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Why the second wave of the 1918 Spanish flu was so deadly

andyjohnson0 7y ago
"The virus infected 500 million people worldwide and killed an estimated 20 million to 50 million victims" "Somewhere in Europe, a mutated strain of the Spanish flu virus had emerged that had the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection." I knew this, but its still utterly terrifying to see it expressed so bluntly. As the article says, rapid population movement was a key factor in its spread and mutation. We can't take the world back to a time when international travel was rare, so when we're done with the immediate effects of the Covid-19 pandemic, we (as a species) need to get better at rapid vaccine creation. Like an order of magnitude better. Otherwise the next one could be one that takes us down.
- avip 7y ago
  Can we not? Why can't Australia for example close all borders and call it the day?
  - saagarjha 7y ago
    Because Australia already has a number of cases?
  - mikekchar 7y ago
    For one thing, most countries are not self sufficient in basic necessities (not even food!). You could do it for a very short time, but not sustain it. Also, the economy of the country depends on international trade. Modern economies actually don't have a lot of slack. If you shut down trade, quite a few companies will just go under. You would have to back that up with huge subsidies. It would be a massive undertaking.
    - avip 7y ago
      Sure but shutting down all schools also shuts down the economy. Isn't closing borders for people, a more cost effective course of action ?
    - asah 7y ago
      Viruses don't live long enough to survive ocean shipping, so as long as the (tiny) crew is kept isolated, ocean shipping is fine. Within a country, it's not hard to disinfect a truck and keep the driver isolated. Of course, if the originating factory is shut, then you're screwed - but that's true regardless of trade. Also worth noting: it takes a tiny number of people to produce tons of food (calories). Maybe not true for artisanal salami but for bulk basics.
      - blaser-waffle 7y ago
        The US is the single largest exporter of grain in the world. Not the largest producer, not the largest consumer, but the largest exporter. And the US farming population is ~1% of the total US pop. Modern tractors and combines are amazing. Doesn't mean there aren't a ton of bodies involved in processing and transportation, though. You can probably find local-ish wheat in the US, but you're not going to boil and eat the wheat berries for a porridge like it's 1850 (though you could); you're going to buy breakfast cereal.
    - trevyn 7y ago
      You don’t need a whole modern economy to feed people.
    - coldtea 7y ago
      Well, if there's a widespread virus that has "the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection" the "economy" and "international trade" would be the least of our worries...
  - andyjohnson0 7y ago
    In addition to the reasons others have given (self-sufficiency, and it being too late this time), closed boarders as a general and ongoing solution is very brittle. All it takes is one infected person to get across the border and you have no defence-in-depth. As a short-term measure in combination with other public health efforts, it might have some merit, but thats all really.
- ailideex 7y ago
  > need to get better at rapid vaccine creation. What is stopping you from making a vaccine for COVID-19? I can promise you nobody will be upset with you if you do it, you don't need anyone's permission either.
  - khafra 7y ago
    I don't think he's saying vaccine creation is easy, I think he's saying it's a hard problem that needs a concerted effort at developing shortcuts. Also, this is technically true, but vacuous: > What is stopping you from making a vaccine for COVID-19? I can promise you nobody will be upset with you if you do it, you don't need anyone's permission either. Even if by some herculean effort and unbelievable luck, I brewed up a Covid-19 vaccine in my garage, I would be unable to help people at scale with it unless it passed millions of dollars worth of testing for regulatory approval.
    - ailideex 7y ago
      Okay - so ... "we (as a species) need to get better at rapid vaccine creation. Like an order of magnitude better" ... and andyjohnson0 will do what exactly then to make this happen?
      - scrollaway 7y ago
        Generally, when someone makes statements like the one you're trying very hard to make fun of, the "we need to" means "our leaders should prioritize". Not that hard to understand really.
        ailideex 7y ago
        Ah, so ... if andyjohnson0 is not part of the human species ... the heck is andyjohnson0? Also if andyjohnson0 wants their "leaders" to do something ... I mean ... andyjohnson0 can vote no? And are you suggesting "our leaders" are dragging their asses or something?
- flarg 7y ago
  Do you think a vaccine is the right answer? Surely development and stockpiling of anti virals is the key, Tamiflu or similar. The lead time for vaccines will also be far too long and the protection against flu like illnesses is variable over time. What do you think?
  - andyjohnson0 7y ago
    > Surely development and stockpiling of anti virals is the key, Tamiflu or similar. Tamiflu doesn't have any effect on Covid-19. There might be antivirals that are effective, and testing is happening now. I'd argue we should be trying to find ways to speed that process up for next time. > The lead time for vaccines will also be far too long and the protection against flu like illnesses is variable over time. Thats what I was saying: can we (humans) get better/faster at doing this?
