Three Waves of the 1918-20 Flu: UK

The 20181918-20 pandemic waxed and waned. This suggests there is not necessarily a quick return to “normalcy”.

Figure 1: Three pandemic waves: weekly combined influenza and pneumonia mortality, United Kingdom, 1918–1919. Source: Taubenberger and Morens (2006).

Update, 4/15:

Reader Ed Hanson asks why refer to the flu, when the current pandemic is associated with a coronavirus. From Scientific American:

“Past influenza pandemics give some sense of what the overall [trajectory] of a virus like this would be because the reproductive number of this virus”—defined as how many people each infectious person transmits the disease to in a completely susceptible population—“is pretty similar to that of a pandemic flu,” says Marc Lipsitch, a professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard University. Although it is difficult to determine exact figures for an emerging disease, reports put the reproductive number of COVID-19 between 2 and 2.5. The median reproductive number for the 1918 flu pandemic was around 1.8. Lipsitch estimates that between about 20 and 60 percent of the global population will ultimately become infected with the novel coronavirus, or SARS-CoV-2.

Although every virus and resulting disease is different, a look at epidemic dynamics of both COVID-19 and the 1918 flu points to similar successful containment procedures. …

I thought this was obvious, but Mr. Hanson apparently needs some justification for my reference to the 1918-20 pandemic. My point was that we could see multiple waves of the epidemic. Maybe the drivers will be different — perhaps premature re-openings of the economy will spur additional deaths in the current episode. Nevertheless, we should not dismiss the possibility that this will not be the only wave.

Update, 4/16:

From EconoFact:

Policies designed to reduce public interactions between people (“social distancing”) reduced mortality. In their research, Howard Markel, Harvey Lipman and J. Alexander Navarro collected and analyzed data on the weekly pattern of deaths in 43 of the largest US cities between September 1918 and February 1919. They augmented these data with the timing and duration of social distance measures, like closing schools and prohibiting large public gatherings. Both earlier enactment and longer duration of such measures were associated with lower overall mortality. They also showed that numerous cities had two peaks in their mortality rates during the fall of 1918, with the first often occurring while social distancing measures were in place and the second occurring after the social distancing measures were relaxed.

57 thoughts on “Three Waves of the 1918-20 Flu: UK

  1. Ulenspiegel

    The origin of the 1918 flu was most likely China. Chinese construction workers, who were shipped via USA and Canada to France brought the virus with them.

    See the very good 2014 War in History paper by Mark Osborne Humphries “Paths of Infection: The First World War and the Origins of the 1918 Influenza Pandemic”

    There are also some very good newer online lectures by US scientists on this topic. Unfortunately, I don’t have the links on my computer at home.

    1. Barkley Rosser

      U.,

      It is not agreed upon where the Spanish flu started aside from that it was definitely not Spain. As it is, the most widely accepted theory is that it started in Kansas in the US, not China, and was taken to Europe by US troops fighting in WW I.

      1. Ulenspiegel

        “As it is, the most widely accepted theory is that it started in Kansas in the US, not China, and was taken to Europe by US troops fighting in WW I.”

        No, that is contradicted by military records and biological data. You had already cases BEFORE US troops arrived in larger numbers and many of tehse cases were in camps for Chinese workers.

    2. macroduck

      The Humphreys article notes that the China-origin hypothesis is not widely accepted as correct because it is circumstantial. It makes clear two other points, as well. One is that none of the origin stories is accepted as clearly true and that the Kansas story fails to account for infection on military bases prior to the outbreak spreading to civilians in Haskell, Kansas. Humphreys argues that there is epidemiologal evidence for origin in China, having made clear that his claim is not universally accepted.

      1. Ulenspiegel

        “The Humphreys article notes that the China-origin hypothesis is not widely accepted as correct because it is circumstantial.”

        If you read biological papers on the virus evolution then the Chian hypothesis is supported.

        1. Barkley Rosser

          No, it is not on the basis of the latest papers, see Worobey et al, 2019, Evolution, Medicine, Public health. A major problem with the China theory is that there was almost no flu in China, nor among the Chinese laborers who supposedly spread it in France behind the lines. Worobey et al find likely North American origin looking at phyogenetic data, but not necessarily Kansas.

          Another quite possible source is a British origin story, although involving a camp in France, Etapes, with British soldiers taking it back to Aldershott in England from where it got to US and elsewhere. See papers by J.S. Oxford, especially on in 2005 with coauthors in Vaccine.

          Pretty clearly, there is not agreement about whetre it started, as I stated, aside from universal agreement it did not start in Spain.

