How can we apply the lessons of the second wave of Spanish flu to Covid-19?



The Spanish flu has returned to public awareness thanks to Covid-19 and has ended its status as a “forgotten pandemic”. Experts point out that the infamous second wave of this flu a century ago was a very different disease than Covid-19 – but also say it provides historical lessons to counter fears of a resurgent coronavirus.

Covid-19 Infection rates are rising in a variety of countries, several months after the grueling Lock that shaped spring all over the world.

By doing USthe average daily number of confirmed new infections has skyrocketed since mid-June – while in Spain, one of the countries where the virus was hit hardest in the first few months of the pandemic, led to a sharp surge in cases United Kingdom to impose sudden travel restrictions on Saturday. Several countries previously praised for skillfully managing the pandemic – such as Australia and Vietnam – have seen alarming new coronavirus clusters.

The World Health Organization argued on Wednesday that the term “second wave”, despite frequent use by journalists and politicians, was imprecise and that it would be preferable to describe Covid-19 as “one big wave” as the virus never went away and does not follow seasonal fluctuations.

“Covid-19 appears to be ready to return to every population in the world as soon as we ease our vigilance,” Joel Wertheim, Assistant Professor of Medicine at the University of California, San Diego, told FRANCE 24. “It is important to distinguish between seasonal waves and the ebb of Covid-19 due to public health measures.

Police officers in Seattle, USA wearing face masks towards the end of the infamous second wave of the Spanish flu in December 1918. © Wikimedia Creative Commons


This puts it in stark contrast to the previous pandemic to take the world by storm. The 1918-20 Spanish flu occurred in three waves that killed at least 30 million people around the world, with some historians estimating the number at 100 million – making it more deadly than the Great War that kept it long in the collective memory overshadowed.

This first wave of the pandemic in the spring of 1918 was highly contagious and thwarted the war effort on both sides enormously. Still, it wasn’t particularly contagious – official death rates were similar to seasonal flu.

But in the fall, the virus reappeared in a terrifying second wave, the most severe of the three. In the United States – where historical data on Spanish flu are most complete – the excess mortality rate reached 266,000 from September to December 1918. “Let’s just say the reconstructed virus continues to be fatal in laboratory animals,” says John Barry, author of The big flu, a study on Spanish flu, said FRANCE Jan.

The flu tendency was likely to be responsible for this increased virulence, explained Erin Sorrell, assistant professor of microbiology and immunology at Georgetown University: first wave, as influenza viruses are susceptible to point mutations called antigen drift, allowing them to perceive existing immunity to withdraw from previous infections, ”she told FRANCE 24

In this respect, the coronavirus appears less threatening: “This virus is much more stable,” said Barry. “Nowhere in the world is there any indication that it is getting more deadly than it was in 1918.”

A “Super Spreader” parade in Philadelphia

There have been a number of different reactions to the new strain of Spanish flu. In France, where 240,000 people were killed in all three waves combined, the government still focused on the war effort during the second wave, with the conflict in its final before the November 1918 armistice. There were bans on gatherings and some public places were closed – but nothing on the same scale as the Covid-19 bans.

In the US – a fighter in the final year of the war but far from the carnage on the Western Front – some authorities felt free to contain the spread of the disease, with several parts of the country leaving schools, churches and restaurants.

“The initial wave was glossed over a bit; the war was still going on and doctors were focused on keeping the soldiers healthy and on the battlefield, “Jim Harris, a science historian at Ohio State University, told FRANCE 24.” But during the second wave when it became much more contagious, some politicians felt compelled to react. “

An infamous super-spreader event early on in the second wave testifies to the benefits of social distancing measures. On September 28, 1918, more than 200,000 people attended the Philadelphia Liberty Loans Parade to promote the sale of US state war bonds – albeit experts told the city’s health officer that the event should not take place.

A historical lesson can be learned by comparing Philadelphia to St. Louis, which canceled its parade along with other mass gatherings. “In the next month, more than 10,000 people died of pandemic influenza in Philadelphia, while the death toll in Saint Louis did not exceed 700. This deadly example shows the benefit of canceling mass gatherings and using social distancing measures during a pandemic, “the remarked to us Centers for Disease Control and prevention.

Experts say this contrast between Philadelphia and St. Louis is part of a bigger picture where public health actions have clearly helped fight Spanish flu. “We learned that during the response to the 1918-19 pandemic (particularly in the US), cities and states that have regulations on the use of face masks, banning large gatherings, and closing schools have outperformed those who do didn’t do this, ”said Sorrell, making a note of it.

Young adults have been hit hard

The coronavirus has opened a generation gap in this type of measure – demonstrated in particular by one Follow this week in Brittanywhere a cluster of cases among beachgoers in their twenties sparked an angry reaction from the top French government official in the region who berated “irresponsible” young people who “ignored the danger”.

But during the second wave of the Spanish flu, many young people found themselves in the same position as the older ones today: The pandemic a century ago was fatal, especially for previously healthy people between the ages of 25 and 35. Their second wave affected age groups in a W-shaped curve – hitting infants, young adults, and the elderly hardest. This was unusual because the flu – including the first wave of Spanish flu – typically has a U-shaped curve: it is most dangerous to infants and the elderly, without being particularly contagious in young adults.

The question of why this age group has been so brutally affected has “still not been answered,” said Barry. “There are only hypotheses,” he continued. “Most likely, young people have stronger immune systems that overreact and create cytokine storms in the lungs” – where the body’s overly active defenses cause even more inflammation.

Despite this confusing phenomenon, many people of all ages grew tired of taking precautions as the months passed to avoid infection. During the second wave of the Spanish flu and the coronavirus pandemic, “people think it’s time all of this is over,” Naomi Rogers, professor of medical history at Yale University, told FRANCE 24.

Despite some presumptuous behaviors during the current crisis, the tremendous advances in science and technology since the Spanish flu – when the nature of viruses remained a mystery – are a real source of hope, added Sorrell: “We have scale, scientific capability, on a global scale and expertise, technology, resources and methods for exchanging information. “

However, she went on to say it remains a crucial task in the fight against the coronavirus – highlighted by the disastrous results in places like Philadelphia during the second wave of the Spanish flu, where officials refused to heed warnings of the need for social distancing. “Our challenge today,” said Sorrell, “is to give the public the right information about the pandemic, give recognition and voice to our scientists to dispel misinformation, and encourage our national leaders to prepare and respond to to give priority to public health. “



Comments are closed.