>
<p>This all has echoes of the great influenza pandemic, aka <a href="https://theconversation.com/why-historians-ignored-the-spanish-flu-101950">the Spanish flu</a>, which <a href="https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm">killed some</a> 50 million people in 1918-20. It’s a <a href="https://www.oxfordscholarship.com/view/10.1093/oso/9780198819660.001.0001/oso-9780198819660">great case study</a> in how people will put up with very tough restrictions, so long as they think they have merit. </p>
<h2>The great shutdown</h2>
<p><a href="https://www.oxfordscholarship.com/view/10.1093/oso/9780198819660.001.0001/oso-9780198819660">In the US</a>, no disease in history led to such intrusive restrictions as the great influenza. These included closures of schools, churches, soda fountains, theatres, movie houses, department stores and barber shops, and regulations on how much space should be allocated to people in indoor public places. </p>
<p>There were fines against coughing, sneezing, spitting, kissing and even talking outdoors – those the Boston Globe called “big talkers”. Special influenza police were hired to round up children playing on street corners and occasionally even in their own backyards. </p>
<p>Restrictions were similarly tough in Canada, Australia and South Africa, though much less so in the UK and continental Europe. Where there were such restrictions, the public accepted it all with few objections. Unlike the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422154/">long history of cholera</a>, especially in Europe, or <a href="https://www.jstor.org/stable/312523">the plague</a> in the Indian subcontinent from 1896 to around 1902, no mass violence erupted and blame was rare – even against Spaniards or minorities.</p>
<p>Face masks came closest to being the measure that people most objected to, even though masks were often popular at first. The Oklahoma City Times in October 1918 described an “army of young women war workers” appearing “on crowded street cars and at their desks with their faces muffled in gauze shields”. From the same month, The Ogden Standard reported that “masks are the vogue”, while the Washington Times told of how they were becoming “general” in Detroit. </p>
<h2>Shifting science</h2>
<p>There was scientific debate from the beginning about whether the masks were effective, but the game began to change after French bacteriologist <a href="https://www.famousscientists.org/charles-nicolle/">Charles Nicolle</a> discovered in October 1918 that the influenza was much smaller than any other known bacterium.</p>
<p>The news spread rapidly, even in small-town American newspapers. Cartoons were published that read, “like using barbed wire fences to shut out flies”. Yet this was just at the point that mortality rates were ramping up in the western states of the US and Canada. Despite Nicolle’s discovery, various authorities began making masks compulsory. San Francisco was the first major US city to do so in October 1918, continuing on and off over a three-month period. </p>
<p>Alberta in Canada did likewise, and New South Wales, Australia, followed suit when the disease arrived in January 1919 (the state basing its decision on scientific evidence older than Charles Nicolle’s findings). The only American state to make masks mandatory was (briefly) California, while on the east coast and in other countries including the UK they were merely recommended for most people. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=352&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=352&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=352&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=443&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=443&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331958/original/file-20200501-42923-1k8sptw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=443&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">San Francisco gathering, 1918.</span>
<span class="attribution"><span class="source">Wikimedia</span></span>
</figcaption>
</figure>
<p>Numerous photographs, like the one above, survive of large crowds wearing masks in the months after Nicolle’s discovery. But many had begun to distrust masks, and saw them as a violation of civil liberties. According to a November 1918 front page report from Utah’s Garland City Globe:</p>
<blockquote>
<p>The average man wore the mask slung to the back of his neck until he came in sight of a policeman, and most people had holes cut into them to stick their cigars and cigarettes through.</p>
</blockquote>
<h2>Disobedience aplenty</h2>
<p>San Francisco saw the creation of the <a href="https://www.theguardian.com/world/2020/apr/29/coronavirus-pandemic-1918-protests-california">anti-mask league</a>, as well as protests and civil disobedience. People refused to wear masks in public or flaunted wearing them improperly. Some went to prison for not wearing them or refusing to pay fines. </p>
<p>In Tucson, Arizona, a banker insisted on going to jail instead of paying his fine for not masking up. In other western states, judges regularly refused to wear them in courtrooms. In Alberta, “scores” were fined in police courts for not wearing masks. In New South Wales, reports of violations flooded newspapers immediately after masks were made compulsory. Not even stretcher bearers carrying influenza victims followed the rules. </p>
<p>England was different. Masks were only advised as a precautionary measure in large cities, and then only for certain groups, such as influenza nurses in Manchester and Liverpool. Serious questions about efficacy only arose in March 1919, and only within the scientific community. Most British scientists now united against them, with the Lancet calling masks a “dubious remedy”.</p>
<p>These arguments were steadily being bolstered by statistics from the US. The head of California’s state board of health had presented late 1918 findings from San Francisco’s best run hospital showing that 78% of nurses became infected despite their careful wearing of masks. </p>
<p>Physicians and health authorities also presented statistics comparing San Francisco’s mortality rates with nearby San Mateo, Los Angeles and Chicago, none of which had made masks compulsory. Their mortality rates were either “no worse” or less. By the end of the pandemic in 1919, most scientists and health commissions had come to a consensus <a href="https://theconversation.com/should-everyone-be-wearing-face-masks-its-complicated-135548">not unlike ours</a> about the benefits of wearing masks. </p>
<p>Clearly, many of these details are relevant today. It’s telling that a frivolous requirement became such an issue while more severe rules banned things like talking on street corners, kissing your fiancé or attending religious services – even in the heart of America’s Bible belt. </p>
<p>Perhaps there’s something about masks and human impulses that has yet to be studied properly. If mass resistance to the mask should arise in the months to come, it will be interesting to see if new research will produce any useful findings on phobias about covering the face.</p><img src="https://counter.theconversation.com/content/137648/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Samuel Cohn does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Over 30 countries today are making people wear masks in public, despite serious doubts from scientists.Samuel Cohn, Professor of History, University of GlasgowLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1370582020-04-30T19:49:09Z2020-04-30T19:49:09ZIt could take two years for the economy to recover from the coronavirus pandemic<figure><img src="https://images.theconversation.com/files/331599/original/file-20200429-155252-2jpdjc.jpg?ixlib=rb-1.1.0&rect=77%2C0%2C5639%2C3828&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Economists are using models to try to determine what short- and long-term impacts the coronavirus pandemic will have on the global economy. </span> <span class="attribution"><span class="source">(AP Photo/Koji Sasahara)</span></span></figcaption></figure><p>Predictions about <a href="https://www.marketwatch.com/story/us-gdp-in-the-first-quarter-is-going-to-be-bad-and-the-damage-is-far-from-done-2020-04-28">the effects of the coronavirus pandemic</a> on the world’s economy arrive almost daily. How can we make sense of them in the midst of this economic storm? After all, research shows that economic forecasts made <a href="https://www.ncbi.nlm.nih.gov/books/NBK92473/">during events such as SARS</a> are often <a href="https://doi.org/10.1016/j.healthpol.2008.03.003">wildly inaccurate</a>. </p>
<p>To calibrate current forecasts — such as the International Monetary Fund’s prediction of a 6.2 per cent decline in <a href="https://www.thesolutionsjournal.com/article/a-short-history-of-gdp-moving-towards-better-measures-of-human-well-being/">Gross Domestic Product</a> for Canada — I’ve looked at the history of similar worldwide economic shocks, studied macroeconomics models and reviewed nearly <a href="https://ssrn.com/abstract=3581243">75 studies</a> to better understand what might happen in a post-pandemic world.</p>
<h2>The economic effects of 1918-20 flu</h2>
<p>The <a href="https://www.stlouisfed.org/%7E/media/files/pdfs/community-development/research-reports/pandemic_flu_report.pdf">influenza outbreak of 1918-20</a> killed at least 40 million people, or approximately two per cent of the world’s population. <a href="https://www.canadashistory.ca/explore/arts-culture-society/killer-flu">In Canada</a> alone, at least 50,000 deaths were attributed to the flu, approaching the number of Canadian deaths in the First World War. Solid data about GDP did not exist for that era, so economic historians have to recreate economic measurements based on the data that was collected. </p>
<p>The <a href="https://www.sciencedirect.com/science/article/pii/S0167629614000344">most thorough study</a> focuses on how the influenza pandemic 100 years ago affected Sweden. The Swedish study took advantage of the fact that the country kept very detailed data on causes of death, as well as having a history of accurate economic record-keeping dating back to the 1800s.</p>
<p>Sweden was a neutral country in the First World War, so unlike other Western nations, the war had limited impact on the country’s economy. The fatality rate from the flu in Sweden was comparable to most Western nations and its economy was similar to other developed countries.</p>
<p>The study of Sweden’s flu experience a century ago suggests there could be permanent negative long-term economic effects from the current pandemic. There was a decline in income from capital sources such as interest, dividends and rents of five per cent that lasted at least until 1929. This was a permanent decline not recovered once the flu pandemic passed. </p>
<h2>Swedish poor never recovered</h2>
<p>There was also an increase in absolute poverty for those Swedes at the bottom of the economic pyramid: enrolment in government-run “poorhouses” in higher flu-incidence regions jumped 11 per cent and did not decline over the next decade. There was some good news: while employment income was reduced during the crisis, it quickly rebounded to predicted normal levels.</p>
<p>A <a href="https://www.nber.org/papers/w26866">recent study</a> attempts to measure the effects of the influenza on 1918-21 GDP. Harvard economist Robert Barro and his colleagues painstakingly put together a set of economic data that attempts to recreate what GDP in 42 countries would have been. </p>
<p>They have found that the flu was responsible for an additional six per cent decline in global GDP. The study concludes that the effects were reversed by 1921. This estimate of the flu’s historical GDP effects is strikingly similar to the IMF’s current prediction of six per cent reduction in GDP for Western economies as a result of the coronavirus pandemic.</p>
