In what has been regarded as one of the most devastating pandemics in human history, about 50 to 100 million deaths were recorded between 1918 and 1919, when the airborne H1N1 “Spanish flu” broke out [1]. A third of the world’s population was infected in 18 months, and this flu defied all known treatments at the time. Everyone could be affected; the young, the old, and everyone else in between. No part of the world was spared from this lethal virus and people suffered intensely gruesome symptoms, hemorrhaging and drowning in their own bodily fluids.

About 10 percent to 20 percent of the infected people died from the virus [2]. As horrifying as the records are, people managed to recover, although at widely varying rates. Back in those days, there were no antiviral drug routines or vaccines to cure or prevent the flu. There were no antibiotics to cure bacterial infections often associated with severe viral illnesses.

What many people had were nature and self-care, and such was the motive behind the open-air treatment invented by a hospital in Boston, Massachusetts, in 1918 [3]. The hospital found that a combination of sunlight, natural ventilation, proper hygiene, and reusable face masks helped save the lives of some of the worst-affected patients under their care.

Back then, many traditional hospitals were intentionally built with high ceilings and dozens of windows to promote intense air flow and inward streaming of natural sunlight [4]. Fresh air and sunlight are said to have natural anti-microbial properties, where the UV rays from the latter possess powerful germicidal and anti-microbial properties [5]. This is why modern hospitals often use UV sterilization and air extraction to remove pathogens. 

Earlier this month, the World Health Organization declared the COVID-19 outbreak a global health pandemic, emphasizing the fact that countries aren’t working as aggressively as required to curb the spread of the airborne disease [6]. As of March 17th, the current death toll is 7330 with over 185,000 cases around the world. This is the first time since the 2009 swine flu outbreak that a pandemic is being declared globally. Taking lessons from the past, could the current coronavirus outbreak respond to the same open-air UV exposure strategy of 1918 [7]?

Low-cost, low-tech, and easily accessible 

One report from the 1918 pandemic stated that open-air therapy reduced the mortality rates of hospitalized patients from 40 percent to 13 percent [8]. 

As with any other airborne disease, the Spanish flu spread faster in overcrowded and poorly ventilated spaces. Soldiers and sailors who lived in barracks and sailed in cramped ships were some of the worst affected, and so many of them rapidly developed other conditions such as pneumonia and bacterial infections from internal scarring. Simply put, the unhealthy environment greatly affected their chances of survival.

As the situation worsened, the State Guard set up an emergency hospital in Boston and the worst cases amongst the soldiers were put up there to be treated. Consequently, they freed up space in the barracks and troop-ships, enabling the remaining soldiers to have better access to fresh air and the healing sun.

The make-shift hospital was equipped with outdoor tents and when the sun came up each day, the patients were brought out of their tents to soak up the warm rays. After a while, the doctors discovered that severely ill patients fared better when treated outside than the mildly ill being treated indoors.

Influenza patients getting sunlight at the Camp Brooks emergency open-air hospital in Boston. The medical staff was not supposed to remove their masks.  (National Archives)

Read: Coronavirus Can Live On Surfaces For 2-3 Days — Here’s How To Clean Them

Fresh air and sunlight worked better when utilized together, although they could still work independently of each other. Scientists from the Ministry of Defense were able to show in the 1960s that fresh air possesses germicidal properties [9]. Although they couldn’t pinpoint any elements in the air directly that were responsible for this “open-air” factor (as they called it), they were fairly certain of its efficacy. The fresh air helped patients feel better both during the day and at night when the sun had gone down. 

We’ve known that ultraviolet rays work as a disinfectant for quite some time, and a recent study supports this. In it, they demonstrated that simulated sunlight can affect the survival of microorganisms, including viruses in varying levels of humidity [10].

Another factor that didn’t account for at the time was vitamin D, as the process of its synthesis had not bee discovered yet. Poor vitamin D status has been linked to a higher risk of respiratory diseases, which could make one more susceptible to influenza [11]. This could potentially be one factor that contributed to the positive outcomes from the open-air treatment.

The scientists and doctors in that era may have been unaware of the intricacies of their treatments, but these solutions were simple, harmless, and effective in bringing relief to their patients.

The role of proper hygiene and reusable face masks

Airborne infections spread through aerosolized droplet transmission. When drops of fluid from the nostrils or mouth of an infected person are launched out when they cough or sneeze, they may land directly on the faces or hands other people, or on surfaces which are then touched. This is how the infection is transmitted and one reason why airborne diseases can be so lethal. 

While they may not offer complete protection, face masks are helpful to a great extent for front line health care workers and those that are sick. During the 1918 crisis, healthcare providers at the Boston hospital wore improvised face masks made of gauze fitted on a wireframe. Each mask comprised of five layers of gauze and offered a good measure of protection from the infection. However, the mask was sterilized every two hours and fresh gauze was strapped in. 

While COVID-19 cannot be stopped by surgical masks, WHO and other health authorities advise that infected people and anyone who may come in contact with them use masks to provide a barrier to the disease-causing pathogens. Just ensure that there are no gaps between your face and the mask. Sadly, there is a scary shortage of surgical masks in many places around the world. People are panic-buying more than they need, causing the available little to be priced exorbitantly in some locations.

Please note that not everyone needs to wear a mask, and stockpiling them may only take them out of the hands of those who truly need them. For more information visit the WHO website.

Hand sanitizers are also in short supply, but it’s better to stick to washing your hands frequently and properly with soap [13]. Several cities in China have taken to manually disinfecting their streets with high-powered aerosol-spraying technology as a sanitation measure. If everyone can work hard to keep their surroundings clean and disinfected, avoid touching their faces, and maintain social distancing and proper hygiene during these times, the severity and stress on the healthcare system can be minimized. We need to flatten the curve. 

There is currently no cure for COVID-19. While many countries are working hard to come up with vaccines and antivirals, healthcare officers may provide supportive care to help patients breathe easier and relieve them of severe symptoms. Soaking up lots of sunlight and plenty of fresh air may not be the ultimate solution to the COVID-19 situation, nor is it practical in cold climates. However, there is still some usefulness there, and implementing the benefits of UV light and fresh air may be practical in some ways. Outside of the primary protocols already in place, maybe it’s worth a try? 

If you are looking to prevent contracting or think you are sick, please visit the CDC website for more information. 

Keep Reading: ‘Don’t panic’ says US woman who recovered from coronavirus

The post Taking cues from the 1918 Influenza Pandemic, could sunlight and fresh air might help manage the coronavirus outbreak? appeared first on The Hearty Soul.