    - flarg 7y ago
      I think we can if we start to try and treat viral illnesses in the animals in wet markets
  - 46Bit 7y ago
    The protection of antivirals is variable too. The value of Tamiflu itself still seems controversial.
  - wbl 7y ago
    Tamiflu blocks neuramidase from releasing the viral particles. Coronavirus does not bind to salic acid so neuramidase is irrelevant.
- hef19898 7y ago
  International travel, especially between Europe and the US, was very much a thing back in 1918. Even more so for the younger, male population who tended to be packed in ships for the journey.
  - andyjohnson0 7y ago
    I'm not saying there was no international travel in the early 20th century, just that the numbers are massively higher now.
    - hef19898 7y ago
      My point was the massive mobilization, and subsequent de-mobilization, of armies during World War I. Especially starting in 1917 across the Atlantic when the US entered the war in large numbers. Sure, not comparable to the way are traveling today, but the numbers still were in the millions. And they were cramped into ships for weeks, as compared to aircraft. The Diamond Princess showed us that this a nice breeding ground for a virus. EDIT: Some numbers: USA: 1.5 million men demobilized by February 1919, so it started right uring the second wave, in the US. Another roughly 2 million men in cramped demobilization camps in Europe. Later these US troops were moved from these camps to French towns and cities to ease tension among troop caused by crowded conditions. Also happening right during the second flu wave. Germany: roughly one million men simply walked home after the armistice in Nov. 1918, leaving roughly 6 million men under arms. These were demobilized in the four month after the armistice. So you have 7 million men travelling across the German Empire. During the second wave of the flu. Austria: No numbers found after a quick gogle search, except for 400,000 soldiers taken prisoner by the Italian during the desintegration of the Austr-Hungarian army. The demobilization in Austria collided with the desintagration of the Empire, so it was even more chaotic than the German one. Also taking place after the armestice in Nov. 1918 and during the second wave of the flu. Great Britain: demobilized roughly 3 million men between the armistice in Nov. 1918 and late 1919. Mostly from the Western Front. During the second wave of the flu. France: Demobilized 2.5 million men between Nov. 1918 and April 1919. Also from the western front, also during the second wave of the flu. There we talk about young men, the demographic most ht by the flu. All war powers kept the flu under wraps during the war, that's why it's called the Spanish Flu, Spanish newpapers were the first to report it. All these men travelled, moreor less coordinated, across Europe and the US. Most of them coming from the Western Front, from cramped conditions with sometimes bad hygenic conditions. And they met up with the young female population upon return, for obvious reasons. All in the time frame of a couple of months. The equivalent would be to move a large protion of our elderlies around the world now. Source: https://encyclopedia.1914-1918-online.net/article/demobilization https://encyclopedia.1914-1918-online.net/article/demobiliza... EDIT 2: From the submitted article: "Historians now believe that the fatal severity of the Spanish flu’s “second wave” was caused by a mutated virus spread by wartime troop movements." EDIT 3: It was much easier to find demobilization numbers thn mobiliztion numbers. The second wave hit before the Armistice in November. Demobilization is,if you want to call that, the return ticket of all these young people taking their trips to the western front. So they all moved there in the months before. And they travelled, from the trenches, to rear, on front vacation, to field hospitals, to hospitals elsewhere. They also travelled on the same ships that ran across the Atlantic, with much larger crews than we have today. The amount of traffic during the months before, and drung, the second wave was mind boggeling. Entente powers geared up for the huge, planned, 1919 spring offensive. EDIT 4: Nice tid bit, not only for the second wave. "By the end of the summer the virus had reached the German Army. The virus created serious problems for the German military leadership as they found it impossible to replace their sick and dying soldiers. The infection had already reached Germany and over 400,000 civilians died of the disease in 1918." from here: https://spartacus-educational.com/FWWinfluenzia.htm https://spartacus-educational.com/FWWinfluenzia.htm. I would have thought barbed wire, artillery, tranches, chemicla warfare and machine guns would have formed a nice barrier. Social contact, trenches have a lot of that, seemto be a much bigger factor it seems. Proves the point of avoiding gatherings, self-quarantine and sch things, IMHO.
raphaelj 7y ago
The article does not answer the question, except for "it mutated"
- gambiting 7y ago
  Does it not? It clearly says that countries like the UK knew full well that the best way to combat the illness was to isolate and quarantine people and cities, but decided not to do it to avoid harming the war effort - resulting in a lot more deaths. How is that not an answer to this question?
  - Spare_account 7y ago
    I'm watching the UK government decide not to implement 'delay' measures today, ostensibly to protect the economy. It seems there is always a reason not to do the right thing. I hope they change their mind very soon.
    - gambiting 7y ago