  2. Moses Herzog

    What did Fauci get for not resigning???—-which he should have done, near to the very beginning of this. All Fauci did was lend the orange creature badly needed credibility at the time the crisis started, only to lose ALL of his reputation in the end. A sad man, running from the microphone like a 9 year old boy for fear of losing his job:
    https://twitter.com/realDonaldTrump/status/1249470237726081030?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1249470237726081030&ref_url=https%3A%2F%2Fwww.nytimes.com%2F2020%2F04%2F12%2Fus%2Fpolitics%2Ftrump-fauci-coronavirus.html

    They all keep thinking like some woman with a perennial womanizer: “I am the ‘magical’ one, he really loves ME” and the end is always the same. Kathy Gifford thought it was cute to screw around with Frank, then she found out the flight attendant could do the same to her. Now maybe Fauci has finally figured out, he was never donald trump’s “one true love”.

    1. baffling

      i’ve got mixed feelings about fauci. but my feeling is he is taking the same position that gary cohn took, which is that he could have a greater influence on trumps decision making staying next to him rather than shouting from outside the whitehouse. look, trump will NEVER let a truth teller stay inside his circle during a crisis. but if you get rid of fauci, who i think has been a bit of a trump whisperer, what is your ALTERNATIVE? you really want peter navarro and jared kushner as the only folks talking to trump about how to deal with a pandemic? i don’t think there is any alternative that could have been any more effective than fauci. this is simply the hand fauci was dealt, and he figured it is better to play the hand than fold and walk away.

      1. macroduck

        Agreed on the Cohen comparison. I think Fauci may we’ll have prevented a worse situation. We cannot know what he has done behind closed doors, because discretion is the cost of having influence. The fact that Fauci is publicly trying to prevent Trump from rewriting history may mean he sees his tenure at the CDC is nearing an end.

        1. Moses Herzog

          My question is, do you lend a lifesaver to Hitler when you see he’s drowning?? You know what Fauci has really done for donald trump?? Has Fauci helped hospitals in New York and other states get ventilators trump was stockpiling?? He Fauci gotten equipment that was being sold overseas during the beginning of the pandemic only to be purchased back at higher prices?? Has Fauci stopped USA states from competing with each other to purchase the same equipment?? Let me attempt to explain to you the main function of Mr. Fauci during the COVID-19 pandemic:
          https://commons.wikimedia.org/wiki/File:Bundesarchiv_Bild_183-2000-0110-500,_BDM,_Gymnastikvorführung.jpg

          1. baffling

            “My question is, do you lend a lifesaver to Hitler when you see he’s drowning??”
            depends. if he is willing to push the big red self destruct button as he drowns, i guess the answer is yes. if you think he drowns and cannot continue to cause damage, then let him sink. this is not a well posed question moses.
            lets deal with another hypothetical, perhaps more relevant to the discussion at hand. if fauci does not exist, who is your alternative in that position? who in this world has the medical knowledge and personal integrity that allows them to override trumps dangerous impulsiveness AND remain in their influential position? is there anybody out there who could have produced a better outcome? none that i am aware of. on the other hand, there are plenty of alternatives out there that would have produced far more negative consequences. or do you think letting kushner control trumps impulses would have saved lives?
            at the end of the day, i am thankful that a well respected guy like fauci is willing to fall on the sword and at least have some positive impact before trump tires of him. there are few of those folks left for trump to choose from. more likely, you get a mnuchin or meadows. fauci at least got trump to see the magnitude of this virus, even if late. fauci was not ignorant of the virus, but he was dealing with an ignorant student. trump is responsible for the failure to properly prepare for the pandemic, not fauci. you are playing right into his hands when you allow trump (and others) to shift the blame to fauci. trump is commander in chief, and as he says, has “absolute authority” as president.

          2. Moses Herzog

            @ baffling
            I hate to belabor this, as in actuality I don’t think our core opinions are that far apart. But to put it in very simpleton terms, Fauci could do the same thing over at CNN or CBS, or you name the media outlet here _____, and have the same exact platform (maybe better). But Fauci (and apparently you) would have himself adding credibility to donald trump, There’s no added value here by being donald trump’s beta cuck at his press conferences and hiding behind Mike Pence for fear someone is going to show you a microphone.

          3. baffling

            moses, then answer the question. who could have replaced him and produced a better outcome? and no, fauci sitting on cnn would not have had the same outcome. perhaps if he would have sat on fox-since that platform talks directly to trump-but that would never have occurred. i understand people’s anger towards fauci-my wife has a similar view. but as of yet, nobody can tell me who would have been more effective on trump’s decision making. you are trying to make a logical argument when dealing with trump. trump defies logic.

          4. Moses Herzog

            @ baffling
            The answer to your rather elementary question is, it makes no difference who heads the CDC under donald trump. Elmer Fudd or Stephen Hawking in his prime. When you are underneath a man who tells lies daily, and tries to destroy the WHO— YOU RESIGN

            There is NOTHING “heroic” about what Fauci is doing, he will be thrown out on his A$$ the same as all of them, having achieved ZERO more than he would have achieved sitting at a CNN or MSNBC anchor desk as their “go to” expert or doing a carousel of appearances on TV/cable as a Brookings Institute “Distinguished Fellow” . He has achieved NOTHING on trump’s staff but making an ass of himself. What has Fauci become?? You think he’s like Gary Cohn. Really!?!?!??! I think the more suitable comparison is Rod Rosenstein. A man too cowardly and sheepish to even stand up for his own code of morals.

