OREGON, USA — Both health experts and historians say the "end" of the COVID-19 pandemic will not be a finish line. Some changes and impacts will be felt for generations.
Oregon State University associate professor Christopher Nichols has done a lot of research into the flu pandemic of 1918, which killed at least 50 million people worldwide and about 675,000 people in the US.
He said since the beginning of the COVID-19 pandemic, his work gained a lot of attention for the lessons 1918 can lend.
"How do we understand our present moment, how do we grabble with something like this?" Nichols described.
Both pandemics involved similar prevention strategies, such as closure policies, distancing and masks.
However, without robust health infrastructure and means of mass communication, people in 1918 didn't know why so many were dying.
"People wouldn't help their neighbors in some communities," Nichols said. "They really got clammed up by fear related to the flu."
Misinformation was also a problem, with some publications speculating about how the flu virus spread.
"One newspaper said ... from the phone, so people avoided phone calls," Nichols explained.
However, he said the political division seen during COVID-19 was much less present.
"In 1918, there really wasn't politics of the flu," Nichols said. "And it wasn't a deliberate misinformation campaign in the way that we've seen perpetuated on social media. That's really different, really insidious. And there's no historical precedent to help us deal with that, except that we need to keep talking about it."
After the 1918 pandemic, health was never the same. Variants of the virus persisted.
"That gave rise to the seasonal flu as we know it ... That is almost exactly what's going to happen with COVID," Nichols said. "[What's different now], the capacity to ramp up vaccines, which we've amazingly done, the fastest in world history."
He said the era after COVID will likely see similar culture trends as the 1920s: renewed joy and appreciation for events and gatherings that were put on hold. The 1920s saw a community renaissance of music, dance, movies and sporting events.
That same decade also serves as a warning, Nichols said.
"We may also see the underside — the xenophobia, alienation, fractured and fragmented politics."
That included a rise in the Ku Klux Klan in national politics.
One factor in the U.S. trend of xenophobia at the time was the designation of "Spanish flu," implying some people were the source or more susceptible to getting sick. Nichols said that parallels anti-Asian sentiments today with COVID.
"Pejoratives that have been expressed about this being a 'China flu.'"
For many countries, including Germany and Canada, the 1918 pandemic was a turning point for health care reform, with shifts to more universal models.
"The U.S. largely didn't create federal structures to deal with health care or the next pandemic, so that will be a question people have to ask moving forward."
He said many companies will likely change marketing tactics to serve people's newfound priorities post-COVID, much like advertisers did in 1920.
"Trying to live your life as fully as you can, and you have to believe some of that comes out of the pandemic experience."