      Have you watched the presentation yesterday? Or just reading the news articles today? Because that's precisely not what they said. What was said was - from epidimiology point of view, there's no point in telling everyone to stay at home right now when the spread is in the early stages. It will have a marginal effect, and the spread will continue anyway. By government's own estimates 80% of people in the UK will get infected, and imposing a quarantine right now won't change that. What would help is setting the quarantine for 14-18 weeks, and they know that people won't abide by that, so instead, they clearly said they will impose quarantine just before UK hits the predicted peak infections - to lower the stress on the NHS and to achieve the maximum effect of the quarantine. Like, it all made sense if you watched the actual conference.
      - empiricus 7y ago
        I watched a part of the presentation, but it was actually unclear to me what is the peak infections mentioned. I mean, in Italy, the numbers are very small compared to 80% of population, and the health system is already not able to cope, and mortality rate is quite high. Does it mean that UK will wait for their numbers to be 10 times the current Italy numbers before starting the quarantine?
sschueller 7y ago
All interesting but you just can't compare a Flu in 1918 with today. The list is endless of what we didn't have in 1918, from computers to do DNA sequencing to even testing the way we do today.
- matwood 7y ago
  Just basic hygiene is much better than in 1918. I think it's instructive to look at the Spanish Flu, but I agree that too many people are using it to draw direct comparisons. With respect to viral spread, many things are greatly improved today as you mention, but some are worse (such as the ease of global travel).
- poooogles 7y ago
  >The list is endless of what we didn't have in 1918, from computers to do DNA sequencing to even testing the way we do today. And the vast majority is useless to people when you've got 100x more patients than you can deal with.
  - sschueller 7y ago
    China was able to build a 645,000-square-foot medical facility in 10 days with 30 ICU units and 1000 beds. Coordinating such a feat in such a short time would not have been possible in 1918.
    - jfkebwjsbx 7y ago
      Keyword: China. Not many countries (any?) have the capability to build things as fast as China does. And even if a country has them, China is the source of so many supplies that they will simply keep them for themselves. Let this be a lesson to avoid dependencies on a single entity.
      - TheNorthman 7y ago
        > that they will simply keep them for themselves Not true, China has sent, and are continuing to do so, aid to, amongst others, Italy and Spain [1], including 100k respirators [2]. [1]: https://www.reuters.com/article/us-health-coronavirus-spain-aid/china-offers-aid-to-spain-to-fight-coronavirus-spanish-government-source-idUSKBN20Z27G https://www.reuters.com/article/us-health-coronavirus-spain-... [2]: https://www.corriere.it/politica/20_marzo_10/coronavirus-mille-respiratori-cina-telefonata-maio-wang-yi-faa5f50a-62b6-11ea-a693-c7191bf8b498.shtml https://www.corriere.it/politica/20_marzo_10/coronavirus-mil...
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fxj 7y ago
There is a very good post from univ oxford on this topic: https://ourworldindata.org/spanish-flu-largest-influenza-pandemic-in-history https://ourworldindata.org/spanish-flu-largest-influenza-pan... which provides more scientific background and real numbers and compares it with other flu pandemics and the ongoing covid pandemia.
fxj 7y ago
Differences in health systems and infrastructure also matter. The Spanish flu hit the world in the days before antibiotics were invented; and many deaths, perhaps most, were not caused by the influenza virus itself, but by secondary bacterial infections. Morens et al (2008) found that during the Spanish flu “the majority of deaths … likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory–tract bacteria. Morens D. M., Taubenberger J. K., Fauci A. S. (2008) – Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J. Infect. Dis. 198 962–970.
- OJFord 7y ago
  Haven't many of the COVID-19 deaths also been due to pneumonia?
  - rimliu 7y ago
    Yes, but this time its viral pneumonia.
    - etiam 7y ago
      Not only viral pneumonia though. According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan, many ultimately get killed off by bacterial secondary infection. Encouraging in some ways, under the horrifying circumstances, with the catch that in many parts of the world that secondary infection will be caused by multiple resistance bacteria. I'd say this pandemic is going to be by far the biggest single consequence post to date for the antibiotic resistance problem, despite being driven by a pathogen that was never sensitive to the antibiotics.
      - grabbalacious 7y ago
        Yes, and isn't this cause for some optimism since many people have now received vaccines such as Prevnar-13 and Pneumovax-23?
cletus 7y ago
There's a surprising amount of well-intentioned but misinformed speculation in this thread. "We don't know" is the best answer to a lot of the questions about Spanish flu. What we do know is that it disproportionally killed young, healthy people who could go from no symptoms to dear in 24 hours. There's a lot of speculation as to why. I've seen medical experts theorize this is likely due too a cytokine response, meaning basically that a healthy immune system goes nuts. Apparently there are other diseases that have fit this pattern. The mortality rate is estimated at about 3%. Influenza is 0.1%. Coronavirus is somewhere between those. Best guess of why the second wave was so deadly was due to a mutation that likely happened in Europe. It's true we have things we didn't in 1918 but we still have surprisingly few tools to combat viruses. Fun fact: only one virus has had a cure developed and that was Hepatitis-C in recent years. To be clear, vaccines != cures. We also have problems we didn't have in 1918, specifically mobility of people. It's that mobility combined with people being highly contagious while being asymptomatic that makes this particular diseases such a challenge.
