Coronavirus, Spanish Flu And The Dark History Of 'Keep Calm And Carry On'

As the government encourages Britons not to overreact to the Covid-19 outbreak, we look at the surprising origins of a famous motto

How should we as individuals and a population respond to a public health emergency like coronavirus?

Historians believe the language of 'keep calm' originated during Britain's wartime response to the Spanish flu

By Luke Mintz: The government's advice – that we go about our regular lives, regularly wash our hands with soap or hand sanitizer, self-isolate if feeling unwell and look out for our friends and neighbours  – talks to that most British of phrases “keep calm and carry on.”  
However, the idea that we should simply “carry on” – while quite possibly correct in this instance – comes with chequered historical baggage.
It is an idea that is connoted with national pride, harking back to an idea of Brits as sturdy, resilient, creatures. Indeed, the iconic ‘Keep Calm and Carry On’ poster – first designed by the British government in 1939, to be deployed in the event of a Nazi invasion – has become a popular design for T-shirts, mugs, and cushions, ever since it was re-discovered in a dusty bookshop in Alnwick, Northumberland, in 2000.

The term Keep Calm and Carry On has been popularised in the 21st Century Credit: Mark Makela 

But according to Dr Mark Honigsbaum, medical historian and author of The Pandemic Century, the language of 'carry on' originates not from World War Two but World War One. It is traced back to comments made in 1918 by Sir Arthur Newsholme, Britain’s then senior medical officer, in response to the outbreak of Spanish flu, a deadly strain of the H1N1 virus first spotted in late 1917.
By late 1918, ministers were aware of the horrific potential impact of the virus, which was known to turn its victims’ bodies blue and black before death, and so drafted a memorandum which advised Britons to isolate themselves at home if they were sick, and avoid any public gatherings.
But the nation was also facing its final stretch of the First World War, which had already claimed hundreds of thousands of British lives, and Sir Arthur worried that telling workers to stay at home could hinder Britain's war effort. Men and women needed to return to the factories day after day if Germany was to be defeated, officials believed, and so the memorandum was buried. Instead, Sir Arthur told the Royal Society of Medicine that Britain’s “major duty” was to “carry on” largely as normal, “even when risk to health and life is involved”.
In startlingly honest language, Sir Arthur told the conference: “The relentless needs of warfare justify the risks of spreading infection and the associated creation of a more virulent type of disease.”

Women sort blackcurrants at a factory in York in 1920. Such close working conditions would have been a breeding ground for the spread of germs Credit: Heritage Images/ Hulton Archive 

According to Dr Honigsbaum, the “carry on” advice may well have been responsible for thousands of the 250,000 Britons who ultimately died in the Spanish flu pandemic. Worldwide, between 50 million and 100 million died – more than the number killed by the bombs and bullets of the First World War.
“It was the closing months of the war, a lot of people were dying, [so the government thought that] a few flu deaths here and there didn’t make much difference,” says Dr Honigsbaum.
It is a theme that Catharine Arnold picks up in Pandemic 1918, her grizzly account of Spanish flu. She writes that the British government essentially told its subjects that it was their patriotic duty to “carry on” as normal and make sure the cogs of the economy continued to whir. This created a perfect environment for mass infection, she argues, a mistake repeated in the United States when President Wilson led a parade of 25,000 New Yorkers down the ‘Avenue of the Allies’ in October 1918. “That same week, 2,100 New Yorkers died of influenza,” writes Arnold.

The Keep Calm and Carry On message was produced in 1939 in case of Nazi occupation. 2.5 million copies of the poster were printed, but it was rarely seen in public until 2000 Credit:  Print Collector/Hulton Archive 

Although we now live in a “different geopolitical situation” and the world is no longer at war, Dr Honigsbaum says, economic concerns could still be playing their part in shaping how governments respond to public health crises like coronavirus. He believes British ministers are worried that the “real danger of the pandemic is panic”, and that the mass closure of offices could prompt an economic shock more disruptive in its impact than coronavirus itself. 
This could also inform the logic to keep schools open: multiple studies have shown that school closures have a knock-on, detrimental effect on the economy by forcing parents to take time off work.
“Pandemics are always political because they bring up questions about whether administrations have invested sufficiently in health resources,” says Dr Honigsbaum, pointing to Donald Trump's insistence yesterday that the risk to the United States remains “very low” thanks to the “very good” early precautions taken by his own administration – comments that contradicted his own government health expert. “In the case of America, it’s well known that Trump has slashed the budget for the Center for Disease Control and Prevention. The idea that America's going to escape this is just a fantasy. We know it's already in the United States [and] we're seeing more cases as we speak.”
The reputation of health officials also matters: the World Health Organisation (WHO) was criticised for “overreacting” to swine flu during the 2009 outbreak of the H1N1 virus, says Dr Honigsbaum, and other health experts were reprimanded for giving ghastly predictions about how many people would die. That may be part of the reason the WHO has stopped short, this time, of labelling coronavirus as a pandemic, even though it now has a foothold in every continent bar Antarctica.
“What’s remarkable is how, although we’ve got all this medical technology today which didn’t exist in 1918, when faced with a fast-moving respiratory virus, we really have to fall back on the tried and tested public health measures from the 19th and early 20th Century," says Dr Honigsbaum. "That’s why you’re seeing messaging that it’s essentially ‘business as usual’.”

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