What Can We Learn from the Spanish Flu Pandemic of 1918?

In my recent post, Pandemics in History, I, naturally, included the 1918 Flu Pandemic (also called the “Spanish Flu”) on the list. I want to expand on that part of our history for one very obvious reason; there are many parallels between the flu pandemic and the nightmare we have been living for the last 17 months.

First, allow me to be very clear; Covid-19 and the flu ARE NOT the same thing. Yes, I made sure to underline, italicize, bold, and color the “are not” because this is a crucial point. The “flu,” as we know it today, is hardly comparable to covid, but you’ll find that there are a not-so-shocking number of commonalities in government and public response.

Let’s dig a little deeper into the 1918 Flu Pandemic. How did it start and finish? What parallels can you pinpoint between this pandemic and ours? Maybe it can give us a little hope about the future…

a brief summary of the 1918 flu pandemic

Emergency hospital during influenza epidemic, Camp Funston, Kansas (1918). Original image from National Museum of Health and Medicine. Digitally enhanced by rawpixel.

As many as 50 million people died globally when influenza type A (subtype H1N1) hit western Europe in March 1918. It spread rapidly, and by August 1918, a second wave arrived. By then, it had mutated into a more contagious and deadly variant.

“For example, at Camp Devens, Massachusetts, U.S., six days after the first case of influenza was reported, there were 6,674 cases.”1

It reached every country in the world from the crowded train routes of Asia to the more secluded islands, like New Zealand and Samoa. India lost 12.5 million people in total; the United States lost 675,000. The majority of deaths occurred during the second and third waves of the pandemic, when the virus began to hit what was thought to be the most unlikely age groups the hardest.1

Healthy young adults were taken by the virus at unprecedented rates, and this was just one of many firsts in the flu pandemic. To date, historians and scientists continue to debate over the origins and consequences. As a result, there are many misconceptions and falsehoods surrounding the pandemic, including:

  • The flu originated in Spain. This is simply incorrect, and the name “Spanish flu” is largely misleading. The most likely explanation for this name is that it was a consequence of the First World War. The key countries involved in the conflict had every reason to downplay the effects of the pandemic in their countries. Spain, being neutral in the war, did not. As such, the pandemic appeared to be worse there; in reality, it was no worse than the majority of countries.
  • Treatments were just as lethal as the disease. Some argue that the death rate was exacerbated by the large doses of aspirin prescribed by doctors to treat the symptoms of the flu. It is certainly possible that aspirin poisoning was present (doctors were prescribing doses nearly eight times the safe daily amount); however, death rates in parts of the world without easy access to aspirin were just as high.
  • No one knows what made it so deadly. The virus was replicated in 2007 and studied in monkeys. They now know that the leading cause of death in healthy, young people was an overreaction of the immune system. They named it the “cytokine storm.”2

In all the precariousness, you may wonder how public officials handled this pandemic. Does it compare to how our leadership has handled covid?

Official response to the 1918 flu pandemic

“Public health officials, law enforcement officers and politicians had reasons to underplay the severity of the 1918 flu, which resulted in less coverage in the press.”2

The American Soldiers in Presence of Gas suring World War I (1918). Original image from National Museum of Health and Medicine. Digitally enhanced by rawpixel.

With the war in full swing, officials in the United States deemed it necessary to downplay the pandemic’s severity. They feared that acknowledging it globally would weaken their position in the war and embolden their enemies. They did, however, taken action.

Without proper treatment or vaccinations available, officials had to resort to preventative measures to stop the spread of the virus. Many of these will sound very familiar:

  • They pushed the use of disinfectants and regular sterilization.
  • Cities with larger outbreaks were placed under quarantine.
  • In some areas, public places were closed for extended periods of time.
  • They wrote legislation to stop the use of common cups and utensils in public places.
  • Masks were mandated nationally.
  • Schools shut down, but often opened too soon.
  • Committees were formed to canvas rural areas for unreported cases.
  • Health Departments released posters and imagery to educate the community on the importance of hand-washing and personal hygiene.

Hospitals also had to adjust their practices to accommodate the influx of patients and contain the spread within the facilities. In keeping with the preventative measures for any contagious, airborne disease, they tried to utilize well-ventilated spaces, like large rooms with high ceilings and even outdoor areas.

Of course, just as we are seeing right now with covid, they experienced massive overflow in hospitals. Historical photographs show nurses attending to patients in rows of beds inside gymnasiums and on balconies. They practiced continuous disinfection and sterilization and “utilized scientific ideas of germ theory to reduce transmission.”3

Walter Reed Hospital flu ward (ca. 1910–1920). Original from Library of Congress. Digitally enhanced by rawpixel.

how did it end?

