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This is how the third wave of Spanish flu unfolded: predictions for covid-19

The history of pandemics teaches us that airborne viruses almost always follow the same pattern. #Faced with the new SARS-CoV-2 virus, we have a clear and well-studied landmark: the #Spanish flu pandemic.

#As has happened now, on that occasion, in the summer of 1918, an influenza A (H1N1) subtype appeared which, in the midst of the disaster of the #First #World #War, spread rapidly throughout the world. #It then caused, in the fall of 1918, most of the 40 million deaths that we attribute to the pandemic flu of 1918-1920.

#What we have learned from the covid-19 pandemic

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The new virus that has appeared in 2019 does not carry an instruction book under its arm. #We are learning as the pandemic develops and we are improving our response.

#Our increasingly profound medical knowledge is allowing us to improve care and obtain better ratios: if the mortality rate of those admitted to ICUs in the first wave of spring 2020 was 42%, in this second wave #Fall 2020 is down significantly to 25%.

#We are better acquainted with this coronavirus and the multiple clinical manifestations it produces in the body. #We began to understand how it works and what consequences it leaves. #Doctors are also beginning to worry about the enormous cost involved: each patient who survives the ICU costs us three million euros.

The analysis of all the effects of this pandemic is increasingly complex. #It will take us years to correctly assess which sectors have suffered the most and which have benefited from this paradigm shift that is taking place.

#Nothing new under the sun

#At #Christmas 2020 we are still at the end of the second wave of covid-19, which has caused in #Spain more cases than the first but fewer deaths.

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#In other #European countries, as might be expected, it has caused more cases and more deaths than in the first, so they have taken very radical measures. They have had to paralyze economic and social activity during the vacation period. #Possibly in #Spain, at the beginning of 2021, we will miss those measures that were not wanted to be taken to “save #Christmas”.

#In fact, we can already get an idea of ​​what the closest evolution of covid-19 will be like and what awaits us in the coming months and years, since we have the #Spanish flu pandemic as a reference. #At that time, the first light wave, in the spring of 1918, was followed by a second, very serious wave, in the fall of 1918.

Then, when it seemed that that nightmare, like the #Great #War, had passed, a third wave appeared in the first months of 1919, which especially affected the southern hemisphere.

#And it did not end all because, in #Europe, we have also documented up to a fourth wave that occurred in 1920. #In other parts of the world we can even speak of a fifth wave and, of course, of different behaviors in the countries of both hemispheres.

#On the evolution of these waves and their incidence at the local level and in #Western #Europe, we have recently published the book A new history of the #Spanish flu. #Parallels with covid-19.

#Third wave, just around the corner

#Continuing with the similarities of the #Spanish flu pandemic, we recall that in the first months of 1919 the third epidemic wave broke out with some elements that differentiated it from the previous ones. The age of the deceased began to vary, young adults decreased and the elderly increased.

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#In addition, it did not have a peak or zenith but was a trickle of cases and deaths, such as fine rain, which lasted between 3 and 4 months. #It appeared scattered, irregular, without direction, as if it were simple sprouts. #It lasted several months and varied according to the territories of #Europe between #January and #May 1919.

The death certificates reflected the doctors’ perception that it was “complicated flu”, #Because the patients presented respiratory, digestive and other organ and system manifestations.

#At this time, in which epidemic waves advance and intersect, it is very difficult to monitor them. The first wave can even be followed spatially. #For example, that of the covid-19 in #China-Middle #East-Europe-America.

#But in the third wave, the virus is everywhere, there are variants, the containment measures are different according to territories and countries, so predicting its evolution tends to be increasingly difficult.

#When the second wave ended, in the autumn of 1919, more than half of the #Spanish population had passed the flu. #Today only 10% of the #Spanish population is seropositive for SARS-CoV-2.

#For this reason, we are surely at the beginning of the coronavirus pandemic and we will suffer a third wave of the characteristics of 1919. #However, comparing historical moments is complex, although #Cassandra’s role is more tricky, and predicting what may happen in the third covid-19 wave is really complicated.

#If the coronavirus followed the guidelines of historical pandemics, it would take the form of a trickle of cases and deaths from covid-19, such as fine rain, which would extend between the first three or four months of 2021.

#Always depending on the amplifying effect that the #Christmas celebration will have and also waiting for the reducing effect that the new vaccines against covid-19 have.

#Vignette by #Lorenzo #Aguirre published in #El Fígaro on #September 25, 1918 that refers to the #Soldier of #Naples, the name initially given to the disease because it is as catchy as the score of the song of the same name belonging to the zarzuela The song of oblivion (#Sarachaga, #Fernández-Shaw #Iturralde and #Serrano, 1916). #Wikimedia #Commons / The #Figaro

The importance of the media

The media have a very important role. They report freely and, above all, analyze in depth what is happening.

#In the #Spanish flu pandemic they had a disastrous role, since they banalized the story of that pandemic and made jokes that have endured about “the fashionable disease” or “the soldier from #Naples”.

#Vileta by #Lluís #Bagaría published in the newspaper #El #Sol on #June 7, 1918. #Wikimedia #Commons / #El #Sol

#While in #May 1918 the #Madrid newspapers gave such empty information, they did not mention that mortality in the city was skyrocketing: if at the beginning of the month 40 people were dying a day from all causes of death, as of the 24th of #May the number of deaths began to rise to 53.

Then it continued to climb. #For example, on the 27th 84 died and on the 31st 114 people died. The media acted as power transmission belts and did not convey this important data.

#Now the media inform us of the mutations that are being detected: in #Aragon in summer, in #Danish minks in autumn and in the #United #Kingdom and other places in this early winter.

#This significant news, together with independent and contrasted information on the new vaccines, as well as the historical projections that a third wave will arrive in the first months of 2021, will help our society to better understand what is happening and to face the difficult challenges that await us in 2021.

The Conversation

#Anton #Erkoreka #Barrena, #Director of the #Basque #Museum of the #History of #Medicine (UPV / EHU), #University of the #Basque #Country / #University of the #Basque #Country

#This article was originally published on The #Conversation. #Read the original.

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#wave ##Spanish #flu #unfolded #predictions #covid19


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