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Was a 19th Century Global Pandemic a Case of COVID 1.0?

— Medical historians suspect Russian flu was caused by a coronavirus and holds lessons for today

Last Updated February 16, 2022
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London’s Illustrated Police News depicts the Russian Flu pandemic in 1892.

The delicate prince had just turned 28, and he looked forward to marrying his fiancée and living the easy life of an aristocrat until he became king a few decades down the line. Critics called him dull and dumb -- everybody knew he was far from an intellectual -- and some darkly hinted that he was gay, too. Later, conspiracy theorists who'd perhaps dipped too far into the cooking sherry him of being Jack the Ripper.

For now, Prince Albert Victor, better known as Eddy, was second in line to the British throne after his father, the eldest son of Queen Victoria. To celebrate his winter birthday in 1892, he traveled to Sandringham House and went out hunting despite a cold. He came back shivering with chills and promptly developed pneumonia.

As the prince's fever hit 107° F, he raved deliriously that his brother -- later to become Queen Elizabeth II's grandfather -- was dead. But it was Prince Eddy who was to be mourned, killed by a stubborn virus that snuffed the lives of an estimated 1.5 million people across almost every corner of the planet.

The "Russian flu" is mostly forgotten, although it killed roughly one in 1,400 people worldwide, making it as deadly as the 2-plus years of the COVID-19 pandemic. Moreover, researchers say that there's evidence that it was also caused by a coronavirus and may offer lessons for us today.

Like COVID-19, the Russian flu kept roaring back in wave after wave over a number of years. And some infected people appear to have suffered from the equivalent to "long COVID," which caused extreme fatigue and mental disturbances.

"If [the Russian flu] was due to a coronavirus, rather than flu, it would tell us how populations were able to adapt to repeated waves of infections and deaths in an era before vaccines, antiviral drugs, and mechanical ventilators," , PhD, an author and medical historian based in the U.K., told ֱ.

But the bad news is that the earlier pandemic may reveal where we're headed this time around -- toward a grim future where COVID-19 doesn't fade away for a long time.

Worldwide Networks Spawned the First Truly Global Pandemic

The Russian flu got its name after the first reported outbreak struck St. Petersburg in 1889, although there were suspicions at the time that it had earlier hit Uzbekistan or Kazakhstan. "The disease spread rapidly to other European capitals following the course of railways and roads, and to North and South America via international shipping lines. Contemporary accounts suggest it took only 4 months to circumnavigate the globe, peaking in the United States 70 days after the original peak in St. Petersburg," Honigsbaum said.

The virus hit every continent, such as Madagascar, Australia, New Zealand, Iceland, Greenland, and . As many as may have been infected.

In the U.S. state of Indiana, suggested that the virus appeared in November 1889. "During the first three months, only a small proportion of the population was affected, but within the next three months, fully four‐fifths of the people, of all classes, had become affected," noted a local health official at the time. "It approached its victims, as a rule, without warning or premonitory symptoms and prostrated them as unceremoniously as an expert sandbagger would fell the belated and weary pedestrian."

The pandemic was similar to COVID-19 in remarkable ways. "It was an event intimately linked to modern transportation and global communications technologies," Honigsbaum said, "and in which fear, panic, and misinformation were amplified by the news media."

Physicians at the time assumed the Russian flu was caused by influenza, hence the name. But scientists in recent years have wondered whether it may have been the world's first coronavirus pandemic, striking more than a century before SARS, MERS, and COVID-19. One prominent theory, , is that a coronavirus jumped from cows to humans and sparked the pandemic.

"We know that OC43, a coronavirus which causes something like a third of common colds, is closely related to a bovine coronavirus, BCoV. They shared a common ancestor in around 1890, suggesting that this is when it probably first jumped from cattle to humans," Honigsbaum said. "The date is intriguing because it coincides with the first reports of the Russian influenza."

He noted that retrospective epidemiological research conducted at the time of the Russian flu suggested that it may have originated in an area of arid grasslands in northern Kazakhstan that's home to huge cattle herds. "We also know that the Russian influenza was preceded by catastrophic outbreaks of a highly infectious respiratory disease in cattle," he added. "These outbreaks led to repeated culling operations between 1870 and 1890 as farmers sought to prevent products from diseased cattle contaminating urban milk supplies."

