CREVE COEUR, Mo. — “History repeats itself. That’s one of the things wrong with history.”
Renowned attorney Clarence Darrow said that in the early 20th century, and countless others have made similar statements.
Just over 100 years ago, the United States and the world were reeling from another pandemic. The 1918-1919 influenza pandemic was estimated to have infected 500 million people worldwide, one-third of the world’s population, leading to at least 50 million deaths, including 550,000 to 675,000 in the United States.
There are differences and similarities in the flu and COVID-19, and life then and today. Those comparisons and economic impacts were the focus of a recent webinar hosted by the Danforth Plant Science Center.
The event featured Sam Fiorello, Cortex Innovation Community president and CEO, and David Wheelock, St. Louis Federal Reserve Bank vice president and deputy director of research.
There were three different waves of illness during the influenza pandemic, starting in March 1918 and subsiding by summer of 1919. The pandemic peaked in the United States during the second wave in the fall of 1918. This highly fatal second wave was responsible for most of the U.S. deaths attributed to the pandemic.
“Because it was an influenza virus, there tended to be a flattening over the summer months, then there was a very large second wave in the fall with a spike in cases and mortality that lasted into the early part of 1919 and then there was a third wave in the spring of 1919,” Fiorello said.
“If we learn anything from the influenza in 1918-1919 is that it’s not like you go through a tough period, hunker down and things end. These things will play out over a series of waves. This one had three; others have had four and five.”
Economic Impact
A study was released in March that focused on the economic impact on the top 50 metropolitan areas of the 1918-1919 pandemic. It was conducted by Sergio Correia, Board of Governors Federal Reserve System economist; Stephan Luck, Federal Reserve Bank of New York Research and Statistics Group economist; and Emil Verner, MIT Sloan School of Management assistant professor of finance.
The study found that areas that had the most stringent lockdown measures and adhered to them the most, fared better after the pandemic in terms of their economic well-being.
“It sort of flies in the face of this, I believe, false paradigm of either we’re saving people or we’re saving the economy. If we look back and learn anything from 1918-1919, it’s that saving people and being safe health-wise also tended to lead to a healthier economy in the region,” Fiorello said.
“They were looking at the effects of non-pharmaceutical interventions that cities imposed. The bottom line is those interventions did help flatten the curve — hold down total mortalities to some extent — and as a result those cities had better economic performance,” Wheelock added.
“It’s not clear that we’re going to have the same experience today, but it does illustrate that it’s not a black-and-white tradeoff — you either have controls or we have an economy. Clearly, if you have widespread deaths, an overwhelmed health care and so forth, that’s going to have economic costs, as well. If you can prevent that to some extent by imposing controls, you might lessen that impact on the economy.
“At the same time, what they’re finding from the earlier pandemic is that those cities that were more aggressive in imposing controls had faster growing economies in the first few years coming out of the pandemic.
“Now, again, my caveat would be that flu pandemic was especially harmful for working-age men. So, the effect on the economic conditions might be different because, obviously, if a lot of men are dying, that’s reducing the supply of labor for the manufacturing sector for agriculture and so forth; that is going to depress those particular industries especially and if you can save their lives and keep the labor supply there available, it stands to reason those sectors are going to be able to come back more quickly.”
Mitigation Levels
Wheelock showed data comparing influenza outbreaks and the number of deaths per 100,000 in Philadelphia and St. Louis during the second wave that began in the fall of 1918. The cities had different measures to contain the spread.
“Philadelphia had a big surge of cases, they were somewhat slow to take mitigating measures and they allowed a large World War I Liberty Loans Parade,” Wheelock said.
The parade was organized to promote government bonds to help pay for the needs of the Allied troops in World War I. More than 200,000 Philadelphians attended the parade.
“They had a tremendous spike in cases, one of the worst death rates in all of the cities in the U.S. There were 748 deaths per 100,000 when it peaked,” Wheelock continued.
“On the other hand, St. Louis took a more aggressive line. As soon as cases started to appear in early October 1918, the city health commissioner lobbied to not have a parade in St. Louis and close schools and take other mitigating measures. St. Louis had a much flatter curve and was more successful containing the virus, averaging 358 deaths per 100,000.
“These city comparisons are really at the heart of what economists have been looking at in terms of trying the gauge the economic affects of the pandemic.”
The response to the virus 100 years ago was determined the local levels by city health commissioners. When the virus appeared, most large cities eventually imposed some sort of non-pharmaceutical intervention, from requiring citizens to wear masks, to closing schools and in some cases temporarily closing nonessential businesses.
St. Louis had a very aggressive health commissioner who immediately ordered the closing of schools, saloons, theaters and other entertainment venues. Large gatherings were also banned. Other businesses were allowed to remain open, but the hours were curtailed and police were in place to keep people moving in stores.
Other cities were less aggressive, including Philadelphia, where they were somewhat slow to react to the growing pandemic. Some cities would close schools, but not take other measures.
Different Era
There are obviously differences between the United States in 1918 and today.
The World War I Armistice was on Nov. 11, 1918, in the middle of the second wave. There also were major differences in the economy. In 1918, about half of the U.S. population lived on a farm or a rural community. Today, the U.S. population is about five times larger in cities than in rural areas.
“We also had a much more of an agricultural and manufacturing based economy back in those days. In 1918, about 33% of the labor force was working in agriculture, either in farming or farm labor of some sort, whereas today it is only about 2%,” Wheelock said.
“So, there were major structural differences in the economy between now and then. That doesn’t mean that we can’t get some insights from going back and looking at the historical experiences, but we do have to cognizant that there are differences in the economy between 100 years ago and today.
“They are different viruses, too, and that’s always something that we have to keep in the back of our minds. They just evolved differently because the nature of the viruses is different.”
COVID-19 presents the greatest mortality risk to the elderly and health-compromised individuals. However, the 1918-1919 influenza not only struck the elderly and young like a typical flu, but the highest death rate was for those between 18 and 44 years old and healthy adults.
Similar to today, businesses and churches in 1918 pressured local health officials to end the restrictions as soon as possible.
“St. Louis imposed restrictions in early October 1918. They started to get some success with getting cases down, and by mid-November, they decided to ease-off the restrictions. They reopened the schools, churches and so forth, and things were fine for couple of weeks, but then there was a resurgence of cases in early December, which forced the city to reactivate its various controls. And, indeed, that second spike that occurred December was somewhat higher than the initial one that occurred earlier in the pandemic,” Wheelock noted.