Thanks to the 1918 Pandemic, We Know How to Avoid a Holiday Surge. But Will We Pay Attention to the Lessons of 102 Years Ago?
There’s no way of knowing how many people actually heeded the call for a “kissless holiday” during the flu pandemic of 1918, but according to a Dec. 21, 1918 edition of the Ohio State Journal, that was the strong advice of the state health commissioner. “Beware of Mistletoe and Be Careful in Osculatory Indulgence, Health Chief Warns,” the Journal wrote.
Osculatory indulgences are to be avoided this year too—along with travel, gatherings with anyone outside your immediate household, shopping in crowded stores and going anywhere at all without the protection of a mask. As my colleagues Olivia Waxman and Melissa Chan report, there are lessons to be learned from how Americans did—and didn’t—look after their health during the last great pandemic 102 Christmas seasons ago, and there are challenges we face in 2020 that the America of 1918 didn’t.
One important difference between now and then is that that first pandemic was not as politicized as the one today. There was no red-state, blue-state divide over the wisdom of masking, no social media calling the pandemic a hoax, and there were fewer heated differences from state to state and county to county about how strictly to police lockdown rules. That’s not so in 2020. In San Diego County, for example, Sheriff Bill Gore has been cracking down on COVID-19 rule breakers for weeks, despite the fact that he gets a lot of angry emails and pushback from a public that doesn’t like being told what to do.
“This is a public health crisis. I’m doing what I think is right,” he says.
But less than 100 miles away in neighboring Riverside County? Not so much. There, Sheriff Chad Bianco slammed the state’s latest mandate that bans personal gatherings and closes non-essential businesses in areas where the virus is surging, adding that his force would not be “used as muscle” against residents to enforce “disastrous” rules.
“These closures and stay-at-home orders are flat-out ridiculous,” Bianco says.
That kind of resistance at the local level has led to resistance at a national level. Despite repeated public warnings against traveling this holiday season, a new TIME/Harris Poll survey shows that 22% of Americans plan to do just that for Christmas, and 18% for New Year’s. Alarmingly, 40% of those who plan to travel for Christmas will do so by plane—with all of the crowding and socially non-distant jostling that implies.
Air travel was not an option or a problem in 1918, but other things—ones similar to today’s dangers—were. Spikes in cases were seen after Thanksgiving, for example, with one 27-case flare-up attributed to a Thanksgiving dinner hosted by an elderly woman and attended by her seven married sons and daughters. Thanksgiving and Victory Day (a November celebration of the end of World War I) saw “indiscriminate visiting to homes in which there are or have been persons ill with influenza,” Dr. M. Victor Safford of Boston’s health department said in a Dec. 12, 1918 Boston Globe article. That helped contribute to a third wave in January, similar to the post-Thanksgiving waves the U.S. is seeing now.
Some lessons have been learned. In New York City, the springtime epicenter of the COVID-19 pandemic, viewings of the celebrated Rockefeller Center Christmas tree are this year by appointment only and limited to five minutes, and while the traditional New Year’s ball will be dropped in Times Square, there will be no throngs of people there to watch.
Similar measures were taken in 1918—at least, in some places. Denver canceled New Year’s Eve parties; Dayton, Ohio took a different approach, opening cabarets and theaters for celebrations. The result of the uneven rules were uneven outbreaks, with the overall pandemic dragging on well through the first months of 1919. Like today, health officials back then continued to stress mask-wearing, social-distancing, and avoiding indoor gatherings small and large as critical steps to at least slowing the spread of the virus. And like today, most—but not remotely all—people got the message.
“Public health officials figured out what tools worked in 1918,” says Christopher Nichols, director of the Oregon State University Center for the Humanities. “[That] December holiday season was a culmination of lessons learned in 1918. The implicit subtext of that is, shouldn’t it be in 2020?”