          5. baffling

            moses, i asked for an alternative who would have produced a better outcome. you could not provide an answer. you really think he would have accomplished more by resigning, and letting the illuminati of trumps inner circle guide him? not even close. have to disagree with you completely on your perspective here. working for trump is a no win situation, i agree. but under these circumstances, you cannot let that seat go empty. without fauci and birx, trump would have pivoted full bore into keeping the economy open. and the ramifications would have been catastrophic. resignation in protest would have been viewed by trump and his supporters as validation and victory.

  3. pgl

    Let’s say our 2nd wave is worse than the 1st. In Trump’s calculus if the 2nd wave shows up after election day, it will not matter. The only thing that matters to Trump is getting re-elected.

    1. Ulenspiegel

      “Let’s say our 2nd wave is worse than the 1st. In Trump’s calculus if the 2nd wave shows up after election day”

      The best guess is that the sh** will hit the fan December or January, normal flu season on top of a second corona infection wave.

      1. Willie

        That’s way beyond the orange guppy’s mental horizon. It’s all about what’s good for him personally, right now. No more than that.

  4. New Deal democrat

    One very big, important difference: the flu virus is *extrememly* unstable and mutates about once every 10 days. That’s why you have to get a new flu shot every year. So each wave of the ‘Spanish flu’ was a meaningfully different virus. The evidence so far is that this virus mutates much more slowly.

    Thus, the only reason to think this virus will spread in waves is if it dies down during the summer months. The evidence of that so far – see, e.g., Singapore, is not so persuasive.

    1. Ulenspiegel

      “Thus, the only reason to think this virus will spread in waves is if it dies down during the summer months. The evidence of that so far – see, e.g., Singapore, is not so persuasive.”

      In summer social distancing is easier, actually more natural. Therefore, a lower infection rate is expected, not a dying out of the virus. In November the flu season starts agian and adds to the stress of the system which then sees an increasing corona virus infection rate again.

    2. 2slugbaits

      There is a theory that a milder but similar version of the Spanish flu made the rounds about 30 years earlier, and exposure to that earlier version might have mitigated the symptoms of the Spanish flu outbreak for those older folks that had survived the earlier outbreak. This is seen as one possible reason why the Spanish flu affected the young and healthy more than older folks.

    3. pgl

      Even if COVID19 mutates what Gilead is testing likely still will work. The problem is that it is hard to make their treatment in mass supplies. Of course had we started earlier – we would have more. Trump’s refusal to listen to people like Susan Rice really has screwed us.

      1. Robert Michael

        Good call. With even less proof than the cocktail of hydroxychloroquine+zak+zinc, you think remdesivir will work. There are reasons there are scripts being written for the former, and please don’t listen to docs who have little experience with hydroxychloroquine.

        I suggest you be quiet on the matter.

  5. dilbert dogbert

    Question for Moses:
    Is this bullshit or a real Chinese saying?
    “Chinese in other provinces have a saying for the eccentric diets of people in Wuhan — “the only thing that the people of Wuhan won’t eat with 4-legs is a table & chairs.””

        1. macroduck

          Love burgoo. Cain’t write no recipe ’cause you make it with whatever you can catch.

    1. Barkley Rosser

      I do not know about this remark, but the current leading theory is that this did not start from somebody eating a bat (or pangolin) from a Wuhan wet market. Rather now the best evidence suggests that it came from a lab where they were trying to develop a vaccine against bat-induced illnesses, but were careless with health security.

      1. Moses Herzog

        @ Barkley Junior
        Can you provide a single link from a single respected source that confirms your statement on “best evidence” that “this came from a lab”?? Or are you pulling this out of your “Trying way too hard to impress everyone” A$$ ???

        BTW, no one has ever said COVID-19 was from eating any bat. The theory was it was probably bat urine or bat poop which had gotten on another animal, then infected a human.

        1. Robert Michael

          Not sure I’ve heard the bat poop which had gotten on another animal theory. Please enlighten.

          1. Moses Herzog

            @ Robert Michael
            Check the Barkley Rosser edited “Journal of Lab Created Pandemics”. Should be in there somewhere.

          2. Moses Herzog

            @ Robert Michael
            To answer your question in a more genuine way:
            https://www.wsj.com/articles/the-bats-behind-the-pandemic-11586440959?st=z8254e626tfzrra&mod=openfreereg

            The first time a tried this article I made it past the paywall. Not this time. Hopefully you can, it’s quite detailed. I wager there are others along these lines, but it’s pretty educational related to the bats theory. If you ever go into a bat cave, or walk underneath a “swarm” of bats (is that the correct term, “swarm”?? flock?? horde?? ) you will find they put rabbits to shame in the crap department.