- TheCondor 7y ago
  Thanks for this, I was going to say that we have had to infer most of the details about it or earlier pandemics.
- kakwa_ 7y ago
  The mortality rate of Covid-19 seems higher than that. The around 3% mortality rate is what you get by dividing the number of deaths by the number of infection (past and present) (as of today: 5359 / 140875 = 3.8%). But this is incorrect as the number of currently infected people is quite high (half the total number of infections) and unfortunately, a few will die in the near future. If you divide the number of deaths by (recovered + deaths), the mortality is much higher (as of today: 5359 / (70174 + 5359) = 7.1%). Which seems actually about as high as the Spanish Flue right in between the low and high estimate (20M/500M, 50M/500M). And it's source for worries since our medical systems are 1) much more developed than in 1918, and 2) they are not yet completely overloaded. If it were to spread rapidly and overload our health systems, the mortality rate could rise even more, let's hope it doesn't reach that level.
andrewseanryan 7y ago
Good article, but this one from Smithsonian is much more detailed. https://www.smithsonianmag.com/history/journal-plague-year-180965222/ https://www.smithsonianmag.com/history/journal-plague-year-1...
- ipnon 7y ago
  Useful given history.com responded to my request with an empty document
known 7y ago
https://en.wikipedia.org/wiki/Information_asymmetry https://en.wikipedia.org/wiki/Information_asymmetry
sebastianconcpt 7y ago
Harris believes that the rapid spread of Spanish flu in the fall of 1918 was at least partially to blame on public health officials unwilling to impose quarantines during wartime. In Britain, for example, a government official named Arthur Newsholme knew full well that a strict civilian lockdown was the best way to fight the spread of the highly contagious disease. But he wouldn’t risk crippling the war effort by keeping munitions factory workers and other civilians home.
- dhosek 7y ago
  Or in 2020: must keep the stock market up.
CodiePetersen 7y ago
Let's just hope we are more equipped to deal with the Wuhan Virus than we were with the Spanish Flu. I know experts have been training waiting and warning about this type of event since 1918 but our leaders seemed to have screwed the pooch on not letting them do their job and taking their advice. There are different challenges of course due to the virus itself and the transportation infrastructure today. But there are better tools too. Our governments just need to act appropriately and stay correctly informed. South Korea is reporting more recoveries than new cases which means it can be extinguished if we take similar measures elsewhere. If South Korea didn't have to worry about new infected entering the country , with those numbers it's on the path to eradication. Unfortunately in America steps were taken to actively refuse help, like offered early tests from the WHO weeks ago that were rejected by the US so we could instead make them here for whatever reason, which as everyone knows lead to the bad tests and put us far behind in the response in catching this before it got off the ground. We have all the tools and experts we need but our leaders are going to need to let the experts call the shots and do their job if we are going to avoid the scale of the Spanish Flu. Once it's past a certain point the strain on the medical industry will cause rises in other preventable diseases and we'll have more problems and deaths than just from Wuhan Virus.
- notacoward 7y ago
  Please stop calling it the Wuhan virus. It's well recognized that such terminology promotes discrimination (even if it's not intended to). The disease is COVID-19; the virus is SARS-CoV-2. Even if it's only for the sake of clarity, please use the correct terms.
  - jacobriis 7y ago
    You may have missed Spanish flu being used a few times in this thread. Please also fight racism against Spanish people. You are doing important work. Gracias!
    - notacoward 7y ago
      "Spanish flu" was coined and popularized literally over a century ago, and it's a bit late to affect what it's called. COVID-19 is still fairly new, and we can use what we've learned in the last hundred years to avoid the mistakes - linguistic and otherwise - of the past.
yters 7y ago
Once the quarantine is lifted we will have a bunch of non inoculated people, and the corona will spread all over again.
- Agenttin 7y ago
  The goal isn't to stop those people from being infected, it's to delay their infection. A massive spike of infections would overwhelm the hospitals. The same number of patients, slower, is doable.
andrekandre 7y ago
in case you don’t read the article, there is an interesting historical anecdote: why it’s called “spanish flu” > Interestingly, it was during this time that the Spanish flu earned its misnomer. Spain was neutral during World War I and unlike its European neighbors, it didn’t impose wartime censorship on its press. In France, England and the United States, newspapers weren’t allowed to report on anything that could harm the war effort, including news that a crippling virus was sweeping through troops. Since Spanish journalists were some of the only ones reporting on a widespread flu outbreak in the spring of 1918, the pandemic became known as the “Spanish flu.”

