The second wave of the 1918 pandemic had fatal 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 have spent several years conducting analysis. Historical data About the 1918 and 1919 influenza-like illness epidemics in Bern. The canton is large and has a diverse landscape, making it ideal as a Swiss case study. The Spanish flu was particularly devastating, and shortly after the start of the pandemic in July 1918, the obligation to report cases was introduced.

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,” said Kaspar Staub, co-lead author of the Institute for Evolutionary Medicine, University of Zurich.After the first wave subsided, Canton completely lifted all measures in September 1918, which led to a rapid resurgence of the incident. Second wave After just a short time.

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 Jueni, co-lead author at the University of Toronto.

In addition, shortly after the peak of the second wave in November 2018, there was a national strike with demonstrations on 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. High mortality in the second wave. Considering that, compared to other countries, there is a third wave threat from viral mutations from England, South Africa and Brazil, so lessons from the past may help authorities and the general public rethink their response. There is, “Jueni 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, including more than 120,000 influenza cases from 473 Bern municipalities, between June 1918 and June 1919. A pandemic spread to create the big picture.