Epidemics and pandemics in Victoria: Historical perspectives Research Paper No. 1, May 2020 Ben Huf & Holly Mclean Research & Inquiries Unit Parliamentary Library & Information Service Department of Parliamentary Services Parliament of Victoria Acknowledgments The authors would like to thank Annie Wright, Caley Otter, Debra Reeves, Michael Mamouney, Terry Aquino and Sandra Beks for their help in the preparation of this paper. Cover image: Hospital Beds in Great Hall During Influenza Pandemic, Melbourne Exhibition Building, Carlton, Victoria, circa 1919, unknown photographer; Source: Museums Victoria. ISSN 2204-4752 (Print) 2204-4760 (Online) Research Paper: No. 1, May 2020 © 2020 Parliamentary Library & Information Service, Parliament of Victoria Research Papers produced by the Parliamentary Library & Information Service, Department of Parliamentary Services, Parliament of Victoria are released under a Creative Commons 3.0 Attribution-NonCommercial- NoDerivs licence. 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Contents Executive summary ................................................................................................................................. 1 Introduction ............................................................................................................................................. 2 A note on terminology: outbreaks, epidemics, pandemics ................................................................ 3 Smallpox and other nineteenth-century epidemics ................................................................................ 4 Smallpox and Indigenous population decline ..................................................................................... 4 Other nineteenth-century diseases .................................................................................................... 5 ‘Russian flu’, 1891 ............................................................................................................................... 6 The politics and culture of nineteenth-century disease ..................................................................... 7 Victoria and the ‘Spanish’ Influenza, 1918–20 ........................................................................................ 9 Spanish flu in Australia ...................................................................................................................... 10 Responses in Australia: a breakdown in federalism? ....................................................................... 11 Victoria’s responses: health and social regulations .......................................................................... 13 Economic impacts: unemployment relief, strikes and coal .............................................................. 15 Controversies .................................................................................................................................... 17 Twentieth-century epidemics: polio, influenza, AIDS ........................................................................... 19 Polio epidemic, 1937–38 ................................................................................................................... 19 1957 ‘Asian flu’ and 1968 ‘Hong Kong flu’ ........................................................................................ 21 HIV/AIDS epidemic, 1980s–90s ......................................................................................................... 22 Twenty-first century .............................................................................................................................. 23 2009 ‘Swine flu’ ................................................................................................................................. 23 What do we learn from history? ........................................................................................................... 26 Policy lessons .................................................................................................................................... 26 General lessons ................................................................................................................................. 27 The bigger picture ............................................................................................................................. 28 Remembering and forgetting epidemics .......................................................................................... 28 History has no lessons ....................................................................................................................... 29 References ............................................................................................................................................. 30 PARLIAMENTARY LIBRARY & INFORMATION SERVICE | Research Paper i Executive summary This paper examines the history of epidemics and pandemics in Victoria over the past 200 years. Focusing on the political, social and cultural impacts and legacies of these health crises, it considers what lessons they may—or may not—offer in helping comprehend the current challenges presented by COVID-19. Victoria has a long history with epidemics and pandemics. Smallpox outbreaks that decimated Indigenous populations during early settlement were followed by frequent epidemics in nineteenth- century Melbourne, the 1891 ‘Russian flu’, 1919 ‘Spanish flu’ and 1957 ‘Asian flu’ pandemics, the 1937 polio and 1980s-90s HIV/AIDS crises, and ‘Swine flu’ in 2009. Particular attention is paid in this paper to the 1919 Spanish flu, the episode with which COVID-19 is most frequently being compared. Several clear themes run through all these episodes, including the ways certain groups in the population tend to be impacted by specific epidemics; recurring political issues of quarantine and federalism; instances of racism and stigmatisation of impacted groups; and community resilience, cooperation and activism. Yet each epidemic is also very much a product of the times, shaped not only by medical knowledge and resources, but political choices and cultural norms, changing economic structures and global interconnectedness, and existing social tensions and inequalities. Searching for historical parallels is an important way to make sense of the scale, cost and severity of the present crisis. There are both limitations and advantages in drawing such analogies to understand the present crisis in a Victorian context. While experts can draw policy lessons from past experiences, as well as identify general patterns in how communities react to the stresses of health crises, historians also stress the crucial differences in the contexts in which each crisis—including the present one— occurs, with unique problems requiring unique solutions. Finally, historians also warn that despite their impact on society, epidemics also tend not to be remembered or memorialised like other disasters and tragedies. PARLIAMENTARY LIBRARY & INFORMATION SERVICE | Research Paper 1 Introduction In Victoria, as around the world, COVID-19—the disease caused by the novel coronavirus, SARS-CoV-2 —has caused the most remarkable interruption to daily life in living memory, if not modern history. The impulse in such circumstances is to search for historical analogies to help comprehend the scale, costs and challenges of the present crisis: the Spanish flu, the Great Depression, the Second World War?1 As was remarked more than once during the Victorian Parliament’s emergency sitting on 23 April 2020, ‘right now we are living through history’. 2 What, if anything, can we learn from history as we live ‘through history’? Victoria has a long past with epidemics and pandemics, from epidemics of smallpox and other diseases through the nineteenth century, the ‘Russian flu’ (1890), ‘Spanish flu’ (1919) and ‘Asian flu’ (1957) pandemics, polio (1937–38) and HIV/AIDS (1980s to today) crises, and the 2009 ‘Swine flu’ pandemic. Each episode has had an important impact on Victoria. They were not only public health crises. These events reshaped political and social life, the relationship of the Commonwealth to the states, exacerbated existing social tensions and also created new kinds of community strength and cooperation. This paper examines the history of epidemics and pandemics in Victoria over the past 200 years. It seeks to draw out the parallels between these events, discussing what lessons may be drawn from the past in making sense of the current crisis. At the same time, it emphasises the limits of drawing lessons from the past and the importance of appreciating the novel circumstances and problems of each crisis. When comparing past epidemics, the most obvious point of contrast is mortality rates. As the table below summarises, Victoria has had a chequered and, at times,