The second wave of the Spanish flu exhibited an unusual curve; high numbers of deaths among the young and elderly, but also a huge spike in the middle composed of otherwise healthy 25- to 35-year-olds. In just one month, October 1918, an estimated 195,000 Americans died from the particularly virulent flu. As shocking as the deaths were, it was the speed and severity that shocked doctors.
Healthy young patients were reporting symptoms in the morning and dying that evening. The virus was triggering a phenomenon now known as “cytokine explosion.” When the human body is being attacked by a virus, the immune system sends messenger proteins called cytokines to promote helpful inflammation. But some strains of the flu, such as that responsible for the Spanish flu outbreak, trigger a dangerous immune overreaction in healthy individuals. In those cases, the body is overloaded with cytokines leading to severe inflammation and the fatal buildup of fluid in the lungs. British military doctors conducting autopsies on soldiers killed by this second wave of the Spanish flu described the heavy damage to the lungs as akin to the effects of chemical warfare. And they also noticed damage to other major organs. As early as mid-summer doctors began petitioning public health officials to initiate a quarantine. In the United States and Britain, the doctors were censored and prohibited from publicly expressing their concerns. Health services were ordered to distribute reassuring messages, and in Britain a government official named Arthur Newsholme was threatened with imprisonment when he began advocating for a strict civilian lockdown. Such a measure would have devastated the war effort and resulted in factory closures.
In the United States efforts to restrain with the growing pandemic were further hampered by a severe shortage of doctors and nurses as thousands had been deployed to military bases and
front lines military hospitals. This problem was magnified when by the American Red Cross’s refusal to use trained African American nurses. But one of the chief reasons that the Spanish flu claimed so many lives in 1918 and 1919 was that science did not have the tools to develop a vaccine for the virus nor adequate understanding of infectious disease control.
Though the pandemic has been a subject of renewed interest in 2020, it remains a nearly forgotten chapter in history. And yet the ramifications were far reaching. Thousands of children
were orphaned. The deaths and quarantines implemented in 1919 were contributing factors in the major post war recession that set the stage for a decade of rural bank closures. Resultant of President Wilson’s infection during attendance of the peace conferences in Europe he was unable to negotiate his plans for the League of Nations. He was also unable to stand against the harsh demand for German reparations that economically crippled that country, a situation that led to the rise of Adolf Hitler.
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