In fact, there was no definitive end to the 1918 pandemic, which is a significant bummer. Given that I spent nearly all of 2020 pregnant and worried and now all of 2021 a new mother and worried, a part of me is holding out hope for some miraculous day when I will walk out of my house without an N-95 and a bottle of Purell and just feel safe. I won’t hold my breath.

In 1919, they thought the pandemic had ended. Cases dissipated in the summer season when people were spending more time outside, but they shot back up in the winter when everyone was indoors again. Once so much of the world population had been infected and so many lives had been lost, there simply weren’t enough susceptible people left to create another pandemic. Of course, that does not mean there weren’t epidemics.4

Today we have the vaccine, and we simply live with the flu. It is what it is. You go to the grocery store for a gallon of milk and stop by the pharmacy for a flu shot. Easy as pie. We have much bigger fish to fry these days.

what can we learn from the flu pandemic?

Women wearing surgical masks during the influenza epidemic, Brisbane (1919). Original image from State Library of Queensland. Digitally enhanced by rawpixel.

One key difference between the flu pandemic and the covid pandemic is the faith that the population had in science. In 1918, there was much more of it. When people were asked to put on masks, they did. When they were asked not to get too close to each other, they didn’t. When they were quarantined, they complied, and when kids didn’t go to school, parents understood.

The most important difference is the vaccine. It took several years to develop the flu vaccine, and even though we have it now, it did not play a role in the end of the pandemic. Now, more than 100 years later, medicine did what it always does; it improved. We can develop a vaccine more quickly because we have been developing vaccine technology for over a century. Vaccines eradicate infectious diseases. The proof is in our history.

Lastly, one key similarity is that people were shaken in the beginning and gradually started to break the rules. Without preventative measures and in the absence of a vaccine, of course the spread continued, and the flu came back in deadly waves because…surprise, surprise…”a pandemic isn’t over just because we’re over it.”

click below to read more from pandemic-reset.com…

Sources:

  1. Britannica. “Influenza pandemic of 1918-19.”
  2. Healthline. “1918 flu pandemic facts.”
  3. Stanford University. “The Public Health Response.”
  4. Time Magazine. “How Does a Pandemic End? Here’s What We Can Learn from the 1918 Flu.”

Blood Types and Covid: Does Your Blood Type Make You Less Vulnerable to Covid?

Photo by Fusion Medical Animation on Unsplash

There are rumors floating around in the ocean of covid information and misinformation about the connection between COVID-19 and blood types. You may have heard that blood type O is less likely to catch covid. It certainly piqued my interest when I heard it. So, what’s true? What’s the science behind blood types and covid? Is type O safer? Says who? What about severity? Are any blood types more susceptible? I looked into it with all these questions about covid and blood types in mind, starting with…

What even are blood types?

To be honest, I didn’t know my own blood type until I had a baby last year. I’m O positive, by the way. Until recently, I never bothered to look up what that means. Fun fact for my fellow O positives, we are popular. Apparently, 37.4% of the population is O positive, making us the majority. If you’re curious about your blood type, here are the population stats:

Blood TypeOccurrence in PeopleFrequency
O+1 in 337.4%
O-1 in 15 6.6%
A+1 in 335.7%
A-1 in 16 6.3%
Source: Stanford Blood Center
Blood TypeOccurrence in PeopleFrequency
B+1 in 12 8.5%
B-1 in 671.5%
AB+1 in 293.4%
AB-1 in 1670.6%
Source: Stanford Blood Center

This chart does not provide any information about a connection between blood types and covid. However, it does speak to all the rare blood types out there, and it’s saying “please donate!” All you O negatives, you’re the most in demand because you are the only universal donor.

Speaking from personal experience...I lost one fourth of my body's entire blood content at once when I gave birth. I'm forever grateful to whomever donated that bag of blood used for my transfusion.

so, How do blood types relate to covid?

Since the COVID-19 pandemic began in late 2019, researchers have administered many population-based studies on the standard risk factors, including age, obesity, preexisting medical conditions, race, ethnicity, and sex. They have even investigated blood types as risk factors for covid.

This is not a new hypothesis to test, and blood type has been determined a valid risk factor in several disease processes, including infectious diseases. Blood types have been linked to bacterial and viral infections before; therefore, it’s not a stretch to assume that it might be a risk factor for covid as well.

What are people saying about blood types and covid, and what is true?

