Comparing the Coronavirus and the 1918 Influenza Pandemic

The Pandemic CenturyMark Honigsbaum is a medical historian and lecturer in journalism at the City University, London. His is the author of The Pandemic Century: One Hundred Years of Panic, Hysteria and Hubris. Check out his piece at The New York Review of Books in which he compares the coronavirus to the 1918 Influenza Pandemic.

Here is a taste:

To be sure, the SARS-CoV-2 coronavirus is a very different pathogen to influenza. Although both spread via respiratory droplets in coughs and sneezes, coronaviruses do not transmit very efficiently as aerosols, as flu does. Indeed, SARS-CoV-2 is not thought to present a risk at distances further than six feet. Instead, the virus’s principal mode of spread appears to be through prolonged social contact, such as occurs in family groupings.

Another difference is that, unlike the Spanish flu, which had a notably high rate of mortality for adults between the ages of twenty and forty, SARS-CoV-2 is principally a risk to the elderly, those sixty and over, and people with underlying medical conditions. There is also no firm evidence, as yet, that children are a significant vector of infection, a crucial contrast with influenza and, indeed, the Spanish flu, which was seen to sicken children before adults.

On the debit side, there is mounting evidence that people who are symptom-free but infected may be capable of transmitting the virus. Worse, the average reproduction rate of SARS-CoV-2—that is, the number of people who will be infected by one infected person—is running at 2.2, which is markedly higher than the rate for Spanish flu, which was 1.8.

Another consideration is that in 1918 almost everyone had been exposed to some type of influenza before, meaning most people could count on a degree of immunity. The result was that the Spanish flu infected only a third of the world’s population. By contrast, no one has any immunity to the new coronavirus—hence the estimates that as much as 80 percent of the world’s population could have been infected by the time the pandemic will have run its course.

The greatest reason for concern, though, is that so far, SARS-CoV-2 appears to kill about 2 percent of confirmed cases. That is a very similar mortality rate to the Spanish flu.

But even that should not be a cause for panic or despair. One of the chief lessons of the 1918 pandemic is that cities such as St. Louis that acted early and decisively to contain the virus by banning large public gatherings, closing schools, and isolating ill or suspected case, fared notably better than cities such as Philadelphia that failed to take timely measures or did not sustain them. The problem, of course, is that such actions are hugely disruptive to the economy, a fact reflected in the reluctance of authorities to employ such measures except as a last resort.

That was before last week. Now that President Trump has reversed his previous position, rejoined evidence-based reality, and declared a national emergency, officials are having to contemplate even more decisive measures, such as calling on the Army Corps of Engineers to erect temporary medical shelters to cope with the expected influx of patients. This is not something we saw, outside of the US Army’s own camps, even in 1918.

Read the entire piece here.