"The virus infected 500 million people worldwide and killed an estimated 20 million to 50 million victims" "Somewhere in Europe, a mutated strain of the Spanish flu virus had emerged that had the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection." I knew this, but its still utterly terrifying to see it expressed so bluntly. As the article says, rapid population movement was a key factor in its spread and mutation. We can't take the world back to a time when international travel was rare, so when we're done with the immediate effects of the Covid-19 pandemic, we (as a species) need to get better at rapid vaccine creation. Like an order of magnitude better. Otherwise the next one could be one that takes us down.

avip 7y ago
Can we not? Why can't Australia for example close all borders and call it the day?
- saagarjha 7y ago
  Because Australia already has a number of cases?
- mikekchar 7y ago
  For one thing, most countries are not self sufficient in basic necessities (not even food!). You could do it for a very short time, but not sustain it. Also, the economy of the country depends on international trade. Modern economies actually don't have a lot of slack. If you shut down trade, quite a few companies will just go under. You would have to back that up with huge subsidies. It would be a massive undertaking.
  - avip 7y ago
    Sure but shutting down all schools also shuts down the economy. Isn't closing borders for people, a more cost effective course of action ?
  - asah 7y ago
    Viruses don't live long enough to survive ocean shipping, so as long as the (tiny) crew is kept isolated, ocean shipping is fine. Within a country, it's not hard to disinfect a truck and keep the driver isolated. Of course, if the originating factory is shut, then you're screwed - but that's true regardless of trade. Also worth noting: it takes a tiny number of people to produce tons of food (calories). Maybe not true for artisanal salami but for bulk basics.
    - blaser-waffle 7y ago
      The US is the single largest exporter of grain in the world. Not the largest producer, not the largest consumer, but the largest exporter. And the US farming population is ~1% of the total US pop. Modern tractors and combines are amazing. Doesn't mean there aren't a ton of bodies involved in processing and transportation, though. You can probably find local-ish wheat in the US, but you're not going to boil and eat the wheat berries for a porridge like it's 1850 (though you could); you're going to buy breakfast cereal.
  - trevyn 7y ago
    You don’t need a whole modern economy to feed people.
  - coldtea 7y ago
    Well, if there's a widespread virus that has "the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection" the "economy" and "international trade" would be the least of our worries...
- andyjohnson0 7y ago
  In addition to the reasons others have given (self-sufficiency, and it being too late this time), closed boarders as a general and ongoing solution is very brittle. All it takes is one infected person to get across the border and you have no defence-in-depth. As a short-term measure in combination with other public health efforts, it might have some merit, but thats all really.
ailideex 7y ago
> need to get better at rapid vaccine creation. What is stopping you from making a vaccine for COVID-19? I can promise you nobody will be upset with you if you do it, you don't need anyone's permission either.
- khafra 7y ago
  I don't think he's saying vaccine creation is easy, I think he's saying it's a hard problem that needs a concerted effort at developing shortcuts. Also, this is technically true, but vacuous: > What is stopping you from making a vaccine for COVID-19? I can promise you nobody will be upset with you if you do it, you don't need anyone's permission either. Even if by some herculean effort and unbelievable luck, I brewed up a Covid-19 vaccine in my garage, I would be unable to help people at scale with it unless it passed millions of dollars worth of testing for regulatory approval.
  - ailideex 7y ago
    Okay - so ... "we (as a species) need to get better at rapid vaccine creation. Like an order of magnitude better" ... and andyjohnson0 will do what exactly then to make this happen?
    - scrollaway 7y ago
      Generally, when someone makes statements like the one you're trying very hard to make fun of, the "we need to" means "our leaders should prioritize". Not that hard to understand really.
      - ailideex 7y ago
        Ah, so ... if andyjohnson0 is not part of the human species ... the heck is andyjohnson0? Also if andyjohnson0 wants their "leaders" to do something ... I mean ... andyjohnson0 can vote no? And are you suggesting "our leaders" are dragging their asses or something?
flarg 7y ago
Do you think a vaccine is the right answer? Surely development and stockpiling of anti virals is the key, Tamiflu or similar. The lead time for vaccines will also be far too long and the protection against flu like illnesses is variable over time. What do you think?
- andyjohnson0 7y ago
