We’re living in a Covid world, that’s just a fact. But we’ve been here before in a way: in 1918 when a Flu virus took over the world. This week, for the final episode of our first season, we take a look at how a simple strain of the Flu killed 5% of the world’s population. Find out where the Spanish Flu got its name, why the virus seemed to affect mostly young men and the revolutionary impact it had on women at the time. Then join us as we compare it to the COVID-19 and how this pandemic continues to impact women of all backgrounds and experiences, including women in medicine.
- What are some immediate differences you noticed between the 1918 flu and COVID in terms of impact on women?
- When you’re old and wrinkly sitting with your 28 grandchildren, what are you going to tell them about COVID-19? What are you going to tell them about being a medical student during COVID?
- How do you think COVID has reinforced or maybe changed how you viewed women physicians or the practice of medicine in general?
Listen to the episode, discuss these questions with friends and family, let us know what you think!
This week we are tying the topic back to episode 1 and discussing COVID-19, paralleling it to the 1918 Spanish Flu pandemic and the impact that both of these pandemics had/are having on women.
History of the Spanish Flu:
The flu is a virus that mutates very rapidly and basically whenever cells from an animal for example a pig or bat, get infected with two different viral DNA stains that becomes a new strain of the virus.
For example, the swine flu epidemic in 2009 was a brand new type of flu that has the H1 and the N1 subtypes whereas other flu types are H3N2, etc.
The origin of the Spanish flu virus is actually unknown, but its name came from the fact that during World War I, Spain remained neutral and was genuinely reporting its cases. The news made everyone believe that Spain was where the virus originated when in fact other countries were really underreporting their cases.
That same year, the virus came to Kansas in the United States. The first wave of the pandemic was that spring but was pretty mild in comparison to the second wave that came in the fall of that same year. In the spring the symptoms people had were chills, fever and fatigue but they recovered in several days. In the fall, people died within hours or days of getting symptoms, their skin turning blue and their lungs filling with fluid causing them to suffocate.
We don’t know when the virus began but it killed mostly healthy, young people who are usually resistant to these kinds of illnesses, especially WWI military servicemen.
- It might have been a result of the poor immune systems of the servicemen who underwent the stressors of war
- Another theory is that these men has overactive immune systems, leading to cytokine storms and an aggressive inflammatory response
- One final theory is that men were previously susceptible to respiratory infection because of the high rates of tuberculosis among men at the time
Women of the 1918 Flu pandemic:
- More women were brought into the workforce
- With so many men off to war and then men just dying off, the number of women in the workforce was 25% higher than it had been and by 1920
- Women were also moving into employment that only men had before like manufacturing for example
- And as they entered these spaces, they began demanding for equal pay and also now that they had more economic power, they were pushing for the right to vote
- What is important is that the flu changed people’s minds about women’s roles in socio political spaces
- They saw women out at work and being involved in community decision making
- Women in healthcare were taking charge as well!
Covid-19, women and women healthcare workers
Women have been experiencing a diverse range of challenges right now.
- The general trend worldwide is that women earn less, save less, have lower job security, are the majority of single-parent households and for those reasons are more susceptible to economic shocks like the one covid has created.
- For women in developing countries, for example, ⅔ of female employment is through jobs in the informal economy and those are the jobs that disappeared first.
- Some 243 million women are thought to have experienced sexual or physical abuse at the hands of an intimate partner at some point over the last 12 months. IPV within relationships between female-identifying people is actually higher than heternormative couples.
- Girls are facing higher risks of female genital mutilation and early marriage because school is a safe environment that vulnerable girls no longer have access to.
- Women of color are at particularly vulnerable positions as well
Women physicians have been having to sacrifice even more than they already were.
1918 Pandemic Influenza Historic Timeline | Pandemic Influenza (Flu) | CDC. (2018, March 20). Retrieved October 6, 2020, from https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/pandemic-timeline-1918.htm
Blackburn, Parker and Wendelbo (2018, March 2). How the 1918 Flu Pandemic Helped Advance Women’s Rights. Retrieved October 6, 2020, from https://www.smithsonianmag.com/history/how-1918-flu-pandemic-helped-advance-womens-rights-180968311/
Brubaker L. Women Physicians and the COVID-19 Pandemic. JAMA. 2020;324(9):835–836. doi:10.1001/jama.2020.14797
Burki, T. (2020). The indirect impact of COVID-19 on women. The Lancet Infectious Diseases, 20(8), 904–905. https://doi.org/10.1016/s1473-3099(20)30568-5
Erickson, L. (2020, April 30). The Disproportionate Impact of COVID-19 on Women of Color. Retrieved October 6, 2020, from https://swhr.org/the-disproportionate-impact-of-covid-19-on-women-of-color/
Fowers and Wang. (2020, August 18). ‘The volume has been turned up on everything’: Pandemic places alarming pressure on transgender mental health. Retrieved October 6, 2020, from https://www.washingtonpost.com/gdpr-consent/?next_url=https%3a%2f%2fwww.washingtonpost.com%2fhealth%2f2020%2f08%2f18%2fcoronavirus-transgender%2f%3farc404%3dtrue&arc404=true
History.com Editors. (2020, May 19). Spanish Flu. Retrieved October 6, 2020, from https://www.history.com/topics/world-war-i/1918-flu-pandemic
Key Facts about Swine Influenza (Swine Flu) in Pigs | CDC. (2014). Retrieved October 6, 2020, from https://www.cdc.gov/flu/swineflu/keyfacts_pigs.htm
Mineo, L. (2020, May 19). ‘The lesson is to never forget.’ Retrieved October 6, 2020, from https://news.harvard.edu/gazette/story/2020/05/harvard-expert-compares-1918-flu-covid-19/
Moore, W. (2020, April 28). First the Women Who Ran This U.K. Military Hospital Faced World War I. Then Came the 1918 Flu Pandemic. Retrieved October 6, 2020, from https://time.com/5828236/1918-pandemic-endell-street/
Noymer, A., & Garenne, M. (2000). The 1918 influenza epidemic’s effects on sex differentials in mortality in the United States. Population and development review, 26(3), 565–581. https://doi.org/10.1111/j.1728-4457.2000.00565.x
Types of Influenza Viruses. (2019, November 18). Retrieved October 6, 2020, from https://www.cdc.gov/flu/about/viruses/types.htm
Robson, D. (2018, October 30). Why the flu of 1918 was so deadly. Retrieved October 6, 2020, from https://www.bbc.com/future/article/20181029-why-the-flu-of-1918-was-so-deadly
Spindler, L. (2020, May 18). Women: The Unsung Heroes of the 1918 Flu Pandemic. Retrieved October 6, 2020, from https://www.wimlf.org/blog/women-the-unsung-heroes-of-the-1918-flu-pandemic