Echoes of the past

Nurses wear masks during the 1918 Spanish Flu epidemic.

The spectre of the 1918 influenza pandemic looms ominously in the history of medicine. Every time a new disease rears its head – from SARS to H1N1 – journalists and writers around the world inevitably namedrop the “Spanish Flu” that killed millions towards the end of the First World War.

A fair comparison?

“It’s scaremongering to talk about 1918 in relation to H1N1 because it was quite a different disease in its nature,” explains Jock Murray, professor emeritus and former Dean of Medicine at Dalhousie. “It truly was a deadly disease. What we know about (H1N1) is that it’s a very infective disease but it is mild. And so for the vast majority of people who get it, it’s not a threatening disease.”

He understands, though, why so many leap to 1918 so quickly when seeking out comparisons. Though fear of plague and disease is a constant throughout human history, the 1918 pandemic remains the definitive influenza horror story of the modern era. Fuelled by the grueling conditions of the First World War and spread by soldiers being shipped around the world, it targeted the young and the healthy, killing upwards of 40 million (the actual death toll is a major point of historical contention). Here in Nova Scotia, though, smart precautions taken by public health officials limited the disease’s impact significantly.

“We had a warning,” explains Dr. Murray. “We knew it was occurring in the U.S., starting in military bases and spreading from city to city. So public health officials here sent people to Boston to see what was happening and how they were managing it. They returned home knowing it was going to happen here and began to take precautions in advance. They closed theatres, they told the churches to stop having services, they told people not to congregate in groups.

"As a result, even though you had about 1,200 people in Nova Scotia who died, that’s a lot less (proportionally) that happened in a lot of other places.”

Classes were suspended at Dalhousie for five to six weeks in the fall of 1918. According to the Dalhousie Gazette, the "new peril completely arrested college life."

These sorts of approaches aimed at limiting the spread of infection wouldn’t have happened to the same degree even 100 years beforehand. And today, medical science in both prevention and treatment is dramatically more advanced than it was in 1918, even as public health officials face new challenges. But society’s fear of disease remains.

“Look at the affect of media stories,” notes Dr. Murray. “One of the reasons that there’s a shortage of vaccine is a dramatic, sudden, unexpected change in the attitude of the public because a child died. People suddenly got very concerned and started to line up for the vaccination. It was a drive for immediate vaccination when people were expecting a slower adoption. That story kicked our fear impulse into gear.”