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The Aetiology of the Influenza Pandemic of 1918 and the COVID-19 Pandemic of 2019–2021


Notably, the influenza pandemic of 1918 and the covid-19 pandemic of 2019-2021 resulted in the most fatal disease infections in modern times. The two have been separated by a century. Even though unrelated viruses caused them, these two pandemics can be regarded as similar in terms of their pathological, clinical, and epidemiological features and incorporate almost similar public, civic and other medical and Health responses to combat them. Thus, the lens of this paper will be centred on critically assessing the aetiology of the two pandemics, their risk factors and some of the public health policies initiated in response to combat their spread.

Disease Etiology

Influenza Virus; Looking at The influenza virus of 1918 was the most severe in recent history. It was caused by the H1N1 virus that had genes of an avian origin. Thus, there may not be a universal consensus about the origin of the influenza virus; it spread across the globe between 1918 and 1919 (Linlin et al., 2020). Looking at the United States, the disease was formally identified by military personnel during the 1918 spring. After its identification, it was later estimated that about 500 million individuals, equivalent to one-third of the world’s population, would become infected with the virus (1918 flu pandemic). A massive and significant number of deaths was witnessed and was estimated to attest to 50 million of the world’s population and 675,000 deaths reported in the united states.

Influenza Virus and Covid-19 based on the ideas of (Morens & Taubenberger 2021)

Figure 1 Influenza Virus and Covid-19 based on the ideas of (Morens & Taubenberger 2021)

Covid-19; looking at the aetiology of the covid-19 virus, the virus can be said to have developed due to the entry of SARS-CoV-2 into a host cell through the ACE2 receptors (Yang & Zheng, 2020). In addition, the infection as a result of SARS-CoV-2 resulted in AMI (Acute Myocardial Injury) and later gave rise to chronic damage to the cardiovascular system. It was first reported in an outbreak in 2019, and this was in Wuhan, Hubei Province, in China (Hashim & Alsuwaidi, 2020). It is a virus that was identified to belong to the beta coronavirus class and alongside the Middle East corona Virus repository syndrome.

Risk factors:

Covid-19 virus; looking at the current evidence, it has been suggested that children who exhibit medical complexities, have metabolic conditions and genetic or neurologic factors, and have congenital heart disease, are likely to be infected or contract the covid-19. Similarly, looking at adults, some children have obesity, chronic lung disease, asthma, sickle cell disease, and are immune compromised; they will also be at risk of getting to contract the covid-19 virus (Rashedi et al., 2020). Other risk factors for the global covid-19 pandemic are the male gender, older age or the elderly in the society or community, obese individuals and those who exhibit chronic kidney diseases. Other risk factors include being in close contact with someone who has contracted the virus, especially someone who has exhibited the civil-19 symptoms. Being sneezed or coughed on by an infected person and being near or in close contact with an infected person in an indoor space that lacks proper ventilation or airflow.

Influenza virus; people at a higher risk of contracting the influenza virus will be the following; young children under age 2, older adults older than 65 years, residents of all nursing homes as well as other long-term care facilities (Flerlage & Boyd, 2021). Nursing or expectant mothers, those planning to be pregnant during the influenza virus period, individuals who have weakened immune systems, Alaska natives and American Indians, individuals who showcase chronic illnesses such as heart disease, asthma, kidney failure, diabetes and even lover disease (Kalil & Thomas, 2019)—finally, those who have a body mass index of 40 and higher.

Public health policies to reduce the spread of the two diseases;

Covid-19, the government, in conjunction with the Ministry of, Health, formulated and adopted several containment measures to flatten the curve of the epidemic peak and suppress the disease transmission. Some of the containment measures included staying at home, office closure, community mobility, good personal hygiene, sanitization measures, massive education among the citizen on hand washing techniques, the use of masks, a quarantine period of 21 days, not touching animals in the market, and visiting a doctor whenever one feels to have fever or flue like infection (Rashedi et al., 2020). This gave rise to the invention of covid-19 vaccines to contain the spread of the virus as a public policy measure, as individuals were required to get vaccinated, especially those from the risk factor groups.

Influenza virus; one of the most effective public policies to contain the soaring virus was having safe and effective vaccines, which were expected to be used for over 60 years. Isolation procedures were followed to the letter, such as droplet precautions, contact precautions, and airborne precautions.


The bottom line is that both covid-19 and the influenza virus are not similar diseases but share similar clinical features. They are all transmitted or acquired through respiratory inoculation, and they both emerged or originated from global populations with little to no preexisting immunity. Some typical full-blown signs and symptoms are fatigue, chills, fever, cough, headache, nausea, dementia, vomiting, and diarrhoea. In the case of covid-19, there are unusual and late complications with increased frequency, organ damage, and inflammation syndromes. However, for the 1918 influenza virus, it has not been clear to what extent the neurological complication occurred.


1918 flu pandemic. C. (n.d.).

Rashedi, J., Mahdavi Poor, B., Asgharzadeh, V., Pourostadi, M., Samadi Kafil, H., Vegari, A., … & Asgharzadeh, M. (2020). Risk factors for COVID-19. Infez Med28(4), 469-474.

Hashim, M. J., Alsuwaidi, A. R., & Khan, G. (2020). Population risk factors for COVID-19 mortality in 93 countries. Journal of Epidemiology and Global Health10(3), 204.

Kalil, A. C., & Thomas, P. G. (2019). Influenza virus-related critical illness: pathophysiology and epidemiology. Critical care23, 1-7.

Flerlage, T., Boyd, D. F., Meliopoulos, V., Thomas, P. G., & Schultz-Cherry, S. (2021). Influenza virus and SARS-CoV-2: pathogenesis and host responses in the respiratory tract. Nature Reviews Microbiology19(7), 425-441.

Linlin, L., Shi, H., Xiao, Y., Xiang, L., Guojun, Y., & Bin, F. (2020). Epidemiology and aetiology of influenza in Hubei province, 2016–2019. 疾病监测35(12), 1105-1109.

Yang, R. X., Zheng, R. D., & Fan, J. G. (2020). Aetiology and management of liver injury in patients with COVID-19. World Journal of Gastroenterology26(32), 4753.

Morens, D. M., Taubenberger, J. K., & Fauci, A. S. (2021, June). A centenary tale of two pandemics: The 1918 influenza pandemic and covid-19, part I. American Journal of Public Health.


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