Thesis: As a result of the rapid evolution and advancement in medicine and technology, the pandemic of 1968 saw changes in the approach to the mitigation and control of the disease, advancements in treatment compared to previous pandemics, and different approaches to informing and communicating with the public.

When looking at images and accounts from the late 1960’s, it is nearly impossible to tell the world was in the midst of one of the most dangerous pandemics in human history. Rather, photos of mobs of young adults at Woodstock and images of large crowds huddled together to watch the launches of the Apollo missions tell a different story (Spitznagel). In the infamous pandemic of 1918, the idea of social distancing and lockdowns first began to appear around various cities across the country (Pancevski). While these precautionary measures against the virus were far from being widespread, epidemiologists, began to explore the impacts that precautions like social distancing had on the spread of disease. In the pandemic of 1968, however, scientists and government officials alike decided to take a significantly different approach. Rather than the implementation of strict lockdowns and precautious quarantining procedures during the height of the pandemic, the decision was taken to let life go on as usual, nearly undisturbed. While precautions like masks in public spaces were introduced and encouraged by professionals, the preventative measures against the virus ended there (National Center for Biotechnology Information). In some ways, this “laissez-faire” approach to the control of the Hong Kong Flu signaled a temporary paradigm shift in society.

From an initial examination, however, this paradigm shift appears to indicate society “moving backwards in time” or regressing, especially in the context of the integral roles that social distancing and similar measures have played in the “flattening of the curve” of the current COVID-19 pandemic. In reality, though, this decision to apparently disregard the danger of the Hong Kong Flu came from the position of a generation where, in some ways, death was a “more accepted part of American life” (Spitznagel). With the echoes of the world wars, as well as the waves made by the tensions and conflicts going on at the time, the virus posed a far less-urgent threat for many Americans. These same sentiments were echoed across the world as well. As Bojan Pancevski sums it up, “In the 1960s and ’70s, the carnage of World War II was a recent memory. Life expectancy was significantly lower than today and such diseases as polio, diphtheria, measles or tuberculosis were part of everyday life.”

Scientists only recognized after the peak of the pandemic that taking more precautionary measures (like social distancing) would have lowered the death toll of the pandemic, especially the massive toll of the second wave of infection in regions like Western Europe (Charles Cockburn et al.). In addition, scientists found that the strain of the Hong Kong Flu (H3N2) “has had a disproportionate impact on older adults” (National Center for Biotechnology Information). With much of the death toll being comprised of individuals aged 65 and over, many of these deaths could have been avoided with preventative measures like social distancing. These failures of the pandemic of 1968 generated massive changes in not only epidemiology, but society as well. From a scientific perspective, the pandemic of 1968 prompted the World Health Organization (WHO) to adopt better influenza forecasting systems (many of which are still in use today), as well as a “a standard surveillance reporting form for National Influenza Centers, which had been implemented by many and had begun to work well by the fall of 1969” (National Center for Biotechnology Information). After the pandemic, society as a whole began to understand the personal responsibility involved for the mitigation and control of disease. According to Jeffrey Tucker, the editorial director for the American Institute for Economic Research. “We left disease mitigation to medical professionals, individuals and families, rather than politics, politicians and government.” After the pandemic of 1968, that responsibility began to be transferred to the general population, as evidenced by the emphasis placed by the media and officials alike on personal responsibility and accountability as a citizen.

While it is clear that many of the evolutions and paradigm shifts relating to the ways in which pandemics (and diseases in general) are treated and approached came as a result of the aftermath of the pandemic, it begs the question of why the death toll was so relatively-low when compared with other wide-spread events like the pandemic of 1918 (especially when the Hong Kong Flu strain was the most transmissible)? The answer lies in massive leaps in science and medicine. The pandemic of 1968 saw the introduction of antiviral medications, as well as the introduction of a vaccination to be administered during the pandemic.