<h2>Modelling economic effects of a pandemic</h2>
<p>Beyond economic history, we can look at macroeconomic models of the global, regional or national economies that run scenarios about pandemic economic shocks. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S0277953611003029?via%3Dihub">One scenario</a> by British economists and health science academics is particularly apt in light of COVID-19.</p>
<p>Their scenario models virus incidence and fatality rates close to the current best estimates and includes strong and early social distancing measures such as school closures and work-from-home arrangements that we see today in many countries fighting the pandemic.</p>
<p>Their model estimates a 21 per cent decline in U.K. GDP in the first full quarter of the pandemic, with a 4.45 per cent decline in GDP for first year. The model also suggests the time frame to economic recovery is about two years. The current IMF projection for the U.K. is a 6.5 per cent decline in annual GDP.</p>
<p>There is no doubt that COVID-19 is a major shock to the global economy. Across all the studies I reviewed, the conclusion of a significant decline in GDP in the order of 4.5 to six per cent with full recovery within two years seems to be well justified.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=500&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=500&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=500&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=628&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=628&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331601/original/file-20200429-155205-4g1irl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=628&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men wear masks in Alberta during the influenza pandemic of 1918. Second and third waves of the flu added to economic woes in the early 20th century.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/National Archives of Canada</span></span>
</figcaption>
</figure>
<p>The economic history of the influenza pandemic 100 years ago suggests early easing of social distancing measures and the inability to develop an effective vaccine contributed to second and third flu waves. These waves might have greater effects on the modern service-based economy of Western nations than they did on the more agrarian economy of 100 years ago.</p>
<p>Economic history serves as a potential warning that the economy could get much worse if these measures are ignored.</p>
<p>It’s important to remember that GDP is a marker of a nation’s overall economic health. On an individual level, the effects may be more far-reaching and painful. There are financial and professional losses that may never be recovered.</p>
<p>The 1918-20 flu offers an important history lesson for the world’s current economic outlook: there may be significant declines in the returns to capital in the next decade, as well as relative increases in poverty for the neediest in our society.</p><img src="https://counter.theconversation.com/content/137058/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven E. Salterio receives funding from the Social Sciences and Humanities Research Council for his research on evidence based policy making. </span></em></p>As countries get ready to re-open their economies, will there be a post-pandemic recovery? History and current economic models suggest those looking for a quick rebound will be disappointed.Steven E. Salterio, Stephen JR Smith Chair of Accounting and Auditng, Professor of Business, Queen's University, OntarioLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1371192020-04-27T12:11:52Z2020-04-27T12:11:52ZLethargic global response to COVID-19: How the human brain’s failure to assess abstract threats cost us dearly<figure><img src="https://images.theconversation.com/files/330444/original/file-20200424-163098-1rmkdu0.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5771%2C3818&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Trump administration was not alone with its slow response to the COVID-19 crisis.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/president-donald-trump-participates-in-a-signing-ceremony-news-photo/1210884734?adppopup=true">Getty Images / White House Pool</a></span></figcaption></figure><p>More U.S. citizens have confirmed COVID-19 infections than the next <a href="https://www.worldometers.info/coronavirus/countries-where-coronavirus-has-spread/">five most affected countries</a> combined. Yet as recently as mid-March, President Trump <a href="https://www.cnn.com/2020/03/17/politics/fact-check-trump-always-knew-pandemic-coronavirus/index.html">downplayed the gravity</a> of the crisis by falsely claiming the coronavirus was nothing more than seasonal flu, or a Chinese hoax, or a deep state plot designed to damage his reelection bid.</p>
<p>The current U.S. administration’s mishandling of the coronavirus threat is part of a larger problem in <a href="https://www.theatlantic.com/technology/archive/2020/03/what-really-doomed-americas-coronavirus-response/608596/">pandemic management</a>. Many government officials, medical experts, scholars and journalists continued to underestimate the dangers of COVID-19, even as the disease upended life in China as early as mid-January. </p>
<p>The results of this collective inertia are catastrophic indeed. The U.S., along with Italy, Spain, Iran and the French Alsace, is now the <a href="https://coronavirus.jhu.edu/map.html">site of humanitarian tragedies</a>, the kind we see erupting in the aftermath of natural disasters or military conflicts. Much of the world appears inadequately prepared to recognize, let alone anticipate, when such threats occur. </p>
<p>Times of deep crisis offer the opportunity for new kinds of conversations. As a <a href="https://psychiatry.med.wayne.edu/profile/dz0083">psychiatrist</a> studying how the human brain responds to fear and stress, and as a <a href="https://lsa.umich.edu/history/people/graduate-students/ccapotes.html">historian</a> working on humanitarian responses to disasters, we find surprising points of agreement on the coronavirus pandemic. From a historical and psychological perspective, there are good explanations for why so many among us fail to read the writing on the wall before a catastrophe strikes with full force.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/330448/original/file-20200424-163088-dhh2sr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Beachgoers in Jacksonville, Florida on April 17. Many were not observing social distancing.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/jacksonville-beach-police-officer-patrols-the-crowded-news-photo/1210313300?adppopup=true">Getty Images / Icon Sportswire</a></span>
</figcaption>
</figure>
<h2>It’s hard to prepare for sudden change</h2>
<p>Our failure to assess risks and make sense of calamitous events is not limited to government politics. It permeates our daily lives and social relationships. Consider the recalcitrant friend, neighbor or family member who shrugged off the seriousness of COVID-19. Think of the <a href="https://www.nytimes.com/2020/03/22/us/deniers-and-disbelievers-if-i-get-corona-i-get-corona.html">disinterested spring breakers</a> on Florida’s beaches in mid-March. Even in the eye of a cyclone, societies fail to come together when faced by a looming catastrophe. </p>
<p>Perhaps partisanship and tribal thinking hamper our ability to accurately assess risk. Maybe this pandemic is so complex that it overwhelmed existing institutional preparedness. Certainly presidential vanity, dysfunctional loyalism and personality cults, on stark display in the White House, greatly exacerbated the crisis. </p>
<p>That said, here’s an overarching explanation: It’s difficult for humans to adapt to sudden change. That’s because we don’t know how to tie personal experience to the broader historical context in which we live.</p>
<p>Put another way: We ignore history. We don’t learn from similar events or direct antecedents. We don’t consider worst-case scenarios. We don’t plot how a relatively isolated event (such as the early outbreak in China) could trigger a worldwide chain reaction. </p>
<p>Two examples: The Great Depression, beginning with the stock market crash of 1929, spiraled into the deepest economic plunge in U.S. history. The 1939 invasion of Poland by the Nazis violently erupted into a world war. A variety of cognitive challenges confronted those living during those times. As during the current pandemic, few saw what was coming, and few correctly assessed the long-term consequences.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=387&fit=crop&dpr=1 600w, https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=387&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=387&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=486&fit=crop&dpr=1 754w, https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=486&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/330451/original/file-20200424-163058-1dd4lwz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=486&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Even with the Great Depression, it took time before Americans fully understood how serious the crisis was.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/the-front-page-of-the-brooklyn-daily-eagle-newspaper-with-news-photo/78075346?adppopup=true">Getty Images / Icon Communications</a></span>
</figcaption>
</figure>
<h2>Distant threats don’t spur us to action</h2>
<p>There is also a distinct psychology of threat that often hampers rational and predictive behavior. The human brain <a href="https://www.pbs.org/newshour/science/the-science-of-fright-why-we-love-to-be-scared">isn’t well suited</a> to assign emotional valence to what it perceives as abstract dangers. We often don’t respond appropriately to distant threats. </p>
<p>Instead, we function on a primordial level where close, immediate experiences will trigger a real sense of danger. Someone standing in front of you with a gun is one. An explosion from across the street is another. But spatially or temporally distant events remain intangible. <a href="https://theconversation.com/the-politics-of-fear-how-it-manipulates-us-to-tribalism-113815">As tribal beings</a>, we seem much less interested in caring for a problem that might not – at least at first – be ours. </p>
<p>Consider President Trump’s turnaround from stubborn denial to seeming acceptance that COVID-19 could claim up to more than 200,000 American lives. Only after someone close to him contracted the coronavirus and fell into a coma did Trump seem taken aback by the <a href="https://www.nytimes.com/2020/04/01/us/politics/trump-friend-coronavirus-stanley-chera.html">tragedy</a>. </p>
<p>As a species, we are unable to grasp abstract events that are outside our personal experience or do not occur in our immediate vicinity. Tragedies occurring in other tribes, such as COVID-19 in China or Europe, appear as vague possibilities. They elicit as much curiosity as a Hollywood movie (think of “Contagion”). To the human mind, these events seem unreal. </p>
<p>When a threat is temporarily or spatially distant, we will fail to correctly determine the risk of these looming events. This is true if the disaster occurred 100 years ago (like the Spanish flu) or if it will happen 100 years from now (like global warming). It’s true if the threat is 50 days or 5,000 miles away from us. As long as a threat is not in immediate proximity, we will find it difficult to imagine its repercussions. We may fail to take the necessary precautions.
