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7 December, 2020

Covid-19 in view of Past Pandemic

Dr. Farah Naz, Dow University


The world is suffering from the most virulent and fatal type of a novel coronavirus strain, Sars-Cov-2, effecting nearly 188 countries. The first case was reported on 19th Dec 2019 in Wuhan, China. Later on, the cases were seemed appearing rapidly in various regions around the world. According to WHO statistics, America and Europe are the most affected regions, whereas, West Pacific is the lowest infected.

The new strain of coronavirus is so virulent that it infects people ten times faster than the seasonal flu(SARS). According to the latest statistics, It has infected more than 90million people and resulted in nearly 2millions deaths worldwide. The world had been through numerous pandemics before, which were equally violent and damaging to the world and its dwellers. As 2019 and, 1918 pandemics began by the viral outbreak, and both caused respiratory illnesses among people therefore, this review aims to gain insight from 1918 pandemic and make reasonable comparisons with Covid-19 pandemic.

What is Pandemic?

Pandemic is a global outbreak of a disease which is infective and fatal to most of the population. It disturbs the entire equilibrium of the world, creating an economic, political, and social disturbance. The threats of pandemics are judged by infective organism diversity, virulence and human interaction.

Influenza has become the common cause of the likelihood of pandemic. Any year, there is a 1% chance that influenza would flare-up into a pandemic.

Nearly 100 years ago, like Covid-19, Spanish flu broke out in 1918, which originated from birds (Avian flu).

The first infected case reported on 17th Sep 1918, and just following two weeks, the graphs of infected people rose to more than 20,000. The Spanish pandemic was considered the most deadly as it killed more than 20 to over 100 million deaths worldwide-more than 2.5% of the total population and lasted for two years with three waves in between1918 and 1919.

Difference between the Spanish Flu  and Covid-19 pandemic

The duration of almost ten decades between two viral pandemics in history self explains the probability of changes from that time till now. Here are a few as follow,

  • Spanish flu caused by the H1N1 type of influenza virus whereas, Coronavirus outbreak due to a new SARS-coV-2 strain.

  • Spanish flu started in the middle of World War I, Covid-19 first case was reported in Wuhan, China.

  • Spanish flu targeted youngs and adults mostly. However, Covid-19 is more dangerous and fatal to the elderly, suffering from co-morbid.

  • CFR (case fertility risk) for SARS-coV-2 is 1% while that of Spanish flu was 2%.

  • Covid-19 can spread through infected people having milder or no symptoms (asymptomatic). Spanish flu spread was only though the symptomatic patients.

  • Spanish flu was believed to be dissipated due to less hygiene, congested living, poverty, less education and awareness whereas, fast travel and exploitation of natural resources are blamed for Covid-19 spread.

Lesson learned from 1918 pandemic

Non pharmacological interventions (NPI)

Closure of businesses, shopping malls, churches, schools, public gatherings was among the NPI restrictions, that were applied. Also, imposing lockdown and effective quarantine seemed the most effective method to cease the viral spread.

Two studies investigated a co-relation of NPI and less viral spread. The results showed a decrease in peak death rate with the number of interventions used.

Impose social distancing and lockdown rules as early as possible

As per researches, the best measure was how early the interventions imposed. Those regions, who put restriction rules earlier with the first infected case reported, managed to cut off the peak early, than those who waited a few weeks. For instance, according to the studies, Boston and Philadelphia imposed the same restrictions. But Philadelphia implied two weeks early, that curb the spread better than Boston, which later declared the worst affected city with influenza.

Problems faced in 1918 vs Covid-19 pandemic

Firstly, although social restriction and home confinement soared the death toll and infections in pandemics, limited exposure to the outside world enhanced the mental illnesses. Recent studies confirmed that the Covid-19 pandemic and its consequences have already increased the suicidal risk worldwide. People in the Spanish flu also suffered anxiety owing to being infected or losing their loved one’s.

Secondly, the health care system during the 1918 pandemic was underdeveloped and not advanced. The study on microbes(virology and microbiology) begun in the 1930s therefore, people had no clue of influenza as a virus causing infections and deaths. Also, there were no high powered microscopes to visualize virus and no testing available.

On the other side, the viral spread in Covid-19 pandemic become instantaneous and uncontrollable due to the fast and modern air travel.

The economic crisis in 1918 Vs Covid-19 pandemic

Pandemic years(1918-1919) appeared the toughest years to the world due to the influenza outbreak and world war(I) at the same time, compounding the economic crisis. The economy suffered a collapse owing to the closing of business, unemployment and less GDP. Shortage of labour occurred due to more fatalities of young adults working class during the 1918 pandemic.

Perhaps, coronavirus is more infected to older people, assuming that it may not cause the labour shortage once clear. According to the world bank report, the 1918 pandemic caused approximately $800 billion loss however, the damage is expected to be greater.

Coronavirus pandemic has not ended yet, but millions of people are furloughed or redundant. As per reports, the U.S has reported 10.4% of redundancies during this time. Global market saw the first decline in Feb 2020, and later in March 2020, the market suffered a crushed (since 1987). The travel industry is badly affected, and the oil prices per barrel dropped to the lowest in the last 18 years ($20.6).

According to the world bank, the global economy is expected to shrink from 2.5 to 5 % this year.

Economy boosting efforts in 1918 Vs Covid-19 pandemic

As per researches, it took the world nearly 2-3 years to re-establish the economy after 1918 pandemic.

During Covid-19, countries are taking actions to uplift their economies such as England has bought easy money borrowing schemes and encouraging spending. However, economists have speculated that it would take many years to renormalize the employment levels as pre Covid-19.

Administrative role in defeating 1918 Vs Covid-19 pandemic

In1918, governmental bodies put toughened constraints to curb the viral control .People were gun-shoot and fined money if not abided by the rules, which resulted in a viral spread dropped to lesser than 50%. Also, lowest death rates attained in regions who implemented early lockdown. Whereas, people vaccinated for influenza virus in the 1940s.

Evidently, imposing social restrictions and the lockdown was proven useful in both past and Covid-19 pandemics.

Public support in 1918 Vs Covid-19 pandemic

There are insufficient or no data available to acknowledge the public contribution in controlling the 1918 influenza pandemic.

However, internet technology has quite helped to analyse public reaction and contribution amid Covid-19 pandemic. As per researched data, 45 to 99% of people had good knowledge about Covid-19. They had a positive attitude (24-93%). Nevertheless, practising the protective measures(washing hands, social distance and facemask use) were linked with education, marital status, financial status, religious belief, race, gender and age.


Since 2019, the whole world is fighting against Coronavirus outbreak, and it is uncertain how long it would last. Undoubtedly, we are living in the modernized era, using the technology and best modern healthcare facilities. Perhaps, most victims of catastrophes, like pandemics, are still from lower-income, less education and living in poor conditions. History from the past pandemics taught us that using correct intervention at the right time could be worthwhile to win against Coronavirus pandemic. Also, government contribution and public cooperation is the key to achieve a pandemic free world.


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