What the COVID-19 pandemic and the 1918 flu pandemic have in common

Today, the Big Pharma conspiracy theory holds that in order to promote and sell pharmaceutical products, companies intentionally spread disease. This conspiracy theory has resurfaced in relation to the COVID-19 pandemic, though it is hardly a 21st-century phenomenon.

During the pandemic of 1918, one myth propagated in the United States and the United Kingdom was that the pandemic was linked to the use of aspirin produced by the German pharmaceutical company Bayer.

The mistrust of products of German origin is not as strange as it may seem, given that the start of the pandemic coincided with the end of World War I, in which the U.S. and Germany had fought as enemies.

The myth caused enough of a stir to prompt the American branch of Bayer to reassure potential buyers in the U.S. One advert, published on October 18, 1918, stated that “The manufacture of Bayer-Tablets and Capsules of Aspirin is completely under American control.”

Ironically, some later studies have suggested that aspirin may indeed have worsened some symptoms of the flu responsible for the pandemic, but not due to tampering.

A study paper published in Clinical Infectious Diseases in 2009 suggests that aspirin may have worsened the symptoms of the illness because doctors were prescribing dosages that were too high.

The paper’s author, Dr. Karen Starko, notes that at the time, doctors were routinely prescribing dosages of 8.0–31.2 grams of aspirin per day, unaware that this can cause hyperventilation and pulmonary edema in some people.

“Just before the 1918 death spike, aspirin was recommended in regimens now known to be potentially toxic and to cause pulmonary edema and may therefore have contributed to overall pandemic mortality and several of its mysteries,” Dr. Starko writes.

During the ongoing COVID-19 pandemic, one widespread rumor claims that SARS-CoV-2, the virus responsible for the disease, was created in a laboratory and nefariously spread throughout the world.

The most prominent of these rumors holds that the virus was created in and leaked from a lab in China — though research indicates that SARS-CoV-2 is, in fact, of natural origin.

This is not a far cry from myths and spurious claims about the origin of the influenza virus that emerged and spread in 1918.

One such rumor, found in the pages of a Brazilian newspaper, suggested that the influenza virus was spread around the world by German submarines.

Similar stories claimed that German boats coming ashore on the East Coast of the U.S. had released the infectious agent into the atmosphere.

According to an account in Gina Kolata’s book Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It, a woman claimed to have seen a toxic cloud spreading over Boston as a camouflaged German ship drew close to the harbor.

Kolata writes:

“The plague came in on a camouflaged German ship that had crept into Boston Harbor under cover of darkness and released the germs that seeded the city. […] There was an eyewitness, an old woman who said she saw a greasy-looking cloud that floated over the harbor and wafted over the docks.”

Kolata goes on to describe other rumors that Germans had snuck into the city carrying vials of germs and proceeded to release them in theaters and at rallies.

When the COVID-19 pandemic started, some referred to SARS-CoV-2 as the “China” or “Wuhan” virus. This naming has racist and xenophobic connotations, suggesting that a specific country or population is responsible for the emergence and spread of a pathogen.

The misnomers soon attracted an international outcry, with human rights advocates citing related surges in racism throughout the world.

However, the phenomenon of naming a pandemic or epidemic after a specific country is by no means new. The 1918 flu is often called “the Spanish flu,” though it did not originate in Spain. In fact, its origins are still unclear. So how did it get this name?

According to a research paper published in Clinical Infectious Diseases in 2008, the name “probably [emerged] because of the misinformation surrounding the news about the origin of the epidemic.” The authors go on to explain:

“It is usually accepted that, because Spain was a neutral country in World War I, freedom of the press in Spain was greater than that in the allied countries and in Germany. The U.S. and European press, likely for political reasons, did not acknowledge or transmit timely and accurate news about the high number of casualties among their military and civilian population that were attributable to the ongoing influenza epidemic.”

While “the Spanish flu” remains the best-known moniker for the cause of the 1918 pandemic, the illness took on other names, depending on the country.

In Spain, it was sometimes referred to as “the French flu,” possibly because Spanish seasonal workers traveled to and from France by train, prompting Spanish authorities to believe that they had “imported” the virus from France.

Another name for the flu in Spain was “the Naples Soldier,” referring to a musical performance popular at the time, suggesting that the virus stuck as easily as the melody.

In Brazil, meanwhile, it was “the German flu,” in Poland it was “the Bolshevik disease,” and in Senegal it was “the Brazilian flu.” In short, each country nicknamed the virus after a political opponent.

In the past, as now, myths and conspiracy theories surrounding the origins of disease spread like wildfire.

As the authors of a 2017 study in Current Directions in Psychological Science observe, conspiracy theories give people quick, easily acceptable explanations for issues that otherwise have no simple answers or solutions.

The researchers found that people who believe in conspiracy theories do so for three reasons:

• epistemic motives — the need for ready-made causal explanations of certain problems or phenomena in order to regain a sense of certainty
• existential motives — the need to regain control over one’s situation or environment
• social motives — “the desire to belong and to maintain a positive image” of oneself and the society that one inhabits or wishes to inhabit

Our senses of certainty, control, and belonging can easily become jeopardized in crisis situations, such as a pandemic.

Both the influenza virus behind the 1918 pandemic and the coronavirus responsible for COVID-19 have maintained an aura of mystery: Scientists and governments do not and did not provide quick, easy solutions for stopping the spread.

The means available to prevent infection — wearing face masks in public, minimizing social contact — feel precarious and often alienating, sometimes seriously harming mental health and altering daily life.

Naturally, widespread anxiety in times of crisis prompts people to look for answers and solutions everywhere — and conspiracy theories seem to provide them.

Yet, time and time again, experts have shown that buying into conspiracy theories does more harm than good, damaging public health and social well-being.

Past public health crises such as the 1918 pandemic can teach us important lessons about crisis management — as long as we learn from our mistakes.