Lessons from the 1918 Influenza Pandemic for the COVID-19 Pandemic and Experience from Cancer Navigation in Indonesia
"1918 influenza pandemic is the fountainhead virus which gave a background to the major global pandemic which had taken the lives of millions of people worldwide", said Prof. Siddarth Candra. He is an epidemiologist who attended the WEBINAR series of South East Asia Talk, organized by the Centre of Southeast Asian Social Studies (CESASS), Universitas Gadjah Mada, a center of excellence in social science under the Indonesian Ministry of Research, Technology and Higher Education since 2016. This Webinar 36# was a cooperation between CESASS and the American Institute of Indonesian Studies (AIFIS), State University of Michigan, USA.
Not many knew that the 1918 influenza pandemic had taken more or less 50.000.000 million people worldwide. In Indonesia, the epidemic took a hefty toll in terms of loss of life [1]. The population's reduction due to the outbreak, which includes increased deaths and lowered births, exceeded 4 million. While the COVID-19 pandemic has not taken as many lives to date, nevertheless, there are still many parallels between the 1918 pandemic and the COVID-19 pandemic nowadays. For instance, a virus is a cause for both diseases, for which there has yet not found a cure. As a result, today, we are using the same measures to prevent the spread of the disease as people took in 1918 to prevent the spread of influenza. The measures include paying close attention to personal hygiene, social distancing, and avoiding travel and large gatherings.
Although COVID-19 is highly contagious and there is no cure at least for today, there are many reasons Indonesia's experience with COVID-19 may end up being very different from the experience with the 1918 influenza. First, communication today is much more rapid than it was in 1918. As a result, Indonesians are in a position to share experiences and best practices with people around the world as well as to learn from the best practices and experiences of others. For example, by the time COVID-19 arrived in Indonesia, the government and large portions of the population had already heard about China's experience where the disease originated. They also prepared to take steps to prevent the spread of the disease. In 1918, when influenza arrived in Java, most people were completely unaware of the condition. We also swiftly learned that COVID-19 struck older people more harshly, and we prepared to take extreme precautions to prevent them from falling ill. The 1918 influenza affected people between the ages of 20 and 40 the most severely, but there was little awareness of this fact while Indonesia was experiencing the pandemic. We also know that social distancing can help prevent the rapid spread of COVID-19, and thus we have soon implemented these social-distancing practices. This appeal is significantly vital in several crowded areas in Indonesia.
The most important reason to be optimistic about the global experience with COVID-19 is that we have much better technology preparation to confront a viral pandemic today than we were in 1918. In 1918, scientists were debating the most basic questions about influenza, including whether a virus or a bacterium caused it. When COVID-19 arrived, we were able to sequence the virus's genetic code within a few weeks. Today, based on that and other kinds of scientific knowledge, over 100 different candidates for vaccines are being developed and tested. In addition to the possibility of having a vaccine within the next year, we can test people for the presence of the virus and quarantine them if necessary. We have communication technology where we can trace contacts of infected people and soon isolate them, thereby preventing the spread of the disease. In hospitals, we have ventilators to help severely ill patients breathe as their bodies fight the virus. None of these options was available during the 1918 influenza pandemic.
Also, at the same important, is the latest study of the navigation of cancer surgery care in limited-resource countries during COVID-19 pandemic by Sumadi Lukman Anwar, MD, Ph.D. from the Faculty of Medicine, Universitas Gadjah Mada. In this presentation, he shared the complexity of Indonesia's health system, especially the treatment for patients who have problems with cancer. Amid the massive gravity of Covid-19 and amid the government protocol in eliminating the spread of this pandemic, he argued that it still should take specific considerations as a counterbalance between on the one side preventing COVID-19 transmission and on the other hand also preserving patients' long-term life expectancy.
In their closing statement, for all of the above reasons, both scholars highlighted that today's experience with COVID-19 is likely to be very different and complex. However, while we wait for the development of a vaccine or, better still, a cure, we need to remember that there are still millions of people who remain susceptible to COVID-19. The virus that causes this illness is novel, and our immune systems have not yet developed the ability to fight it. As a result, keeping these populations safe while gradually opening the economy to provide livelihoods to millions of people is going to be an ongoing challenge until we can develop a vaccine or a cure for COVID-19.
Dr. phil. Vissia Ita Yulianto (CESASS) who moderated this webinar series, added that the task to combat the spread of Covid- 19 should be shouldered not only on the government intervention and medical workers but must also be realized by collective awareness from the public by obeying the protocol from the government.
Author:
Pusat Studi Sosial Asia Tenggara (PSSAT) UGM
[1] Chandra, Siddharth. 2013. "Mortality from the influenza pandemic of 1918-19 in Indonesia," Population Studies 67(2):85-93. https://www.tandfonline.com/doi/full/10.1080/00324728.2012.754486