Somehow, we must learn not to be stubborn creatures of the here and now.</p>
<p>[<em>Get facts about coronavirus and the latest research.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=upper-coronavirus-facts">Sign up for The Conversation’s newsletter.</a>]</p><img src="https://counter.theconversation.com/content/137119/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Human beings have difficulty assessing distant threats.Arash Javanbakht, Associate Professor of Psychiatry, Wayne State UniversityCristian Capotescu, Doctoral Candidate, Department of History, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1364132020-04-23T20:05:24Z2020-04-23T20:05:24ZIn 1919, Anzac Day was commemorated despite the Spanish flu pandemic. In 2020, we will remember them again<figure><img src="https://images.theconversation.com/files/329911/original/file-20200423-47804-vl374j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">AAP/Paul Miller</span></span></figcaption></figure><p>Anzac Day 2020 will be a far cry from the Australian War Memorial’s dawn service of recent years. While dignified and solemn, the dawn service has also been spectacle. Sophisticated technology is used to project images from the memorial’s photographic collection onto the building. From an hour before the service, members of the armed forces read from the diaries and letters of men and women who have served in war over more than a century.</p>
<p>The choreography of the whole event is unmistakable as national performance. Even the birdlife at the foot of Mount Ainslie seems to recognise it has a role to play with its singing and screeching and laughing – instantly recognisable as an Australian soundscape – alongside the speechmakers, <a href="https://www.army.gov.au/our-history/traditions/catafalque-party">catafalque party</a> and bugling of the Last Post.</p>
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Read more:
<a href="https://theconversation.com/how-australias-response-to-the-spanish-flu-of-1919-sounds-warnings-on-dealing-with-coronavirus-134017">How Australia's response to the Spanish flu of 1919 sounds warnings on dealing with coronavirus</a>
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<p>This year, thanks to the coronavirus pandemic, it will be different. The dawn service will be held without members of the public, but will be televised on the ABC and streamed online. There will be no local marches. </p>
<p>The Returned and Services League (RSL) has encouraged people to film themselves reciting the ode in their homes and post it online. The RSL is partnering with News Corp in <a href="http://www.anzaclive.com.au/">Light Up The Dawn</a>, asking Australians to step into their driveways to observe a minute’s silence, possibly carrying a candle or using mobile phones for illumination. They have even created a virtual candle you can download to your phone.</p>
<p>We can be sure the novelty of the 2020 Anzac Day commemoration will attract plenty of media attention. The Australian media have a ready-made, multipurpose rhetoric that is easily adapted to whatever novelty – minor or otherwise – each year’s Anzac season brings with it. This year will be no exception. </p>
<p>We can expect to read and hear of Australians in these troubled times expressing mateship, of children in pyjamas and dressing gowns showing the young are connecting more and more with Anzac each year, that coronavirus has not dampened the Anzac spirit of the nation – and so on. We will learn of the doughty Australian suburbanites who weren’t going to let a mere global pandemic get in the way of their appreciation of those who defend their freedoms. Our health workers will be seen as displaying the self-sacrifice and heroism of Anzac, born all those years ago on the shores of Gallipoli.</p>
<p>Anzac 2020 will be less novel than it is presented. In the enforced private nature of Anzac commemoration in 2020, we are being returned to some of the <a href="https://www.tandfonline.com/doi/full/10.1080/1031461X.2014.912667">earliest themes in Anzac commemoration</a>. </p>
<p>While the day has had its elements of public ritual since 1916, much early Anzac Day commemoration was private rather than public, sometimes conducted at the gravesides of Australian soldiers buried in cemeteries in Britain and Australia. Women were prominent in these efforts, honouring the memories of men they might or might not have known by placing flowers on their tombs. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/329985/original/file-20200423-47815-155szfy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There was no big Anzac Day march in Sydney in 1919. At the time, Spanish flu was ravaging the world.</span>
<span class="attribution"><span class="source">Parramatta Heritage Centre</span></span>
</figcaption>
</figure>
<p>There are other echoes of the past. Anzac Day in 1919 was also disrupted by a major crisis in public health. In New South Wales, where the rate of infection from Spanish influenza was high and the number of deaths – approaching 1,000 by Anzac Day – was alarming, the government had banned public meetings.</p>
<p>The government called off the march until May 22. When that happened, it was a fiasco. Rain prompted organisers to decide against marching all the way to Sydney’s Domain, and soldiers and sailors who had come from Central Railway Station instead slipped straight into the service in the Town Hall. Unfortunately, no one remembered to tell <a href="https://trove.nla.gov.au/newspaper/article/239595027?browse=ndp%3Abrowse%2Ftitle%2FD%2Ftitle%2F1297%2F1919%2F05%2F23%2Fpage%2F25781638%2Farticle%2F239595027">the thousands of people lining the streets</a> to watch.</p>
<p>On Anzac Day itself, there had still been activity – more than we’ll see this year. The Centre for Soldiers’ Wives and Mothers <a href="https://trove.nla.gov.au/newspaper/article/15835737?browse=ndp%3Abrowse%2Ftitle%2FS%2Ftitle%2F35%2F1919%2F04%2F24%2Fpage%2F1255472%2Farticle%2F15835737">appealed to the parents</a> of the city’s children – home for their Easter break – to take their Shakespeare down from the shelf and read their children <a href="https://scalar.usc.edu/works/henry-v/transcript-henry-v-agincourt-speech">Henry V’s speech</a> to his troops before <a href="https://www.britannica.com/event/Battle-of-Agincourt">Agincourt</a>.</p>
<p>Gallipoli might have made the nation, but Australians still looked for inspiration to a much longer British history stretching back through Mafeking, Rorke’s Drift, Balaclava, Waterloo and Trafalgar – and even further to that “band of brothers” who made short work of the French on St Crispin’s Day, 1415.</p>
<p>The Centre of Soldiers’ Wives and Mothers held a service in the Domain. “Womenfolk, many of them in mourning, preponderated”, <a href="https://trove.nla.gov.au/newspaper/article/28098205?searchTerm=Womenfolk%2C%20many%20of%20them%20in%20mourning%2C%20preponderated%20masks%20Anzac&searchLimits=">the Sydney Morning Herald reported</a>, and most were wearing masks. The location of this service was pointed: it was at Woolloomooloo Bay, where so many soldiers had embarked for the war.</p>
<p>Outside Sydney, there was also some disruption. “The Approach of Anzac Day this year was overlooked locally,” <a href="https://trove.nla.gov.au/newspaper/article/171857066?browse=ndp%3Abrowse%2Ftitle%2FD%2Ftitle%2F879%2F1919%2F04%2F26%2Fpage%2F20549298%2Farticle%2F171857066">explained a local newspaper</a> at Dorrigo in northern New South Wales. “Owing to the presence of the influenza epidemic, the thoughts of the people seem to have been turned away from other things.” But there were Anzac Day activities; a surprising number, actually. </p>
<p>Anzac Day was commemorated at Lismore, notwithstanding that the town had seen several serious cases of influenza and, in the week before Anzac Day, the deaths of two men. At Grafton, thousands enjoyed a soldiers’ carnival. And in the other states, there were <a href="https://trove.nla.gov.au/newspaper/article/5646800?browse=ndp%3Abrowse%2Ftitle%2FA%2Ftitle%2F34%2F1919%2F04%2F26%2Fpage%2F987810%2Farticle%2F5646800">few signs of difficulty</a>: </p>
<blockquote>
<p>Adelaide was gay with flags from end to end, and the trains and tramcars brought thousands of people into the central city to view the procession of soldiers.</p>
</blockquote>
<p>In Brisbane, despite heavy rain, <a href="https://trove.nla.gov.au/newspaper/article/27602668?searchTerm=brisbane%20anzac%20day%20%20%20the%20route%20of%20the%20procession%20was%20lined%20with%20thousands%20of%20people&searchLimits=dateFrom=1919-01-01%7C%7C%7CdateTo=1919-12-31">the route of a march of soldiers</a> and returned men “was lined with thousands of people”.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/329987/original/file-20200423-47799-yvdpro.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Australia Post</span></span>
</figcaption>
</figure>
<p>A subdued Anzac Day in Perth <a href="https://trove.nla.gov.au/newspaper/article/27602677?searchTerm=Anzac%20Day%20Perth&searchLimits=exactPhrase%7C%7C%7CanyWords%7C%7C%7CnotWords%7C%7C%7CrequestHandler%7C%7C%7CdateFrom=1919-04-26%7C%7C%7CdateTo=1919-04-26%7C%7C%7Cl-advstate=Western+Australia%7C%7C%7Csortby">was attributed not to the influenza</a> but to the authorities’ hope that the proclamation of peace in Europe would be timed so that the two “celebrations” might merge. </p>
<p>In 1919, as soldiers returned to Australia on ships and often went into quarantine, the nature of Anzac Day commemoration remained fluid. It was still not a public holiday, and the Anzac Day march had not yet become an essential or permanent fixture of the city commemorations. Melbourne had no march on April 25 1919, but then it didn’t have a march on most other Anzac Days in these early years, either. </p>