As everyone knows, social media platforms like Facebook and TikTok have algorithms, and those algorithms know what you like and how to show it to you. If, like me, you’re impatient and a fan of instant gratification, TikTok is the app for you. In 2020, the algorithm picked up, pretty quickly, that I was consuming covid news like chocolate cake.

For quite some time now, I have seen several posts, both serious and satire, talking about the link between covid and blood types. Overwhelmingly, the consensus was that type O blood is significantly less likely to catch covid than the other blood types. Of course, there were a few posts, often from the POV of a hospital bed with captions like, “I’m type O, and I got covid” that stated the contrary. Now we should ask the very vital question, “where is the thin line of truth in the nonsense?”

Photo by Karolina Grabowska on Pexels.com

The National Center for Biotechnology Information (NCBI) published a study on July 18, 2021 from the Elsevier Public Health Emergency Collection about the relationship between blood type and covid infection (CLICK HERE to read). The question addressed was the same I’ve been discussing, the conclusion was (surprise, surprise!) significantly more convoluted than the videos on TikTok.

What do the studies say about blood types and covid?

What I learned is that there have been nine large studies on the correlation between blood type and covid-related illness, and most of them report that there is an association between the two. Eight of them reported association. Four of them found some blood types to be more severely affected by covid while five of them did not.

You may be asking, “what does that mean?” Well, it means that the studies were inconsistent. However, what they did find is plenty of very important information about covid and some overlapping trends. For example, several studies showed that type A might be more susceptible of infection while type O and Rh-negative groups may not be. Ultimately, the studies as a collective came to one important conclusion for now…

“At this point in time, there does not appear to be any relationship between blood type and COVID-19-related severity of illness or mortality. Current literature does not support blood type as a part of a predictive model of viral illness or mortality…”

PMCID: PMC8286549

is your blood type more or less vulnerable to covid?

Is type O less vulnerable to covid? The answer for now is no, and I think there is a valuable lesson to be learned here. If I placed all my trust in TikTok trends and shackled it to my mental vault as fact, I’d have assumed my husband, my son, and myself were all safe from covid because we all have O blood types, but I’d be wrong.

If you’re out there thinking you are covid-proof because you have a variation of the O blood type, please be careful. There is not yet nearly enough information on the blood types as a risk factor for covid, and no one is invincible.

Disclaimer: All the information in this article comes from a reputable, peer-reviewed source published by a medical journal. Nothing has been interpreted by myself or anyone other than medical professionals.

Click below to read more from pandemic-reset.com…

Source:

  • Kim Y, Latz CA, DeCarlo CS, et al. Relationship between blood type and outcomes following COVID-19 infection [published online ahead of print, 2021 Jul 18]. Semin Vasc Surg. 2021;doi:10.1053/j.semvascsurg.2021.05.005

Pandemics in History

Did you know there have only been a few actual pandemics in history? Epidemics and endemics, yes, there have been plenty, but there is just a small number of recorded pandemics in human history, and it’s hard to believe sometimes that we are actually living through one right now. In modern history, this is the worst, but take a look at some pandemics of the past and how we got through them…

Here are some other pandemics in history…

The plague of justinian

(541-750 CE). Multiple bubonic plagues occurred throughout history, but scholars refer to the Plague of Justinian as the first pandemic. It’s origins have not been identified, but what we do know it is that it wiped out nearly half of the population during the rule of Roman Emperor Justinian from present day Turkey to what we now know as England. Today, we know that bubonic plague refers to a deadly bacterium called Yersinia pestis that travels through infected fleas and lice found on rats and humans alike. (If you’ve read “8 Nasty Historical Facts You Probably Didn’t Know,” you’re aware that people have historically struggled with proper hygiene.) First hand accounts of the disease describe fever, chills, and lymph nodes that are swollen and even oozing. It spread so rapidly that families were often unable to properly bury their loved ones. In Constantinople, the ruling government assisted in collecting bodies and burying them in mass graves outside city walls. Today, bacterial infections are relatively easily cured thanks to modern medicine and antibiotics. 1

the black death pandemic

1347-1352. The bubonic plague returned centuries later. It traveled from Asia Minor to the Crimean Peninsula via Tartar armies attacking a city called Kaffa on the shores of the Black Sea in present day Ukraine. The Tartars successfully sieged the city, and first hand accounts tell the tale of soldiers using a catapult to hurl the dead bodies of plague victims over the sides of the city walls. Traders fled the city during the siege and carried the plague with them to present day Turkey and across the Mediterranean to the shores of Sicily, which became ground zero of the mass spread across Europe. The Tartar soldiers made their way through eastern European countries and into India, leaving a trail of death along the way. Accounts of symptoms mimic those of the first bubonic plague. They spoke of “tumours in the groin or armpits,” which we now know to be swollen lymph nodes. Today we call this pandemic “The Black Death.” In the mid 14th century, they referred to it as “the pestilence.”2

