The Pandemics of 1918 vs. 2020

by Ana Wang

In these times of the COVID-19 pandemic, you have probably heard many mentions and comparisons of this current, world-wide crisis to the 1918 flu (a.k.a. the Spanish Flu) pandemic. In difficult times in our history, re-visiting and learning from past events can teach us much about how to handle modern, similar situations. There are many parallels that between the pandemics of 1918 and 2020, so let’s delve a little deeper into what happened 100 years ago and see how it relates to our world today.

What is a pandemic?

WWI soldiers being treated during the 1918 pandemic. American Unofficial Collection of World War I Photographs, Getty Images

A pandemic is when a disease has spread throughout a country, continent, or the world. This is different from an epidemic, which is a rapid spread of a disease within a locality, like a community or a region. The 1918 influenza (shortened to “flu”) and the 2020 COVID-19 outbreaks are both global pandemics because there have been (and still are) cases all around the world. It is estimated that the 1918 pandemic claimed about 50 million lives. As of this writing, the 2020 pandemic has claimed about 2.2 million lives.

How did the 1918 and 2020 pandemics start, and how did they spread?  

In the industrial era of 1918, there were new forms of transportation that helped the flu spread more quickly, not to mention an ongoing world war. Now, in the 21st century, we live in an extremely globalized society, in which people travel very frequently, for both pleasure and for business, around the world. This unfortunately allows viruses to spread around the world at a quick pace.

Viruses are not living organisms; they require a host (e.g. humans) to reproduce. A virus reproduces by hijacking the biological processes and tools in its hosts’ cells to replicate itself. People who are carrying a virus can spread that virus unknowingly to anybody with whom they come into contact. This is why many countries during the COVID-19 pandemic have implemented travel bans and discouraged travel.

Although the 1918 flu is informally known as the Spanish flu, the name is misleading, as it likely did not originate in Spain. The name stuck because the Spanish press was the first to publish information about the pandemic; Spain was neutral in World War I, and news of the war dominated the press of the countries involved in it. Furthermore, many countries censored the publication of information about the pandemic because they were afraid of causing public panic. There are several hypotheses about where the 1918 virus originated, and none of them trace back to Spain.

Similarly, during the 2020 pandemic, COVID-19 was referred to by many as the “China virus,” or the “Wuhan flu” because the first diagnosed and publicized cases occurred in Wuhan in the Hubei province of China. Theories about the virus’s origins say that the virus escaped or was released from a research lab in Wuhan. This is highly unlikely as genetic mapping shows that the virus was born in nature, not a lab. The exact origin point of the virus is not known. Additionally, the name “Wuhan flu” is misleading as COVID-19 is caused by SARS-CoV-2 - an entirely different virus from influenza. (SAR-CoV-2 is the name of the virus that causes COVID-19, the disease. Science has separate names for the virus itself and the resulting illness).

A checklist of symptoms caused by the 1918 H1N1 virus. By Otis Historical Archives nat'l Museum of Health & medicine (OTIS Archive 1) -

The 1918 flu was caused by the H1N1 virus. (You may recognize the name ‘H1N1;” it was a different H1N1 virus that caused the “swine flu” in 2009-2010). One of the first documented and established cases of an infection by the H1N1 virus, the virus that caused the 1918 flu, was on March 4, 1918 in a cook named Albert Gitchel at Camp Fuston in Kansas. Within only three weeks, that one case led to thousands of cases, with 1,100 soldiers hospitalized. H1N1 was further spread throughout Europe, wreaking havoc on the World War I military operations. Although this first wave of infections showed that the virus was very contagious (meaning it spread easily), it was not initially extremely virulent (meaning harmful or deadly). However, the virus soon underwent a dangerous change. 

