When it began, it was considered something banal, “the fashionable disease” against which “the medical profession believed itself capable of successfully fighting”. However, in a short time, “concern was not limited to the identity of the epidemic disease, but also its degree of spread and severity.” “Try to be outdoors, avoid places with rarefied atmosphere, ventilate and disinfect” became general recommendations in the absence of treatment. There was a shortage of some products and protests from citizens due to the absence of measures, the disparity of these, and the insufficient health resources. It is not a chronicle of the current coronavirus, it is a reflection of the pandemic suffered between 1918 and 1919 and collected in the book La flu española 1918-1919 (Editorial Catarata) by the doctor and professor of History of Science at the University of Castilla- La Mancha María Isabel Porras, 62-year-old from Madrid.
The similarities between two epidemics a century apart suggest that humanity suspends history. “I would like to think that no, but I fear that it will not be learned, especially at the political level, among those who have decision-making capacity,” admits Porras, who advocates a healthcare model away from neoliberal theories to return resources to health, correcting economic inequalities and giving the necessary weight to science and health, or to release patents on vaccines to get the entire population immunized. That failure in the knowledge of the past has an explanation, in the opinion of the researcher. “Politicians do not want to consider history because it would force them to take measures that do not see the immediate effect, in the period they hold office. It’s a shame, he laments.
And you don’t have to go back a century to discover the effect of the forgetting of the past by those responsible for health. “They haven’t even seen the short-term history, the lessons of the first outbreak. At that time they need for reinforcements was already seen and it has been done very little, ”adds Nieto. The similarities are reflected from the start of the two pandemics. The newspaper El Sol collected in 1918 the opinion of Gregorio Marañón, who became part of the Spanish Medical Commission, in which he referred to the then incipient disease as a “flu-like process. Like that newspaper, many other internationals downplayed the outbreak. “Doctors who had known the pandemic of 1889 had seen that it could be serious. But when Gregorio Maranon lived in 1918, he was very young and the social and medical perception at that time was that it was something mild, ”explains the historian. As has happened with the covid, the rapid spread of the disease and the severity of it radically change that idea.
The initial reaction of governments was to hide reality, as happened with the current pandemic. Former US President Donald Trump insisted in May last year on minimizing the ravages of the coronavirus. As the United States became the world epicenter of the disease, with a record number of cases and deaths, Trump attributed the increase in cases to the proliferation of tests, he branded Anthony Fauci, the White House epidemiologist, as “a bit alarmist ”And stated that the virus would disappear by itself. It also happened a century ago. “The governments pressured the press not to give information about what was happening. The first response of the public powers is to hide. It has been established since the plague epidemics of the fourteenth century. It is done partly to avoid panic in the population, but also because admitting that there is a problem implies taking action and, if the public knows it, they will demand it.
.Until it is so serious that they realize that they are avoiding the adoption of formulas to prevent the disease, ”says Porras. Also, although saving the distances due to historical circumstances, the two pandemics surprised humanity without sufficient means. In the 19th century, we had a significant scientific and health backwardness. In Spain, there was no health insurance system, like those in the United Kingdom or Germany. But now it shouldn’t have happened to us. At present, we start with a scarcity of resources in general due to the neoliberal trend, especially since 2008, of thinning health institutions and the budgets that are allocated. We have a shortage of personnel and facilities in very important areas, from primary to epidemiological care. If, on top of that, it is necessary to bear a much higher demand than usual, what is happening is generated, says the historian.
As of now, in 1918 there was no specific treatment and the hospital network was too limited to cope with the pandemic. There were malnutrition and lack of resources that affected the population, ”says Porras.
As society became aware of the seriousness, the general acceptance of the proposed hygiene measures increased, which do not differ from the current ones: open-air, avoid places with rarefied atmosphere, ventilate and disinfect. So, in Madrid, public centers were closed, but open cafes were kept. “There was a follow-up, but the lack of coherence in certain measures generated critical responses from the public,” explains the historian.
Starting in 1920, the incidence of influenza decreased, leaving behind more than 50 million deaths (up to 100 million, according to different studies).
Porras trusts that current scientific advances will avoid a similar balance, although he warns that this new fight has not yet ended: “At the end, when the pandemic is controlled, the virus, according to the researchers, will remain seasonal. But for now, serious outbreaks will reappear. The incidence is very high and a sufficient minimum immunity is needed, of 70% or more. Meanwhile, the virus continues to circulate and is adapting, as the new variants show .In the same way, the professor of the Michigan State University Siddharth Chandra thinks that “the 1918 flu pandemic provides an account of what the covid can bring in the future,” as explained to the academic institution after a study published in the American Journal of Public Health (AJPH).
