CAF health protection during pandemic disease events: 1918 and 2020

The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses serious challenges to the Canadian Armed Forces (CAF). They are not, however, novel challenges, as the CAF weathered an almost identical situation in its history. This article presents new research findings on the 1918-1919 H1N1 influenza A pandemic's effect upon the Canadian Corps (Cdn Corps) fighting in France and Belgium during the Hundred Days Campaign of 1918. This was a quantitative and qualitative study, randomly sampling 685 cases from the 5,542 Cdn Corps deaths between September 15 and November 11, 1918. Of these 685, 44 were killed by influenza or pneumonia (6.4%), suggesting with the margin of error that between 260 and 450 Canadians died of influenza in France, a comparatively low number considering the Corps was undertaking high-intensity operations in a region of France badly afflicted with influenza. Qualitative population traits are assessed. Among many important elements that may have bearing upon COVID-19 response, one in particular is drawn out for discussion: non-pharmaceutical interventions in the light of effective leadership. This study ultimately makes recommendations for how the experience of the 1918-1919 pandemic on Canadian fighting formations can inform force health protection (FHP) measures in 2020.