The Current

A century ago, physical distancing helped slow the Spanish flu. Here's what we can learn from that pandemic

CBC Radio’s former national health reporter Pauline Dakin says that there are plenty of similarities between the war-time epidemic and today’s coronavirus crisis, including physical distancing.

Regions that closed public spaces early on in the 1918 outbreak had 50% fewer deaths: study

Nurses care for victims of a Spanish influenza epidemic outdoors surrounded by canvas tents in Lawrence, Mass., in this undated photo from 1918. (Getty Images)

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More than 100 years ago, the best approach to eradicating the so-called Spanish flu wasn't an "exciting" one. It was tried and true physical distancing.

"That was the public health measure at the time. Be isolated; stay in your homes; don't go out. Don't go to bars; don't go to pool rooms; don't go to church," said renowned physician Dr. Jock Murray, now professor emeritus at Dalhousie University.

Without a vaccine or treatment, there was little public health officials could do to slow the spread of the disease short of asking people around the world to stay home.

Those measures, according to one study, found regions that closed public spaces early on in the pandemic had a death rate that was around 50 per cent lower than those without physical distancing measures. 

But it's not just physical distancing that rings true during today's COVID-19 pandemic. CBC Radio's former national health reporter Pauline Dakin says that there are plenty of similarities between the war-time epidemic and today's coronavirus crisis.

Pauline Dakin is a journalism professor at the University of King's College in Halifax.

In 2005, amid worry about a bird-flu outbreak, Dakin examined what lessons from the Spanish flu pandemic could be carried forward into modern day. "What they were saying then now seems eerily relevant today," Dakin told The Current's Matt Galloway on Tuesday.

That year, experts warned Dakin of an impending pandemic that would bring "the world to its knees," by shutting borders, closing restaurants, cancelling concerts and tanking the economy.

"It's fascinating when you listen to them; so much of what they described to you in 2005 has come to pass with this pandemic," Dakin added.

Everybody wants a 'magic bullet' cure

The Spanish flu pandemic, which began in 1918 and lasted a full two years, is estimated to have killed more than 50 million people worldwide, including 55,000 in Canada.

At the time, the infection spread largely through trade and shipping routes, and among First World War soldiers, Dakin explained. After the war ended, the disease spread swiftly thanks to Armistice Day parades celebrating the soldiers who returned from battle.

During a pandemic, everybody wants a "magic bullet" cure — anything to stop the spread and get society back on its feet, according to Murray.

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The same was true a century ago as the Spanish flu ravaged the world. Snake oil salesmen profiteered off fake cures, and everyday people turned to questionable and sometimes unsafe treatments to rid themselves of the illness.

Meanwhile, cloth face masks became mandatory for doctors and nurses, and public health officials in some regions required civilians to don the face coverings as well.

But it was only after enough people had developed an immunity to the Spanish flu that the pandemic subsided. In Canada, one in six people were infected with the disease.

"They were like rods in a reaction. The virus couldn't transmit if these immune rods [were] in there," said Dr. Michael Osterholm, a pandemic expert and the director of the Centre for Infectious Disease Research and Policy at the University of Minnesota.

Scare us 'into our wits'

Osterholm cautions that when cases begin to slow, governments risk a resurgence of infections if they take their foot off the physical distancing pedal too soon.

"Everyone is trying to call the game after one inning when there's eight innings left to go," he told The Current. "As we're learning, when ... we're not accelerating into this distancing activity, the virus is going to come back."

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According to Murray, Halifax's municipal government did just that back in the day.

"There was a lot of pressure from the media and from the public to loosen the restrictions and when they did, within a matter of days, the cases started to spike," Murray said.

While physical distancing measures may slow economies to a snail's pace, past epidemics have brought positive changes to society.

The federal government's Department of Health was created in response to the 1918 Spanish flu outbreak. Similarly, after SARS wreaked havoc around the world, the Canadian government instituted the Public Health Agency of Canada.

"We have to be open and prepared to continue to learn the lessons every day and then not get through it and kind of breathe a sigh of relief and say, 'Well, now that's all done with,' because what's now done with is going to happen again and again and again," said Osterholm.

"If nothing else, I hope this [COVID-19] pandemic doesn't scare us out of our wits, [but that it] it scares us into our wits to understand what we can do to make sure that we are much better prepared in the future."


Written by Jason Vermes with files from Pauline Dakin.

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