When Pandemics End

I’m teaching a course this semester on disability and epidemics, and this is my first class-inspired post. This week my students and I are thinking about the Influenza Pandemic of 1918-1919. This long-forgotten pandemic has received a lot of attention in recent years as 2018/2019 marked the 100 year anniversary of this global crisis. Because of this, journalists had access to a lot of high-quality, current research about the so-called "Spanish Flu," when COVID19 emerged. Few could miss the blatant parallels between that time, and ours: a world under extreme political and military duress (the flu ravaged troops during the tail-end of WWI), the striking black and white images of people wearing masks, school closures, hospital tents, and stacks of coffins. The similarities were ominous, eerie, and attention-grabbing. However, while there has been a lot of great coverage of the Influenza Pandemic over the past few years, less has been done to examine what happened after the Great Flu dissipated. And that, of course, is what our "Afterlives of Pandemics" project is really all about--what happens when pandemics end? How do their effects continue to ripple forward, into the future? How do they change us? And how might studying these historical moments help us to imagine building our world anew after the worst of COVID19 has passed?

The afterlife of the influenza pandemic hasn't received as much press as has it's staggering death toll (over 30 million with some estimates as high as 100 million). First, most people probably heard very little about the 1918-19 pandemic before COVID19 hit, and that’s because the world pretty quickly moved on and forgot about it after 1919. Considering how disruptive the pandemic was in terms of mortality, economic devastation, and political landscape, this seems striking and odd. Even more bizarre is that it’s not likely people could have actually forgotten about it even if they had wanted to—the 1918-1919 pandemic killed so many people in the prime of their adult lives that it created a generation of orphans. So many kids lost parents in Philadelphia, alone, that North Philadelphia’s Girard College saw a noticeable influx of applicants the following year—all had lost parents to the pandemic.

Around the nation, the situation looked similar. The New York Times reported in 1918 (before the pandemic had even ended) that approximately 21,000 children had lost one or both parents since the outbreak began. The trauma that children faced during this period has gone largely uninvestigated, but contemporary understandings of childhood trauma link these sorts of events to all manner of health risks and disabilities. In the nineteen teens and twenties, childcare norms stressed physical wellness, nutrition, and strict routines for psychological health. Today, however, pychologists and trauma-specialists point out that children who experience traumatic events, such as the loss of one or both parents for example, are more likely to have difficulty in school and to suffer from addiction, anxiety, depression, and PTSD.

Even today, however, providing trauma-informed care and education is far from routine for the children who arguably need it most. In addition to the link between trauma, illness, and disability later in life, there is the more material reality that kids whose families lost breadwinners would have found themselves in a highly precarious position--dependent on the kindness and support of family, or, if they were not quite so lucky, reliant on the services of religious charities. Children without a working male parent at this time would have found themselves living a much more tenuous existence filled with stress, uncertainty, and more often than not, poverty. The pandemic’s toll on pregnant women, young mothers, and their infants, too, was noticeably high. Data suggests that pregnant women were far more likely to fall seriously ill, suffer miscarriages, or die than women who were not pregnant. Infants who lost mothers would have borne the risks of bottle feeding at a time when not breastfeeding was still highly correlated with severe gastrointestinal and respiratory infections. In short, these are just some of the ways that the Great pandemic continued to make its mark on people’s lives in deep and intimate ways, even if most tried not to think about it, to move on, and forget.

My own family’s history carries some of the legacies of the 1918-19 pandemic. Family lore is that my Great-great grandfather, Bernard John Crandley, died after being weakened from a severe case of spinal meningitis that he contracted while stationed during World War I at an army base in Texas. His illness occurred in 1918, making it highly likely that it had something to do with the influenza, which ravaged the troops during WWI. In fact, there is extensive historical and epidemiological research linking surges in meningitis infections with influenza outbreaks. When he died, he left behind a wife and 8 children. In the same year, 1919, the family lost two grandparents (perhaps also related to the influenza, though the records are unclear). The family scraped by with a pension from the Army, but life became much, much harder.

The reality is that most of us, whether we know it or not, have family histories that were touched by the Influenza Pandemic of 1918-19. How will we, the survivors of our own generation's pandemic carry forward the memories, burdens, sickness, disabilities, and traumas of this time with us into the future? Learning more about pandemics of the past helps us to understand history better, but it also helps us ask better questions about the present—and the future. (Jessica Martucci, PhD, MBE)

Image credit: "2,000 Children Need Care: Measures Taken to Aid Children of Influenza Victims," The New York Times (November 9, 1918).

Sources:

Susan Kingsley Kent, The Influenza Pandemic of 1918-1919: A Brief History with Documents (Bedford/St. Martin's, Boston: 2013).

William E. Copeland, Lilly Shanahan, Jennifer Hinesley, et al. "Association of Childhood Trauma Exposure with Adult Psychiatric Disorders and Functional Outcomes," JAMA Netw Open. 2018;1(7):e184493. doi:10.1001/jamanetworkopen.2018.4493.

Brundage JF. Interactions between influenza and bacterial respiratory pathogens: implications for pandemic preparedness. Lancet Infect Dis. 2006;6(5):303-312. doi:10.1016/S1473-3099(06)70466-2.