The Spanish flu, COVID-19 and Malta's reactions: Contrasts and similarities

The historical seriousness of the challenge of the Spanish flu and COVID-19 is well documented as both diseases, then and now, spread indiscriminately across the planet. A century apart, these two pandemics have devastated the world. The advances in health and science over the past hundred years have proved only partially effective against the current pandemic. At the moment, the therapeutic strategies to deal with the infection are only supportive and prevention is aimed at reducing transmission in the community. This outbreak is more than an intensive care phenomenon, rather it is a public health and humanitarian crisis. Western health care systems have been built around the concept of patient-centred care but a pandemic requires a change of perspective toward a concept of community-centred care. Malta has painfully learned this the hard way. This paper examines the sources of variability during both pandemics in shaping the morbidity experience of the Maltese islands which in turn allows for a better understanding of how developments of isolation, exposure, history and physical distancing could play important roles in shaping the epidemic experience.