With the threat of Covid-19 breathing down our necks at every turn and life as we knew it uprooted with little warning, it’s hard not to feel anxious about the future and our ability to fight this invisible enemy.  It all seems so daunting but did you know that Grenada  (and the Caribbean) has been in this position once before?  A century ago we warded off a major worldwide pandemic, and survived.  

The Pandemic of 1918-1919

The Spanish Flu  hit our region about 100 years ago.  It appeared in 1918 during the final stages of WWI.  The whole world was reeling from the grief of a four four-year long war when this virulent killer struck. Virology studies and technology were merely decades old and countries were picking up the pieces in war–torn areas.  The world was ill-prepared.  Colonialism was in full swing around the world, including on most Caribbean islands.

The term, “Spanish Flu,” is a misnomer since it originated in the US in the first quarter of 1918.  It was so dubbed because Spain was the only country reporting on its devastation at the time, due to its neutral status during the war. [2].

This (new) influenza virus spread to Europe and then returned to the Americas with renewed vigour.  It killed an estimated 50-100 million, which is a figure revised upwards from the first estimates of  24.7- 39.3 million [2].  Not much is widely known about it because it is often overshadowed by WWI, which occupied press headlines and social statistics records throughout the world[3].

The Flu was said to have come in three waves.  The first wave caused only mild symptoms (although highly contagious), the second was most virulent in spread and mortality and the third wave was less severe.  The Flu affected the Caribbean between September 1918 and the first 4 months of 1919[1].

The Pandemic in the Caribbean

The virus entered the Caribbean via ships from the US and was seen in Guadeloupe and Puerto Rico from early September, 1918.  Jamaica was one of the worst hit along with Puerto Rico, Belize and Guyana.  The true scale of its impact in the Caribbean is unknown because of various factors; including the non-existence or incompleteness of official social statistics records.  

The overall death toll recorded in the Caribbean was about 100,000. Some areas were ravaged by the disease whereas others were mildly affected.  Disparities in mortality (death toll) and morbidity (infection rate) are attributed to varying factors. Some authorities took early preventative action while others did not.  The late arrival to the Windward Islands may have caused them to experience a weakened strain.  Some governments made the disease quarantinable but stopped short of making it a notifiable disease and, at that time in the Caribbean, hundreds of deaths in poor and isolated areas went unregistered[1].  

The Most Vulnerable

Unsurprisingly, the virus was most severe on the poor, living in small crowded houses or overpopulated areas. The isolated indigenous communities also received a colossal blow.  Reports in Guyana indicate that between 60-80% of the indigenous people were affected at one time and entire communities were obliterated.  Officials in badly affected areas observed that a lost sense of morale seemed to have an impact on mortality.  Those who fared well tended to live in less densely populated areas where it was easy to spend time outdoors[1].  

Whereas common influenza epidemics typically affected children and the very old, large numbers of young people in their 20s fell to this influenza.[3] 

Common Measures Taken in the Caribbean

The common preventative measures taken by territorial authorities in the Caribbean were not unlike those adopted around the world.  There were quarantines on shipping from the USA and other countries, restriction on movements from one parish to the next, isolation of affected individuals, dissemination of information via pamphlets, restriction on gatherings of more than 10 people and suspension of schools and worship gatherings.  The pamphlets contained information about the disease and its spread as well as preventative recommendations and suggested remedies.  Protective masks, a common measure also employed in the USA, were also recommended.  Unfortunately, most of these resources would have been inaccessible to many because of their expense or because of endemic inequities such as those relating to literacy.  

Communities in territories whose governments took little or no action imposed their own  restrictions.[1]

The Windward Islands and Our Neighbours

The Windward islands had varying experiences with the virus’s impact.  St. Lucia saw the Flu’s entry in mid-November and it had spread throughout the whole island by the end of the month, with its highest death rate concentrated in the Roseau valley and Cul-de-Sac.  

In Dominica, the “Christmas Flu,” as it was locally dubbed, was present from late November.  They experienced a mild touch at first and its spread was fairly slow but, by the end of December, it had paralyzed the island.  

As for St. Vincent, anticipating its imminent arrival, several demands for the government to improve sanitary conditions were made early via the press.  The virus exhausted itself within two weeks of its first showing in mid- December, causing only a low death toll.  The press of that period highlighted the interruption of trade in imported fish and meat and the urgent need to improve public health as the most important issues in the wake of the pandemic.

Barbados was very mildly touched with a low mortality rate, although many were infected.[1]

Grenada’s Pandemic Experience

In Grenada, the Flu appeared in early December and by 12th December, 1918,  quarantine measures were in place on trade with Venezuela, Panama, Canada and the United States.  It was declared a notifiable disease before the end of the year.  Its actual toll is difficult to interpret because of seemingly conflicting reports vs records: Medical officers described it as devastating, yet death records don’t reflect any significant increase in that year nor was there a significant number of deaths attributed to the flu.  This could be because of poorly regulated death certification at the time.  One could make an informed guess that, perhaps, the disease was severe for many but not not fatal.

Trinidad and Tobago

Our southern neighbours, Trinidad and Tobago were touched fairly lightly by the disease despite its impact in Venezuela.  The press was vocal, both in its reporting and in demanding action from the government. Trinidad recorded more than 350 deaths from the Flu and pneumonia in that period.  Tobago had no deaths recorded from it whatsoever, although the disease was prevalent in some areas.  One health official stated that the disease was mild and hoped it was a secondary wave of Influenza which “would confer on the inhabitants of Tobago a partial immunity.”[1]

The Takeaway

Our small island and region has done this before.  We confronted a severe pandemic in times when health systems, communication and resources were a lot more limited than they are today.   We sustained injuries but survived with the employment of preventative measures and the leadership of authorities that were quick to action.  In fact, reading about some of these measures was like reading about our situation in Grenada today.  Oh, how history can repeat itself!

But aren’t we in a better situation today? We have more access to healthcare, a better understanding of how viruses work, more access to preventative resources, the ability to transition to online work, learning and worship, quick thinking and responsive authorities, amazing medical professionals and access to ongoing discoveries on COVID-19.  Can we overcome this?  Yes, we can and we will.  Let’s keep calm and follow official guidelines.  Stay Safe, Grenada.

WRITTEN BY FAYOLA MOORE-EDWARDS

REFERENCES

1. DAVID KILLINGRAY, The Influenza Pandemic of 1918–1919 in the British Caribbean, Social History of Medicine, Volume 7, Issue 1, April 1994, Pages 59–87, https://doi.org/10.1093/shm/7.1.59
2. Roser, Max (2020). The Spanish flu (1918-20): The global impact of the largest influenza pandemic in history. Retrieved from https://ourworldindata.org/spanish-flu-largest-influenza-pandemic-in-history
3. [The Great Courses Plus]. (2020, March 26). The 1918 Spanish Flu-A Conspiracy of Silence | Mysteries of the Microscopic World (Part 1 of 3) [Video]. YouTube. https://www.youtube.com/watch?v=7MHT5xTkL2g&t=32s
4. [The Great Courses Plus]. (2020, March 26). The 1918 Spanish Flu-A Conspiracy of Silence | Mysteries of the Microscopic World (Part 2 of 3) [Video]. YouTube. https://www.youtube.com/watch?v=TkgQQaVgqMw