“Pandemics do not end in style”

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There is a quiet corner to the far east of Dublin’s Glasnevin Cemetery. Few tombs here are maintained. The remains of men, women and children of all rest here. Some of the same family, most of them forgotten victims of a largely forgotten chapter in Irish history.

The Spanish flu pandemic hit Ireland during one of the most tumultuous times in modern history. World War I was still ongoing, and it was the period between the end of the Easter Rising and the start of the Revolutionary War.

Although there are no plaques or monuments to mark it, the Spanish Flu provided one of the greatest single events in the cemetery’s history. People were dying so quickly and in such large numbers that the gravediggers simply couldn’t keep up, working overtime as coffins piled into the vaults.

Globally, 50 million lives have been claimed by the Spanish flu, at least 20,000 of them here in Ireland, where 800,000 have been infected.

Some 100 years later, does the Spanish Flu have any lessons to learn from the current pandemic, particularly about how it ended and what the future might hold?

Gravediggers at Glasnevin Cemetery simply couldn’t keep up during the Spanish Flu

The world wasn’t as connected as it was in 2022, but people were still on the move in 1918.

Ireland’s rail network was the most extensive and proved to be very effective in spreading the flu virus throughout the country. Infected passengers entered through ports – soldiers returning from war and civilians – and from there onto trains.

In Rathvilly, Co Carlow, what was once a ticket office for the station is now a private home. The station has been closed for 60 years.

In towns like Rathvilly all over Ireland, the Spanish Flu has forced people into effective lockdown.

“Whole communities would go silent,” Dr. Ida Milne, a historian who has researched the Spanish flu extensively, told Prime Time.

“People were staying home maybe because their families had caught the flu or maybe they were afraid of getting it.”

Sporting events were cancelled, the local school in Rathvilly closed and locals were fed milk churns of soup brought in from the large house nearby, she said.

Newspaper clippings from the time reflect familiar themes of the past two years: debates over school closures, a health service under extreme pressure, not to mention the extraordinary claims made about the products and their usefulness in treating or infection prevention.

The Spanish flu pandemic had three distinct waves in Ireland

After three separate waves over the course of a year, the pandemic has come to an end, but not to a complete halt.

“Pandemics don’t end with a bang – they end with a fizzle,” said Dr Milne, author of Stacking The Coffins: Influenza, War and Revolution in Ireland 1918-1919.

This was certainly the case with the Spanish flu. The flu came and went sporadically, taking lives with it each time.

“You would often see small harvests of it across the country or in different parts of the world. Parts of the Nordic countries had a fourth wave in 1920 – and the same in South America.”

The result, she said, was that people were very nervous about the prospect of another outbreak.

The societal changes of the 1920s were partly driven by the experience of the Spanish flu, particularly in the area of ​​health.

There has been a change in the way we treat sickness and disease as Western societies in particular have moved towards a centralized healthcare system, one of the factors that has pushed people from rural areas to move to towns.

But will the lessons learned during the Covid pandemic also lead us to positive change?

Cathal Friel, executive chairman of Open Orphan, thinks so.

The pandemic saw the dawn of mRNA vaccines

Having been at the forefront of his company’s work in testing and developing vaccines, he says the developments made in response to Covid will benefit us for many years to come, especially in the dawn of mRNA vaccines.

“I think we have two very, very exciting decades ahead. People are going to be much healthier as we move forward,” Friel said.

He also believes the pandemic will allow people to take a step back from cities.

“After the pandemic, I think you will see people flourishing, returning to remote work in rural villages.”

Friel is confident the Omicron wave signals the pandemic is coming to an end, saying it will end similarly to the Spanish flu, with deaths coming to an end and those infected showing symptoms much less severe than previous variants.

“They don’t go away, but people get immunity, people stop getting sick and people learn to live with them. We’re in that final phase and I’m extremely optimistic.”

Professor Peter Hotez, dean of the National School Tropical Medicine at the Baylor School of Medicine in Texas, is less optimistic.

While he understands everyone is exhausted, he said it was premature to call this the end.

Spanish flu survivors suffered poor physical health for many years after infection

“I don’t think we’re going to see much in terms of lasting or long-lasting immunity,” Professor Hotez told Prime Time.

“I think it will look like other upper respiratory coronaviruses and produce short-lived protection and we will be just as vulnerable to the next variant that could come from the African continent, Asia, Latin America, everything. like the last two variants.”

A theory in virology and epidemiology circles is that viruses don’t want to kill us – that they mutate and adapt to give themselves the best chance of survival and being transmitted to another host.

But, although this is the case with omicron – a more transmissible but less pathogenic variant, it would be foolish to make predictions about what Covid-19 will do next, said Dr Rodney E Rohde, chair of the science program State of Texas Clinical Laboratory. University.

“People say they can predict the behavior of a virus. My comment is that it makes us all look very dumb.”

“I have absolutely no confidence [viruses] at all due to their nature of being able to adapt faster than human beings and other animals and things. I think we are getting closer but I wouldn’t be surprised if we had a really big surprise next winter.”

The current pandemic will end, like all pandemics. With the Spanish flu, its effects continued for some time. Dr. Milne told Prime Time that survivors suffered from poor physical health for many years after infection.

The Spanish flu was deeply traumatic for families

Some studies have suggested a link between influenza and the onset in later years of other medical conditions.

Families have been devastated by the loss of parents and children, sometimes both. Not only that, but the upheaval and trauma caused by the pandemic seem to have left lasting anxiety in those who have lived through it.

Once again, the flu was rarely mentioned. Dr Milne said interviews she conducted suggest people were simply afraid he would return.

“It’s very interesting that we don’t talk about something like the Spanish flu and my interviews suggested that the reason we don’t talk about it was because it was so deeply traumatic for their families, even though it affected them very, very badly.”

A century later, the parallels with Covid-19 are clear, but it will be some time before the full impact on the physical health of those who survived Covid and on the mental well-being of the population as a whole really be known.

Even then, Professor Peter Hotez thinks it will be profound.

The upheaval of Covid-19 could cause lasting psychological damage to people

“There is a small doubt that this Covid-19 pandemic will leave indelible marks on us and will haunt us for many years to come.”

“We are still at the beginning of understanding what Covid has been doing for a long time in terms of long-term neurological damage, as well as cardiopulmonary effects,” he said.

“But it goes beyond that. I think there is the psychological damage to populations, due to all the upheaval and social upheaval that is happening because of Covid.”

Of course, in both pandemics, the greatest impact has been on those who lost their lives and the families they left behind. Glasnevin Cemetery now provides a final resting place for victims of both pandemics, split by a century in time – but only a short physical distance away.

In 2022, the world is a very different place than it was when the Spanish flu claimed 50 million lives. Vaccines then came too late, but they may have turned the tide now for Covid-19. Medications and hospital treatments have come a long way. Covid-19 will leave behind a changed population in a changed world.

The current pandemic will end, the immediate threat of the virus will diminish, but its consequences could still be with us for many years to come.

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