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Read more:
<a href="https://theconversation.com/this-isnt-the-first-global-pandemic-and-it-wont-be-the-last-heres-what-weve-learned-from-4-others-throughout-history-136231">This isn't the first global pandemic, and it won't be the last. Here's what we've learned from 4 others throughout history</a>
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<p>Some will be disappointed there will be no marches and other public gatherings this year. But Anzac Day 2020 is less likely to be recalled as an absence than as yet another way in which Australians adapted their national life to the challenges of the greatest public health crisis for a century.</p><img src="https://counter.theconversation.com/content/136413/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Frank Bongiorno does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As Spanish flu ravaged the world in 1919, Australians found novel ways to commemorate Anzac Day, and they will do so again this year.Frank Bongiorno, Professor of History, ANU College of Arts and Social Sciences, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1365152020-04-22T06:25:35Z2020-04-22T06:25:35ZHow the Spanish flu affected Kenya – and its similarities to coronavirus<figure><img src="https://images.theconversation.com/files/329373/original/file-20200421-82645-10elwvu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Kenya's government have issued a directive that people must wear masks while in public places.</span> <span class="attribution"><span class="source">Boniface Muthoni/SOPA Images/LightRocket via Getty Images</span></span></figcaption></figure><p>The 1918 influenza pandemic – called the “Spanish flu” – remains <a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html">the most</a> significant public health event ever recorded in human history. It’s estimated that half a billion people were infected, and that between <a href="https://doi.org/10.1353/bhm.2002.0022">20 million and 100 million people died</a>. Most deaths occurred in Asia (36 million). In Africa 2.5 million died, Europe 2.3 million and North America 1.6 million. </p>
<p>The exact origin of the flu is still unclear. Some <a href="https://archive.org/details/influenzaepidemi00vauguoft/page/n1/mode/2up">reports indicate</a> that it first occurred and spread within the US in 1918. A more <a href="https://doi.org/10.1177/0968344513504525">recent study</a> suggests the pandemic originated in China in 1917, and was introduced into Canada and the US by Chinese labourers. Soldiers, returning home after the end of World War I, then brought it to Europe and the rest of the world. </p>
<p>The Spanish flu is believed to have <a href="https://elibrary.ru/item.asp?id=7411876">come to Kenya with returning</a> veterans who docked in the <a href="https://www.jstor.org/stable/44447656">Mombasa port</a>. The country was still a British colony at the time. In nine months the epidemic killed about 150,000 people, between <a href="https://www.academia.edu/31804192/Spanish_Influenza_in_Kenya.pdf">4% and 6% of the population</a> at the time. </p>
<p>In a <a href="https://www.mdpi.com/2414-6366/4/2/91">recent study</a>, my colleagues and I examined the impact of the Spanish flu in coastal Kenya. We chose the coastal province because it was the colony’s most critical administrative area, due to its port in Mombasa. It also had better administrative and health records.</p>
<p>Vital data from this period is incomplete and biased, so we examined narratives of how the pandemic affected people’s lives. We saw that there were various forms of social and economic disruption, ranging from social distancing to the suspension of nonessential services, paralysed administrative operations, widespread food shortages, commercial losses, and an overwhelmed healthcare sector. </p>
<p>Kenya is battling a new pandemic: COVID-19. Even though it’s 100 years later, the new coronavirus has echoes of those experiences a century ago.</p>
<h2>The flu spread rapidly</h2>
<p>For our study we used colonial records and correspondence from Kenya’s National Archives Library in Nairobi. The interactions between district and provincial level administrations on the pandemic were key sources. They included the minutes of local chiefs’ weekly meetings, health facility case and death summaries, case report forms, district officers’ letters and routine district briefs. </p>
<p>In the same period (1912-1925), the entire Coast Province (seven districts) had a population that ranged between 170,000 and 243,841 people. We focused on five of the seven districts with data on pandemic cases: Kilifi (previously Nyika), Kwale (previously Vanga), Mombasa, Taita Taveta and Malindi.</p>
<p>Before the Spanish flu came, patient visits to healthcare facilities varied between 9 and 33 for every 1,000 people per year. By 1918 this had increased five-fold, to 146.8 visits. </p>
<p>Similarly, trends of mortality increased sharply from 1918, from less than five deaths per 1,000 people per year to 25 deaths. This high mortality rate continued through to 1925. </p>
<p>We found that the Spanish flu spread rapidly, and had a high mortality rate. In just nine months – from September 1918 to June 1919 – there were approximately 31,908 cases and 4,593 deaths associated with the Spanish flu in Kenya’s coastal province. In the same period, 150,000 deaths were <a href="https://www.academia.edu/31804192/Spanish_Influenza_in_Kenya.pdf">reported</a> across the country. </p>
<p>A letter from the Kwale assistant district commissioner in 1919 explained who was most susceptible: </p>
<blockquote>
<p>Death occurred mostly among the old men and women, and judging from the number of elders of council reported to have died must have run into hundreds…and…Very few of the young and middle aged…</p>
</blockquote>
<p>In 1919, the Kilifi district commissioner also described the conditions that led to more cases:</p>
<blockquote>
<p>I consider the deaths have been augmented when either of the following two conditions have been present. (a) Overcrowding, as in Malindi, Mambrui and Roka. (b) Normally difficult conditions of life. I mean when food has been hard to come by or water far removed from villages…</p>
</blockquote>
<h2>Health interventions</h2>
<p>To tackle the pandemic, colonial authorities developed guidelines for healthcare workers, including social distancing, personal hygiene practices and medical treatment. The ultimate goal was to reduce community transmission. </p>
<p>Healthy people were told to avoid contact with sick individuals and to take prophylactic remedies, such as gargling with potassium permanganate, and oral quinine. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/south-africa-bungled-the-spanish-flu-in-1918-history-mustnt-repeat-itself-for-covid-19-133281">South Africa bungled the Spanish flu in 1918. History mustn't repeat itself for COVID-19</a>
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<p>Those already sick were advised to seek bed rest, home nursing and proper nourishment, in addition to oral quinine three times a day. These rudimentary prescriptions did very little.</p>
<p>For most local Kenyans, who couldn’t access or afford medication, the recommendations included home nursing, a teaspoon of paraffin oil three times a day and eating meals that were high in starch and enriched with milk. </p>
<p>Prolonged bed rest and a slow return to work was advised, and for patients with depression, a tonic treatment was prescribed.</p>
<h2>Social and economic disruption</h2>
<p>In four of the five district administrative offices, absenteeism due to sickness led to several disruptions of public service provision.</p>
<p>Among the local Kenyans, the illness caused job losses, increased food insecurity and affected households’ ability to pay colonial taxes. Consequently, many suffered reduced “vitality” and low incomes. </p>
<p>For those depending on subsistence farming, the total or partial crop failure occasioned by poor weather in 1918 and lack of seed supplies worsened the poor health of the population. </p>
<p>Economic disruption was also reported in large commercial farms. These suffered massive losses due to unprecedented labour shortages. </p>
<p>In the healthcare sector, the situation was grave. Understaffed facilities were overwhelmed with the influx of patients, low reserves of medical supplies and little colonial administration support. The scale of the problem caused such panic that the authorities allowed the use of placebo therapeutics to pacify residents’ anger.</p>
<p>A century ago, the Spanish flu caused untold suffering and social disruption to hundreds of thousands of locals. We can argue that the mitigation efforts and medical advances of the time did little. In addition, what brought it into the country – global war and colonial rule – were beyond the control of locals. </p>
<p>But what stands out is that the actions of locals, individually and collectively, contributed to the sickness and death. We found that most locals disregarded quarantine measures and, in the peak of the outbreak, went to their rural villages. This amplified community transmission. </p>
<p>In the COVID-19 pandemic, we can draw parallels and learn from our past.</p><img src="https://counter.theconversation.com/content/136515/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Fred Andayi received funding from French science and technology research institute (Institut de Recherche pour le Developpement (IRD), France.
