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Coronavirus: far to go before rivalling Spanish Flu of 1918

In depth
This article is part of the dossier: Corona Chronicles: 23-27 March

By David Whitehouse
Posted on Thursday, 26 March 2020 15:21

Passengers on the cruise liner MV AidAmira, quarantined in Cape Town on March 18. Cape Town was a point of entry into Africa for the Spanish Flu of 1918. REUTERS/Mike Hutchings

The Spanish Flu, spread by troop movements at the end of World War One, was the planet’s worst ever pandemic, and killed nearly 2% of Africa’s population in six months.

Sub-Saharan Africa had the highest average mortality rate in the outbreak, which had first become apparent in US military training camps.

It was called ‘Spanish Flu’ because Spain, as a neutral country, produced the most reliable statistics.

The flu swept across Africa in three waves: a relatively mild first wave in March-July 1918, a much worse second wave from August to December 1918, and a more moderate third wave in 1919. The second wave entered Africa through the ports of Cape Town in the south, Mombasa to the east and Freetown in the west, coming to Freetown aboard a British Royal Navy warship.

From the ports, the pandemic spread along the coasts and penetrated inland. It was spread by newly demobilized soldiers and their porters, families fleeing urban centres, and railway personnel and migrant workers trying to escape from mines and barracks.

It’s estimated that 50% of South Africa’s population contracted Spanish Flu in the space of a single month. The epidemic killed 300,000 people, or 6% of South Africa’s population, the bulk of them working adults between 18 and 40. De Beers resorted to mass company graves for its workers as there was nowhere else to bury them.

Like today, the blame game soon swung into action, with accusations of witchcraft and wizardry increasing. Howard Phillips, emeritus history professor at the University of Cape Town, writes in Epidemics: The Story of South Africa’s Five Most Lethal Human Diseases that some whites blamed Africans for spreading the disease as they fled. Some whites called for blacks to be banned from trains to prevent transmission; some Africans, especially in rural areas, believed that the flu was a white plot to slaughter them, and that hospitals and vaccinations had to be avoided at any cost.

The country’s developed railway system served as a vector of transmission and meant that the death rate was the highest in Africa. Many South Africans, Phillips writes, responded by self-isolating, which was already a time-honoured practice.

READ MORE: African Development Bank picks Citi for US dollar coronavirus bond sale

‘Insure to the Hilt’

According to Phillips, three factors determined which countries in Africa suffered most:  initial exposure only in the most virulent, second-wave form; being part of an extensive sea or land transport network and being regularly crossed by large numbers of people on the move.

These factors combined with the most devastating effect in South Africa, Kenya, Cameroon, Gold Coast, Gambia, Tanganyika and Nyasaland.

The most effective official action in South Africa, Phillips finds, was taken by municipal authorities. Volunteers opened temporary hospitals and relief depots which supplied food and medicine. These volunteers also disinfected houses where outbreaks had occurred and cleaned up unsanitary areas.

The apocalypse had one positive side-effect: people were prompted to buy life insurance.

Adverts proclaimed that insurers in South Africa had paid out a million pounds (about 57 million pounds or 1.16 billion rand in today’s money) to widows and orphans in October and November 1918. The insurance companies comfortably got their money back: new life insurance sold in South Africa in 1919 was estimated as being worth 20 million pounds, easily a record.

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