Several similarities can be seen between the 1918 Influenza pandemic and today’s Coronavirus Disease 2019 (Covid-19) pandemic even though occurred 100 years apart. Both pandemics are suggested to have been transmitted from an animal reservoir, the 1918 influenza by an H1N1 virus originating in birds, and the SARS-coronavirus-2 (the virus that causes COVID-19) from bats (CDC, 2020). They are also both considered “novel” viruses meaning, they are so new, no one in either era had any immunity to them. A striking difference between the two was the age groups affected. In the 1918 pandemic, mortality was highest among the 20-40 age group but mortality is higher among the elderly with Covid-19.
Even though there are antiviral medications and antibiotic treatments today that were not available for the 1918 pandemic, they both resulted in significant mortality and morbidity due to rapid community spread. Attentive nursing care proved the only effective treatment of curbing symptoms of influenza and preventing deadlier secondary pneumonia infections in 1918 (Jones & Saines, 2019). Confounding the crisis in 1918, the pandemic fell on the heels of World War I. Unlike today where a majority of medical practitioners have joined forces to treat and take care of sick patients, racial prejudice and political factors in 1918, barred qualified African American (AA) nurses from military practice (Jones & Saines, 2019; Keeling, 2010). While AA nurses are not excluded from caring for patients during the covid-19 pandemic, there is a disparity in access to care for vulnerable AAs and a higher rate of mortality in certain regions (Dorn, Cooney & Sabin, 2020).
Over the past 100 years, nursing has changed in response to pandemics. The emergence of Practical Nursing occurred in response to overwhelming need for nursing care (Bauers, 2018). Practical Nurses were able to complete training in 3-6 months to care for those in communities. As nursing roles were highlighted, the status of the nurse rose and attracted more people to the profession. Healthcare became population focused, and public-health services and disaster-preparedness policies and procedures grew with nursing recognized as a partner in decision making.
Today, attentive nursing care remains paramount in the care of patients with Covid 19 and nurses remain on the front-lines. While protective measures and social distancing are significant, nurses and other healthcare providers also play a role in flattening the curve of the spread of Covid-19 through their influence. Nurses are trusted, and therefore have a duty to educate their communities in prevention as well as to care for the sick.
Bauers, S. (2018, November 9). 5 questions: How the 1918 Spanish flu pandemic changed the nursing profession. The Philadelphia Inquirer. Retrieved from https://www.inquirer.com/philly/health/5-questions-how-the-1918-spanish-flu-pandemic-changed-the-nursing-profession-20181109.html
CDC (2020). Coronavirus Disease 2019 (COVID-19). COVID-19 Background. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html#background
Jones, M., & Saines, M. (2019). The Eighteen of 1918-1919: Black Nurses and the Great Flu Pandemic in the United States. American Journal of Public Health, 109(6), 877-884.
Keeling, A. (2010). “Alert to the necessities of the emergency”: U.S. nursing during the 1918 influenza pandemic. Public Health Reports (Washington, D.C. : 1974), 125 Suppl 3, 105-12.