By John Barry, author of “The Great Influenza”
St. Louis Red Cross workers in 1918 waiting to receive influenza patients
In today’s New York Times, John Barry discussed the Spanish Flue that killed between 50 million and 100 million people. Adjusted for today’s population, some three times greater, this would equal some 220 million to 430 million people. According to Barry, the coronavirus is not as lethal as the 1918 pandemic.
About 15 years ago the so-called bird flu killed 60 percent of the people it infected. Fortunately, governments worldwide took action to mitigate its impact.
Today’s advice -social distancing, washing hands, coughing into elbows, staying home when sick- are good but will not provide all the protection we need. Barry argues that containment has failed in part because the virus is circulating invisibly in developed and developing countries. This means that the influenza will stay and will constantly threaten to reinfect even countries that initially control it.
The United States is now in a phase of intervention labeled “suppression” by the infectious-disease expert Michael Osterholm: identifying infected people, isolating them, tracing contacts and asking contacts to self-quarantine. Because its incubation period is longer than influenza’s, Covid-19, caused by the coronavirus, allows that time. Whether we use that time well will determine whether a month from now the United States looks like Italy, where the virus seems out of control, or South Korea, which seems to have gained control by testing more than 270,000 of its 51 million people.
Suppression has no chance of succeeding unless cases are identified. With the United States having tested only 40,000 of its nearly 330 million people–the worst record in the developed world–we are struggling to catch up, which will take weeks.
The crucial statistic from China is that the case fatality rate inside Wuhan is 5.8 percent but only 0.7 percent in other areas in China, an eightfold difference — explained by an overwhelmed health care system. That illustrates why flattening the curve matters; lessening stress on the health care system, especially the availability of intensive care beds, saves lives.
Flattening the curve is a key goal. Closing schools and banning all events of more than 50 people be cancelled is a very important step. The Federal government is correct in recommending no more than 10 people gather.
For interventions to work people have to comply and they have to sustain compliance. If we are haphazard, we cannot control Covid- 2019.
The most important lesson of 1918 is “Tell the Truth!” In 1918 trust in authority disintegrated. People lost trust in one another. Society began fraying — so much that the scientist who was in charge of the armed forces’ division of communicable disease worried that if the pandemic continued its accelerating for a few more weeks, “civilization could easily disappear from the face of the earth.
