Pandemic 1918

The so-called Spanish flu of 1918/19 is estimated to have killed more than 50 million of the 500 million people it infected, including 228,000 in the UK. It was the planet's biggest single natural human catastrophe - a flu pandemic that killed more people than both world wars put together in a fraction of the time. And yet this huge moment in history remains largely under the radar.

In three programmes, he charts the story of how the 1918/19 flu pandemic affected the UK and the world.

In Episode 1, he looks at the much debated origins of the H1N1 strain of flu. There are three theories - firstly it incubated in an army camp in the United States, secondly it originated from China, and thirdly (John's theory) that it probably began a couple of years earlier inside a military camp near the Western front in France. The real truth about the origin remains a conundrum to frustrated scientists.

John also looks at the symptoms, some of them remarkably similar to the ones we see today with coronavirus. Both diseases affect the respiratory system and lead to coughs and fevers but there are specifics which make them both unique. The H1N1 strain of the flu would turn people a strange purple colour, give them severe headaches and, in many cases, delirium. In 1918, a secondary disease like bacterial pneumonia could not be treated with antibiotics.

This particular strain of the flu tended to affect younger, fitter people. Around half of all those who died were in their 20s to 40s. Pregnant women died and so did their children. It's thought many elderly people had built up immunity from previous serious outbreaks of flu in the 1800s.

Through powerful testimony we hear how the spread of the disease was stark and affected the whole world in extremely quick time. Ships and trains became the incubators and it's believed the flu was first brought into Britain by soldiers returning to Scotland. It wasn't unusual for a soldier who had survived four years of bloody conflict to return from the front on a Monday and be dead by Thursday. Whole families were wiped out by the Spanish flu.

In every part of the world, the fear of death was palpable. Professor Howard Phillips, Professor of History (Capetown University, South Africa), tells the programme, 'It all happened at dramatic speed. One man wrote, 'I wonder if humanity will survive'. In that situation, hearing a sneeze would have been spine-chilling.

And in a frightening reminder of how pandemics evolve, John explains how the killer flu came in three waves - firstly in the spring of 1918, then in the autumn of the same year and again in early 1919. Armistice celebrations at the end of the First World War helped to make the second wave even more deadly than the first.

Episode 2 looks at how the authorities in the UK and around the world reacted to the flu in different ways and how misinformation played its part. Episode 3 examines the long term impact on people, communities and on general health.

Produced by Ashley Byrne and Iain Mackness

A Made in Manchester production for BBC Radio 4

Virologist Professor John Oxford charts the spread and impact of the 1918-19 flu pandemic.

Series on the flu pandemic that devastated much of the planet just over 100 years ago.

The so-called Spanish flu of 1918/19 is estimated to have killed more than 50 million of the 500 million people it infected, including 228,000 in the UK. It was the planet's biggest single natural human catastrophe - a flu pandemic that killed more people than both world wars put together in a fraction of the time. And yet this huge moment in history remains largely under the radar.

In three programmes, he charts the story of how the 1918/19 flu pandemic affected the UK and the world.

In Episode 2, he looks at how communities and the different authorities in the UK and around the world reacted to the arrival of this killer disease.

In Britain, towns and cities which acted quickly in shutting schools, cinemas and so on, managed to prevent the worst. This was a time before the NHS, so everything was dealt with on a very local level. In Manchester, the medical officer Dr James Niven (brought to life here through reports he wrote at the time) was praised for his work in protecting the city from the worst of the first wave. But other parts of the UK were much slower and there were often rebellious outbursts from cinema owners and others determined to keep open, despite the obvious threats.

There were no mass quarantines, social distancing practices or lockdowns in 1918/19. Factory work continued, but half of workers were off with symptoms and many would never return. in some places, people were advised not to touch, kiss or shake hands, to keep distances and to wash hands regularly, while in New York a strict ban on spitting in the street was introduced.

There was no mass media in 1918 but it didn't stop the spread of mis-information around quack cures and how you could prevent yourself from contracting the illness - not unlike some of the unreliable advice being pushed over the internet today around Covid-19.

Despite the death rate and risks, people still joined in huge crowds on the streets across Britain and Ireland to celebrate the Armistice in November 1918. Inevitably more were infected as a result, in what became the second wave.

Basic nursing was key to whether or not people survived. In some places, St John's Ambulance personnel were brought in. In other places, older and retired medical staff joined in the care effort.

Some doctors had huge catchment areas and couldn't get around all their patients. This was made worse by a shortage of doctors. Many were still on the Western Front and doctors and nurses treating the sick in makeshift hospitals succumbed to the virus and died themselves.

We hear how very few parts of the world were unaffected in some way. The population on the tiny Island of Western Samoa was almost completely wiped out due to poor decisions by the New Zealand government which only recently apologised to the people of the island. Meanwhile, American Samoa was the only place in the world to completely escape after the US General there implemented the very strictest of quarantine measures.

Episode 3 examines the long term impact on people, communities and on general health.

Produced by Ashley Byrne and Iain Mackness

A Made in Manchester production for BBC Radio 4

Virologist Professor John Oxford charts the spread and impact of the 1918-19 flu pandemic.

Series on the flu pandemic that devastated much of the planet just over 100 years ago.

The so-called Spanish flu of 1918/19 is estimated to have killed more than 50 million of the 500 million people it infected, including 228,000 in the UK. It was the planet's biggest single natural human catastrophe - a flu pandemic that killed more people than both world wars put together in a fraction of the time. And yet this huge moment in history remains largely under the radar.

In three programmes, he charts the story of how the 1918/19 flu pandemic affected the UK and the world.

In Episode 3, he looks at the long-term impact of the flu on health, communities, the economy and governments.

Britain and much of the world was never the same again. Whole generations and communities were wiped out - 900,000 orphans were created in just four weeks in one part of Africa, while some people never recovered from the long-lasting impact of having the flu. Many remained desperately weak and died long before their time. Others developed Encephalitis Lethargica, which put 5 million people worldwide into a long term coma.

And the events of 1918/19 changed dramatically the way different countries saw health provision. New Zealand was quick off the mark with huge changes almost immediately, while the devastating experiences of 1918/19 in the UK would lead eventually to the development of the National Health Service.

The economy wasn't helped by the killer flu. The war, political uncertainty in Ireland and the aftermath of the Russian Revolution created a perfect storm. Many businesses around before the war would not return, and unemployment and poverty were rife in the early 1920s.

But it did lead to some early change in Britain around general health and well-being, with more focus on housing to deal with a huge overcrowding crisis, clean water supplies and access to other utilities.

The impact on mental health can't be underestimated. Depression was a huge fact of life for many in the post-flu period, and we hear testimony about loved ones who were never quite themselves again - some never wanting to discuss the flu, others having a severe continual sense of fear and insecurity that nothing was safe and that, one day, more people might be taken from them.

Produced by Ashley Byrne and Iain Mackness

A Made in Manchester production for Radio 4

Virologist Professor John Oxford charts the spread and impact of the 1918-19 flu pandemic.

Series on the flu pandemic that devastated much of the planet just over 100 years ago.