Disclaimer: The findings and conclusions in this article are those of the author and do not necessarily represent the official position of his past or present affiliate institutions.
</span></em></p>In Kenya, the Spanish flu caused various forms of social and economic disruption, ranging from social distancing to the suspension of nonessential services and widespread food shortages.Fred Andayi, Research Associate, Kenya Medical Research InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1336052020-04-17T12:11:15Z2020-04-17T12:11:15Z1918 flu pandemic killed 12 million Indians, and British overlords’ indifference strengthened the anti-colonial movement<figure><img src="https://images.theconversation.com/files/327346/original/file-20200412-8893-1ihy43t.jpg?ixlib=rb-1.1.0&rect=0%2C56%2C4200%2C4011&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Cremation on the banks of the Ganges river, India.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/crémation-sur-les-bords-du-gange-à-benarès-inde-circa-1920-news-photo/833384176?adppopup=true">Keystone-France via Getty Images</a></span></figcaption></figure><p>In India, during the 1918 influenza pandemic, a staggering <a href="https://doi.org/10.1007/s13524-012-0116-x">12 to 13 million people died</a>, the vast majority between the months of September and December. According to an eyewitness, “There was none to remove the dead bodies and the jackals made a feast.” </p>
<p>At the time of the pandemic, India had been under British colonial rule for over 150 years. The fortunes of the British colonizers had always been vastly different from those of the Indian people, and nowhere was the split more stark than during the influenza pandemic, as I discovered while researching <a href="https://scholar.google.com/citations?user=zQnyI1cAAAAJ&hl=en&oi=ao">my Ph.D. on the subject</a>. </p>
<p>The resulting devastation would eventually lead to huge changes in India – and the British Empire. </p>
<h2>From Kansas to Mumbai</h2>
<p>Although it is commonly called the Spanish flu, the 1918 pandemic likely <a href="https://www.cambridge.org/us/academic/subjects/history/twentieth-century-american-history/americas-forgotten-pandemic-influenza-1918-2nd-edition?format=PB">began in Kansas</a> and <a href="https://doi.org/10.1093/aje/kwy191">killed between 50 and 100 million people</a> worldwide. </p>
<p>During the early months of 1918, the virus incubated throughout the American Midwest, eventually making its way east, where it <a href="https://www.army.mil/article/210420/worldwide_flu_outbreak_killed_45000_american_soldiers_during_world_war_i">traveled across the Atlantic Ocean</a> with soldiers deploying for WWI. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=639&fit=crop&dpr=1 600w, https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=639&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=639&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=803&fit=crop&dpr=1 754w, https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=803&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/327347/original/file-20200412-138728-1tayb5b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=803&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Indian soldiers in the trenches during World War I.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/indian-soldiers-in-the-trenches-world-war-i-1914-1918-news-photo/463957843">Print Collector / Contributor via Getty Images</a></span>
</figcaption>
</figure>
<p>Introduced into the trenches on Europe’s Western Front, the virus tore through the already weakened troops. As the war approached its conclusion, the virus followed both commercial shipping routes and military transports to infect almost every corner of the globe. It <a href="https://www.macmillanlearning.com/college/us/product/Influenza-Pandemic-of-1918-1919/p/0312677081">arrived in Mumbai in late May</a>.</p>
<h2>Unequal spread</h2>
<p>When the first wave of the pandemic arrived, it was not particularly deadly. The only notice British officials took of it was its effect on some workers. A report noted, “As the season for cutting grass began … people were so weak as to be unable to do a full day’s work.” </p>
<p>By September, the story began to change. Mumbai was still the center of infection, likely due to its position as a commercial and civic hub. On Sept. 19, an English-language newspaper reported 293 influenza deaths had occurred there, but assured its readers “The worst is now reached.” </p>
<p>Instead, the virus tore through the subcontinent, following trade and postal routes. Catastrophe and death overwhelmed cities and rural villages alike. Indian newspapers reported that crematoria were receiving between 150 to 200 bodies per day. According to one observer, “The burning ghats and burial grounds were literally swamped with corpses; whilst an even greater number awaited removal.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/327348/original/file-20200412-1397-po6zou.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Members of the British Raj out for a stroll, circa 1918.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/members-of-the-british-raj-walking-together-in-an-indian-news-photo/3398825?adppopup=true">Fox Photos/Stringer via Getty images</a></span>
</figcaption>
</figure>
<p>But influenza did not strike everyone equally. Most British people in India lived in spacious houses with gardens and yards, compared to the lower classes of city-dwelling Indians, who lived in densely populated areas. Many British also employed household staff to care for them – in times of health and sickness – so they were only lightly touched by the pandemic and were largely unconcerned by the chaos sweeping through the country. </p>
<p>In his official correspondence in early December, the Lieutenant Governor of the United Provinces did not even mention influenza, instead noting “Everything is very dry; but I managed to get two hundred couple of snipe so far this season.”</p>
<p>While the pandemic was of little consequence to many British residents of India, the perception was wildly different among the Indian people, <a href="https://www.saada.org/item/20130823-3118">who spoke of universal devastation</a>. A letter published in a periodical lamented, “India perhaps never saw such hard times before. There is wailing on all sides. … There is neither village nor town throughout the length and breadth of the country which has not paid a heavy toll.” </p>
<p>Elsewhere, the Sanitary Commissioner of the Punjab noted, “the streets and lanes of cities were littered with dead and dying people … nearly every household was lamenting a death, and everywhere terror and confusion reigned.” </p>
<h2>The fallout</h2>
<p>In the end, areas in the north and west of India saw death rates between 4.5% and 6% of their total populations, while the south and east – where the virus arrived slightly later, as it was waning – generally lost between 1.5% and 3%. </p>
<p>Geography wasn’t the only dividing factor, however. In Mumbai, almost seven-and-a-half times as many lower-caste Indians died as compared to their British counterparts - <a href="https://doi.org/10.1177/001946468602300102">61.6 per thousand</a> versus 8.3 per thousand. </p>
<p>Among Indians in Mumbai, socioeconomic disparities in addition to race accounted for these differing mortality rates.</p>
<p><iframe id="9Mq9o" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/9Mq9o/2/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>The Health Officer for Calcutta remarked on the stark difference in death rates between British and lower-class Indians: “The excessive mortality in Kidderpore appears to be due mainly to the large coolie population, ignorant and poverty-stricken, living under most insanitary conditions in damp, dark, dirty huts. They are a difficult class to deal with.” </p>
<h2>Change ahead</h2>
<p>Death tolls across India generally hit their peak in October, with a slow tapering into November and December. A high ranking British official wrote in December, “A good winter rain will put everything right and … things will gradually rectify themselves.” </p>
<p>Normalcy, however, did not quite return to India. The spring of 1919 would see the <a href="https://www.britannica.com/event/Jallianwala-Bagh-Massacre">British atrocities at Amritsar</a> and shortly thereafter the launch of <a href="https://www.britannica.com/event/noncooperation-movement">Gandhi’s Non-Cooperation Movement</a>. Influenza became one more example of British injustice that spurred Indian people on in their fight for independence. A <a href="https://www.saada.org/item/20130128-1271">nationalist periodical stated</a>, “In no other civilized country could a government have left things so much undone as did the Government of India did during the prevalence of such a terrible and catastrophic epidemic.”</p>
<p>The long, slow death of the British Empire had begun.</p>
<hr>
<p><em>This article has been updated to correct that the final quote is not from a periodical published by Mahatma Gandhi, but rather a separate nationalist publication of the same name based in New York.</em></p><img src="https://counter.theconversation.com/content/133605/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maura Chhun does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When the 1918 influenza pandemic struck India, the death toll was highest among the poor.Maura Chhun, Community Faculty, Metropolitan State University Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1362312020-04-16T19:43:22Z2020-04-16T19:43:22ZThis isn’t the first global pandemic, and it won’t be the last. Here’s what we’ve learned from 4 others throughout history<figure><img src="https://images.theconversation.com/files/328576/original/file-20200417-192754-2rbcdc.jpg?ixlib=rb-1.1.0&rect=5%2C1%2C793%2C479&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Black_Death#/media/File:Doutielt3.jpg">Wikimedia/Pierart dou Tielt</a></span></figcaption></figure><p>The course of human history has been shaped by <a href="https://www.washingtonpost.com/graphics/2020/local/retropolis/coronavirus-deadliest-pandemics/">infectious diseases</a>, and the current crisis certainly won’t be the last time. </p>
