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Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How. Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How.
(7 days later)
It was a disease so awful that it terrified people for generations.It was a disease so awful that it terrified people for generations.
The 1918 flu pandemic, thought to be the deadliest in human history, killed at least 50 million people worldwide (the equivalent of 200 million today), with half a million of those in the United States. It spread to every part of the world, affecting populations in Japan, Argentina, Germany and dozens of other countries.The 1918 flu pandemic, thought to be the deadliest in human history, killed at least 50 million people worldwide (the equivalent of 200 million today), with half a million of those in the United States. It spread to every part of the world, affecting populations in Japan, Argentina, Germany and dozens of other countries.
Maybe most alarmingly, a majority of those killed by the disease were in the prime of life — often in their 20s, 30s and 40s — rather than older people weakened by other medical conditions.Maybe most alarmingly, a majority of those killed by the disease were in the prime of life — often in their 20s, 30s and 40s — rather than older people weakened by other medical conditions.
As the coronavirus spreads around the world and public anxieties spike, comparisons between today’s situation and the Spanish flu pandemic of 1918 are proliferating in journalistic outlets and on social media.As the coronavirus spreads around the world and public anxieties spike, comparisons between today’s situation and the Spanish flu pandemic of 1918 are proliferating in journalistic outlets and on social media.
While the fearful atmosphere — surgical masks, stockpiling of food and avoidance of public gatherings — and potential economic ramifications are like those of 1918, the medical reality is quite different.While the fearful atmosphere — surgical masks, stockpiling of food and avoidance of public gatherings — and potential economic ramifications are like those of 1918, the medical reality is quite different.
“Nurses often walked into scenes resembling those of the plague years of the fourteenth century,” wrote the historian Alfred W. Crosby in “America’s Forgotten Pandemic.” “One nurse found a husband dead in the same room where his wife lay with newly born twins. It had been twenty-four hours since the death and the births, and the wife had had no food but an apple which happened to lie within reach.”“Nurses often walked into scenes resembling those of the plague years of the fourteenth century,” wrote the historian Alfred W. Crosby in “America’s Forgotten Pandemic.” “One nurse found a husband dead in the same room where his wife lay with newly born twins. It had been twenty-four hours since the death and the births, and the wife had had no food but an apple which happened to lie within reach.”
In 1918, the world was a very different place, even without the disruptive influence of World War I. Doctors knew viruses existed but had never seen one — there were no electron microscopes, and the genetic material of viruses had not yet been discovered. Today, however, researchers not only know how to isolate a virus but can find its genetic sequence, test antiviral drugs and develop a vaccine.In 1918, the world was a very different place, even without the disruptive influence of World War I. Doctors knew viruses existed but had never seen one — there were no electron microscopes, and the genetic material of viruses had not yet been discovered. Today, however, researchers not only know how to isolate a virus but can find its genetic sequence, test antiviral drugs and develop a vaccine.
In 1918, it was impossible to test people with mild symptoms so they could self-quarantine. And it was nearly impossible to do contact tracing because the flu seemed to infect — and panic — entire cities and communities all at once. Moreover, there was little protective equipment for health care workers, and the supportive care with respirators that can be provided to people very ill with coronavirus did not exist.In 1918, it was impossible to test people with mild symptoms so they could self-quarantine. And it was nearly impossible to do contact tracing because the flu seemed to infect — and panic — entire cities and communities all at once. Moreover, there was little protective equipment for health care workers, and the supportive care with respirators that can be provided to people very ill with coronavirus did not exist.
With a case fatality rate of at least 2.5 percent, the 1918 flu was far more deadly than ordinary flu, and it was so infectious that it spread widely, which meant the number of deaths soared.With a case fatality rate of at least 2.5 percent, the 1918 flu was far more deadly than ordinary flu, and it was so infectious that it spread widely, which meant the number of deaths soared.
Researchers believe the 1918 flu spared older people because they had some immunity to it. They theorize that decades earlier there had been a version of that virus, one that was not as lethal and spread like an ordinary flu. The older people living in 1918 would have been exposed to that less lethal flu and developed antibodies. As for children, most viral illnesses — measles, chickenpox — are more deadly in young adults, which may explain why the youngest were spared in the 1918 epidemic.Researchers believe the 1918 flu spared older people because they had some immunity to it. They theorize that decades earlier there had been a version of that virus, one that was not as lethal and spread like an ordinary flu. The older people living in 1918 would have been exposed to that less lethal flu and developed antibodies. As for children, most viral illnesses — measles, chickenpox — are more deadly in young adults, which may explain why the youngest were spared in the 1918 epidemic.
Regardless of the reason, it was a disaster for life expectancy, which plummeted. In 1917, life expectancy in the United States was 51 years. It was the same in 1919. But in 1918, it was just 39 years.Regardless of the reason, it was a disaster for life expectancy, which plummeted. In 1917, life expectancy in the United States was 51 years. It was the same in 1919. But in 1918, it was just 39 years.