In 1928, Alexander Fleming discovered penicillin, “the first true antibiotic” (American Chemical Society). Since Fleming’s revolutionary discovery, the study and development of antibiotics has been one of relatively rapid progress and success. In fact, during the 1950s and 1960s, antibiotic discovery reached a “golden age,” where nearly 50% of today’s antibiotics were discovered during this period (National Center for Biotechnology Information). Why wasn’t this the same case with antiviral drugs? For one, antibiotic medications can’t be used to treat viral diseases like influenza, hence the need for these antiviral treatments. One of the main roadblocks with the discovery of antiviral drugs has always been finding candidate molecules which are efficient, effective, and have low toxicity. The difficulty of finding these candidate molecules, combined with limitations concerning experimentation, mean that antiviral drugs are among the most difficult to develop (Bryan-Marrugo et al.). The pandemic of 1968 marked the first global pandemic that antiviral medications were available for treatment. According to the National Center for Biotechnology Information, “During the pandemic, a multicenter double-blinded randomized controlled trial in Japan demonstrated a statistically significant reduction in fever duration among laboratory-confirmed pandemic influenza patients treated [with the antiviral medication].” As studies like these began to yield convincing and encouraging results, public confidence in both medicine and science (especially in the context of the pandemic) continued to grow. In addition to improved public perceptions of medicine, society’s confidence in the relatively new and experimental antiviral drugs grew as well, as antiviral treatments for conditions like Parkinson’s disease began to be discovered around the same time.

The rapid development and deployment of a vaccine against the H3N2 strain only bolstered this increased confidence as well. The pandemic of 1968 was the first time that scientists were able to isolate the virus and develop a vaccination before the end of the pandemic (Kiple 810). This accomplishment was an indication of how far medicine, specifically in the area of influenza, had advanced in the past few decades. As William Charles Cockburn et al. assert in their paper on the epidemiology of the Hong Kong Flu, “It is difficult to imagine circumstances in which the interval from arrival of specimens in a national influenza centre to the characterization and distribution of the strain could be shortened.” Many other experts agreed with Charles Cockburn’s assertion, commending the pace at which the vaccine was developed. While the true impact of the vaccine is still a matter of debate, one of the vaccine’s largest impacts was outside of the field of medicine. Similar to the successful introduction of antiviral drugs, the pandemic of 1968 ushered in a new era of medical expertise and tools to combat mass-spread illnesses like the pandemic. Both the vaccine and antiviral treatments created a newfound confidence within the public, a crucial sentiment to create and maintain for a generation plagued with multiple pandemics and overall geopolitical chaos. Jeffrey Tucker reflects this confidence in his account, “But as with now [with COVID-19], no one knew for certain how deadly [the pandemic] would turn out to be. Regardless, people went on with their lives . . . . That generation approached viruses with calm, rationality and intelligence” (Spitznagel). The sense of unspoken confidence that Tucker describes comes in part as a result of the giant leaps and bounds made in the field of medicine. These advancements were only strengthened by the additional innovations happening at the time, with the Apollo and Gemini space programs acting as further demonstrations of what human innovation can produce.

Another innovation which was steadily-transforming society was the television. By the 1960s, TVs were found in close to 90% of households, making them a normal aspect of American life. As TV slowly began to take its form as a political force around the same time and as TV journalism became more prevalent, televisions transformed the ways in which Americans got their news. With all of these evolutions in media and news happening as the pandemic of 1968 gripped the world, it’s almost surprising that the Hong Kong virus made so few and insignificant appearances in the media. In fact, the pandemic is often briefly (if at all) discussed in today’s history curriculum. According to Nathaniel Moir, a postdoctoral fellow at Harvard University’s Kennedy School of Government, “It was like the pandemic hadn’t even happened if you look for it in history books” (Spitznagel). Why is this? The answer is quite simple: news outlets had far more “pressing issues” to cover, especially in a time when very little emphasis or care was put into developing precautionary policies for the pandemic. The late 1960s was a time of intense chaos, both in the United States and internationally. Despite the horror stories of dead patients having to be stored in Berlin’s subway tunnels or half of France’s workforce unable to work as a result of the virus, none of these stories were widely-covered. Pancevski writes, “news outlets devoted cursory attention to the virus while training their lenses on other events such as the moon landing and the Vietnam War, and the cultural upheaval of the civil-rights movements, student protests and the sexual revolution.” With all of the national and global chaos ensuing in such a short period of time, the news of the pandemic seems almost pedestrian.