What Happened to U.S. Cities That Practiced–and Didn’t Practice–Social Distancing During 1918’s “Spanish Flu”

Americans have long been accused of growing socially distant, bowling alone, as Robert Putnam wrote in 2000, or worse becoming radicalized as "lone wolves" and isolated trolls. But we are seeing how much we depend on each other as social distancing becomes the painful normal. Not quite quarantine, social distancing involves a semi-voluntary restriction of our movements. For many people, this is, as they say, a big ask. But no matter what certain world leaders tell us, if at all possible, we should stay home, and stay a safe distance away from people who don’t live with us.

People in the U.S. have done this before, of course, just a little over a hundred years ago during the influenza epidemic called the “Spanish Flu,” though the buzzy term "social distancing" wasn’t used then. As the short VOA News video above explains, during the spread of the disease, city officials in St. Louis did what cities all over the country are doing now: shut down schools, playgrounds, libraries, churches, public offices, and parks and banned gatherings of over 20 people. Philadelphia, on the other hand, refused to do the same. The city “allowed a major World War I support parade to take place that attracted 20,000 people.”

The refusal to shut down large gatherings cost thousands of lives. “Three days later, every bed in Philadelphia’s 31 hospitals was filled with sick and dying Spanish flu patients.” COVID-19 may be a far milder illness in children and most healthy people, but this is exactly what makes it so insidious. One person can infect dozens before showing any symptoms, if ever. During the “Spanish” flu pandemic, “the best approaches were layered,” writes German Lopez at Vox. “It wasn’t enough to just tell people to stay home, because they might feel the need to go to school or work, or they could just ignore guidance and go to events, bars, church or other big gatherings anyway.”

The comparison between St. Louis and Philadelphia stresses the need for city officials to intervene in order for social distancing strategies to work. However we might feel in ordinary circumstances about governments banning public gatherings, the global spread of a deadly virus seems to warrant a coordinated public response that best contains the spread. “In practical terms,” Lopez points out, “this meant advising against or prohibiting just about every aspect of public life, from schools to restaurants to entertainment venues (with some exceptions for grocery stores and drugstores).”

Lopez cites several academic studies of the 1918 influenza outbreak as evidence of the effectiveness of social distancing. For even more data on our current pandemic, see Tomas Pueyo’s extensive Medium essay compiling data and statistics on COVID-19’s spread and prevention. And if you’re still having a little trouble figuring out what exactly “social distancing” involves, see this excellent guide from Asaf Bitton, physician, public health researcher, and director of the Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health.

As Bitton tells Isaac Chotiner in a recent New Yorker interview, “social distancing isn’t some external concept that applies only to work and school. Social distancing is really extreme. It is a concept that disconnects us physically from each other. It profoundly reorients our daily life habits. And it is very hard.” No matter how polarized we become, or how glued to our various screens, we are “social creatures” who need connection and community. When we make the transition out of life at a distance, maybe the memory of that need will help us overcome some of our pre-virus social alienation.

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Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

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