A New Flu for Old
I had a little bird
Its name was Enza
I opened a window
And IN-Flu-Enza
Spanish flu virus 1918
In the spring of 1918, all most people were talking about was the war raging in Europe, and when American troops would join the fight. As the United States prepared to join the British and French in their conflict with Germany the newspapers were encouraged to censor unfavorable news. That spring, events that would lead to another deadly story were just getting started. It seemed to start at Fort Riley, a military training camp in Kansas. March 11, 1918 an army cook, private Albert Gitchell, reported to the infirmary with flu systems. He was immediately isolated, but within hours more soldiers reported in sick with the same symptoms. Within five weeks, 1,127 soldiers at Fort Riley had been stricken and 46 of them died. Cases of this new flu were reported in several other military bases as well all through the spring of that year. But this story did not make the papers.
US Army flu ward 1918
Fewer cases were reported by the end of spring. Most men recovered and were deemed fit and healthy so the deployment of American troops to Europe began. Unfortunately the flu went along with them. By early summer reports of flu among French troops and the flu spread across Europe infecting thousands. Heaviest hit in the early months was Spain. As Spain was not involved in World War I its newspapers were free to print all the news and so the Flu was known as the Spanish Flu. By July of 1918 the flu had spread to Asia and Africa, but seemed to be dying out. Unfortunately a second wave of infections began in early fall of 1918, this version more deadly that the first, with patients dying within hours of symptoms. When the Armistice came in November of 1918, and people came together in large groups to celebrate, a third wave of the flu spread around the world. This version was not as deadly as the second, but more deadly than the first. The epidemic lasted well into1919 before it finally ended.
WWI ambulance drivers 1918
The statistics of the 1918 pandemic are astounding: An estimated 500 million were infected worldwide, with somewhere between 20-50 million deaths. In the United States 675,000 flu deaths, a figure ten times the American WWI battlefield deaths. Modern researchers have been able to identify the flu as a strain of the H1N1 virus, and discovered that three genes in the virus worked to weaken human bronchial tubes leading to bacterial pneumonia. But they did not discover a way to kill the offending virus. The most effective way of stopping the spread is to deny it human hosts; in other words keep people away from those infected.
So what lessons have we learned? Apparently not as many as we need. The advances of modern science have enabled us to discover the sources of many illnesses that confused populations of the past. We know that it was bacteria on rats that caused the bubonic plague of the 14th century. The microorganisms that cause many diseases have been identified, but not all diseases have cures even today. Viral flu is one of them. In fact the world has seen three other major flu epidemics since 1918. The “Asian flu” 1957-58 saw estimated deaths of two million worldwide, while the estimated deaths of the “Hong Kong Flu” of 1968-69 were one million. The first pandemic of the 21st century was the “Swine Flu” outbreak of 2009-2010. According to the Centers of Disease control (CDC) approximately 700 million people worldwide contracted this flu but only about 285,000 died from it.
The difference in death rates for modern flu epidemics can probably be attributed to the development of vaccines. Unfortunately the viruses that cause flu-like symptoms constantly mutate so a one-size-fits-all vaccine is not medically possible. With this reality firmly in the minds of the medical community, the CDC was asked to develop a response plan to future pandemics in 2005. Entitled National Strategy for Pandemic Influenza, the twelve page document outlined a concrete plan of action should a pandemic occur. Execution of the plan depended on early governmental action and global cooperation. The creators of the plan recognized the need for coordinated action of multiple players and that leadership from reliable authorities was necessary; that included leadership from the medical, political, and private sectors.
Since prevention is the most important part of the plan, it outlines simple rules for stopping the spread of the flu in an effort to halt it before it reached pandemic proportions: 1.Isolation of those infected; 2. Quarantine of those suspected of being exposed; 3. Good personal hygiene – wash hands etc.; 4. Disinfection of public and private areas; 5. Limit public gatherings. The 2005 plan was updated several times to reflect conditions as each new form of the mutated viruses caused flu epidemics. In 2017 a forty-page update to the plan built on the medical containment successes using information learned from each flu outbreak after the 1918 pandemic.