the flu pandemic

1918-1919. Before COVID made its debut, the 1918 influenza outbreak was the worse pandemic in modern history. Five hundred million people were infected, 50 million of them died, nearly 700,000 of those were in the United States. Studies of the virus showed genes of avian origin, and with no vaccine or antibiotics to treat the bacterial infections common with the flu, the death toll was devastating. The only means of control available might sound familiar: “isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.”3 U.S. citizens were ordered to wear masks. Schools, churches, and other public places were shut down, but another wave of the pandemic hit when soldiers started to come home from war. Pressure to appear patriotic and censored media downplaying the severity of the disease led to many wrong turns. By the summer of 1919, the pandemic finally ended. The reason: so many were infected that nearly enough of the population either died or survived with immunity.4

the aids pandemic

1981-Present. It is very likely that HIV and AIDS debuted before the 1980s; however, with no obvious signs or symptoms, many may have died without ever knowing they were infected. Many believe it started in the Democratic Republic of Congo in the early 20th century and originated in chimpanzees, then transmitted to humans. By 1980, HIV, which can develop into AIDS (Acquired Immunodeficiency Syndrome), had reached Africa, the Americas, Europe, and Australia, reaching pandemic status. It was first recorded as severe cases of pneumonia and thought to predominantly affect the gay community until reports of transmission in heterosexual relations emerged in 1983.5 Initial infection of HIV can manifest as flu-like symptoms, but for the most part, it is asymptomatic until it develops into AIDS. AIDS symptoms include weight loss, fatigue, night sweats, and reoccurring infections. To date there is no known cure, but treatment has come a long way. Because HIV and AIDS are not airborne diseases, awareness and prevention techniques are the best strategies to protect yourself from contraction.

swine flu pandemic

2009. In 1976, a subtype of H1N1 known as the Swine Flu emerged in Fort Dix, NJ where one young man died and 13 were infected. The U.S. government, fearing a pandemic, hurried to create a mass immunization program. Just a under a decade before, a new strand of the flu had caused the death of over one million people globally. The immunization program was rushed and the swine flu pandemic of 1976 never happened, but a similar virus did make a global impact some 33 years later. The first occurrence of swine flu was in America during April 2009. It was not the same combination of flu viruses detected in Fort Dix in 1976, and it spread very quickly on a global scale. By June, it was declared a pandemic, and one year later, it resulted in “60.8 million illnesses, 273,304 hospitalizations and 12,469 deaths in the U.S.” Vaccinations were made available in October 2009, and the World Health Organization declared an end to the spread in August 2010. Global estimates are scattered, but anywhere from 150,000 to 575,000 people died during the swine flu pandemic.6

Stay safe out there everyone. It’s not over, and we’re relying solely on the compassion and empathy of others at this point.

Click below to read more from pandemic-reset.com…

Sources:

  1. Kristina Sessa, The Ohio State University, Origins. “The Justinianic Plague.”
  2. John Frith, JMVH. “The History of Plague – Part 1. The Three Great Pandemics.”
  3. CDC. “History of 1918 Flu Pandemic.”
  4. History.com. “Spanish Flu.”
  5. Avert. “History of HIV and AIDS Overview.”
  6. Becker’s Hospital Review. “A look back at swine flu: 8 facts about the world’s last pandemic in 2009.”

Netflix Says I’m Depressed, TikTok Says It’s Just ADHD

These days, TikTok has become my source for all things at all times. Our short attention spans, need for instant gratification, and handheld super computers called, and TikTok answered with just the right dose of information overload.

In 2020, while pregnant and quarantining, Netflix and TikTok became my socialization, my only connection to the outside world. It’s so sad, honestly.

I went to TikTok to learn what was going on out there from through the people living it, and I turned to Netflix to escape the reality of it (shoutout to the Tiger King). Of course, 2020 eventually breached Netflix and now there’s hardly any escape (except old episodes of Real Housewives, a guilty pleasure).

I got a hard dose of reality when I watched Bo Burnham’s special, Inside, on Netflix.

Thanks Bo Burnham…

If you haven’t watched Inside yet, go do it, or, well, maybe don’t do it. Actually, evaluate your mental stability at the moment, and if you feel like you’re in a good, strong place, go watch it. If you are feeling particularly pessimistic about the future and angry about 2020, it’s probably not the right time for you.

