1918 saw a pandemic popularly known as the ‘1918 Influenza’ (Jordan, Tumpey et al., 2019). It is tempting to compare it with the current pandemic (Santayana, 1905). However, the mode of spread, the mutation capacities of the virus RNA, and the trade-off between economic activity and public health due to the mitigation measures implemented, demonstrate disparities.
COVID-19’s 14-day incubation allowed its rampant spread with minimal detection, mostly via travellers unaware of being infected
A major factor for the 1918-1919 pandemic was due to soldier mobilisation during World War I. Soldiers travelled by the thousands in troop ships and interacted with civilians at transit hubs, which led to the first wave of the 1918 Influenza. The second, more deadly wave was due to infection via sea and rail routes used by soldiers as they demobilized (Weber, Freeman, 2020). Today, the global economy has mobilised people internationally and domestically, requiring frequent travel. COVID-19’s 14-day incubation allowed its rampant spread with minimal detection, mostly via travellers unaware of being infected (Linas, 2020). The new coronavirus could become as deadly as the 1918 Influenza, which is estimated to have killed in excess of 40 million people (p.108 of Donaldson, 2017).
Influenza is seasonal and mutates rapidly in winter months, but new vaccinations are available annually. The new coronavirus, however, has a lower mutation rate.
SARS-CoV-2 and the 1918 Influenza are RNA viruses, which mutate as they multiply. They react differently in every species, with varying levels of infection and mortality. Influenza is seasonal and mutates rapidly in winter months, but new vaccinations are available annually. The new coronavirus, however, has a lower mutation rate. Despite its rapid spread, there have been less than 10 mutations from the initial RNA sequence. This reduces the ability to predict future waves. Non-pharmaceutical control measures such as quarantine, wearing masks, social distancing, and regular handwashing have been the only interventions proven successful for reducing infection rates. As COVID-19 is not as predictable as influenza ‘waves’ in terms of seasonal oscillations and expected RNA mutations, it is harder to mitigate the virus (Weber, Freeman, 2020).
In the medium term, social distancing and school closures in 1918 had better economic outcomes than they currently do because society is more interconnected today.
In the medium term, social distancing and school closures in 1918 had better economic outcomes than they currently do because society is more interconnected today. Pressure to ‘reopen’ communities and trade and also contain the new coronavirus to stabilise the global economy demonstrates the massive trade-off between public health and global economic activity (Eberts, Brown, 2020). Several governments have stated that the “consequences of economic meltdown could be even more deadly than the disease.” Along with combating the virus, mitigation measures for COVID-19 present the challenge of providing financial support to those in need and restarting the economy. A sustained economic recovery is a pre-requisite to a sensible public health approach. Both must work in tandem since they are interdependent (Hammer, Hallegatte, 2020).
The 1918 Influenza has become a reference point, allowing us to visualise the progress and end of the current pandemic. However, in the present pandemic, the scientific complexities of the new coronavirus must be considered to gain a realistic perspective for public health and policy. The trends in mobilisation, genetic makeup, and economic repercussions of both pandemics shows that “history does not repeat itself, but it often rhymes” because it challenges people to expand the value of history’s embedded wisdom (Banaszynski, 2019).
By Samia Khan
A contributor and member of the Cov360 team
21 July 2020
Image source: National Library of Medicine — History of Medicine resource.nlm.nih.gov/101580385