COVID-19 flu virus
We are now in the middle of another flu pandemic. Like the early stages of the 1918 flu knowledge of the existence of the flu outbreak was kept quiet and locally contained, until it couldn’t be. First reported on December 31, 2019 in one province in China, and two weeks later the first death was announced. Since January 20, 2020 the virus identified as a corona- virus and designated COVID-19 has spread across the world. On January 30 the World Health Organization (WHO) declared a global health emergency. In an effort to stop the spread of the disease, countries all over the globe have instituted travel restrictions, local quarantines, and shelter in place orders. Leading to disruption of businesses large and small, and the closure of schools and universities.
The new normal is “social distancing” if you need to leave your home for essential shopping for items such as food or household needs. The year 2020 will be the year of toilet paper hording ( why I do not know since COVID-19 is a respiratory disease). Life has changed for many Americans as the disease puts great strain on our health system and economy. We will either follow the commonsense rules and let the infections die out, while scientists world-wide search for a treatment or vaccine, or we can choose to ignore our experts and see the infection numbers grow leading to unnecessary casualties.
For China, there is a glimmer of hope. By March 19, 2020 they have reported no new cases of sedentary population (34 new cases reported for people returning home from elsewhere). According to WHO, as of March 23, 2020 the total number of reported cases worldwide was 377,045, with confirmed deaths of 23,673 and 123,329 recovered or discharged with minimum symptoms. Most countries are reporting cases equal to a small percentage of their total populations, but Italy appears to be an outlier. With a population of just over 60 million people, Italy has reported 80589 cases with 8215 deaths, which accounts for 35% of total deaths worldwide. With a population number over five times that of Italy, the United States has reported 80857 cases with only 1163 deaths. The death rates make news but in reality, over 85% of people infected have recovered. The goal in this crisis should be to avoid getting infected in the first place. Follow your health professionals suggestions!
The Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH) and the National Institute of Allergies and Infectious Diseases (NIAID) employ the leading medical experts in the United States. They helped develop that 2005 plan for a pandemic. We need to follow their advice until the crisis is over.
A salient point from the 2005 Pandemic plan states:
“Potential pandemic influenza viruses can be unpredictable, characterized by significant uncertainty of their place of emergence, timing, and severity. Flexibility is essential to any pandemic influenza planning effort, as plans will need to be easily and quickly adapted to the circumstances. HHS must be prepared to respond to the specific needs of an evolving pandemic, as epidemiologic and laboratory data emerge. Each response is different, even if the same basic principles apply. A nimble and effective pandemic response with flexible, sustain able capabilities will save lives and mitigate social and economic disruption.” P40 https://www.cdc.gov/flu/pandemic-resources/pdf/pan-flu-report-2017v2.pdf
An action plan is only successful if followed. How many Americans knew that such a plan existed or even to look for it? This national plan assumes that local plans enhance and support it for the health and well-being of all communities in the US. We have more rapid deployment of information available to us now than our great-grand parents had in 1918. Medical advances have improved treatments for many diseases, but not for viral flus. No single pill or vaccination has been created to treat the underlying causes of influenzas; we still can only treat symptoms and related infections for flu patients.
SO – Follow the guidelines listed by our medical experts. 1. Don’t travel
if you can avoid it. 2. Practice social distancing when you must interact with
others in your community. 3. Don’t hoard vital supplies of medial equipment
such as masks, gloves and sanitizers needed by medial facilities. 4. WASH YOUR
HANDS.
The History of pandemics is lengthy, stretching back to Antonine Plague (165 AD) which decimated the Roman army returning from Mesopotamia. The 20th century Spanish flu remains the deadliest in the modern era. Let’s not make COVID-19 historical.
For credible medical information about the current pandemic you can go to the following websites:
CDC https://www.cdc.gov/coronavirus/2019-nCoV/index.html
WHO https://www.who.int/emergencies/diseases/novel-coronavirus-2019
NIAID https://www.niaid.nih.gov/