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London's Illustrated Police News depicts the Russian Flu pandemic in 1892. The panel at center-left refers to the death of 28-year-old Prince Albert Victor, Duke of Clarence, heir to the British throne and great-uncle of Queen Elizabeth II.

Some 19th-Century Symptoms Line Up With COVID-19

On the clinical front, the Russian flu and COVID-19 also share symptoms, including some that are "rather untypical for influenza viruses in humans," said Harald Brüssow, PhD, a virologist in Switzerland and leading proponent of the coronavirus hypothesis. Physicians reported high fevers, dry coughs, headaches and eyeball pain, and loss of taste and smell, according to a by Brüssow that appeared last summer in Microbial Biotechnology, which he edits.

In an interview with ֱ, Brüssow noted other similarities to COVID-19, such as possible re-infections and higher rates among the obese and the elderly. In contrast, the much deadlier Spanish flu pandemic of 1918 famously struck the young, possibly because their generation lacked immunity.

In addition, "there is some contemporary literature about signs that resemble what is now called long COVID" following infection during the Russian flu pandemic, Brüssow said. "And there is indirect evidence of the Russian flu extending over several years, which is untypical for influenza. Influenza seems to evolve more by recombination of its segmented RNA genome than by the evolution of new variants that cause new infection waves."

Critics Question the Coronavirus Theory

The coronavirus theory about the Russian flu has skeptics. "I find this whole line of thinking so speculative as to be a pretty total waste of time," said Ann Reid, MA, executive director of the National Center for Science Education and a former influenza researcher, in an interview.

For one, "the symptoms of influenza and coronavirus are highly variable and overlapping. For example, many people -- including my own mother -- lost their sense of smell in the 1968 influenza pandemic. It would be a big stretch to take a few clinical reports from 1889 and jump to the conclusion that this particular symptom means the pandemic was caused by a coronavirus," she told ֱ.

Even if the Russian flu was caused by a coronavirus, there's little to be learned from its progression, she noted. "There certainly won't be any useful data capturing the number of cases of whatever caused the Russian flu pandemic. All of the upper respiratory illnesses and deaths would all be lumped together because they didn't have any way to differentiate among different viral and bacterial causes. There's just nothing there."

Jon Bang Ploug, MA, a history teacher in Denmark who's written about the Russian flu, also questions the possibility of a coronavirus connection. Like Reid, he noted that loss of smell isn't limited to coronavirus cases and also occurred during the Spanish flu pandemic.

Additionally, "supporters of the hypothesis also argue that the Russian pandemic mainly affected the oldest people," he said. "However, they overlook the fact that many young people also died from the Russian pandemic. For example, no fewer than three European princes died of it: Amadeo I of Spain (at age 44), Prince Baudouin of Belgium (at age 21), and Prince Albert Victor (at age 28), heir to the English throne. So it was not mild for young people."

The Pandemic That Stayed, and Maybe Stayed Some More

Experts estimate that the out of a world population of 1.5 billion. That is 0.066%, or roughly one in every 1,500 humans alive at that time. The estimated death rate of COVID-19 is nearly identical so far: 5.8 million of a world population of 7.9 billion, or 0.073% -- roughly one in 1,400.

Brüssow believes that the Russian flu afflicted the world from 1889 to 1892 in three separate waves, but he acknowledged that it could have lasted even longer. Honigsbaum, who said he's agnostic about the pandemic's cause, thinks it went on to cause outbreaks in 1893, 1895, and 1900.

"If the Russian flu was a coronavirus pandemic, it could mean that we have to count on a longer duration of the current outbreak," Brüssow said. "I do not want to be unduly pessimistic. We live in a time of scientific revolution with new vaccine technologies reaching humans within a year's time. However, if the Russian flu as hypothetically reconstructed from historical records had a long duration, we need to develop strategies how to live with a pandemic in a sustainable way."

As for the long-term future, virologist Shane Crotty, PhD, of La Jolla Institute for Immunology, told ֱ that it's reasonable to suspect that the Russian flu was caused by a coronavirus, and that's important. "We shouldn't think of SARS-CoV-2 as being a really unique, once-in-a-millennium type of event," he said. "Coronaviruses have probably done this before, and probably can do this again."

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    Randy Dotinga is a freelance medical and science journalist based in San Diego.