5 Ways the World Is Better Off Dealing with a Pandemic Now Than in 1918

Better Social Distancing
One of the reasons the influenza pandemic thrived in 1918 was because of overcrowded living conditions. Though influenza viruses spread most efficiently in cool, dry environments, the 1918 flu thrived in the tropics because of dense populations. India was the hardest-hit nation: As many as 14 million people died in the British-ruled districts alone, with the death rate more than 10 times higher than in Europe. Our research shows that the most crowded areas suffered the highest losses.

With today’s response protocols in place, countries including Germany, Singapore and South Korea were able to rapidly enact measures to prevent contagion by enforcing lockdowns, shelter-in-place rules and social distancing orders. To date, these interventions have prevented or delayed about 62 million confirmed cases and averted 530 million infections across Asia, Europe and North America.

Nutrition
In 1918, India’s colonial administrators noted that the poor and malnourished were much more likely to succumb to flu than the more affluent. Overall, people across the world are better nourished today. While malnutrition remains a global crisis, the World Health Organization reports that daily food consumption rose by 25% between 1965 and 2015. To the extent that better nutrition strengthens the immune system, we are in a better position to fight off infection than our ancestors were in 1918.

Disease Demographics
During the 1918 pandemic, pregnant women were at particularly high risk. Statistics reported monthly from Buffalo, New York, show the extent of the tragedy. At the height of the pandemic in October 1918, premature births more than doubled, reaching 57 a month; stillbirths rose to 76, an 81% jump. In Massachusetts, the number of women who died during or right after childbirth more than tripled to 185. In a study in Maryland, half of all pregnant women who developed pneumonia died.

They were part of a particularly hard-hit demographic: This flu disproportionately affected healthy women and men in the prime of their lives, 20-40 years old. It also killed many children under five years of age.

This is not the case with COVID-19. While expectant mothers are at greater risk from infectious disease outbreaks and should take extra precautions, there is scant evidence that COVID-19 infection impacts childbirth, the growing fetus, babies or young children in the same way that the influenza pandemic did. COVID-19 is also far less deadly for young adults.

Better medical Science
Today’s medical technologies are infinitely more advanced than they were a century ago. During the 1918 pandemic, medical researchers were debating whether the disease was viral or bacterial. Doctors didn’t yet know influenza viruses existed. Without tests or vaccines, there was limited ability to prevent or contain the spread.

There were few treatment options for those who developed pneumonia, a common complication: Antibiotics were still years away, and mechanical ventilation wasn’t available.

Today’s innovations allow us to rapidly detect outbreaks, inoculate large numbers of people and better treat severely ill patients. Scientists were able to sequence the COVID-19 genome within seven weeks of the first reported hospitalized case in Wuhan, China, enabling rapid development of tests and identification of possible targets for treatments and vaccines.

Word of Caution
While these factors give cause for optimism and it is unlikely that COVID-19 will take as many lives as the 1918 H1N1 pandemic, that event offers important cautionary lessons.

Depending on the location and timing, influenza pandemic infections came in waves, each ranging from a few weeks to a few months. The timing and duration of these spikes was influenced by transportation routes, overcrowding and social distancing measures. In some places, the pandemic dragged on for two years.

Recent data shows that globally, rates of infection are on the rise. But the fact that there is hope in the form of a possible vaccine is an indication of the vast progress humanity has made in the century since the outbreak of the influenza pandemic.

Siddharth Chandra is Professor, James Madison College and Director, Asian Studies Center, Michigan State University. Eva Kassens-Noor is Associate Professor, Urban & Regional Planning Program and Global Urban Studies Program, Michigan State University. This articleis published courtesy of The Conversation.