Both Moderna and Pfizer are urging calm as they rush to test their vaccines against the new strain of COVID-19 circulating in the U.K. and elsewhere, CNN reports . This is not remotely the first time the virus has mutated and both companies have found their vaccines were effective against those earlier variants—but the rapidity with which the newest strain is spreading has caused greater concern. Pfizer is testing the blood of patients already inoculated with its vaccine against the new strain and is “generating data” on how well it neutralizes the virus. Moderna is performing similar tests, and anticipates good results. “Based on the data to date, we expect that the Moderna vaccine-induced immunity would be protective against the variants recently described in the UK,” the company said in a statement.
With the first tranche of 2.9 million vaccine doses distributed in the U.S. last week—mostly to front line health care workers—vaccination efforts are now turning to 1,300 nursing homes and long-term care facilities, Reuters reports. Up to 7.9 million doses will be distributed this week, with vaccinations expected to begin in the facilities immediately, including on Christmas Eve and Christmas day, according to U.S. Army General Gustave Perna, who oversees vaccine distribution for Operation Warp Speed. At the current rate of distribution, Secretary of Health and Human Services Alex Azar expects up to 50 million Americans to have received the first of their two necessary injections before the end of January.
The Vatican took an unexpected but welcome step Monday when it announced in a statement that vaccines developed with the aid of cells derived from aborted fetuses were “morally justified” and “can be used in good conscience,” reports the BBC . The Church drew a distinction between the Pfizer-BioNTech and Moderna vaccines—which use fetal cells only in the testing stage—and the Oxford-AstraZeneca formulation, which also uses the cells in design, development and production. But if no alternative was available, “it would be permissible to accept the AstraZeneca vaccine.” The long time lag between the abortions that produced the fetal cells—which took place in some cases decades ago—and the modern day work factored into the Church’s thinking.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 77.3 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 1.7 million people have died. On Dec. 21, there were 541,155 new cases and 9,391 new deaths confirmed globally.
Editor's note: On Nov. 25, Turkey changed its policy to include asymptomatic cases in its daily numbers. On Dec. 10, the country provided a large case dump to bring the total historical reporting in line with this new standard. However, the data are not yet available to accurately distribute this increase retroactively. The result is a significant anomaly that impacts the charts and maps both for Turkey, and, due to the country’s large case numbers, the world.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here is every country with over 1 million confirmed cases:
South Korea, which had been seen as the gold standard for rapid and successful control of the coronavirus, is now suffering from the same kind of resurgence that so many other countries are facing. Much of the new caseload has come from the region in and around Seoul and in response, the government is imposing new lockdowns through at least Jan. 3, the Associated Press reports. Social gatherings of more than five people will be prohibited, and ski resorts and other tourist attractions will be shuttered by Christmas Eve. Visits to nursing homes and long-term care facilities will also be banned.
Taiwan had been on a long winning streak, going 253 days—since April—without a case of domestic transmission of the coronavirus. That streak was snapped earlier this month, the Washington Postreports, when a pilot from a New Zealand cargo plane who was infected with the virus, arrived in the country and passed it on to at least one other person. The pilot was reported to have been coughing during the inbound flight but was not wearing a mask. In response, Taiwan today announced it would reduce the number of permissible arriving flights and increase the mandatory quarantine for pilots and crew from three days to as much as 14, with a definite decision to be made later this week.
The Mexican government implemented a smart and publicly transparent formula for determining when Mexico City or any of the country’s 31 states should enter lockdown, based upon the number of cases, deaths and hospitalizations, and that has helped the country manage the pandemic, especially over the summer when cases were declining. But as The New York Times reports , earlier this month, officials played loose with those rules in Mexico City, lowballing the hospitalizations and case rates and keeping the city open after cases began to surge in early December. The government has not explained the reason for its actions, but there has been a price to pay: Last week the city had the highest number of hospitalizations since the start of the pandemic and has now, belatedly, gone into lockdown.
The Situation in the U.S.