A model of the Coronavirus virion structure. By SPQR10 - Own work, CC BY-SA 4.0

Mutations  and new virus strains

Why do viruses change? When a virus finds a host (meaning it infects an organism), it uses the host’s machinery in the cell to reproduce itself. This involves a very rapid process of making copies of the viral genes for the new virus particles being made. The speed helps the virus replicate quickly, allowing it to infect more cells quickly before being detected and attacked by your immune system. During this process, copying errors occur. Think about when you are doing work or typing/writing very quickly; you are more likely to make mistakes when you are rushing than when you take your time. These copying errors, or mutations, get packaged into new virus particles. Some of these errors may have no effect at all, while other errors can make the new virus more contagious and/or more harmful for hosts.

A more dangerous virus emerged in August 1918, when there was a second wave of H1N1 infections. This new strain was believed to have been spread by passengers on ships from Plymouth, England to Sierra Leone and to Boston, USA. The virus was further carried with the movements of the armies, so you can imagine how expansively and quickly it spread across all continents! In the first strain, there were mild, short-lived symptoms that we generally associate with the flu, such as fever, aches, and coughing. In this new, mutated strain, symptoms included nasal hemorrhage, pneumonia, encephalitis, deadly fevers, and coma. 

If you are keeping up with the COVID-19 pandemic, you have undoubtedly heard about the new strains that have been recently identified in the U.K. and South Africa and are already spreading to other parts of the world. Although copying errors of viral genes are happening all the time, and therefore new mutants are being made all the time, most often these strains do not have a noticeable effect on the transmission or severity of the virus. Once in a while, however, a mutant strain will catch our attention. In the U.K. and South African mutants, the copying errors that occurred may have rendered the SARS-CoV-2 virus more contagious and possibly more virulent. Even more concerning is that the vaccines that have been produced might not be as effective against the South African strain. To be clear, the vaccines do appear to provide protection against the new strains, but they are less effective.  

Why the speed of vaccination is crucial

Now that you understand the phenomenon of how new virus strains are created, you can understand why it is so important to get pandemics under control quickly. The more cases of disease there are, the more virus that is produced. The more virus that is produced, the more mutations that can occur. The more mutations that occur, the more likely we will have cases that can cause more and deeper problems with elusive solutions.

Children lined up for the flu shot in New York City, late 1940s. Library of Congress.

To put it plainly, if the virus continues to spread uncontrolled, new strains will pop up that may be more transmissible or more deadly than any we have seen so far. Vaccines not only fight spread of the current virus, but decrease the chances of new, even deadlier strains emerging.

A sign from the Cincinnati Board of Health Streetcar, educating people how to protect themselves from the flu. CDC.

Until we are all vaccinated, other measures to contain the virus need to be continued. Because we have long known that viral infections spread largely by human-to-human contact, similar guidelines implemented in 1918 are being used today; wearing masks, limiting gathering, and avoiding stuffy, indoor environments have been known to be effective for fighting pandemics for over 100 years!

Lessons Learned

What can we learn from the 1918 pandemic that will help us manage current and future pandemics? Although H1N1 and SAR-CoV-2 are different viruses, the way they spread and their economic, social, and medical impacts can be very similar. Although we understand much more about viruses now than was known in 1918, and even though we have improved treatments for symptoms, the goals in both cases are the same:  to minimize the number of cases to limit damage.

The blue “circles” here are SARS-CoV-2 in a slice of tissues as seen through a transmission electron microscopic. PHIL 23354, CDC.

To control spread of the virus we need to follow the guidelines given by the Centers of Disease Control and Prevention (CDC). To protect yourself and those around you, remember to wash your hands, wear a mask over both your nose and mouth, stay in well ventilated areas, avoid large or close gatherings, and get vaccinated when it is your turn. The actions of every individual matters in a crisis this large. The more that people follow the guidelines, the more quickly and more safely we can end the crisis. Although it’s been a hard year for most of us, the vaccine brings hope for easier times soon. Every time you make the decision to stay at home, wear a mask, or engage only in outdoor physically distanced activities, you are saving lives!

