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By David E. Hubler
Contributor, In Homeland Security
Unless you are a historian or a public health specialist, you might not have heard of the “Black Death.” That was the 14th century pandemic that threw the world into a panic and killed tens of millions of people. The pandemic wiped out 30 to 50 percent of the European population.
More familiar today is the so-called “Spanish flu” pandemic of 1918-19 that killed at least 50 million people worldwide. That is the equivalent to 200 million deaths today. The flu killed many more than the 8.5 million combatants who died in the concurrent First World War.
Spanish Flu Pandemic Caused Life Expectancy to Drop to 39 Years
“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,” notes Gina Kolata in The New York Times. In just one year, the life expectancy fell from 51 years in 1917 to 39 years in 1918.
But this year so far, the annual seasonal flu epidemic in the United States is proving much more devastating than the coronavirus known as COVID-19.
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. As of this week, coronavirus has killed 27 people in the United States.
Kolata points out that “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.”
Similarities and Differences: Coronavirus COVID-19 and Spanish Flu
Jeremy Brown, an emergency physician and author of “Influenza: The 100 Year Hunt to Cure the Deadliest Disease in History,” concurs. Writing in the Atlantic, Brown notes: “What’s most striking about these comparisons … is not the similarities between the two episodes, but the distance that medicine has traveled in the intervening century.”
Brown says “Today we live in a world that is flooded with antibiotics ….We also have another class of drugs available today: antivirals, which directly target the virus responsible for a disease.”
Although no specific antiviral drug is yet available to treat COVID-19, there are “at least four approved antiviral medications, some given orally and others intravenously. There are not as effective as we would like, but they have been given to a number of very sick COVID-19 patients.”
As Brown points out, “we have options that were simply undreamed of a century ago.”
1918 versus 2020 Infection Control Protocols
There were also no mass communications in 1918 to alert people to the imminent danger or to provide health care instructions. Kolata notes that “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.”
Brown cites another major difference from 1918: “Today we understand the importance of infection control and the need to isolate patients to prevent cross contamination.”
The countries that are battling COVIS-19, including China, the U.S. and Italy, are using these and other modern medical and practical steps to contain—and eventually eradicate — the virus by isolating those afflicted. That’s a far cry from 1918 when Spanish flu patients were crowded together in hospital wards to die.
Dr. Victor C. Vaughan, the dean of the medical school at the University of Michigan , was an eyewitness to what Brown calls ”the carnage” at a field hospital. Vaughan wrote of seeing patients “placed on the cots until every bed is full and yet others crowd in. The 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.”
Vaughan concluded, “The deadly influenza demonstrated the inferiority of human interventions in the destruction of human life.”
That 20th century medical stoicism is a far cry from today’s aggressive attack on the current pandemic. Like Dylan Thomas, we will “rage, rage against the dying of the light.”
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