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Coronavirus: Is there reason for optimism?

By Curt Anderson
February 27, 2020 8:05 pm
Category: History
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Considering the scientific limitations of the early 20th century, medicine's fight in 1918 against the influenza pandemic should give us reason for optimism even if a Coronavirus vaccine isn't developed immediately. (Spoiler alert: wash your hands and cover your sneezes.)

A brief history of the 1918 influenza pandemic
The 1918 influenza pandemic (January 1918 – December 1920; colloquially known as Spanish flu) was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Incidentally, Coronavirus likely resided in snakes before being transmitted to humans.

In the United States, Spanish flu was first identified in military personnel in spring 1918. The close quarters and massive troop movements of World War I hastened the pandemic, and probably both increased transmission and augmented mutation.

About 2–3% of those who were infected with Spanish flu died.
According the CDC it is estimated that about 500 million people or one-third of the world's population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. Bulletin of the History of Medicine (The Johns Hopkins University Press) reported that approximately 30 million were killed by the flu, or about 1.7% of the world population died.

The World Health Organization estimated that 2–3% of those who were infected died.

Spanish flu vs. non-pharmaceutical interventions
During the Spanish flu pandemic there was no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections associated with influenza infections. Control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.

Today's advantage over health workers 100 years ago
In 1928, a decade after the pandemic, it was discovered that airborne microorganisms could be killed using mists of dilute bleach. Also in 1928, Alexander Fleming discovered the first antibiotic, penicillin.

The golden era of antibiotics, 1940 to 1962, was when most of the antibiotic classes we use as medicines today were discovered and introduced to the market

Alcohol-based hand sanitizer is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system. Unheard of 100 years ago, hand sanitizers are inexpensive, convenient and ubiquitous today.

A century ago, face masks were often poorly designed and/or worn improperly. See the images below of masks that don't cover the mouth and masks worn with the nose exposed. Today's form-fitting masks can be expected to offer better protection and containment.

It is inevitable that some people will die as a result of the Coronavirus and any death will be a tragedy. However, there is reason to be hopeful that with our medical, scientific and technical advances we can reduce the infection and fatality rates over the efforts of doctors and nurses a century ago.

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