Just over 100 years ago we dealt with the first major pandemic of the post-industrialized world, the 1918 influenza pandemic. This pandemic claimed 50 million lives or 2.5% of the world’s population at the time. The flu came in three waves, the first being relatively mild, then approximately 5 months later a second wave that was more lethal and a third and final wave in early 1919 that was intermediate in severity between the two. It was the worst pandemic since the black death, approximately 500 years earlier. Studying past pandemics and extrapolating social and economic changes that occurred post-pandemic offer some window into what our post COVID world might look like, for better or worse. Fortunately, there were many positive changes to society that came out of an even worse pandemic.
From a health care standpoint, countries came out of the 1918 pandemic with recognition of the increased importance of the need to coordinate health care internationally. There were several international organizations founded to combat a future global threat including the now-defunct League of Nations which partially morphed into today’s World Health Organization (WHO). (1) The 1920s witnessed a rebirth of interest in socialized medicine in many countries, but the US leaned towards instituting employer-based insurance plans. Although different countries took different directions, all nations took steps to consolidate and expand access to healthcare in post flu years. We are facing the reality of a fragmented health care system with a large, aging population and the likelihood of future pandemics we aren’t prepared for. It’s likely that the healthcare debate will be even more front-and-center than it has in the past and is likely to impact the upcoming election more than it may in a pre-COVID world.
Economically things fared somewhat better. Most of the economic effects of the 1918 influenza pandemic were short-term. Businesses in the service and entertainment industries suffered the greatest losses, but businesses that specialized in health care products experienced a net increase in revenues subsequent to the period of downturn. This bodes well for the eye care industry. Cities and states that experienced greater mortality rates experienced a greater increase in wage growth; states with larger mortality rates resulted in increasingly higher rates of growth in per capita income after the pandemic
Environmentally we already see some “clouds lifting” (pun intended) that hopefully will result in more permanent and positive medium-to-long-term changes. In Beijing and LA smog has lifted and air quality across the US has improved dramatically. Locals in Venice have noticed how clear the water appears perhaps due to the lack of motorboats and general crowds and pollution. These clearer waters have even led to wildlife appearing in the canals with swans, fish and more spotted in recent days. (2)
Socially, the recentering of family life seems to be occurring; general social trends such as people reconnecting with loved ones for an extended period of time for the first time in a long time. Citizens are coming together at their own risk to help the sick regardless of race or political party. Crime rates are down and looting, predicted to be a big issue hasn’t been a problem as of the time this article was published. When this is all over it is likely many people will have renewed appreciation for social contact. Business owners whose business survives will be better prepared to survive future crises and employees and business owners will have a newfound appreciation for each other.
From a medical and scientific angle, society is learning about the value of social distancing as a method of avoiding disease. It is possible that in hindsight this pandemic was a shot across the bow that saves us from an even worse pandemic, maybe even saves our society at some point. Social distancing was something most of society paid little attention to in terms of importance during previous epidemics and pandemics. The world-wide emphasis on the importance of social distancing is a lesson that’s likely to stick with our society, helping us to better survive pandemics in the future when they occur. The intense drive to find a cure will not only lead to a deeper understanding of virology of influenza viruses and the database of knowledge gleaned from these efforts will undoubtedly lead to new, improved therapies and advances in public health and biotechnology. People will be more aware of the importance of handwashing and other hygienic advice and incorporate them into their daily lives, increasing the general health of the population subsequent to this pandemic.
If past pandemics are any lesson, we can look forward to benefitting from what now are painful lessons for our society and take steps to mitigate damage from future pandemics. In the meantime, there are signs that while painful, there is hope that good things will come out of these trying and difficult times.