The health crisis we are going through with the Covid-19 is the most important known by the USA for a century, when the Spanish flu hit Europe, in 1918 and 1919. Appeared in a context very different from the one we know today. Today, the epidemic killed 20 to 50 million people worldwide in two years, about four to five times more than the number of victims of the First World War.
It is the most serious pandemic known in history, ahead of the “black plague” of 1348 (34 million deaths according to estimates). This murderous episode also prompted the newly created League of Nations (SDN) to set up a Health Committee, the ancestor of the World Health Organization.
Originally from China, the disease then mutated in the United States. Why call it “Spanish flu”? Because Spain was the only state to freely publish information on the disease. Neutral during the war, the country was indeed not bound by military secrecy. Because of this context of conflict, and the state of health of the populations at the time, the current pandemic is very different from that of a century ago.
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A hygienic context very distinct from ours
According to historian Niall Johnson, the Spanish flu severely affected India (18 million dead, or 6% of its population), China (9 million) and Europe (2.3 million dead).
It was therefore characterized by a mortality 10 to 30 times higher than the seasonal flu, with a fatality rate between 2 and 5%. In the absence of antibiotics, the disease often caused death after ten days of painful symptoms, in exhausted and weakened individuals.
But let’s be reassured. If the proliferation of Spanish flu was so strong at the time, it was because the populations were not aware – unlike today – of the basic hygiene and precautionary measures to be taken: confinement, social distancing, handwashing… At the time, the Spanish flu spread in ocean liners filled with travelers who crossed the Atlantic and caused a particularly intense epidemic center on the Boston and California side. Quickly, the majority of large American cities were infected.
Population weakened by the conflict
In Europe, the virus was undoubtedly brought back by the American soldiers come in 1917 in reinforcement to help the Triple Entente in the war. In 1918, the virus spread exponentially: in two weeks, it covered the entire North American continent. The month of October 1918, a few weeks before the end of the war, was particularly deadly. The virus is all the more virulent and deadly there as the populations are then harassed by the conflict. Personalities like the poet Guillaume Apollinaire succumb to it, and in the United States, one in four nurses dies.
From Europe, the virus spreads to the colonies through ocean liners. In November 1918, when the end of the war was celebrated, the epidemic became a global pandemic, present on all continents. In Africa and Asia, the proportion of infected people fluctuates between 30 and 80%, due to the low level of hygiene, poverty and the poor situation of the colonized. Only Australia succeeds in setting up an effective quarantine system.
Lack of information
Why was there not much talk of this pandemic in the press at the time? Because of war censorship. In fact, the Spanish flu did not remain very present in collective memories, overshadowed by the very strong memory of the First World War, which was in the following years and decades widely celebrated by official ceremonies and by veterans.
After a lull in December 1918, the epidemic picked up again in 1919. Some countries even remained affected until 1920. Among the oddities linked to rumors and panic, the price of rum reputed to be an antidote, flames.
Medical staff on the front
Why did this flu appear at that time? As Professor Berche, a professor of microbiology at Necker Hospital (Paris), recalls, this is explained by “poor sanitary conditions, weak populations and large gatherings” linked to the context of the end of a long planetary war. five years old.
“The Spanish flu is thought to have first appeared in Kansas, where it infected young American soldiers, who were assembled three months in military training camps, at the rate of 50,000 to 70,000 individuals, before crossing the country. and set sail for Europe, ” adds the expert. Indeed, opinions still differ on the primary geographic origin of this virus.
As the science historian Guillaume Lachenal analyzes, at the height of the epidemic, in the fall of 1918, the medical response was completely unsuitable: “Lack of beds, drugs and especially staff, doctors, nurses and nurses – who are also among the first victims of the disease – being massively mobilized on the front. The military authorities act blindly, leaving patients on leave to spread the flu throughout the country while doing their best to identify the cases, thanks to a careful and discreet bureaucracy – censorship requires.”
Spanish flu at the origins of WHO
The epidemic was a catalyst for pushing for the creation of an international organization devoted to global health.
Already in 1907, the “Office international hygiene Publique” (OIHP) had been created in Paris, equipped with a permanent secretariat and a “permanent committee” which organized several conferences. But in 1918-1919, the United States objected to the OIHP coming under the control of the newly created League of Nations (League of Nations), to which it did not join – the United States Congress speaking out against this. adhesion, in the name of isolationism.
In the interwar period, the Organization continued its action, however, and in 1926 adopted an International Sanitary Convention containing for the first time provisions relating to smallpox and typhus. Until the Second World War, two separate international health organizations coexisted in Europe, the OIHP and the Health Organization of the League of Nations. On the American continent, the Pan American Sanitary Organization is trying to set up continental health governance.
Finally, it was not until the end of the Second World War and the creation of the United Nations in 1945 that a specialized health agency, WHO, was created, and based in Geneva, in 1948. Its mission is to lead the world’s population to “the highest level of health possible”.
Covid-19, an unprecedented challenge for WHO
The current media coverage of influenza alerts should not, however, make us forget that in daily life, for years, other diseases have been much more deadly – especially for the peoples of the countries affected by poverty in the South. Malaria kills 400,000 people a year, and AIDS, considered since 2002 as a global pandemic, currently kills 770,000 people a year (compared to 2 million a year a dozen years ago).
On March 11, 2020, the WHO announced the pandemic alert and deplored the inaction of governments to fight this virus. “We are very concerned about the levels of dissemination and dangerousness, as well as the alarming levels of state inaction,” said WHO Director-General Ethiopian Tedros Adhanom Ghebreyesus.
In just three months, nearly 120,000 cases of coronavirus have occurred in 110 countries, killing more than 6,000 people. States react distinctly, each in their own way, to this pandemic crisis. The European Union is just beginning to organize its activities.
At the global level, it is now up to WHO to coordinate the measures to be taken, in a democratic and humanist spirit, and in particular to ensure that the poorest populations are not abandoned and that States cooperate between them to defeat the disease. An unprecedented test for this organization, which will reveal its strength or its fragility.