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'Pandemics kill just as much as nuclear bombs': Historians warn about dangers of reopening too soon

Lessons of 1918 as Denver lockdown expires
A Pandemic And A Parade: What 1918 tells us about flattening the curve
Posted at 4:54 PM, May 04, 2020
and last updated 2020-05-05 13:05:51-04

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DENVER — A new influential coronavirus model, often cited by the White House, has increased its COVID-19 death projections in the U.S. from 72,000 to 135,000.

The updated projection comes, in part, because of relaxed social distancing guidelines – and just as the City of Denver is set to scale back stay-at-home orders later this week.

The revision serves as a warning shot across many states, including Colorado, and harkens back lessons learned from the Spanish Flu pandemic of 1918.

It's been said that if we don't learn from the past, we are doomed to repeat it.

"We were - in a way - head in the sand, I think," said Denver historian Dr. Stephen Leonard, a professor of history at Metropolitan State University of Denver. "Denver officials didn't see (the Spanish flu) coming even though it was ravaging the East Coast."

Historians like Leonard say the parallels between 1918 and what we're all living through today are strikingly similar.

Theaters and schools were closed, and "public meetings indoors were forbidden," according to reports in the Denver Post at the time. "Officials advised (people to) wear masks," and the football season was canceled.

Even Denver Mayor Robert Speer died halfway through his third term in office of influenza.

"It is blamed for killing Denver's mayor, Robert Speer," Leonard said. "He died on May 14, 1918, of what was called 'the grip' at the time. They weren't calling it the flu at that point."

It didn't get its name until that fall when outbreaks started around the globe. Denver experienced two waves of death in the fall of 1918. The second wave was much worse because historians say public officials bowed under tremendous pressure to reopen the city.

"Because we reopened, we were hit with a resurgence of the spread," Leonard said.

He says everything at the time was a 'halfway measure.'

"By October the 5th, we were doing some things. We were banning indoor meetings, church services, we closed schools," Leonard said. "But it was not effective in many ways because restaurants were still open, department stores were open with revised hours. Under pressure, theaters were closed, and then they were reopened, then they were closed again, and then they were reopened after one day the second time."

In Colorado, the Spanish Flu killed 8,000 people. In the U.S., nearly 675,000 people died.

"That's more than all the American deaths in all the wars in the 20th and the 21st centuries," Leonard said. "It took the nation by storm."

And the pandemic was happening at the same time as WWI.

"the country was going through two traumas at once," Leonard said.

Dr. Susan Schulten, a professor of history at the University of Denver, says a potential birthplace of the bird-flu like 1918 virus was quite close to Colorado.

"The best information that we have now is that it probably originated pretty near Colorado, in Haskell County, Kansas," Schulten said.

Haskell County sits in the pathway of several bird flyaway migrations.

"And the theory is that a bird may have infected a hog farm and the virus mutated within hogs into a much more lethal form that could infect humans," Schulten said. "Those who were infected sought treatment at nearby Camp Funston, which is at Fort Riley. Many, many young men were there being trained to be deployed overseas in the First World War."

Schulten was careful to point out that these are all theories.

"I want to be careful that we're speculating here," she said.

Many new or novel viruses do come from animals and pass on to humans after close contact in a process called zoonotic spillover, much like the 2009 Swine flu.

Most viruses then spread through movement of people.

"In WWI, it was due to massive troop movements to and from Europe," said Dr. John Hammer with Health One and Rose Medical Center in Denver.

"Today, it's business and personal travel," Hammer said. "For example, Chinese traveling internationally now travel four times more than they did just 10 years ago."

The 1918 pandemic was Spanish only in name.

"Having it named the Spanish flu is just an absolute misnomer," Leonard said.

It got that name because Spain was not involved in the war," Hammer said. "So, newspapers were not censured like other parts of Europe. Spain was the only country allowed to report illnesses and death."

Hammer says while there are many similarities, the 1918 flu was primarily a respiratory virus, while COVID-19 has symptoms all over the place.

"Maybe a cough and sore throat, maybe profound fatigue," Hammer said. "Maybe the loss of taste and smell."

And while COVID-19 attacks the vulnerable, like the elderly and those with compromised immune systems, Spanish flu attacked those in the prime of their lives, between 18 and 60 years old.

"What we saw was a pattern where young, healthy adults were the primary target," Hammer said.

"It was roughest and deadliest for people who you would consider to be the healthiest," Schulten said.

It's believed older adults had already gone through a less-reported pandemic in the 1890s.

"One theory is that pandemic gave a certain number of people immunity to the 1918 flu," Leonard said.

While the pandemic lasted nearly two years, the vast majority of deaths were packed into three exceptionally cruel months – October, November and December of 1918.

Eventually, 1,500 would die in Denver.

"That would be comparable to having 15,000 people die today," Leonard said.

In 1918, just like today, the economic toll was disastrous.

"By late October, you are seeing push back, largely by business owners," Schulten said. "The owners of theaters, for instance, are saying – why is it fair that people can congregate in department stores, but not in our live and film theater houses?"

And just like the rallies today, there was major push back.

"We're living through it now, and we see the very real costs," Schulten said. "It's not just quarantine fatigue -- it's the very real economic costs."

And at the end of WWI on Armistice Day, despite warnings, thousands flooded streets nationwide to celebrate.

"On Armistice Day - the end of the war - there are mass celebrations all over the United States, and Denver is part of that," Schulten said. "In gathering, what they do is lay the groundwork for a second surge."

"Probably more than 100,000 people into the streets during part of the day," Leonard said.

And that might be our biggest takeaway.

Both historians and doctors praise the way Americans have reacted this time around. Hammer says hospital admissions for COVID-19 are down sharply.

"The numbers coming in have slowed significantly over the course of the past several weeks," Hammer said.

Our ability to stay at home is starkly different than in 1918.

"It's been huge," Hammer said. "It essentially saved our health care capacity."

"We've done a better job this time around," Leonard said.

Leonard says continued success will depend on pinpointing surge points.

"We must be able to do things like contact tracing and testing," he said.

"While balancing the economy against public health at the same time," Schulten said. "Learning about the Spanish flu while living through our current moment has made me a lot more humble about judging the past."

"We've learned that you can't act too soon," Leonard said. "It started as early as March 1918 in a much weaker form, then migrated to Europe through troops and then came back to the U.S. in the fall of 1918 with a vengeance. It swept through military camps. In a lot of cases, that was the vector for transmission."

"What happens in Europe is that it mutates into deadlier form, and when it comes back to the U.S. again through soldiers in the fall of 1918, it was much deadlier and lethal," Schulten said. "It's not immediately clear in September that this is the same disease that Coloradans have heard about abroad. It really doesn't come to the attention of city and state leaders until the very, very end of September. And that's when it really becomes urgent overnight."

Leonard says if we let down our guard too soon, there's no question there could be a second wave of COVID-19 this fall or even this summer.

"In 1918 – we knew it was coming, and we still really didn't prepare for it very well," Leonard said. "We can't make that mistake again. Even in 1919 – it lingered."

Leonard says we don't put a fraction of the money we put into civil defense into pandemic defense.

"It's an absolute mystery to me why we don't learn from these horrendous events," Leonard said. "Pandemics will kill us just as much as nuclear bombs might. This is a wake-up call."