With masks over their faces, members of the American Red Cross remove a victim of the Spanish Flu from a house at Etzel and Page Avenues, St. Louis, Missouri in 1918.

With masks over their faces, members of the American Red Cross remove a victim of the Spanish Flu from a house at Etzel and Page Avenues, St. Louis, Missouri in 1918. St. Louis Post Dispatch/Wikimedia Commons

1918 Pandemic Provides Warning about COVID-19’s Future

Even if we start to see a decrease in COVID cases, a study of the 1918 influenza pandemic suggests a spike could occur in late 2021 or early 2022.

The 1918 influenza pandemic provides a cautionary tale for what the future may hold for COVID-19, says Siddharth Chandra.

After a decade studying a flu virus that killed approximately 15,000 Michigan residents, Chandra, a professor in the James Madison College at Michigan State University, saw his research come to life as he watched the spread of the COVID-19 pandemic.

“It was so surreal,” says Chandra, who has a courtesy appointment in epidemiology and biostatistics. “All of a sudden, I was living my research.”

Using influenza infection and mortality data on Michigan from 1918-1920, Chandra identified four distinct waves. The first large peak was in March 1918. “After a second spike in cases in October 1918, the governor instituted a statewide ban on public gatherings,” Chandra says. “Much like the restrictions that were put in place during the COVID-19 pandemic.”

After three weeks, the number of cases decreased and the ban was lifted, which led to another peak in December 1918. “The ban didn’t stop the spread of the flu. It just delayed the spike in cases,” he says.

A chart shows the timeline of the four distinct 1918-1920 pandemic waves
This graph shows the four distinct waves. Wave #1 March 1918 (Spring 1918 Wave), #2 October 1918 (Fall 1918 Wave), #3 December 1918 (Winter 1918 Wave), and #4 February 2020 (Winter 1920 Wave). (Credit: MSU)

Chandra mapped the data showing the peaks and spikes in cases from October 1918 and December 1918 and tracked flu virus case growth by county over time. In October, counties in the southern part of the state and near the Mackinac Straits had the highest numbers but by December, the highest numbers of cases were in the heart of the state.

The most surprising piece of data came 18 months later in February 1920, when a statewide explosion of cases created a massive spike even larger than the one in October 1918. For Chandra, it is an educated guess as to the reasons for this delayed increase.

“Assuming it’s the same influenza virus, World War I ended in 1918 and the men were coming home to their families,” he says. “We had a mobile agent that brought the virus home to infect family members, which would explain the increase in cases among children and the elderly.”

Unfortunately, there is not a way to confirm this, Chandra says. “We would need samples from patients in 1920 from across the state. Then, we would need to compare those with samples from patients in 1918 from across the state, and that’s not likely to happen.”

The weather may have also been a factor since cool temperatures with low humidity likely provided optimal conditions for the virus to live and spread. Another factor that played a role was the absence of a vaccine.

“In 1918, there was no hope for a vaccine. In 2021, we have a vaccine available,” he says.

One of the key insights from the 1918 pandemic that can inform the public health response to the 2020 COVID-19 pandemic is the number of people susceptible to the virus, Chandra says. Which means that it is possible that a spike like the February 1920 one will occur in late 2021 or early 2022.

“So many people will remain susceptible until they get vaccinated,” Chandra says. “Bad things can still happen a year or two from now even if we see a decrease in the number of cases now. We still have over 200 million people walking around who are susceptible to the virus, including myself.”

The study appears in the American Journal of Public Health. Additional coauthors are from James Madison College and Michigan State University.

Source: Michigan State University

This article was originally published in Futurity. Edits have been made to this republication. It has been republished under the Attribution 4.0 International license.

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.