A Centenary Tale of Two Pandemics: The 1918 Influenza Pandemic and COVID-19, Part II

Abstract

Both the 1918 influenza pandemic and the 2019‒2021 COVID-19 pandemic are among the most disastrous infectious disease emergences of modern times. In addition to similarities in their clinical, pathological, and epidemiological features, the two pandemics, separated by more than a century, were each met with essentially the same, or very similar, public health responses, and elicited research efforts to control them with vaccines, therapeutics, and other medical approaches. Both pandemics had lasting, if at times invisible, psychosocial effects related to loss and hardship. In considering these two deadly pandemics, we ask: what lessons have we learned over the span of a century, and how are we applying those lessons to the challenges of COVID-19?

FIGURE 1—

Wearing of Face Masks, 1918 and 2020 Note. In the pandemics of both 1918 (influenza) and 2019‒2021 (COVID-19), public health officials recommended wearing face masks for both casual outings and at sports events, and at other large gatherings. Parts a and b: Masked pet owners and pets, circa 1918 (a) and 2020 (b). Parts c and d: Fanciful masks seem to mock the pandemic’s “grim reaper” circa 1918 (c) and 2020 (d). Parts e and f: In 1918, some sports events were canceled but others went on, often with masked players or spectators, or both (e). In 2019‒2021, many live sports events have been canceled or played without live spectators (f; Photo by Mike Kireev/NurPhoto via Getty images; published with permission).

FIGURE 2—

The 1918 Pandemic Inspired Many Artists Source. Part b used with permission of the artist, Pete Ryan (https://www.peterthomasryan.com). Note. Part a: Dying in his Vienna, Austria, apartment of influenza pneumonia (1918), painter Egon Schiele produced his last artistic work, a drawing of his wife, Edith Harms, 6 months pregnant and suffering from the same disease. She died hours after the drawing. Part b: A 2020 illustration captures the anxieties of COVID-19 spread; design by Pete Ryan for Vox, printed with permission.