Whether in reports from journalists, briefings from government officials, or socially-distanced conversations with next-door neighbors, “unprecedented” seems to be the word on everyone’s lips these days.
It is certainly true that in the United States, we have not experienced anything quite like the societal, economical, and public health impacts of COVID-19 in our lifetime. However, if we look into the not-too-distant past, we see that today’s events are not entirely unprecedented, and that the past may offer perspective to the healthcare industry as we find a way forward.
1918 flu pandemic as a catalyst for change.
In the flu pandemic of 1918, also called the Spanish flu, between 50 and 100 million people died from the virus worldwide, or up to five percent of the global population, according to a Smithsonian Magazine article.
The healthcare industry and pandemic response looked very different at that time in history. Healthcare was largely decentralized. Doctors operated independently or were funded by charities and religious institutions. Many people did not have access to basic care. As an American Journal of Public Health article explains, the countermeasures available to mitigate the pandemic were limited and relied on nonpharmaceutical interventions. The role of public health officials was minimal in the pandemic response.
The devastating loss of life in the 1918 flu pandemic acted as a catalyst, bringing swift and innovative changes to healthcare. The field of epidemiology emerged as data was collected more systematically. Only six years after the Spanish flu subsided, all states were participating in a national disease reporting system. The public health field began to look more like it does today, as countries restructured their health ministries and departments in the following decade.
Medicine moved beyond a solely biological and experimental focus to elevate sociological considerations as well. Prior to the 1918 flu pandemic, the medical community believed that individuals were to blame to succumbing to infectious diseases. The experiences of the Spanish flu demonstrated that pandemics are a fundamentally social problem. World leaders recognized a need for a mechanism for an international response to public health threats. In 1919, the forerunner of the World Health Organization (WHO) was formed.
