Remembering the ‘Spanish Flu’ in Asia

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Remembering the ‘Spanish Flu’ in Asia

As Asia weathers COVID-19, it’s worth recalling that the 1918 influenza pandemic did not spare Asia.

Remembering the ‘Spanish Flu’ in Asia
Credit: Otis Historical Archives, National Museum of Health and Medicine

The eruption of COVID-19 has focused the attention of the world’s political authorities, but has also made them cognizant of past experience. As we know, the “Spanish Flu,” so named because initial media reports suggested that the influenza originated in Spain rather than in U.S. Army training camps, devastated the United States and Europe in the final year of World War I. The world of 1918 was far less globalized than the world of today, with lower levels of international trade and international travel. Nevertheless, the influenza spread rapidly, attacking in three distinct waves in countries around the world. Distance provided little protection. The war itself helped spread the disease, as U.S. soldiers brought it to Europe, and Europeans spread it across the rest of the world. The flu made its mark on the great nations of East Asia as well, although with vastly different effects in each.

Japan was a co-belligerent of Britain and France in World War I, but had largely stayed out of intense warfare since the reduction of German concessions in China in 1914, although intervention in the Soviet Union in 1918 would bring Japanese troops back into action. Influenza struck the Japanese Army in November 1918, peaking about a month after the flu hit the armies on the Western Front in France. The death rate was somewhat lower in the Japanese Army than in its European counterparts, perhaps because operational demands interfered with treatment in the latter. Still, some 6-8 percent of victims of the influenza died. Overall, between 400,000 and 500,000 Japanese died of the Spanish Flu, with the population displaying the same “W” shape of morbidity that appeared in the West (the flu killed the young, the old, and a high percentage of young adults). Another 200,000 people died in Japanese-occupied Korea and Taiwan.

Influenza devastated British India, killing some 18 million people. India had supplied substantial personnel to the British, both in fighting strength and in auxiliaries. The disease spread quickly from its epicenter at Bombay, while colonial officials dithered and denied the severity of the outbreak. Mohandas K. Gandhi contracted the illness, but survived. The impact of the flu helped demonstrate the underlying weakness of the British imperial system, however, and facilitated the strengthening of the pro-independence movement.

The flu may have touched only lightly upon China. Unlike India, China was not fully colonized by European powers, leaving much of its agrarian population isolated from disease-spreading colonials. Unlike Japan, China’s population remained primarily agrarian in the first decades of the 20th century. Some suggest that traditional Chinese medicine, which had historically focused on the management of epidemics, may have played a role in limiting the spread and virulence of the virus. We should take this conclusion with a grain of salt, as China had little in the way of an effective central government at the time and consequently there are few good statistics about the impact of the virus.

Each of Japan, India, and China face much different problems today than they faced in 1918. Still, the Spanish Flu left a mark on all of them, with the impact mediated by differences in governing structure and in relationship to international society. It’s worthwhile for modern policymakers to keep the 1918 pandemic in mind when considering responses in 2020.