<p>However, we can capitalise on the knowledge gained from past experiences, and reflect on how we’re better off this time around. </p>
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<strong>
Read more:
<a href="https://theconversation.com/four-of-the-most-lethal-infectious-diseases-of-our-time-and-how-were-overcoming-them-78101">Four of the most lethal infectious diseases of our time and how we're overcoming them</a>
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</em>
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<h2>1. The Plague, or ‘Black Death’ (14th Century)</h2>
<p>While outbreaks of the plague (caused by the bacterium <a href="https://en.wikipedia.org/wiki/Yersinia_pestis"><em>Yersinia pestis</em></a>) still occur in <a href="https://www.cdc.gov/plague/index.html">several parts of the world</a>, there are two that are particularly infamous.</p>
<p>The 200-year long <a href="https://www.pnas.org/content/116/51/25546">Plague of Justinian</a> began in 541 CE, wiping out millions in several waves across Europe, North Africa and the Middle East and crimping the <a href="https://www.ncbi.nlm.nih.gov/pubmed/22767313">expansionary aspirations of the Roman Empire</a> (although some scholars <a href="https://www.pnas.org/content/116/51/25546">argue</a> that its impact has been overstated). </p>
<p>Then there’s the better known 14th century pandemic, which likely <a href="https://www.nytimes.com/2010/11/01/health/01plague.html">emerged from China</a> and
<a href="https://en.wikipedia.org/wiki/Black_Death#Previous_plagues">decimated populations</a> in Asia, Europe and Northern Africa.</p>
<p>Perhaps one of the greatest public health legacies to have emerged from the 14th century plague pandemic is the concept of “quarantine”, from the Venetian term “quarantena” meaning <a href="https://academic.oup.com/cid/article/35/9/1071/330421">forty days</a>. </p>
<p>The 14th century Black Death pandemic is thought to have catalysed enormous societal, economic, artistic and cultural reforms in Medieval Europe. It illustrates how infectious disease pandemics can be major turning points in history, with lasting impacts.</p>
<p>For example, widespread death caused labour shortages across feudal society, and often led to higher wages, cheaper land, better living conditions and increased freedoms for the <a href="https://dailyhistory.org/How_did_the_Bubonic_Plague_make_the_Italian_Renaissance_po%20ssible%3F">lower class</a>. </p>
<p>Various authorities lost credibility, since they were seen to have failed to protect communities from the overwhelming devastation of plague. People began to openly question long held certainties around societal structure, traditions, and religious orthodoxy. </p>
<p>This prompted <a href="http://aleph.humanities.ucla.edu/2015/10/06/a-new-relationship-with-death-a-%20synthesized-experiential-portrait-and-analysis-of-mid-fourteenth-century-medieval-%20european-societys-reception-of-responses-to-and-reflections-on-the-black-d/">fundamental shifts</a> in peoples’ interactions and experience with <a href="https://en.wikipedia.org/wiki/Consequences_of_the_Black_Death#Religion">religion</a>, philosophy, and politics. The Renaissance period, which encouraged humanism and learning, soon followed.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=512&fit=crop&dpr=1 600w, https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=512&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=512&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=643&fit=crop&dpr=1 754w, https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=643&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/327951/original/file-20200415-153298-272npj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=643&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Dance of Death, or Danse Macabre was a common artistic trope of the time of the Black Death.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/w/index.php?curid=490534">Public Domain/Wikimedia</a></span>
</figcaption>
</figure>
<p>The Black Death also had profound effects on <a href="https://www.theguardian.com/artanddesign/jonathanjonesblog/2012/feb/15/brush-black-%20death-artists-plague">art</a> and literature, which took on more pessimistic and morbid themes. There were vivid depictions of <a href="https://en.wikipedia.org/wiki/Flagellant">violence</a> and <a href="https://en.wikipedia.org/wiki/Danse_Macabre">death</a> in Biblical <a href="https://www.discovertuscany.com/san-gimignano/duomo-san-gimignano.html">narratives</a>,
still seen in many Christian places of worship across Europe.</p>
<p>How COVID-19 will reshape our culture, and what unexpected influence it will have for generations to come is unknown. There are already clear <a href="https://www.nytimes.com/interactive/2020/04/11/business/economy/coronavirus-%20us-economy-spending.html">economic</a> changes arising from this outbreak, as some industries rise, others fall and some businesses seem likely to disappear forever. </p>
<p>COVID-19 may permanently normalise the use of virtual technologies for socialising, business, education, healthcare, religious worship and even <a href="https://www.politico.com/news/magazine/2020/03/19/coronavirus-effect-%20economy-life-society-analysis-covid-135579">government</a>. </p>
<h2>2. Spanish influenza (1918)</h2>
<p>The 1918 “Spanish Flu” pandemic’s reputation as one of the deadliest in human history is due to a complex interplay between how the virus works, the immune response and the social context in which it spread. </p>
<p>It arose in a world left vulnerable by the preceding four years of World War I. Malnutrition and overcrowding were common. </p>
<p>Around 500 million people were infected – a third of the global population at the time - leading to <a href="https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html">50-100 million deaths</a>. </p>
<p>A unique characteristic of infection was its tendency to kill healthy adults between the ages of 20 and 40.</p>
<p>At the time, influenza infection was attributed to a bacterium (<a href="https://en.wikipedia.org/wiki/Haemophilus_influenzae"><em>Haemophilus influenzae</em></a>) rather than a <a href="https://en.wikipedia.org/wiki/History_of_virology">virus</a>. Antibiotics for secondary bacterial infections were still more than a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109405/">decade</a> away, and intensive care wards with <a href="https://www.nature.com/articles/d41586-020-%2001019-y">mechanical ventilators</a> were unheard of.</p>
<p>Clearly, our medical and scientific understanding of the ‘flu in 1918 made it difficult to combat. However, public health interventions, including quarantine, the use of face masks and bans on mass gatherings helped limit the spread in some areas, building on prior successes in controlling tuberculosis, cholera and other infectious diseases. </p>
<p>Australia imposed maritime quarantine, requiring all arriving ships to be cleared by Commonwealth Quarantine Officials before disembarkation. That likely delayed and reduced the Spanish flu impact on Australia, and had secondary effects on the other <a href="https://www.sciencedirect.com/science/article/abs/pii/S1473309918301786">Pacific Islands</a>. </p>
<p>The effect of maritime quarantine was most striking in Western and American Samoa, with the latter enforcing strict quarantine and experiencing no deaths. By contrast, 25% of <a href="https://pubmed.ncbi.nlm.nih.gov/22564320/">Western Samoans</a> died, after influenza was introduced by a ship from New Zealand. </p>
<p>In some <a href="https://www.nationalgeographic.com/history/2020/03/how-cities-flattened-curve-1918-%20spanish-flu-pandemic-coronavirus/">cities</a>, mass gatherings were banned, and schools, churches, theatres, dance and <a href="https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-cities-social-%20distancing-better-employment.html?campaignId=7JFJX">pool halls</a> closed. </p>
<p>In the United States, cities that committed earlier, longer and more aggressively to social distancing interventions, not only saved lives, but also emerged economically <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3561560">stronger</a> than those that didn’t.</p>
<p>Face masks and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285078/">hand hygiene</a> were popularised and sometimes enforced in cities.</p>
<p>In <a href="https://edition.cnn.com/2020/04/03/americas/flu-america-1918-masks-intl-%20hnk/index.html">San Francisco</a>, a Red Cross-led public education campaign was combined with mandatory mask-wearing outside the home. </p>
<p>This was tightly enforced in some jurisdictions by police officers issuing fines, and at times using <a href="https://www.theatlantic.com/ideas/archive/2020/03/how-fragmented-country-fights-%20pandemic/608284/">weapons</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1458&fit=crop&dpr=1 600w, https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1458&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1458&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1833&fit=crop&dpr=1 754w, https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1833&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/328255/original/file-20200416-140725-1tj8xha.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1833&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>3. HIV/AIDS (20th century)</h2>
