1918: "When the experts said ‘wear masks,’ people were like, ‘okay because I'd like to survive.’"
“In 2012, I published ‘American Pandemic,’ about the 1918 influenza pandemic that swept the world, killing at least 675,000 people in the United States. What has surprised me during the COVID-19 pandemic is how many parallels there are between how we are handling this current pandemic in 2020 and how our predecessors handled the pandemic in 1918. There are parallels in terms of what’s gone well and where we've seen terrible, terrible failures, both as individuals and as a national community.
What you need in the midst of a pandemic is strong and informed national leadership. They did not have it in 1918 and we did not have it in 2020. President Woodrow Wilson never spoke publicly of the influenza pandemic. 675,000 Americans died and he never spoke publicly of this event. He was so concerned that it would distract Americans from the war that he literally never spoke of it. He also refused to slow down the war. In the fall of 1918, when the really serious, second wave hit, he was unwilling to pause things.
Tragically, late September and October were scheduled to be the months for the fourth Liberty Loan drive. This was a huge fundraising effort to pay for the war without having to do it entirely by way of taxes. There was tremendous pressure on people to be patriotic and buy these government bonds. Cities across the country held massive parades and public events in late September and early October to kick off their Liberty Loans drives. In Philadelphia, there were more than 600 new cases three days after the parade. These big public events to push the bonds were devastating in spreading the virus across the nation. So not only did Wilson not pause things because of the war, he actually kept things going and then ignored the reality that the nation was under siege by a disease.
2020 was worse in some ways. President Trump was not silent, but instead misrepresented the circumstances right from the very beginning, whether it was his lies about what was in the stockpile for catastrophes, in terms of what was left behind by President Barack Obama, to the insanities that he murmured about the ways we might be able to use bleach to cure ourselves. He spread misinformation from the very beginning and at the very worst he politicized the use of the most basic public health measures - the wearing of masks and social distancing.
In 1918 and in 2020, a vacuum at the top put responsibility on the states and local communities. We've had the same scattershot approach they had in 1918, with some communities getting great leadership, some communities being left to flounder, and some communities being actively misled.
We know from the information from 1918 that quarantining, wearing masks, social distancing, and prohibiting large public events saves lives. The evidence from 1918 is very clear.
It's interesting to think about the comparison of masking in 1918 and masking in 2020 because in some ways we see again a really similar dynamic. In 1918, people were very frightened, particularly in the beginning. It was a very ugly disease and the symptoms were horrific to see. And the aid-giving was mostly happening at home, so people knew how frightening this thing was. It had a really immediate visceral impact on people. In addition, it was striking really quickly and it was killing young people. Almost half of the deaths were people between the ages of 20 and 40 in the United States. So there was a lot about it that was surprising and really frightening. People were looking for anything that might help them.
There was great hope that medicine could solve this problem. So when the experts said ‘wear masks,’ people were like, ‘okay because I'd like to survive.’ In places like San Francisco, they announced they were going to have a masking order and they ran out of masks at all the stores days before the law even went into effect because people were anxious to do what they could to protect themselves. Also, they were in the midst of a war and they were told they needed to be strong on the homefront to support the boys overseas. To fail to fight the flu was to serve the enemy in the war and those who did not wear masks were called slackers, the term used for those who refused the draft. So, by and large, they donned their masks and cooperated with the directives of public health officials.
One of the big differences between 1918 and now is that the public did not have to wear masks for months and months. Schools, churches, and businesses close for two or three weeks at the height of the spread. People wore masks for maybe five weeks. Six weeks would be a really long time. In many communities, it was quite a bit shorter because of the nature of the influenza and how fast it moved through, literally just burning through communities.
In 1918, though, there were successive waves, which wore down people’s willingness to limit activities and wear masks. The main wave in the fall of 1918 was followed up, in many communities, by another one during the winter of 1918-1919 and into the spring.
When this subsequent wave came through, people were much less willing to put on masks because they were suspicious. ‘This doesn't make sense to me because I wore a mask once before and yet people are still sick. So perhaps it doesn't really work.’ Also, with the ending of the war in November, people no longer had a patriotic reason to comply.
Now in 2020, we know the ways in which wearing masks, maintaining social distance, and not having large gatherings did help in 1918 and do help today. They didn't have the same capacity to do that kind of research in 1918. And yet, knowing all we know now . . .
On a last note, the thing I've been most surprised by, and this is me as an historian talking, is how much I didn't really understand about 1918. It's been so humbling to now live in the midst of a pandemic. What surprised me is the uncertainty and how comprehensive it is that you don't know what's going to happen. And I didn't understand that even in March and April.
Then it starts to wear on you that you don't know how long it will last. What is this virus? What should we be doing? What shouldn't we be doing? How do we deal with the economy? How many people are going to lose their jobs? What are the implications for my mother who is in her 90’s? When they get the vaccine, who will get a vaccine? When will I get a vaccine? When will, more importantly, my mother get a vaccine? That uncertainty is so profoundly affecting. And I didn't understand.
I never have understood fully, in my bones, as I've studied the past, that they don't know what's going to happen. I tell my students that all the time, ‘You realize they don't know what's going to happen, right? You have to try to put yourself in their shoes and they don't know what's coming next.’ We talk about that. But until you actually have to live it, it’s hard to really grasp it. It's been very useful for me as a teacher, and certainly as a scholar, to realize how little I had understood before living through this horrific time in which so many people are losing so much.”
– Nancy Bristow, Author of American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic (January 2021).