Canada’s First Global Pandemic

Medically, scientifically and technologically we are light-years ahead of the Canadians who were caught in the nation’s first global pandemic. But the advice from today’s health authorities is strikingly similar to the guidance offered when the Spanish flu struck in 1918: Avoid large gatherings, don’t get close to anyone showing symptoms, drink lots of water, get plenty of outdoor exercise, help your neighbours and don’t overreact to newspaper reports.

That is not the only similarity. In both eras, public officials initially downplayed the crisis. In 1918 they assured Canadians that the influenza spreading across the land was less dangerous than measles or scarlet fever and urged them to go on with ordinary life. In 2020 the Prime Minister and provincial premiers initially insisted there was nothing to fear. Canada’s health system – tested by the SARS pandemic in 2003 – was robust and well-prepared. As hundreds fell ill, the tone of the Prime Minister and provincial premiers changed.

In both outbreaks, front-line doctors spoke out, urging political leaders to provide the resources they needed to cope. Quarantines and masks were tried with limited success. Schools, public institutions and places of entertainment were ordered to close.

Both epidemics set off panic buying: quinine and cough syrup a century ago; hand sanitizer and toilet paper today. Profiteers popped up, buying essentials in bulk then peddling them at double or triple the price.

There are significant differences, of course.

When the Spanish flu hit, Canada was struggling to get back on its feet after World War One, which had left 60,000 dead and 173,000 wounded. (Keep in mind that the country’s total population at the time was just 8 million). The economy was in a slump, fuel was scarce and people were weary of years of wartime shortages, rations and bad news from Europe. Today’s backdrop is more benign. When COVID-19 arrived, the economy, if not bullish, was growing. Shortages seldom occurred. People took for granted that Canada’s universal health-care system would be there when they needed it.

In 1918, people got their information from newspapers or by word-of-mouth. The flu was not front-page news. That was reserved for the fallout from the Great War. Today COVID-19 has obliterated all other news. Anxious Canadians can get an up-to-the-minute tally of the number infected and the economic and social impact at any time of the day or night on the Internet.

Testing wasn’t a priority during the Spanish Flu outbreak. People got sick so rapidly and became so miserable that they didn’t need a diagnosis. There was no talk of border controls in 1918. With soldiers, sailors, nurses and medics pouring back into Canada from the battle front, families wouldn’t have tolerated any obstruction. The source of the infection didn’t matter much to our forebears. Their priority was surviving.

1918, France — Patients lie in Influenza Ward No. 1 in U.S. Army Camp Hospital No. 45 in Aix-les-Baines, France, during World War I. | Location: Aix-les-Baines, France. — Image by © CORBIS

Finally, the influenza virus of 1918 behaved quite differently from the corona virus of today. It took its greatest toll on Canadians 20 to 40 years of age. People over 65 appear to be most vulnerable to COVID-19.

In this November 1918 photo made available by the Library of Congress a girl stands next to her sister lying in bed. The girl became so worried she telephoned the Red Cross Home Service who came to help the woman fight the influenza virus. No one knows the ultimate origin of that terrifying 1918 flu. But researchers hope they’re finally closing in on stronger flu shots, ways to boost much-needed protection against ordinary winter influenza and guard against future pandemics at the same time. (Library of Congress via AP)

It is too early to compare numbers. The Spanish flu took approximately 50,000 lives in Canada. In Paris alone, 41 people died in the pandemic. We don’t know what the toll of COVID-19 will be. As the pathogen spreads our best hope is that enhanced hygiene, self-isolation and social distancing will minimize the casualties.

What can we learn from Canada’s first global pandemic? Seven lessons stand out:

  • Frequent, credible communication from public health authorities is essential. When there is a vacuum, rumours and false information will multiply.
  • Governments must coordinate their messages and actions. We cannot afford to repeat the uncoordinated scramble of 1918.
  • Mass hospitalization of people with a rapidly-spreading virus is not useful. It heightens the risk of infection for doctors and nurses and crowds out those who truly need medical intervention.
  • A pandemic is the wrong time to constrain government spending. The government of 1918 was so tight-fisted when the Spanish flu pandemic struck that Prime Minister Robert Borden was shamed into setting up the Department of Health to share federal resources with the provinces.
  • Hoarding increases the economic hardship and social tensions triggered by a pandemic.
  • Don’t relax too soon. The Spanish flu left victims so severely weakened that many contracted pneumonia and died.
  • Citizens are often ahead of their governments. Without prompting, people unaffected by the 1918 flu virus filled in for exhausted nurses and orderlies. Townsfolk delivered food to quarantined neighbours.

We can see many of these lessons reflected in the policies announced by our governments amid the evolving COVID-19 crisis.

Times change. Technology advances. Science unlocks new possibilities. But the surest guide to handling a pandemic lies in our history.

by Carol Goar