  > Surely development and stockpiling of anti virals is the key, Tamiflu or similar. Tamiflu doesn't have any effect on Covid-19. There might be antivirals that are effective, and testing is happening now. I'd argue we should be trying to find ways to speed that process up for next time. > The lead time for vaccines will also be far too long and the protection against flu like illnesses is variable over time. Thats what I was saying: can we (humans) get better/faster at doing this?
  - flarg 7y ago
    I think we can if we start to try and treat viral illnesses in the animals in wet markets
- 46Bit 7y ago
  The protection of antivirals is variable too. The value of Tamiflu itself still seems controversial.
- wbl 7y ago
  Tamiflu blocks neuramidase from releasing the viral particles. Coronavirus does not bind to salic acid so neuramidase is irrelevant.
hef19898 7y ago
International travel, especially between Europe and the US, was very much a thing back in 1918. Even more so for the younger, male population who tended to be packed in ships for the journey.
- andyjohnson0 7y ago
  I'm not saying there was no international travel in the early 20th century, just that the numbers are massively higher now.
  - hef19898 7y ago
    My point was the massive mobilization, and subsequent de-mobilization, of armies during World War I. Especially starting in 1917 across the Atlantic when the US entered the war in large numbers. Sure, not comparable to the way are traveling today, but the numbers still were in the millions. And they were cramped into ships for weeks, as compared to aircraft. The Diamond Princess showed us that this a nice breeding ground for a virus. EDIT: Some numbers: USA: 1.5 million men demobilized by February 1919, so it started right uring the second wave, in the US. Another roughly 2 million men in cramped demobilization camps in Europe. Later these US troops were moved from these camps to French towns and cities to ease tension among troop caused by crowded conditions. Also happening right during the second flu wave. Germany: roughly one million men simply walked home after the armistice in Nov. 1918, leaving roughly 6 million men under arms. These were demobilized in the four month after the armistice. So you have 7 million men travelling across the German Empire. During the second wave of the flu. Austria: No numbers found after a quick gogle search, except for 400,000 soldiers taken prisoner by the Italian during the desintegration of the Austr-Hungarian army. The demobilization in Austria collided with the desintagration of the Empire, so it was even more chaotic than the German one. Also taking place after the armestice in Nov. 1918 and during the second wave of the flu. Great Britain: demobilized roughly 3 million men between the armistice in Nov. 1918 and late 1919. Mostly from the Western Front. During the second wave of the flu. France: Demobilized 2.5 million men between Nov. 1918 and April 1919. Also from the western front, also during the second wave of the flu. There we talk about young men, the demographic most ht by the flu. All war powers kept the flu under wraps during the war, that's why it's called the Spanish Flu, Spanish newpapers were the first to report it. All these men travelled, moreor less coordinated, across Europe and the US. Most of them coming from the Western Front, from cramped conditions with sometimes bad hygenic conditions. And they met up with the young female population upon return, for obvious reasons. All in the time frame of a couple of months. The equivalent would be to move a large protion of our elderlies around the world now. Source: https://encyclopedia.1914-1918-online.net/article/demobilization https://encyclopedia.1914-1918-online.net/article/demobiliza... EDIT 2: From the submitted article: "Historians now believe that the fatal severity of the Spanish flu’s “second wave” was caused by a mutated virus spread by wartime troop movements." EDIT 3: It was much easier to find demobilization numbers thn mobiliztion numbers. The second wave hit before the Armistice in November. Demobilization is,if you want to call that, the return ticket of all these young people taking their trips to the western front. So they all moved there in the months before. And they travelled, from the trenches, to rear, on front vacation, to field hospitals, to hospitals elsewhere. They also travelled on the same ships that ran across the Atlantic, with much larger crews than we have today. The amount of traffic during the months before, and drung, the second wave was mind boggeling. Entente powers geared up for the huge, planned, 1919 spring offensive. EDIT 4: Nice tid bit, not only for the second wave. "By the end of the summer the virus had reached the German Army. The virus created serious problems for the German military leadership as they found it impossible to replace their sick and dying soldiers. The infection had already reached Germany and over 400,000 civilians died of the disease in 1918." from here: https://spartacus-educational.com/FWWinfluenzia.htm https://spartacus-educational.com/FWWinfluenzia.htm. I would have thought barbed wire, artillery, tranches, chemicla warfare and machine guns would have formed a nice barrier. Social contact, trenches have a lot of that, seemto be a much bigger factor it seems. Proves the point of avoiding gatherings, self-quarantine and sch things, IMHO.

