Tanzina Vega: This is The Takeaway, I'm Tanzina Vega. Americans across the nation are putting their traditional Thanksgiving plans on-hold this year as the number of COVID-19 cases in the country continues to rise. This isn't the first time Americans have celebrated Thanksgiving during a pandemic. The 1918 flu pandemic claimed 50 million lives worldwide, including 675,000 Americans.

The Takeaway spoke to Alex Navarro, the Assistant Director of the Center for the History of Medicine at the University of Michigan, to give us a look at how people celebrated Thanksgiving in 1918 and how it compares to today. Alex, started by reminding me about the state of the flu pandemic during Thanksgiving in 1918.

Alex Navarro: In 1918, Thanksgiving came at the tail-end of the fall wave, that deadly second wave, and so Thanksgiving was a little bit different than today. Today we're still in the midst of our pandemic. Of course, we're in the third surge of it. Things are getting worse. In 1918, things were actually getting a lot better for most of the country by the time of Thanksgiving.

It really was a time of celebration. It was the end of the war. The war had ended on November 11th and so at least for those family members who hadn't lost someone, and of course, hundreds of thousands of people died during the fall wave of the pandemic in the United States, but for the rest of the country, it was a time of celebration.

Tanzina: Remind us as we are being reminded today to wear masks and social distance, what were the public health regulations back in 1918? Were they similar?

Alex: They were very similar. In some ways they were not quite as sweeping. There were a number of mask recommendations and in some cities and communities, particularly out West, there were some mandatory mask mandates. There were also large numbers of school closures, pretty much every community across the United States with a few notable exceptions in New York City, for example, and Chicago closed their schools. Oftentimes several times closing their schools when they had another surge of cases.

Tanzina: It sounds like what we're going through here.

Alex: Exactly. They also closed places of public amusements. These were the types of business closures that they utilized in 1918. They did not issue sweeping closures of all non-essential businesses, but they did close places like movie theaters, performance theaters, cafes, bowling alleys, and dance halls, et cetera, but those are the types of closures that were used.

Tanzina: We're also hearing this year guidance from the CDC that's telling Americans not to travel for Thanksgiving to avoid passing COVID-19 onto more vulnerable family members. Were there similar restrictions on how people were allowed to celebrate Thanksgiving in 1918 in order to prevent the spread of the flu then?

Alex: There weren't, and this is one of the interesting points of contrast. We often compare the 1918 pandemic with COVID-19, but this is a point of contrast. By and large, no, there were not warnings to not gather. In fact, people were told to go out and celebrate. Again, it was at the end of the war and so if you had a service member in your family who was overseas in Europe, you are now happy, of course, that they would be coming home and being demobilized in the coming months.

If you had a service member who was stationed in the United States, that person may have been able to get some leave and travel to come see you. If not, if they couldn't travel or if it was too far, local families often took in soldiers and sailors from the local camps and Naval stations to celebrate Thanksgiving. The pandemic was, again, largely over, the least of worst of it was over by the time of Thanksgiving, there was another wave in the winter of 1919, the third wave.

It was deadly. It was not nearly as bad as the fall wave, and so for most of the country, again, for those who had not lost someone to the pandemic, people were really celebrating both the end of the pandemic, the end of the war, and in a growing sense of a return to normalcy.

Tanzina: What did the media's coverage of that moment look like of Thanksgiving during the 1918 pandemic?

Alex: If you look at the media coverage at the time, lots of notices of families who were willing to take in soldiers, for example, who are clergy members who were hosting a large Thanksgiving gathering for those who had no family or for perhaps for the indigent. Really quite different than what we're experiencing today. Again, that was partly because of the timing of the epidemics.

These are two, although we compare them, they're two very different diseases and so they had two different types of pandemics. The curves looked different, but also because of public health messaging. Once they realized or thought that they were over that first big spike of cases in 1918, in the fall of 1918, most public health officials looked back and questioned a little bit, whether or not those social distancing orders that they had implemented actually worked.

The thought was that if they had worked there wouldn't really be a pandemic, and of course, that wasn't true, we did have a pandemic. What they had done was they flattened the curve, but they didn't quite realize that at the time and so there was a little bit of hand ringing after that thinking, "Well, we went through all this social dislocation really for nothing, and so for the rest of the pandemic, there will continue to be cases, continue to be deaths. It won't be as bad, and we just need to grind it out."

Now that's not the messaging we're getting today, of course, from public health officials. I do worry that that is sort of what we're going to end up doing as a society at large is just becoming newer to the amount of death and the number of cases and that we're just going to end up grinding out the rest of this epidemic until we get vaccines distributed.

Tanzina: I'm wondering about that January 1919 third wave that you mentioned earlier, because I think there are some people who are deeply concerned about what we're going through right now. There almost feel like there are two Americas. The ones that are saying, "Let's just not see grandma for Thanksgiving and/or Christmas, and let's just batten down the hatches and get through these next couple of months," and others who, to your point, are saying, "That's okay, we're just going to get through this as a nation," but there are big differences, as you've mentioned, between the two diseases. One is that COVID-19 is vastly more contagious, is that right?

Alex: That is true. Yes. It's at least twice as contagious as influenza in 1918 was. Now it's less deadly, but it's far more contagious. That means that the epidemic is going to be longer. We've heard lots of talk about the threshold for herd immunity, which is really a vaccination concept. What it means in terms of herd immunity is that threshold is about twice as high. For 1918, that strain of influenza, the threshold for herd immunity was about 30 to 35%. It's about 60 to 70% for COVID because it's much more infectious.

Tanzina: Alex, I had went to Costco recently and looked around at the thousands of frozen meatballs and other delicacies that one would buy normally for a party. I kept thinking, "Well, you know what, this Thanksgiving is a wash, but next year's Thanksgiving is going to be epic." Will we make it, will we be able by then given what we know about the history of medicine and these types of illnesses to get there? Can I have an epic Thanksgiving next year?

Alex: I think you can, historians are always a little bit leery about making prognostications of the future. I think, however, we know now that we have at least two and recently a third AstraZeneca vaccine announced that seem to be very effective. There'll be others coming on line as well. We're going to have to batten down the hatches as much as we can until we can get these doses distributed.

It's going to be a monumental task to get shots into people's arms and these vaccines require two doses. I think over the course of the next year of 2021, I think we will slowly see a return to normalcy. I would say that if you find any good sales stock up now for next year, put stuff in the freezer and be prepared to have a great holiday bash next year.

Tanzina: Epic, Alex Navarro is the Assistant Director of the Center for the History of Medicine at the University of Michigan. Alex, thanks so much for joining us.

Alex: You're quite welcome.

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