<p>The first reported cases of HIV/AIDS in the Western world emerged in <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a1.htm">1981</a>. </p>
<p>Since then, around 75 million people have become infected with HIV, and about 32 million people have <a href="https://www.unaids.org/en/resources/fact-sheet">died</a>.</p>
<p>Many readers may remember how baffling and frightening the HIV/AIDs pandemic was in the early days (and still is in many parts of the developing world). </p>
<p>We now understand that people living with HIV infection who are on treatment are <a href="http://www.aidsmap.com/news/may-2015/start-trial-finds-early-treatment-%20improves-outcomes-people-hiv">far less likely</a> to develop serious complications.</p>
<p>These treatments, known as antiretrovirals stop HIV from replicating. This can lead to an “undetectable viral load” in a person’s blood. Evidence shows that people with an <a href="http://www.aidsmap.com/about-%20hiv/what-does-undetectable-untransmittable-uu-mean">undetectable viral load</a> can’t pass the virus on to others during sex.</p>
<p>Condoms and <a href="https://endinghiv.org.au/stay-safe/prep/">PrEP</a> (short for “pre-exposure prophylaxis,” where people take an oral antiretroviral pill once a day), can be used by people who don’t have HIV infection to reduce the risk of acquiring the virus.</p>
<p>Unfortunately, there are currently no proven antivirals available for the prevention or treatment of COVID-19, though <a href="https://www.newyorker.com/magazine/2020/04/13/the-quest-for-a-pandemic-pill">research is ongoing</a>. </p>
<p>The HIV pandemic taught us about the value of a well-designed public health campaign, and the importance of contact tracing. Broad testing in appropriate people is fundamental to this, to understand the extent of infection in the community and allow appropriately targeted individual and population-level interventions. </p>
<p>It also demonstrated that <a href="https://www.hiv.gov/hiv-%20basics/overview/making-a-difference/standing-up-to-stigma">words and stigma</a> matter; people need to feel they can test safely and be supported, rather than ostracised. Stigmatising language can fuel misconceptions, discrimination and discourage testing. </p>
<h2>4. Severe Acute Respiratory Syndrome (SARS) (2002-2003)</h2>
<p>The current pandemic is the <a href="https://www.sciencedirect.com/science/article/pii/S0166354213002234">third</a> coronavirus outbreak in the past two decades. </p>
<p>The first was in 2002, when SARS emerged from <a href="https://www.theguardian.com/world/2017/dec/10/sars-virus-bats-china-severe-acute-%20respiratory-syndrome">horseshoe bats</a> in China and spread to at least 29 countries around the world, causing 8,098 cases and 774 <a href="https://www.cdc.gov/sars/about/fs-sars.html">deaths</a>. </p>
<p>SARS was finally contained in July, 2003. SARS-CoV-2, however, appears much more <a href="https://www.abc.net.au/news/2020-03-22/covid-19-how-deadly-and-contagious-is-coronavirus/12068106">easily spread</a> than the original SARS coronavirus.</p>
<p>To some extent SARS was a practice run for COVID-19. Researchers focused on SARS and MERS (<a href="https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)">Middle Eastern Respiratory Syndrome</a>, another coronavirus that remains a problem in selected regions), are providing important <a href="https://www.nature.com/articles/d41586-020-00798-8">foundational research</a> for potential vaccines against SARS-CoV-2. </p>
<p>Knowledge gleaned from SARS may also lead to <a href="https://theconversation.com/like-a-key-to-a-lock-how-seeing-the-molecular-machinery-of-%20the-coronavirus-will-help-scientists-design-a-treatment-134135">antiviral</a> drugs to <a href="https://theconversation.com/covid-19-treatment-might-already-exist-in-old-drugs-were-using-pieces-of-the-coronavirus-itself-to-find-them-133701">treat</a> the current virus. </p>
<p>SARS also emphasised the importance of communication in a pandemic, and the need for frank, honest and timely <a href="https://www.nytimes.com/2003/04/13/weekinreview/china-discovers-secrecy-is-%20expensive.html">information sharing</a>.</p>
<p>Certainly, SARS was a catalyst for change in China; the government invested in enhanced <a href="https://www.businessinsider.com.au/medical-surveillance-allowed-china-to-discover-novel-coronavirus-2020-1?r=US&IR=T">surveillance</a> systems, that facilitate the real time collection and communication of infectious diseases and syndromes from emergency departments back to a centralised government database.</p>
<p>This was coupled with the <a href="http://www.who.int/ihr/en/">International Health Regulations</a>, which requires the reporting of unusual and unexpected outbreaks of disease. </p>
<p>Advances in science, information technology and knowledge gained from SARS, allowed us to quickly isolate, sequence and <a href="https://www.nature.com/articles/s41591-020-0771-1">share</a> SARS-CoV-2 data globally. Likewise, important clinical <a href="https://www.sciencedirect.com/science/article/pii/S0140673620302117?via%3Dihub#bib4">information</a> was distributed early to the medical community. </p>
<p>SARS demonstrated how quickly and comprehensively a virus could <a href="https://www.pnas.org/content/101/42/15124">spread around the world</a> in the era of air transportation, and the role of individual “<a href="https://www.sciencedirect.com/science/article/pii/S1201971211000245">superspreaders</a>”.</p>
<p>SARS also underlined the importance of the <a href="https://www.csiro.au/en/Research/Facilities/AAHL/Animal-and-human-health">inextricable link</a> between human, animal and environmental health, known as “<a href="https://www.who.int/news-room/q-a-detail/one-health">One Health</a>”, that may facilitate the <a href="https://www.theguardian.com/world/2020/apr/06/ban-%20live-animal-markets-pandemics-un-biodiversity-chief-age-of-extinction">crossover</a> of germs between species. </p>
<p>Finally, a crucial, but perhaps overlooked lesson from SARS is the need for <a href="https://www.sciencedirect.com/science/article/pii/S0166354213002234#s0040">sustained investment</a> in vaccine and infectious disease treatment research.</p>
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Read more:
<a href="https://theconversation.com/coronavirus-is-a-wake-up-call-our-war-with-the-environment-is-leading-to-pandemics-135023">Coronavirus is a wake-up call: our war with the environment is leading to pandemics</a>
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<p>Few infectious disease researchers were surprised when another coronavirus pandemic broke out. A globalised world, with overcrowded, well connected people and cities, where humans and animals live in close proximity, provides fertile conditions for infectious diseases. </p>
<p>We must be ever prepared for the emergence of another pandemic, and learn the lessons of history to navigate the next threat.</p><img src="https://counter.theconversation.com/content/136231/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The 14th century Black Death pandemic catalysed enormous societal, economic, artistic and cultural reforms in Medieval Europe. Infectious disease pandemics can be major turning points in history.David Griffin, Infectious Diseases Fellow, Monash UniversityJustin Denholm, Associate Professor, Melbourne HealthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1352932020-04-12T11:45:39Z2020-04-12T11:45:39ZThe NHL put profit ahead of players’ health during last century’s pandemic<figure><img src="https://images.theconversation.com/files/325884/original/file-20200406-110267-pnze20.jpg?ixlib=rb-1.1.0&rect=0%2C41%2C1554%2C988&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Inscriptions on the Stanley Cup shows no winner was declared in 1919 when the final series between Montréal and Seattle was cancelled because of the flu pandemic.</span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span></figcaption></figure><p>If the coronavirus pandemic hadn’t upended the world of sports, the National Hockey League playoffs would be under way now and 16 teams would be fighting for the Stanley Cup. </p>
<p>Instead, the NHL is considering <a href="https://www.sportsnet.ca/hockey/nhl/north-dakota-nhl-location-2019-20-season-resumes/">a number of different scenarios to try to save its season</a> and avoid what happened more than a century ago when a different pandemic prevented players from hoisting the Stanley Cup in victory.</p>
<p>On April 1, 1919, the Stanley Cup finals were cancelled mid-series because of the <a href="https://www.routledge.com/The-Spanish-Influenza-Pandemic-of-1918-1919-New-Perspectives/Killingray-Phillips/p/book/9780415510790">flu pandemic</a> that had ravaged the globe for about a year. Seattle’s Metropolitans, winners of the Pacific Coast Hockey Association (PCHA), and the NHL champion Montréal Canadiens had already played five games of a best-of-seven series. The Stanley Cup was never awarded.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=769&fit=crop&dpr=1 600w, https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=769&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=769&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=967&fit=crop&dpr=1 754w, https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=967&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/325883/original/file-20200406-110267-12zokbr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=967&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">One of the most famous trophies in sports history, the Stanley Cup, has not been awarded only two times prior to the outbreak of the coronavirus pandemic: in 1919, when the Cup final was cancelled because of the 1918 flu pandemic and when a labour-management dispute resulted in the cancellation of the entire 2004-05 season.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span>