The U.S. had recorded more than 18 million coronavirus cases as of 1 a.m. E.T. today. More than 319,000 people have died. On Dec. 21, there were 190,519 new cases and 1,696 new deaths confirmed in the U.S. Here's how the country as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
California, with more daily cases than any other state in recent weeks, has become seen as the epicenter of the current stage of the pandemic in the U.S. But adjusted for population, Tennessee is being hit nearly as hard, according to CNN . In just the past week, the state has averaged 9,300 cases per day. The number is about 20% of California’s 44,000 cases per day—in a state with slightly less than 20% of the population. Health officials in the state attribute the surge to family gatherings over the Thanksgiving holidays. As yet, Tennessee has no statewide mask mandate.
The health of the economy continues to move in lockstep with the health of Americans, as the latest surge in COVID-19 cases has pushed consumer confidence down to levels that are alarming economists, reports the Associated Press . November’s reading was already a disappointing 92.9—compared to 125.5 last November. Confidence fell further to 88.6 in December. Consumer spending accounts for 70% of the overall economy and the holiday season accounts for a big part of those overall outlays. That makes it especially troubling that the Commerce Department has announced a fall in retail sales of 1.1% from October to November, the biggest monthly drop in seven months. Some good news: the stimulus bill approved by Congress yesterday will put $600 additional in the pockets of most Americans—money which is likely to be spent quickly and give the economy a year-end jolt.
Outrage is continuing to grow as members of Congress jump to the front of the vaccination line, despite the fact that many of them belong to no high-risk group, as the Washington Post reports . Lawmakers as diverse as Alexandria Ocasio-Cortez, the left-wing Democratic representative from New York, and Senate Majority Leader Mitch McConnell, one of the key figures of the Republican right, have been publicly vaccinated, in many cases arguing that they are doing so to inspire confidence in the vaccine. Maybe, but with the average age in the House of Representatives 57.6 and in the Senate 62.9, they are receiving vaccines that would otherwise be going to the over-65 group, people with underlying medical conditions and even residents of nursing homes. Meantime, Dr. Anthony Fauci, who is 78, caused no such grumbling when he was vaccinated earlier today, flashing a two thumbs-up after receiving the shot.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Dec. 22, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
Staying Vigilant for the Next Pandemic
Even as vaccines offer hope that the beginning of the end of the pandemic is nigh, Dr. Jean-Jacques Muyembe Tamfum, the microbiologist who helped discover and identify the Ebola virus in 1976, is warning that emerging diseases should be seen as the new normal. Speaking to CNN, Tamfum said he is especially worried about zoonotic diseases which, like COVID-19, jump from animals to humans. Read more here.
Hesitation From the Pulpit
Vaccine hesitancy is common in Black American communities—understandably, given the long history of medical disenfranchisement and episodes like the Tuskegee experiment. In many cases, the medical community relies on Black churches to reassure their congregations that the coronavirus vaccines are safe. But not all pastors are going along, Reuters reports, remaining as unconvinced as their parishioners. Read more here.
Is it Safe to Return to Work?
As vaccine uptake increases across the U.S. in the coming months, offices and other workplaces will warily begin to crack open their doors. But what if you don’t feel safe returning to work? The good news is that there are safety guidelines that have been put in place by the Occupational Safety and Health Administration (OSHA). The bad news is you don’t have a lot of legal protections if your workplace doesn’t comply. Read more here.
Mapping Your Coronavirus Experience
The world shrank for all of us this year, with the physical space we used to occupy contracting to little more than our homes, essential stores, and perhaps a park for a masked walk. Bloomberg CityLab invited readers from around the world to create maps of their life under lockdown and the results—from Hong Kong, Indonesia, the U.K. and elsewhere—are equal parts sad, poignant and, on occasion, bracingly whimsical. Read more here.
Bill Gates on the State of the Pandemic
Few people know more than Bill Gates—co-director of the Bill and Melinda Gates Foundation—about how to look after the health of the world. In a sort of prequel to the foundation’s annual letter—due next month—Gates offers his views why 2021 is all-but certain to be a much better year than 2020. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Elijah Wolfson.
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