The new coronavirus tends to kill older people and those with underlying medical conditions, and it does not seem to kill children. All of which means it will have far less effect, if any, on life expectancy.The new coronavirus tends to kill older people and those with underlying medical conditions, and it does not seem to kill children. All of which means it will have far less effect, if any, on life expectancy.
As for the coronavirus case fatality rate, it is not yet known, but the latest data from South Korea, with 7,478 confirmed infections, show a rate significantly higher than the seasonal flu. After testing 100,000 people for the virus, the country appears to have a case fatality rate of .65 percent. (Though the data is evolving as researchers in other countries track cases.)As for the coronavirus case fatality rate, it is not yet known, but the latest data from South Korea, with 7,478 confirmed infections, show a rate significantly higher than the seasonal flu. After testing 100,000 people for the virus, the country appears to have a case fatality rate of .65 percent. (Though the data is evolving as researchers in other countries track cases.)
What the current situation does have in common with 1918, though, is the tenor of public concern.What the current situation does have in common with 1918, though, is the tenor of public concern.
Among the first places the 1918 flu arrived in the United States was Fort Devens, near Boston. So many young soldiers were sick, and so many were dying, that the Surgeon General sent four of the nation’s leading doctors to investigate.Among the first places the 1918 flu arrived in the United States was Fort Devens, near Boston. So many young soldiers were sick, and so many were dying, that the Surgeon General sent four of the nation’s leading doctors to investigate.
Updated June 24, 2020 Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
One of them, Dr. Victor Vaughan, later recalled: “Hundreds of stalwart young men in the uniform of their country, coming into the wards of the hospital in groups of ten or more. They are placed on the cots until every bed is full, yet others crowd in. Their faces soon wear a bluish cast; a distressing cough brings up the blood stained sputum. In the morning the dead bodies are stacked about the morgue like cord wood.”One of them, Dr. Victor Vaughan, later recalled: “Hundreds of stalwart young men in the uniform of their country, coming into the wards of the hospital in groups of ten or more. They are placed on the cots until every bed is full, yet others crowd in. Their faces soon wear a bluish cast; a distressing cough brings up the blood stained sputum. In the morning the dead bodies are stacked about the morgue like cord wood.”
Accounts like these scared Americans deeply.Accounts like these scared Americans deeply.
On Oct. 3, 1918, Philadelphia closed all schools, churches, theaters, pool halls and other gathering places. Undertakers were overwhelmed — some funeral homes increased their prices sixfold and some even made the bereaved bury their own dead.On Oct. 3, 1918, Philadelphia closed all schools, churches, theaters, pool halls and other gathering places. Undertakers were overwhelmed — some funeral homes increased their prices sixfold and some even made the bereaved bury their own dead.
In Tucson, Ariz., the board of health forbade people to venture out in public without a mask. In Albuquerque, where schools and theaters were closed, a local newspaper wrote, “the ghost of fear walked everywhere.”In Tucson, Ariz., the board of health forbade people to venture out in public without a mask. In Albuquerque, where schools and theaters were closed, a local newspaper wrote, “the ghost of fear walked everywhere.”
Similar actions are being taken today. Seattle has closed some public schools. The South by Southwest festival in Austin, Tex., has been canceled. Apple asked employees to work from home. More than 2,700 people are under some sort of quarantine in New York City. And some Costco stores are having trouble keeping bottled water in stock.Similar actions are being taken today. Seattle has closed some public schools. The South by Southwest festival in Austin, Tex., has been canceled. Apple asked employees to work from home. More than 2,700 people are under some sort of quarantine in New York City. And some Costco stores are having trouble keeping bottled water in stock.
But so far this year, the annual epidemic of seasonal flu in the United States is proving much more devastating than the coronavirus.But so far this year, the annual epidemic of seasonal flu in the United States is proving much more devastating than the coronavirus.
The Centers for Disease Control and Prevention reports that there have been at least 34 million infected with flu this season, 350,000 hospitalizations and 20,000 deaths. So far, coronavirus has killed 27 people in the United States.The Centers for Disease Control and Prevention reports that there have been at least 34 million infected with flu this season, 350,000 hospitalizations and 20,000 deaths. So far, coronavirus has killed 27 people in the United States.
For the economy, the effects of the 1918 flu, despite factory closings and social disruptions, were hard to disentangle from the profound ones of World War I. The world was not as interconnected as it is today, and by the summer of 1919, the pandemic had ended.For the economy, the effects of the 1918 flu, despite factory closings and social disruptions, were hard to disentangle from the profound ones of World War I. The world was not as interconnected as it is today, and by the summer of 1919, the pandemic had ended.
Coronavirus is already having significant impacts on the stock market and other aspects of the economy, but the long-term consequences remain to be seen.Coronavirus is already having significant impacts on the stock market and other aspects of the economy, but the long-term consequences remain to be seen.