What the 1918 flu pandemic can teach us about coronavirus

Authors of books on 1918 warned everyone about future pandemics. Here's where we went wrong.

(CNN)At this point in the coronavirus pandemic, with more than 32 million infected and more than 980,000 dead worldwide, describing this time as "unprecedented" may sound like nails on a chalkboard.

This pandemic, however, actually isn't without precedent: The last time we dealt with a pandemic so mysterious, uncontained and far-reaching was in 1918, when influenza devastated populations around the globe.
1918: Nurses care for victims of an influenza epidemic outdoors amid canvas tents in Lawrence, Massachusetts.
The 1918 flu killed 50 million to 100 million people through 1919. There are eerie parallels between the 1918 flu and the 2020 coronavirus pandemic: a disease with a startling range of symptoms for which there is little treatment, human behavior as a hindrance to public health and cluster outbreaks that have become widespread, to name a few.
For 102 years, influenza scholars and infectious disease experts have attempted to educate the masses in hopes of preventing future pandemics. And yet, here we are.
    To be clear, the coronavirus at fault for the current pandemic isn't a flu virus. And yet the 1918 and 2020 pandemics share similarities in terms of their basis on a novel, formidable virus that took the world and every aspect of society by storm. To learn the lessons of the 1918 flu, the missteps we've taken since and our post-pandemic future, CNN spoke with three experts on the subject.
    They are John M. Barry, author of "The Great Influenza: The Story of the Deadliest Pandemic in History"; Dr. Jeremy Brown, an emergency care physician and author of "Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History"; and Gina Kolata, a science and medicine reporter with The New York Times and author of "Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It."
    These conversations have been edited and condensed for clarity.
    CNN: What are the lessons of the 1918 pandemic?
    John M. Barry: Number one, tell the truth. Number two, nonpharmaceutical interventions work. The Asian countries, New Zealand, Germany and Senegal have done an incredibly good job because of transparency. But we've demonstrated you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven't done them. We haven't adhered to them; we've played with them.
    Dr. Jeremy Brown: There was a backlash against the wearing of masks in San Francisco in late 1918 and early 1919. People essentially were fed up. There was a group of libertarians who suggested that it was a breach of their rights and freedoms to be forced to wear masks, and actually ended up preventing the board of health there from renewing a mandate to wear masks.
    Young adults were more likely to die during the 1918 flu pandemic, in contrast to the current Covid-19 pandemic, in which the elderly face a higher risk of serious illness and death.
    What happened was another spike in San Francisco in influenza cases in early 1919, and they went back to wearing masks. The message is, perhaps, that things are not as novel as they might seem, and that human behavior in response to pandemics of this magnitude is actually fairly predictable.
    Gina Kolata: Even though we know exactly what the 1918 virus looks like, we still don't know why it was so deadly.
    And here we have the coronavirus, and we know so much more, and we still don't really know why it's so deadly or what it's doing. I think that's a very powerful lesson that you can think, "I know molecular biology, I know about viruses, I know how they replicate," and still there can be these diseases that you do not understand.
    CNN: Experts on 1918 and infectious diseases have stressed heeding history to prevent future pandemics. Where do you think we've gone wrong since the 1918 flu?
    Brown: We have to be very careful saying, "Well, it was obvious, do this, do that." But I think it was fairly clear that the next pandemic threat was going to be a virus and not a bacteria, fungus or parasite. Most people thought that it would be an influenza pandemic, and I was one of them.
    What I think we needed to spend more time on was actually considering that it could be influenza and other things. It doesn't really matter, because if we had put enough preplanning into how we would handle an influenza pandemic, we would also have in place a game plan for how we would handle a pandemic from another virus.
    Unfortunately, we know that funding for these things comes in waves. Funding money is allotted based on essentially what's going on today. There's very little attention paid to what may happen down the road, and we've become complacent with our belief that we have the ability to control everything. We're all subject to the great extremes of weather but also nature.
    Women wore cloth surgical-style masks to protect against influenza.