</figcaption>
</figure>
<p>These days, hockey writers retell the peculiar story of the 1919 Stanley Cup as a curious echo of COVID-19 in our own time. In the past few weeks, the NHL and <a href="https://globalnews.ca/news/6667383/coronavirus-chl-whl-next-steps/">Canadian Hockey League have suspended play</a>, the <a href="https://www.iihf.com/en/events/2020/wm/news/18344/2020-iihf-ice-hockey-world-championship-cancelled">International Ice Hockey Federation has cancelled its women’s and men’s tournaments</a>, and minor hockey programs have drawn the curtains on the season because of governments’ calls for social distancing, community solidarity and common sense.</p>
<p>And yet, if we look closely the hockey world’s reactions to the deadly viruses of 1918-19 and 2020, what is most striking is how much things have changed.</p>
<h2>A national passion</h2>
<p>When influenza appeared in 1918, hockey in Canada <a href="https://www.press.uillinois.edu/books/catalog/24qbh7by9780252042201.html">was a national passion with many organizations supporting the sport among diverse groups</a>. By the 1910s, it had become a national passion among a diverse population — men and women, mill, lumber and mining-town workers, urban bourgeois, Indigenous people and settlers, Blacks and whites.</p>
<p>Hockey’s popularity and growth made the sport hard to control, despite the efforts of regional bodies like the Ontario Hockey Association (1890) to standardize rules and eligibility requirements.</p>
<p>The Canadian Amateur Hockey Association was created in 1914 and promised to govern the game uniformly from coast to coast, but by 1918 it had only begun that work. What’s more, hockey was riven by a division between amateurs and professionals.</p>
<p>The <a href="https://utorontopress.com/ca/lords-of-the-rinks-3">first openly pro leagues</a> had appeared only a decade earlier, the PCHA and the National Hockey Association (forebear to the NHL) among them. Canadians had only begun to embrace the legitimacy of paid athletes and pro hockey, shaken by the First World War, had uncertain prospects for survival.</p>
<h2>Haphazard response</h2>
<p>It’s no surprise then, that the sport’s response to the 1918 pandemic flu was haphazard.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1739&fit=crop&dpr=1 600w, https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1739&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1739&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=2186&fit=crop&dpr=1 754w, https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=2186&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/325905/original/file-20200406-125671-14sartr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=2186&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ottawa Senators player Hamby Shore died in 1918 after catching the flu.</span>
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</figure>
<p>When “<a href="https://virus.stanford.edu/uda/">La Grippe</a>” claimed the lives of Ottawa Senators player <a href="https://www.hhof.com/LegendsOfHockey/jsp/SearchPlayer.jsp?player=14311">Hamby Shore</a> in October 1918 and Regina senior amateur Rusty Warren a month later, their deaths were mourned in the local press as lamentable happenstance. But there was no question that hockey games should be cancelled. In Victoria, coach/owner Lester Patrick’s <a href="http://www.vancouversun.com/sports/remembering+when+victoria+aristocrats+world+hockey+championship+1913/9702749/story.html">Aristocrats</a> exemplified the attitude that hockey should continue regardless of the health hazards.</p>
<p>Faced with a flu-sickened team in a playoff race in February 1919, the <em>Victoria Daily Times</em> noted that Patrick “set a record for signing players … as one man was stricken another was secured to fill his place.” It was in Victoria, likely in early March, where the Canadiens camped out awaiting the winner of the PCHA final between Seattle and Vancouver that team members were first infected.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=520&fit=crop&dpr=1 600w, https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=520&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=520&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=654&fit=crop&dpr=1 754w, https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=654&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/325892/original/file-20200406-103690-1c61dzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=654&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Joe Hall of the Montréal Canadiens died after contracting the flu during the 1919 Stanley Cup finals.</span>
<span class="attribution"><span class="source">(Library and Archives Canada)</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Five games into the final series in Seattle, deadlocked 2-2-1, five Canadiens fell ill and were hospitalized. One of them, <a href="http://ourhistory.canadiens.com/player/Joe-Hall">defenceman “Bad” Joe Hall</a>, died there on April 5. The Stanley Cup itself bears the grim result: “1919 … Series Not Completed.”</p>
<p>Today, the commerce of sport, including professional men’s hockey, is firmly entrenched in a <a href="https://www.sup.org/books/title/?id=16485">well-established corporate sport and entertainment nexus</a>. The NHL is not faced with the sort of existential challenges that confronted the early pro leagues like the PCHA and the NHA. And the tensions between amateurism and professionalism no longer exists.</p>
<h2>Blatant profit grab</h2>
<p>In the face of the 1919 pandemic, pro hockey owners pushed ahead with playoff games in what now seems like a blatant grab for profit. This is in contrast to the league’s definitive response to COVID-19 and the NHL Player Association’s <a href="https://www.cbc.ca/sports/hockey/nhl/nhl-covid-19-suspended-season-1.5495002">immediate endorsement</a> of the decision to suspend play. Now, ownership and labour are united — a reverse stance to 1919 where ongoing league activity meant that sick players were quickly replaced and even died.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=479&fit=crop&dpr=1 600w, https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=479&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=479&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=602&fit=crop&dpr=1 754w, https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=602&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/325911/original/file-20200406-125671-4c5fmx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=602&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Seattle Metropolitans won the Stanley Cup in 1917 and were hoping to repeat in 1919. From 1915 to 1922, the winners of the National Hockey Association/National Hockey League played the winners of the Pacific Coast Hockey Association as part of an East-West challenge.</span>
<span class="attribution"><span class="source">(Library and Archives Canada)</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The NHL is also a product of an <a href="http://dx.doi.org/10.1080/16184742.2015.1062990">integrated international sport system</a> where the COVID-19 response was rapid and consistent among pro hockey leagues around the world. Swift action initially came from the International Ice Hockey Federation, which announced that Halifax and Truro would host the 2021 Women’s World Championships because the <a href="https://www.iihf.com/en/events/2020/ww/news/18296/women%E2%80%99s-worlds-cancelled">2020 event was cancelled</a>.</p>
<p>The <a href="https://www.iihf.com/en/news/18312/league-hockey-comes-to-almost-standstill">Asia League</a> was the first pro league to cease operation and within the span of a few days <a href="https://thehockeynews.com/news/article/top-leagues-in-slovakia-austria-poland-norway-cancel-seasons-due-to-coronavirus-outbreak">Swedish, Norwegian, Swiss, German, Polish and Austrian leagues</a> suspended or cancelled play. Russia’s <a href="https://www.chroniclejournal.com/sports/national_sports/khl-gives-up-on-trying-to-reschedule-its-playoffs-cancels/article_9429a6c0-86d4-5258-89f8-8894cd21c335.html">KHL</a> eventually followed suit. The congruent response among all these leagues indicates the extent to which hockey has become a homogeneous, integrated, globalized sport.</p>
<p>The key difference between then and now is the NHL’s strategy. The NHL has taken charge to manage the COVID-19 pandemic while in 1919 the professional leagues simply reacted to the pandemic.</p>
<p>A century ago, hockey took a business-as-usual approach after the flu pandemic ended in 1919. The same stay-the-course ways won’t work in today’s context. The NHL, as a powerful actor within the North American hockey system, needs to respond with genuine efforts to rebuild our sense of community. While corporate social responsibility initiatives are common among professional sport organizations, those with a <a href="https://doi.org/10.1016/j.smr.2018.05.001">community-orientation</a> have a particularly positive impact.</p>
<p>The hockey community, like all of us, has many of its most important decisions regarding COVID-19 ahead of it.</p><img src="https://counter.theconversation.com/content/135293/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Stanley Cup hockey finals were cancelled mid-series in 1919 because of the flu pandemic. Unlike a century ago, the NHL has put player health ahead of profit when dealing with the coronavirus pandemic.Julie Stevens, Associate Professor, Sport Management and Director, Centre for Sport Capacity, Brock UniversityAndrew C. Holman, Professor of History, Bridgewater State UniversityLicensed as Creative Commons – attribution, no derivatives.