References

“‘The 1918 flu is still with us’: The deadliest pandemic ever is still causing problems today.” The Washington Post. https://www.washingtonpost.com/history/2020/09/01/1918-flu-pandemic-end/. 30 January 2021.

“The Spanish Influenza Pandemic: a lesson from history 100 years after 1918.” Journal of Preventive Medicine and Hygiene. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477554/. 30 January 2021.

“The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus.” Centers for Disease Control and Prevention. https://www.cdc.gov/flu/pandemic-resources/reconstruction-1918-virus.html. 30 January 2021.

“Medical Innovations: From the 1918 Pandemic to a Flu Vaccine.” The National World War II Museum, New Orleans. https://www.nationalww2museum.org/war/articles/medical-innovations-1918-flu. 30 January 2021.

“Pandemics in Recent History.” Knowable Magazine. https://knowablemagazine.org/article/health-disease/2020/pandemics-recent-history. 30 January 2021.

“Why the Second Wave of the 1918 Flu Pandemic Was So Deadly.” History. https://www.history.com/news/spanish-flu-second-wave-resurgence. 30 January 2021.

“The Proximal Origin of SARS-CoV-2.” Nature Medicine. https://www.nature.com/articles/s41591-020-0820-9?fbclid=IwAR3w65RgILi01mVjIMQ2LKeZS4xUkLz5LRBinImTKRPOWSnCqIQWw_hDzR0. 31 January 2021.

Ocean Acidification & Its Impacts

Beach in Oahu, Hawaii

With warm weather and summer vacation just around the corner, it is difficult to escape the draw of our oceans and beaches. Almost all of us, especially here in San Diego and other beachside cities, have stories to tell about our oceans, whether it is a fond memory from a family trip to the beach, a fishing voyage with friends, or a solo surf session by a pier at sunset. However, the oceans also tell us stories, and the narrative becoming clearer and more imminent is that of the declining health of our oceans.

A factory in China. The Industrial Revolution brought about a reliance on burning fossil fuels for energy, which pumps large amounts of carbon dioxide and pollutants into our environment.

Since the Industrial Revolution, the use of fossil fuel-powered machinery has emitted billions of tons of carbon dioxide along with other gases into our atmosphere. Today, it is estimated that one million tons of carbon dioxide are emitted every hour – that’s a faster rate than has existed on our planet in tens of millions of years. Our oceans and seas absorb up to one-third of these gas emissions. This helps all of us on land because these greenhouse gases are taken out of the atmosphere, slowing down climate change. But, still, this comes at a cost.  

All solutions are acids or bases, and the acidity or basicity of a solution is defined by its pH value. A pH of 7 is neutral - the pH of pure water. Above pH 7 is basic, and below pH 7 is acidic. The surfaces of our oceans are healthiest when they are slightly basic with a pH of 8.2. Because of the large amounts of carbon dioxide entering our atmosphere, the pH of our oceans is decreasing, which is a process called ocean acidification.

A scientist in Svalbard, Norway studying the effects of climate change on the oceans' chemistry. 

Because of ocean acidifications, our oceans are now at pH 8.1, and at the current rate, the ocean’s pH is predicted to drop about 0.5 pH units before the end of the century! At a glance, this may seem like a small or insignificant change, but it is enough to cause very serious problems in biological systems. For example, human blood is normally between a pH of 7.35 and 7.45. A drop in pH of 0.2-0.3 can cause seizures, comas, and death. You can imagine the large impact such a change can have on an ecosystem that takes up over 70% of our planet! About 250 million years ago, large levels of volcanic activity caused a similar level of ocean acidification, and this change contributed to the death of 90% of marine species.

So, how does ocean acidification occur? Carbon dioxide in our atmosphere dissolves in water to make a molecule called carbonic acid, so as our oceans continue to absorb carbon dioxide, the waters become increasingly acidic. In the past, basic molecules created by weathering rocks and sediments were enough to balance the carbonic acid and keep the oceans at their ideal 8.2 pH. However, rock erosion is not fast enough to keep up with acidification caused by an increasing excess of carbon dioxide released into our atmosphere.

