After I read about Hemingway’s Spanish travels, I asked Mom whether her parents ever mentioned the Spanish Flu to her. Hemingway first visited Spain five years after the Spanish Flue pandemic. My grandparents were about the same age as Hemingway, my grandmother a teenage girl and my grandfather a Navy sailor during the Spanish flu. Mom couldn’t remember my grandparents talking about the Spanish Flu. She did remember the polio quarantine when she was a child, having to spend a summer in the backyard. Since most of what we talk about now is Covid-19, Mom was a little surprised in retrospect that her parents hadn’t spoken to her about the Spanish Flu.
Yesterday Carol posted a comparison between the 1918-19 Spanish Flu outbreak and Covid-19. The article notes the difference in the different economic outcomes of the two pandemics.
The economic fallout from the Spanish flu was far less dramatic. In the United States, industrial output fell sharply but rebounded within a few months. Retail was barely affected, and businesses did not declare bankruptcy at higher rates than usual. According to the latest econometric analysis, the pandemic of 1918–19 cut the United States’ real GDP and consumption by no more than two percent.
Foreign Affairs, “The Spanish Flu Didn’t Wreck the Global Economy,” 28 May 2020
It’s hard to compare pandemics across a century. In my Covid-19 misinformation post a couple days ago, I noted the mis-informative article comparing the 1968-69 Hong Kong Flu outbreak with Covid-19. The misinformation in that article is that the H3N2 virus is an order of magnitude less virulent than Covid-19.
According to the Foreign Affairs article, the Spanish Flu killed about 0.5% of Americans. Based on Spain’s recently measure IFR, Covid-19 would kill about 0.7% of a population before it infected enough people to achieve herd immunity. The two viruses have similar virulence.
The article asks why the US economic outcome was so much better with the Spanish Flu than with Covid-19. “The answer is deceptively simple: for the most part, whether by necessity or choice, people barreled through.”
The article also says that the Covid-19 lockdowns have served to preserve the privileged while punishing the poor.
Meanwhile, a large part of society is left behind, mired in unemployment and precarity or stuck in face-to-face jobs that promise ongoing exposure. The young and the poor, already held down by inequality, debt, and fading prospects of social mobility, are bound to pay the heaviest price.
Ibid.
There are three problems with the Foreign Affairs‘ argument. First, as I pointed out to my anti-lockdown friend Andy, who’s de-friended me on Facebook, avoiding Covid-19 lockdowns does not necessarily result in a country having a minor disruption to its economy. Sweden has demonstrated and Brazil is in the midst of demonstrating that point.
In the case of Brazil, the country’s manufacturing has gone into an effective lockdown even though President Bolsonaro refuses to order one. In fact, the Foreign Affairs‘ description of what the Covid-19 lockdowns have wrought upon the US sounds similar to what the lack of lockdowns has wrought upon Brazil.
Japan provides a counterexample. I would say an instructive counterexample except that no one knows yet how Japan has beat Covid-19 without a lockdown. I think the best anyone can claim is that economic outcomes don’t correlate with lockdowns per se. As I pointed out yesterday, the best economic outcome appears to be to avoid lockdowns in the first place with a robust test, track, and quarantine program a la South Korea, Vietnam, and Ghana. Most advanced western countries were unable to achieve this during the Covid-19 pandemic.
The second problem with the Foreign Affairs‘ lockdown argument is that the US and world economies of 1918-19 and now are two different animals. The US population has more than tripled since 1918, while the GDP has grown over twenty times. In 1918, the concept of a factory was about a hundred years old and the modern assembly line had just been invented. Foreign trade in 1918 was a fraction of today and businesses weren’t built around supply chains.
While the 1918 world had traveled through the industrial revolution and migrated from rural agricultural life to big cities, family still was organized around women raising children at home. It would be another two decades until women were invited into factories because all the men were fighting WWII. Interstate transit was mostly by train and boat, which limited interstate commerce.
All that is to say that the economic impact from a local Spanish Flu breakout was unlikely to ripple through the entire US economy the way a Covid-19 outbreak at a meatpacking plant threatens the country’s food supply. In today’s targeted food distribution world, food supply chains have created unexpected food shortages. As more people ate at home, less food was needed in restaurants and cafeterias, but there was no easy way to get that food from commercial distribution systems into the retail systems. I’ll wager that in 1918, the commercial and retail distribution of food weren’t as segregated as today.
Then there is the travel industry. Need I say anything more than travel looked very different a century ago. Ditto entertainment and other industries struggling with the social distancing Covid-19 requires.
The third problem with the Foreign Affairs‘ argument is that science, medicine, and public health have changed so much. In 1918, there were a handful of vaccines and the basic scientific knowledge to create more. In the first six months of the Covid-19 pandemic there are over 100 vaccine candidates with a handful already in human trials. It would have been insane in 1918 to lock down while awaiting a Spanish Flu treatment or vaccine.
With Covid-19, though, there is not only the hope of a vaccine in 2-5 years, but also monoclonal antibody therapies and repurposed drug treatments likely to come to market even sooner. Plus clinical experience is improving outcomes and reducing mortality. It makes all kinds of sense to lockdown today.
I”ve spent longer on this blasted Foreign Affairs article than I wanted, but I did learn some things about life a century ago. Hope you did, too!
UPDATE 30 May 2020.
In this post, I was focusing on the merits of the Foreign Affairs assertion that it would be better to ride out Covid-19 like people did in the 1918-19 Spanish flu than to implement lockdowns. Three readers brought up issues that I didn’t include because of time constraints.
Alfredo and Cristián noted that the name “Spanish Flu” is a misnomer since the pandemic neither started in Spain nor was it particularly bad here.
Shane noted that President Wilson suppressed coverage of the Spanish Flu to maintain morale during WWI. That might explain why neither of my grandparents discussed it with Mom.
From a useful link Alfredo shared:
The misnomer, according to an episode of the podcast BackStory, came about as a result of geopolitical forces. When the pandemic broke out during World War I, neither side wanted the other to find out they were sick—nor did they want their own troops to lose morale or their publics to panic. News of the outbreak was suppressed or heavily underplayed in Germany, France, the U.K., and the U.S. But Spain, like Switzerland, was neutral in the war, and its media had no qualms about covering the contagious outbreak weakening its population, creating the false impression that this was a Spanish disease.
Slate, “Down With the “Spanish Flu,” 22 October 2018
UPDATE 4 June 2020.
Juan Miguel points out that, while I say Spanish Flu and Covid-19 have similar virulence, the difference between 0.5% (Spanish Flu in US) and 0.7% (implied Covid-19 from Spanish national study) is significant percentage-wise. I agree with Juan Miguel. What I meant and did not state clearly is that the two have similar virulence from a public health perspective. That is, public health policies probably would be the same or very similar for the two different viruses at any given time in history.
COVID Diary BCN 