The delayed response to the 1918 pandemic and the decentralized approach had more deadly consequences.

Researchers at the University of Zurich and the University of Toronto have found that in the event of a pandemic, delayed response by authorities and a decentralized approach at the beginning of the wave of follow-up can lead to longer, more serious and more fatal consequences. I found that there is. The interdisciplinary team compared the 1918 and 1919 Spanish flus in Bern with the 2020 coronavirus pandemic.

The Spanish flu is the largest demographic catastrophe in Switzerland’s recent history, killing about 25,000 people in Switzerland between 1918 and 1919. Following the current coronavirus pandemic, public and scientific interest in what happened at the time has increased.

A team of interdisciplinary researchers in evolutionary medicine, history, geography, and epidemiology at the University of Zurich and the University of Toronto spent years analyzing historical data on the 1918 and 1919 epidemics of influenza-like disease in the Canton of Bern. I did. The canton is large and diverse, and was particularly hit by the Spanish flu, making it an ideal Swiss case study as the obligation to report cases was introduced shortly after the start of the pandemic in July 1918.

Effective public health measures in the first wave

The results of a new study show that the spread of the Spanish flu varies from region to region. In the first wave of July and August 1918, the Canton of Bern intervened relatively quickly, powerfully and centrally, including limiting rallies and closing schools.

The numbers show that these measures, as they are today, are associated with reduced infections. “

Kaspar Staub, Study CofFirst Author, Institute of Evolutionary Medicine, University of Zurich

After the first wave subsided, Canton completely lifted all measures in September 1918. This caused the incident to revive rapidly, and in a short time the second wave began.

The delayed action at the start of the second wave was fatal

At the beginning of the second wave in October 1918, the Canton of Bern, unlike the first wave, responded with hesitation. Fearing new economic implications, state officials have held individual municipalities responsible for the new measures for several weeks. “This hesitant and decentralized approach was fatal and contributed to the fact that the second wave was even stronger and lasting,” said Peter Uni, co-lead author at the University of Toronto. ..

In addition, shortly after the peak of the second wave in November 1918, there was a national strike with demonstrations of social and labor issues and, most importantly, the deployment of larger troops. Relaxation of these large rallies, and subsequent bans on rallies when the number of cases was still too high, was accompanied by a significant resurgence of infectious diseases. Ultimately, about 80% of the reported illnesses and deaths were due to the second wave.

History repeats in 2020

By comparing the weekly numbers of cases of the Spanish flu and coronavirus, researchers found that the second wave began in about the same calendar week in both 1918 and 2020, with similar official delayed responses. I found that there is. “There are still significant differences between the two pandemics, but the steadily increasing similarities between 1918 and 2020 are noteworthy,” says Staub. This study also shows that empirical knowledge from past pandemics (eg, how to deal with challenges and follow-up waves) is available.

“Since November 2020, Covid-19 deaths far outweigh cancer and cardiovascular deaths and have been the most common cause of death in Switzerland for about three months. Second wave mortality is high. Given that, with the threat of a third wave of viral mutations from other countries and from England, South Africa and Brazil, lessons learned in the past may help authorities and the general public rethink their response. There is, “Jüni adds.

Current related historical archive data

The study was based on records from the Bern State Archive of cases of influenza-like illness by municipality and region, which doctors reported weekly to state authorities. “These records are a real treasure trove and a good example of how data from more than 100 years ago are relevant today,” says Staub. In 2015, the research team began posting more than 9,000 medical reports between June 1918 and June 1919, including more than 120,000 influenza cases from 473 Bern municipalities. It then analyzed the data using the latest epidemiological methods and restructured the measures taken at the state level for prevention. A pandemic spread to create the big picture.