raphaelj 7y ago

The article does not answer the question, except for "it mutated"

gambiting 7y ago
Does it not? It clearly says that countries like the UK knew full well that the best way to combat the illness was to isolate and quarantine people and cities, but decided not to do it to avoid harming the war effort - resulting in a lot more deaths. How is that not an answer to this question?
- Spare_account 7y ago
  I'm watching the UK government decide not to implement 'delay' measures today, ostensibly to protect the economy. It seems there is always a reason not to do the right thing. I hope they change their mind very soon.
  - gambiting 7y ago
    Have you watched the presentation yesterday? Or just reading the news articles today? Because that's precisely not what they said. What was said was - from epidimiology point of view, there's no point in telling everyone to stay at home right now when the spread is in the early stages. It will have a marginal effect, and the spread will continue anyway. By government's own estimates 80% of people in the UK will get infected, and imposing a quarantine right now won't change that. What would help is setting the quarantine for 14-18 weeks, and they know that people won't abide by that, so instead, they clearly said they will impose quarantine just before UK hits the predicted peak infections - to lower the stress on the NHS and to achieve the maximum effect of the quarantine. Like, it all made sense if you watched the actual conference.
    - empiricus 7y ago
      I watched a part of the presentation, but it was actually unclear to me what is the peak infections mentioned. I mean, in Italy, the numbers are very small compared to 80% of population, and the health system is already not able to cope, and mortality rate is quite high. Does it mean that UK will wait for their numbers to be 10 times the current Italy numbers before starting the quarantine?

sschueller 7y ago

All interesting but you just can't compare a Flu in 1918 with today. The list is endless of what we didn't have in 1918, from computers to do DNA sequencing to even testing the way we do today.

matwood 7y ago
Just basic hygiene is much better than in 1918. I think it's instructive to look at the Spanish Flu, but I agree that too many people are using it to draw direct comparisons. With respect to viral spread, many things are greatly improved today as you mention, but some are worse (such as the ease of global travel).
poooogles 7y ago
>The list is endless of what we didn't have in 1918, from computers to do DNA sequencing to even testing the way we do today. And the vast majority is useless to people when you've got 100x more patients than you can deal with.
- sschueller 7y ago
  China was able to build a 645,000-square-foot medical facility in 10 days with 30 ICU units and 1000 beds. Coordinating such a feat in such a short time would not have been possible in 1918.
  - jfkebwjsbx 7y ago
    Keyword: China. Not many countries (any?) have the capability to build things as fast as China does. And even if a country has them, China is the source of so many supplies that they will simply keep them for themselves. Let this be a lesson to avoid dependencies on a single entity.
    - TheNorthman 7y ago
      > that they will simply keep them for themselves Not true, China has sent, and are continuing to do so, aid to, amongst others, Italy and Spain [1], including 100k respirators [2]. [1]: https://www.reuters.com/article/us-health-coronavirus-spain-aid/china-offers-aid-to-spain-to-fight-coronavirus-spanish-government-source-idUSKBN20Z27G https://www.reuters.com/article/us-health-coronavirus-spain-... [2]: https://www.corriere.it/politica/20_marzo_10/coronavirus-mille-respiratori-cina-telefonata-maio-wang-yi-faa5f50a-62b6-11ea-a693-c7191bf8b498.shtml https://www.corriere.it/politica/20_marzo_10/coronavirus-mil...

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fxj 7y ago

There is a very good post from univ oxford on this topic: https://ourworldindata.org/spanish-flu-largest-influenza-pandemic-in-history https://ourworldindata.org/spanish-flu-largest-influenza-pan... which provides more scientific background and real numbers and compares it with other flu pandemics and the ongoing covid pandemia.

fxj 7y ago

Differences in health systems and infrastructure also matter. The Spanish flu hit the world in the days before antibiotics were invented; and many deaths, perhaps most, were not caused by the influenza virus itself, but by secondary bacterial infections. Morens et al (2008) found that during the Spanish flu “the majority of deaths … likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory–tract bacteria. Morens D. M., Taubenberger J. K., Fauci A. S. (2008) – Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J. Infect. Dis. 198 962–970.

OJFord 7y ago
Haven't many of the COVID-19 deaths also been due to pneumonia?
- rimliu 7y ago
  Yes, but this time its viral pneumonia.
  - etiam 7y ago
    Not only viral pneumonia though. According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan, many ultimately get killed off by bacterial secondary infection. Encouraging in some ways, under the horrifying circumstances, with the catch that in many parts of the world that secondary infection will be caused by multiple resistance bacteria. I'd say this pandemic is going to be by far the biggest single consequence post to date for the antibiotic resistance problem, despite being driven by a pathogen that was never sensitive to the antibiotics.
    - grabbalacious 7y ago
      Yes, and isn't this cause for some optimism since many people have now received vaccines such as Prevnar-13 and Pneumovax-23?

cletus 7y ago

There's a surprising amount of well-intentioned but misinformed speculation in this thread. "We don't know" is the best answer to a lot of the questions about Spanish flu. What we do know is that it disproportionally killed young, healthy people who could go from no symptoms to dear in 24 hours. There's a lot of speculation as to why. I've seen medical experts theorize this is likely due too a cytokine response, meaning basically that a healthy immune system goes nuts. Apparently there are other diseases that have fit this pattern. The mortality rate is estimated at about 3%. Influenza is 0.1%. Coronavirus is somewhere between those. Best guess of why the second wave was so deadly was due to a mutation that likely happened in Europe. It's true we have things we didn't in 1918 but we still have surprisingly few tools to combat viruses. Fun fact: only one virus has had a cure developed and that was Hepatitis-C in recent years. To be clear, vaccines != cures. We also have problems we didn't have in 1918, specifically mobility of people. It's that mobility combined with people being highly contagious while being asymptomatic that makes this particular diseases such a challenge.

