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episode # 216

What the Spanish Flu Can Teach Us About the COVID-19 Pandemic with NY Times’ Best-Selling Author John M. Barry

The COVID-19 pandemic is unchartered territory. Or is it? New York Times’ Best-Selling Author and Historian, John M. Barry, sits down with Adam & Matt to discuss the last global pandemic’s terror on humanity and how the Spanish Flu can inform our battle with COVID-19. Are we doing all we can? How long will it last? And what will be the fallout? Tune in for a gripping conversation from the comfort of your own home and stay there! Stay safe, Vancouver.

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Episode Summary


Who is John M. Barry?

John M. Barry is a historian and New York Times best selling author of the book, “The Great Influenza: The Story of the Deadliest Pandemic in History”.


Is COVID-19 (Coronavirus) similar to the Spanish Flu of 1918?

Yes, it is similar. Luckly, COVID-19 is considerably less virulent than the 1918 virus and therefore, less lethal. COVID-19 can be considered more contagious. It will inflect a lot more people and even with the lower fatality rate, the world-wide death toll will certainly be in the millions.


Are we more prepared today than in 1918 for a global pandemic?

We are more prepared today than in 1918 for the simple fact that there was no preparation in 1918. Even if we are more prepared, the world is poorly prepared. Many countries are bungling the response, even though they should have done a lot better.

The 1918 pandemic was an animal virus that jumped species into humans. It was a respiratory virus that spread widely around the world. In total, it killed an estimated 50-100 million people, which adjusted for population, would be equivalent to 220 to 440 million people today. Obviously, these are staggering numbers. The virus was transmitted through droplets, airborne transmission and hand transmission.

COVID-19 is still being studied. It is also a respiratory virus that is transmitted in roughly the same way as the 1918 pandemic. Scientists are still studying it COVID-19 to see how it compares to other respiratory viruses.


What is the biggest lesson we can learn from the Spanish Flu?

There were two lessons. First, people in authority should tell the truth. Second, social distancing is of utmost important. The latter flows from the former.

In 1918, the USA was at war and the focus was entirely on the war. To keep the focus on the war effort, there was no negative news being publicized in the USA at the time. National public health leaders in 1918 called the virus a regular flu by another name and discounted it with reassuring messages. Of course, it was not ordinary influenza for everyone. In some cases, you could develop severe symptoms, which included bleeding from the mouth and nose and death in as little as 24 hours. When the population started to realize that many people were dying from the disease, trust in governments and public authorities was greatly affected. If people don’t believe that their government is telling the truth, it is hard to get them to believe that actions like social distancing (which is the right thing to do) are important. The truth from leaders is crucial in getting compliance with any recommendations on what the population should be doing.


Are governments telling the truth today?

It depends on which government. In the USA, Donald Trump was downplaying the virus for a couple of months. We are not sure this was an outright lie and it may have just been ignorance of the virus’ seriousness on his part. A couple of weeks ago, he changed his message and has become quite serious about it and has been providing more accurate information.

Some governments are doing worse than the USA. Other countries like, South Korea, Singapore and Hong Kong are models of the best way to treat this disease. These governments told the truth to the population and managed to stay ahead of COVID-19 without shutting their economies down. They have widespread testing and so forth. Their infections are much lower than other places in the world.


How long did the Spanish Flu take to play out and is this a good model for thinking about COVID-19?

Unfortunately, looking at Spanish Flu in this regard is not a good model. In 1918, there were three different waves of the virus. The first wave was very mild and skipped over many areas of the world. Then came a lethal second wave that was world-wide, responsible for 2/3rds of the total deaths from the disease. Then, there was a final wave in the spring of 1919.

The incubation period of the Spanish Flu was 1-4 days in most cases. People got sick 48 hours after infection. COVID-19 is much much slower moving. This means that COVID-19 will be with us for a much longer period of time as it moves through the population. It is hard to say how long, but we will not be able to exterminate COVID-19. We will have to rely on vaccines, drugs, and natural immunity. There is a good chance COVID-19 will not be the severe problem that it presents right now after we develop these things to combat it.

Just to be clear, we do not anticipate a 2nd lethal wave of COVID-19. In 1918, there were many hints that the virus could be very lethal. For COVID-19, with all the cases world-wide, there are no hints suggesting that it would change into a more lethal version. Another difference to point out is that the Spanish Flu was more severe for younger people, whereas COVID-19 is more severe for the older population.


What was the economic impact in 1918 due to Spanish Flu and does it resemble what is happening form COVID-19 today?

In 1918, many of the cities in North America were doing what we are doing today. Almost all of them closed schools, bars, public gatherings, etc. The cities that waited until there were a lot of deaths in the community and then started to close public gatherings were too late. The cities that acted quickly before their community was infected were able to slow the spread significantly and flatten the curve.

In 1918, the USA did not shut down the economy or businesses like they are doing today, largely due to the war. The economy stumbled during this time, but there were many essential services for the war. As people started to see the effects of the disease, they stopped showing up for work, in large numbers. Many businesses were crippled. In the industrial sector, 3.26% of the entire population of workers aged 18-45 died. This is not 3.26% of people that had the virus, but of the whole population of workers in that age group. The numbers were staggering.

Right now, for COVID-19 in the USA, we are behind the curve. We are basically shutting down the country to try to catch up with the virus, flatten the curve and slow the virus. This will have a large effect on the economy.



Is there any reason to be optimistic when thinking about COVID-19?

COVID-19 is not the bubonic plague. It will not wipe out civilization. We will recover. Also, there is a very good chance that we will develop a good vaccine against COVID-19. COVID-19 does not mutate nearly as rapidly as influenza and the target for the vaccine is more stable. There is also a good chance we will get therapeutic drugs to help with people infected. There are drugs that show promise at this point. The main thing to think about is that social distancing works. This has been proven in many countries, like Singapore, Hong Kong, South Korea and Iceland. If you don’t comply with social distancing, you are not only hurting yourself, but the whole community. It is important to remember that COVID-19 can be serious for younger people as well, especially people with underlying conditions.


What will be the aftermath of COVID-19 for the culture? How did the Spanish Flu change the culture in 1918?

World War 1 ended and there was a brief, but intense recession when soldiers came back from overseas. This was followed by the roaring 20’s. This was a transition time. In terms of culture, this is very speculative, but there is a case to be made that the attitude of the roaring 20’s had something to do with the pandemic; the devil may care attitude, who cares what happens tomorrow. There has been remarkably little that has been written about the pandemic of 1918. There are small examples, but the Spanish Flu is largely absent from the culture in literature. Everyone’s focus was on World War 1.

In regards to COVID-19, it will be more significant for the culture. Because it is slow moving, it will not be a blip like the 1918 pandemic. It will be with us for much longer and will be more significant on the culture.


What are your thoughts on the numbers being released by the White House for estimated deaths in the USA of 100,000 to 200,000 deaths?

These numbers have got peoples attention and they have got Donald Trump’s attention. If the USA keeps to these low (by comparison) numbers, this is something that the public health community will be very happy with. This can only be accomplished through social distancing. One worry will be if people stop complying with social distancing or get bored with it. We need to hope for the best, but prepare for the worst.


How will COVID-19 effect the US election in the fall?

Joe Biden has a good chance of winning the election in the fall. Right now, Donald Trump has some solid support for his handling of COVID-19, but this is because people are not aware of what hasn’t happened. As time goes on and this information becomes more clear, his approval rating should drop. Donald Trump’s administration has had an incredibly poor response to this crisis. Hopefully, his actions put in place now will be effective, but this remains to be seen.

Find out more about John M. Barry.

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