An experiment showing how acidic waters dissolve marine organisms' shells.

Such a rapid change in our oceans’ chemistry is not compatible with our marine organisms, which have evolved over millions of years in an ocean with a stable pH of 8.2. Ocean acidification affects marine organisms’ ability to communicate, reproduce, and grow. For example, at a healthy pH, about 10% of the carbon dioxide dissolved in the water exists as a molecule called carbonate. To make their shells, marine organisms like corals, clams, mussels, and oysters combine calcium with carbonate. Acidic waters have less carbonate, making it difficult for these animals to survive. Furthermore, acidic waters can chemically change the carbonate in the organisms’ shells to slowly dissolve them.

Acidic waters also lower the pH of the body fluids in all marine life, such as fishes, making it difficult for them to breathe and for their brains to function. It’s similar to if the air we breathe changed. If you have ever been at high elevation in the mountains where there is less oxygen in the air, you might have had a similar experience with difficulties breathing or headaches.

Coral reefs in the Red Sea

In addition to harming marine life, ocean acidification is hurting certain industries, creating economic stress. There is a decline in commercial fisheries, especially those that trade in lobster, scallops, and other shellfish. California, which is home to 31 different kinds of salmon and trout, is predicted to lose 23 of these species within the next century. More gravely, in many fishing villages in Indonesia, The Philippines, and Malaysia, fishing is necessary for survival. Hundreds of communities like these around the world must fish to feed themselves, so the depletion of their food source is a serious issue.

Fortunately, ocean acidification is a somewhat gradual process, giving us time to recognize the impact of human activity and change our behaviors to lessen harmful disruption to our oceans. To lower your own individual carbon dioxide emissions (or “carbon footprint”), you can use less electricity, recycle, and reducing use of your car by biking, walking, or using public transportation instead. If you want to find out your carbon footprint, you can visit The Nature Conservancy’s calculator here. More powerful ways to help the oceans are to support political measures that combat increasing carbon emissions and to donate to or volunteer with local organizations that champion environmental causes. One example is the Surfrider Foundation - an international organization that promotes the health of our oceans and beaches. 

Fishermen in Pangadaran, Indonesia

Carbon dioxide is estimated to exist in the atmosphere for hundreds of years, so even if we cut off all carbon emissions today, we will not see a reversal of ocean acidification immediately. By teaching all of our friends and family about how we affect our environment, and by encouraging everyone to reduce our carbon footprints, we can thank our oceans for all that they give to us and ensure that our beautiful oceans and all of its organisms will exist in the future.

For another informative post about ocean acidification, check out John Hawthorne's article https://moboxmarine.com/blog/oceans-are-getting-acidic/

References

·      Bland, Alistair. “Many Of California’s Salmon Populations Unlikely To Survive The Century.”  The Salt. NPR, 17 May 2017. http://www.npr.org/sections/thesalt/2017/05/17/528826774/many-of-california-s-salmon-populations-unlikely-to-survive-the-century. 19 May 2017.

·      Brewer, Peter G. and James Barry. “Rising Acidity in the Ocean: The Other CO2 Problem.” Sustainability. Scientific American, 1 September 2008. https://www.scientificamerican.com/article/rising-acidity-in-the-ocean/. 17 May 2017.

·       “Ocean Acidification.” Pristine Seas. National Geographic. http://ocean.nationalgeographic.com/ocean/explore/pristine-seas/critical-issues-ocean-acidification/. 18 May 2017.

·      “Ocean Acidification.” The Ocean Portal Team and Jennifer Bennett. Ocean Portal. Smithsonian National Museum of Natural History. http://ocean.si.edu/ocean-acidification. 18 May 2017.

·       “Ocean Acidification.” Know Your Ocean. Woods Hole Oceanographic Institute. http://www.whoi.edu/ocean-acidification/. 16 May 2017.

Images:
All images used were found on Wikimedia Commons and are Public Domain