No one knows how to use poignant lyrics added to a catchy melody to punch you right in the feels quite like Bo. “Look Who’s Inside Again,” “That Funny Feeling,” and “All Eyes on Me” really hit home. When the special ended, I found myself in tears, and thinking…”did 2020 break me? Am I depressed now? Do I need help?”

Then TikTok stepped in and said, “eh, maybe it’s just a little pandemic stress mixed with some ADHD.”

TikTok, How Did I Get Here?

For those who know nothing about TikTok, I’ll give you a quick overview of how you end up down the rabbit hole. Your FYP (For You Page) is a stream of videos curated just for you by an algorithm that monitors your likes, comments, and shares. The more you like videos of similar content, the more you will see them on your FYP.

Simply watching a video to the end or sharing it with a friend will trigger the algorithm. Beware: you can accidentally end up on some dark sides of Tiktok…paranormal-tok, for example, which can get a little dicey if you run into it late at night while scrolling in the dark, or worse, underwhelming dance trend-tok. It’s hard to get out once it’s gotten you.

Anyway, this is how I ended up on ADHD-tok. What I found actually surprised me. I’m a 35 year old woman. I grew up in an age when young boys were the only ones getting an ADD or ADHD diagnosis. My brother had ADD; my cousin had ADHD. Both were physically hyperactive.

I was a relatively quiet, self-reflective kid with a hypersensitivity to everything around me. As an adult, I’m still self-reflective and hypersensitive…not very quiet anymore. I started coming across videos with prompts like…”Feel mentally paralyzed when you have too much to do?”, “Wait until the last minute to do everything?”, “Get angry for no reason?”

Of course I answered yes to them all…hit the like button, but this isn’t something special. I’m an older millennial…over-educated, drowning in student debt, and underpaid. We’re all like this, a little depressed, moody, anxious.

Then the TikTok doctors and therapists weighed in. They said, “wait a minute…you might have ADHD.”

The Age of Self-Diagnosis

At this point, you might be asking yourself, “do I have ADHD? How do I know?” First of all, a lot of women have gone undiagnosed for a long time because ADHD manifests differently in us. We tend to internalize much more, making the hyperactivity more mental as opposed to external.

Here are just a few of the potential missed symptoms that I learned while surfing the waves of ADHD TikTok:

  • driving quickly and impatiently,
  • frequent thoughts about changing jobs,
  • lying to avoid shame or conflict,
  • impulsive spending,
  • extreme mood swings,
  • hypersensitivity to loud noises,
  • insomnia,
  • drifting in thought during conversation,
  • forgetting things you said,
  • interrupting others while they speak (I’m really bad about this one),
  • procrastination/struggling with time management,
  • frequent daydreaming,
  • trouble maintaining friendships,
  • feeling anxious/sad (very common in women), and
  • perfectionism.

Have you ever heard of Delayed Sleep Phase Syndrome (DSPS)? I hadn’t…but I have symptoms. People with DSPS have trouble falling asleep early, even when they try, and have a hard time waking up early. Apparently, it is a sign of ADHD.

So, What Now?

I will freely admit that I have ever sign of ADHD listed above, and I’ve had them for as long as I can remember. Doctors and therapists are catching this stuff daily now, and social media has actually been a great tool for helping people.

So, what’s the moral of this story? The lesson I learned is that awareness is everything! Providers with specialities who are on social media are creating amazing content and awareness. ADHD, for example, can be a superpower if you know what to do and how to operate in the world around you as a neurodivergent.

Dr. Kojo Sarfo (@dr.kojosarfo on TikTok) is a mental health expert with over 1.4 million followers. He posts everyday about topics like ADHD, OCD, body dysmorphia, and depression. He’s helping people, many of whom can’t afford healthcare, let alone mental healthcare.

Photo by Dan Meyers on Unsplash

Lindsay Fleming, LPC (@lindsay.fleminglpc on Tiktok) is a licensed therapist with expertise in ADHD, specifically in women. She has nearly 500,000 followers. Women are overwhelmingly misdiagnosed with depression and anxiety when ADHD is overlooked, and the information she provides can help us speak up for ourselves.

Shoutout to the thousands of doctors and healthcare professionals that are taking their knowledge to the internet and sharing it, free of charge! The awareness they bring is saving lives and getting us through this pandemic.

In All Seriousness…

We often joke and minimize mental health struggles in order to power through. White-knuckling our way through life is autopilot for some. For many of us, mental health is very much a daily struggle. We all need a little help sometimes; the last 18 months have thrown curveball after curveball at us. Hang in there, friends; you’re not alone.

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