Monique Keiran: So, do you remember the pandemic of 1918?

Last week, one of Nature Boy’s colleagues was told that a health-care specialist she’d visited just days before might have been exposed to the COVID-19 virus earlier and was being tested.

Within the hour, Nature Boy’s office was shut down, the employees were on their way home to isolate and monitor themselves for symptoms, and the possibly exposed colleague — employed in an essential line of work — was seeking to be tested for COVID-19 herself.

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These are extraordinary times.

We’ve been here before.

Well, not me, personally, and not you, either. Few people remain who experienced the events of 1918-1920. In those three years, as a hugely disruptive world war entered, then completed, its final, most devastating phase, a virulent form of influenza swept the world.

The Spanish flu pandemic killed between 50 million and 100 million people worldwide. The virus sickened almost one-quarter of Canada’s population. Of those, about 50,000 died.

For perspective, only (only!) 20-22 million people — the numbers vary depending on the source cited — including about 61,000 Canadians, are known to have died because of the First World War.

Unlike COVID-19, which poses the greatest risk to the elderly and those with compromised immune systems or underlying health problem, the influenza virus circulating 100 years ago targeted young, otherwise healthy people with strong immune systems.

People ages 20 to 40 years were at greatest risk for dying. The respiratory distress was so sudden and severe, a person could go to bed seemingly healthy in the evening and be dead by morning — having drowned as their lungs filled with fluid overnight.

In B.C., three waves of the pandemic accounted for 4,400 deaths, or about one out of every 100 British Columbians. Of those deaths, about 900 occurred in Vancouver. There, 2.33 per cent of the city’s population died — a rate higher than those reported for most other North American cities.

Victoria fared much better. Only 218 Victoria residents died from flu or combined flu and pneumonia, or about 0.75 per cent of the population at the time.

The difference between the two cities is due largely to their different responses to the pandemic.

Vancouver reported its first case on Oct. 5, 1918, but responded conservatively.

Vancouver Chief Medical Officer Dr. Frederick T. Underhill undertook a public education campaign to urge adults to avoid crowds, wet feet, low necklines and public towels and drinking cups, and to keep their mouths, skin and clothes clean, cover coughs and sneezes, and open windows for ventilation.

Vancouver Mayor R.H. Gale advocated more aggressive measures, including closing public facilities and banning public gatherings, but Underhill and local businesses and churches resisted for days.

Within three weeks, the city was reporting 500 new cases a day. The toll increased as stricken, desperate people from logging and mining camps and isolated communities up the coast converged on the city, seeking treatment. The epidemic peaked on Oct. 27, with the city reporting 24 deaths from the flu in just 24 hours.

When the first case of influenza emerged in Victoria, city health officer Dr. Arthur G. Price responded quickly to deploy tactics that would be familiar to us from these past few weeks.

Price used the newly enacted provincial Public Health Act, which empowered a city’s medical health officer to close public spaces, enforced by the police, to close schools, churches, libraries, theatres, colleges and dance halls, and ban community gatherings — much to some groups’ dismay and disgruntlement.

He urged residents to avoid anyone who showed signs of illness and to isolate themselves if they developed symptoms themselves. City-wide campaigns to disinfect homes, hospitals, schools, churches, hotels, stores, offices and shops also occurred.

The meeting ban remained in force until Nov. 20, was re-invoked in January 1919 and in February 1920 — at which point, the Victoria School Board refused to comply. The city reported its highest number of cases in any single month during that 1920 wave.

This comparison of B.C. community responses to the Spanish flu pandemic and the resulting death rates mirrors examples reported elsewhere.

Even the travel bans, imposed quarantine measures and requests that non-residents postpone visiting communities such as Denman, Hornby and Quadra islands, Tofino and Ucluelet, for example, have precedents in responses taken by communities and even provinces a century ago to help keep residents safe and healthy.

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