TheCondor 7y ago
Thanks for this, I was going to say that we have had to infer most of the details about it or earlier pandemics.
kakwa_ 7y ago
The mortality rate of Covid-19 seems higher than that. The around 3% mortality rate is what you get by dividing the number of deaths by the number of infection (past and present) (as of today: 5359 / 140875 = 3.8%). But this is incorrect as the number of currently infected people is quite high (half the total number of infections) and unfortunately, a few will die in the near future. If you divide the number of deaths by (recovered + deaths), the mortality is much higher (as of today: 5359 / (70174 + 5359) = 7.1%). Which seems actually about as high as the Spanish Flue right in between the low and high estimate (20M/500M, 50M/500M). And it's source for worries since our medical systems are 1) much more developed than in 1918, and 2) they are not yet completely overloaded. If it were to spread rapidly and overload our health systems, the mortality rate could rise even more, let's hope it doesn't reach that level.

andrewseanryan 7y ago

Good article, but this one from Smithsonian is much more detailed. https://www.smithsonianmag.com/history/journal-plague-year-180965222/ https://www.smithsonianmag.com/history/journal-plague-year-1...

ipnon 7y ago
Useful given history.com responded to my request with an empty document

known 7y ago

https://en.wikipedia.org/wiki/Information_asymmetry https://en.wikipedia.org/wiki/Information_asymmetry

sebastianconcpt 7y ago

Harris believes that the rapid spread of Spanish flu in the fall of 1918 was at least partially to blame on public health officials unwilling to impose quarantines during wartime. In Britain, for example, a government official named Arthur Newsholme knew full well that a strict civilian lockdown was the best way to fight the spread of the highly contagious disease. But he wouldn’t risk crippling the war effort by keeping munitions factory workers and other civilians home.

dhosek 7y ago
Or in 2020: must keep the stock market up.

CodiePetersen 7y ago

Let's just hope we are more equipped to deal with the Wuhan Virus than we were with the Spanish Flu. I know experts have been training waiting and warning about this type of event since 1918 but our leaders seemed to have screwed the pooch on not letting them do their job and taking their advice. There are different challenges of course due to the virus itself and the transportation infrastructure today. But there are better tools too. Our governments just need to act appropriately and stay correctly informed. South Korea is reporting more recoveries than new cases which means it can be extinguished if we take similar measures elsewhere. If South Korea didn't have to worry about new infected entering the country , with those numbers it's on the path to eradication. Unfortunately in America steps were taken to actively refuse help, like offered early tests from the WHO weeks ago that were rejected by the US so we could instead make them here for whatever reason, which as everyone knows lead to the bad tests and put us far behind in the response in catching this before it got off the ground. We have all the tools and experts we need but our leaders are going to need to let the experts call the shots and do their job if we are going to avoid the scale of the Spanish Flu. Once it's past a certain point the strain on the medical industry will cause rises in other preventable diseases and we'll have more problems and deaths than just from Wuhan Virus.

notacoward 7y ago
Please stop calling it the Wuhan virus. It's well recognized that such terminology promotes discrimination (even if it's not intended to). The disease is COVID-19; the virus is SARS-CoV-2. Even if it's only for the sake of clarity, please use the correct terms.
- jacobriis 7y ago
  You may have missed Spanish flu being used a few times in this thread. Please also fight racism against Spanish people. You are doing important work. Gracias!
  - notacoward 7y ago
    "Spanish flu" was coined and popularized literally over a century ago, and it's a bit late to affect what it's called. COVID-19 is still fairly new, and we can use what we've learned in the last hundred years to avoid the mistakes - linguistic and otherwise - of the past.

yters 7y ago

Once the quarantine is lifted we will have a bunch of non inoculated people, and the corona will spread all over again.

Agenttin 7y ago
The goal isn't to stop those people from being infected, it's to delay their infection. A massive spike of infections would overwhelm the hospitals. The same number of patients, slower, is doable.

andrekandre 7y ago

in case you don’t read the article, there is an interesting historical anecdote: why it’s called “spanish flu” > Interestingly, it was during this time that the Spanish flu earned its misnomer. Spain was neutral during World War I and unlike its European neighbors, it didn’t impose wartime censorship on its press. In France, England and the United States, newspapers weren’t allowed to report on anything that could harm the war effort, including news that a crippling virus was sweeping through troops. Since Spanish journalists were some of the only ones reporting on a widespread flu outbreak in the spring of 1918, the pandemic became known as the “Spanish flu.”