Alabama looks to learn from past pandemics as COVID-19 numbers continue to rise

Jun 2, 2020


Credit Associated Press

Alabama continues to reopen as the number of COVID-19 cases continues to rise. Mobile currently has the most cases in the state and Montgomery is getting national attention for the growing numbers there. This is not the first pandemic to hit the Yellowhammer State. The responses have similarities to the Spanish Flu outbreak of 1918 and the Yellow Fever outbreaks in Mobile.


Dr. John Higginbotham is an associate vice president for research at The University of Alabama. He wants to define what a pandemic is before looking into the history. 


"A pandemic is an epidemic that goes over a broad geographical area and is usually defined when the WHO, the World Health Organization, based in Geneva Switzerland, makes a proclamation that it has done that and they did that quite a while back with COVID-19,” he said.


Many people are looking to one of the last major pandemics to hit the United States, the Spanish Flu Pandemic of 1918. Higginbotham said there are plenty of similarities.


“Like COVID-19 the 1918 flu was a crowd disease, so it really began to spread when people were close together," he said.


Right now, health care providers and policymakers are still learning about COVID-19 and how it is going to play out. But, they’re not the only ones with something to say about the coronavirus and how it resembles the 1918 Spanish Flu pandemic. Jim Baggett is one of them.


“The local governments closed, theaters, they closed churches, the closed schools, here in Birmingham they shut down the state fair, places like soft drink parlors which would be considered likely to be infected," he said.


Baggett is the archivist for the Birmingham Public Library. During the 1918 Spanish Flu outbreak there were over 145,000 cases of people being infected and there were almost 5500 deaths. It was a respiratory illness too and Baggett says it was a rough way to go.


“Your lungs shut down, filled up with fluid and you drown. People that survived described losing all sense of time and just, some people were sick for weeks and recovered and some people died within days," Baggett said.


He said with the Spanish Flu, it was difficult to predict where the cases would surge next. Something that front line workers are finding with COVID-19.


“Of course the cities saw a lot of cases, and then you a lot of odd hotspots early in October 1918 Shelby County was reporting 4 cases and then the little town of Pell City in St. Clair County was reporting 200 cases, it was unpredictable in that way," he said.


We also have firsthand accounts of what the 1918 flu was like. Edna Register Boone was 10 years old when then pandemic hit Alabama. She did an interview in 2008 that’s part of the collection of the Alabama Department of Archives and History. Boone described what she had to do.


“Momma would wrap a gauze bandage around my face and she kept sterilized fruit jars on the stove at all times and she would fill those jars with soup and I would take those jars to the home of an afflicted family," she said.


She remembered how many people in her small community didn’t make it.


"The people were buried in the clothes they died in and wrapped in the sheets, so they were buried in a common grave," she said. "I do not remember a single church burial.”


Boone said it took a toll on her as a child.


“Lots of times I would just come in and cry because of all the sickness that was around me and I knew that sickness was deadly," she said.


Much like the mask Boone wore, Baggett said many of the precautions we’re taking today would not be that out of place back in 1918.


“Much like today, people were advised, as much as possible, to stay home, people were advised to wear masks, they understood how the disease was spread and they understood that people who were infected, coughed and sneezed could spread it to others," he said.


Churches today are meeting through social media, zoom or even drive up services in many cases. They had a version of that back then too.


“On one of what they called 'Churchless Sundays' the Birmingham News turned over two full pages of the Sunday edition and ran sermons, that pastors would have delivered to their congregations on that Sunday," Baggett said.


Following health guidelines seemed to help people like Boone and her family make it through the Spanish Flu in 1918. Baggett said it helped bring out some of the best in people.


“People coming together, maybe not physically coming together, but people took care of neighbors," he said. "Some cases whole families would get sick, especially in rural Alabama there may only be a handful of doctors in town and in some places the doctors would get sick.”


That did not seem to apply to all of Alabama’s past health epidemics. Yellow Fever hit along the Gulf Coast on multiple occasions. Tom McGehee is the museum director for Bellingrath Garden and Home in Mobile.


“If anyone got sick and even if it had absolutely nothing to do with yellow fever, the train would be stopped and that person would be pushed off the train and he or she could be thirty miles to the nearest town and they would be left to fend for themselves," he said.


Some small groups are gathering at state capitols across the country and protesting some of the health safety measures being implemented by state governments. McGehee said this was no exception back in the 1800’s in Mobile.


“The president of our local board of health in 1853 was criticized about establishing a quarantine and its effect on business. He was quoted as saying, 'commerce brings in nothing but money and money will not compensate for the loss of our citizens nor cheer the hearts made desolate by death, and that same argument is going on today,'” McGhee said.


Mosquitos carried Yellow Fever, which killed a tenth of Mobile’s population in 1853. People fled the cities in often brutal manners. McGehee said an episcopal minister’s diary from the time gives an interesting account.


“He is quoted as saying, 'as the panic-struck social standing, education, even professed Christianity could do nothing ti overcome craven selfishness,'" he said. "As the panic took and it didn’t matter who they were, they were acting like brutes and they were going to get out of there and knock anyone out of their way to get out of there.”


McGehee wants to remind everyone of an old adage but also offers some hope.


“I think it true, like all history that if you don’t know history, you’re gonna repeat it. We got over all these epidemics from 200 years and moved on and others will follow but we’re going to survive it," he said.


Higginbotham said we’re still not 100% sure what we are up against with COVID-19 and for now it does not appear to be as vicious as the 1918 flu outbreak. 


“The death rate for the 1918 flu is far bigger than what we’ve seen here. Also, in the 1918 flu, particularly in the second and third waves we saw people who were targeted were those 20 to 40 year olds right now with COVID-19 the group that is at most risk are 65 and older and have chronic disease conditions," he said.


There’s a theory that COVID-19 might die off as we continue into the summer months. Higginbotham said if history shows us anything, we might not be out of the woods yet.


“The 1918 flu we saw three rounds of that, three things that bubbled up across over a year and a half worth of span. Right now we’re only seeing one movement of this disease worldwide, we have yet to see if it is going to calm down and come back,” he said.


There is one thing Baggett hopes people will take away from the lessons of past pandemics.


“Its something you have to work through, and accept the fact that there is going to be inconveniences, and for some people some really , really tough economic times,” he said.