Spanish Flu of 1918: Week of April 17th, 2020

Students, Faculty, Residents, Staff, Alumni, Board Members and our many Friends,

Greetings again from my home office in Horsham. I hope this update finds everyone we touch healthy, safe and able to keep busy at home. I wanted to begin this update with a little history.   

During the course of the pandemic we’re currently living through we often hear references and comparisons to the Spanish Flu of 1918. As a student of public health, this was something everyone studied in epidemiology. Many of you probably already know the story, but just in case you don’t, I’ll give you the Reader’s Digest version of it. For starters, the 1918 influenza pandemic was caused by an H1N1 virus that people believe had an avian origin. The first wave of the virus was initially identified in military personnel headed across the Atlantic to fight in World War I in the spring of 1918. The spread of the virus was assisted by the large movement of troops in close quarters (mostly in ships and trains). The second wave emerged at Camp Devens, an army training base and at a naval facility, both located just outside Boston. Camp Devens reported more than 14,000 cases and over 750 deaths. By the end of World War I, later in 1918, there was a resurgence of the virus as troops came home in crowded ships from Europe and scattered across the country. 

Just like today, there was no vaccine to protect people, no anti-virals and no antibiotics capable of treating the secondary bacterial infections that were caused by the virus. This went on through 1919. The end result was over 50 million deaths worldwide including 675,000 in our country. As many of you may know, the flu hit Philadelphia hardest. While the pandemic was at its peak, city leaders allowed organizers to hold a Liberty Loan parade in September 1918. Approximately 200,000 people lined the streets in support of the American war effort. The results were devastating. Within a few weeks, 12,000 Philadelphians died of the virus. In contrast, at the same time, the city of St. Louis decided to cancel its parade and imposed strict social distancing, and accordingly, suffered the lowest mortality rate from the 1918 pandemic of any major city in the United States.

Ironically, the architect of St. Louis’ public health policy was a Philadelphian, Dr. Max Starkloff, who is commonly known as the father of social distancing in public health circles (CDC, Sussman, 2020). The pandemic is often referred to the Spanish flu pandemic. The reason for this was that Spain was one of the first countries where the epidemic was first identified and as a neutral nation during the war, freely published early accounts of the illness. While the virus didn’t originate in Spain, many people believe it did because that’s where it was first identified. Because of the lessons learned from St Louis’ response to the pandemic, social distancing is the current “treatment of choice” to help contain today’s coronavirus pandemic. As we practice social distancing to flatten the curve, everyone needs to remember that it doesn’t cure the disease. That’s why it will be so important moving forward that we maintain some degree of social distancing as things start to open up around the country, until we have a viable vaccine. If people start to disregard this, there will be a rapid spike in cases resulting in more deaths. So, now you know more about the Spanish Flu of 1918 than you ever thought you needed to!

Much closer to home, we’ve started to publish Faculty Focus stories on our website. This week we’re highlighting Dr. Elizabeth Sedunov, who works at the Pennsylvania Ear Institute and Emily Vasile, who teaches in our Low Vision Rehabilitation program. I encourage you to read both profiles of these very talented and amazing women.

I’ve recorded a video for our incoming students that’s viewable on our website. The message I’m sending speaks to the fantastic work our faculty and staff have done in pivoting to an online teaching and learning environment. 

Finally, I want to thank our faculty, students and staff for their flexibility and patience as we all work through this crisis together. I know how hard this is, but as I just conveyed to our class of incoming students, this pandemic is a generationally defining event. There’s no playbook, no script and no precedence.

Not even the pandemic of 1918 resulted in the total shutdown of the country. We will emerge from this gradually, with a new normal that we’ll adapt to over time. We are SALUS STRONG and ready to set a new standard for health science education.

Stay safe, practice social distancing, wash your hands often, wear a face mask when outside and in enclosed areas such as grocery other types of stores. Have a great weekend and try to get outside to move around a bit. That always makes you feel better!

Mike