            Well, with that, I’m afraid I’m all crapped out.

      2. Moses Herzog

        To my dearest Barkley Junior: YOU ARE AN IDIOT. From your eternal love, Moses Herzog:
        https://www.sciencenews.org/article/coronavirus-covid-19-not-human-made-lab-genetic-analysis-nature

        https://www.newscientist.com/term/coronavirus-come-lab/

        https://www.livescience.com/coronavirus-not-human-made-in-lab.html

        https://www.nature.com/articles/s41591-020-0820-9

        https://www.sciencemag.org/news/2020/02/scientists-strongly-condemn-rumors-and-conspiracy-theories-about-origin-coronavirus

        1. Barkley Rosser

          Wow, Moes, you have gone full-bore hysterical here. No, I am not going to read any of your liinks. Obviously there is debate about this, and it is unresolved. I suspect some of these might be a few weeks old and about the clearly discredited theory pushed by Sen. Tom Cotton and some others that it was consciously cooked up in a bioweapons lab in Wuhan. No, that is not what this is about.

          I first heard it on NPR and then read about it in a WaPo column on April 2 by David Ignatius, who is about as well-informed and smart as anybody at WaPo. Last time I saw him he was with Madeleine Albright. He is super well connected and not remotely a goofball. It seems that parts of that column are holding up, although the bottom line remains we do not know for sure.

          A more recent link is at Daily Signal by Fred Lucas from two days ago, dailysignal.com/2020/04/12/could-covid-19-have-come-from-chinese-lab-4-things-to-know . Here are the four things, according to him (who takes the Ignatius column seriously, while also saying much of it is unconfirmed):

          1. Definitely not a bioweapon.
          2. It is probably not from a Wuhan seafood market, long the most popular theory. Problem is we are pretty sure it is from bats (possibly pangolins), but bats were not sold at this “wet market.” If it is from there, then somehow a bat infected some animal that was there, but, as its label says, it was a seafood market, not the usual animals bats interact with. As it is, the Chinese have shut it down and thoroughly swabbed the place, so we shall probably not get to know for sure one way or another.
          3. There is indeed a lab 300 yards from the suspect but unlikely seafood market that is a branch of the Chinese CDC and Prevention, and indeed they have been studying bat and other originated diseases over the last several years, as I said and you so hysterically dismissed. In this case, it would not be a plot or a conspiracy, but, as I said, a careless mistake (and Chinese sources note that this lab had been criticized for carelss safety practices). Lucas views this theory as “complicated,” but it is certainly plausible, and, if anything, gaining ground now given how unlikely its main competitor, the seafood market, seems to be.
          4. China has been poor with information on all this, which has clearly fed all sorts of theories.

          So, Moses, there is a source, hardly the only one. If you want to dump on this story, try and upend the column by David Ignatius. Do any of your links specifically address his column? If so, tell us what is in the link. As you know by now, you have zero credibility with me regarding your links, almost always totally worthless junk.

          1. Moses Herzog

            @ Barkley Junior
            You’ve once again shown yourself for what you are. No references or links to your contention “the best evidence suggests that it came from a lab” What’s the problem, you couldn’t find one single link to support this?? Did your favorite “reference library” “Quora” let you down today?? Isn’t “Quora” where you usually go when you can’t find a single respected source to support your laugh riot make-believe??

            Barker Junior—the PhD with “PeakTrader” sourcing sensibilities.

          2. Barkley Rosser

            Now you are really losing it, Moses. This is beginning to look like that time you made a total fool of yourself by denying that Warren and Harris were ahead of Biden in a poll in Iowa after the first Dem debate.

            I gave you a link, even if it does not “link.” The dailysignal one I put in the message is what was in the url when I read it. It is teo days old. It is real. You can easily find it by googling.

            Try googling this: “How did covid-19 begin? Its origin stoey is shaky,” David Ignatius, Washington Post, April 2, 2020.

            Here is another one, which I could not get the url for because it demanded that I sign up for WaPo, but it was out at 3 AM this morning, April 14, 2020, also in Washington Post, couls not catch author of article, but title is “State Department Cables warned of safety issues at Wuhan lab.”

            Thsi is very easily found out, and as I noted, this story is growing. This is where it is at. This did not come out of the seafood market. Is that what you still think, Moses? Iy is time to catch up with the latest news and see what is happening, and what went down. If you continue to push this ridiculous line that there are no links, you will will end up with bat poop all over your face. I provided one above, and you simply lie and claim I did not. Get real and stop immitating that liar Trump.

          3. Barkley Rosser

            Moses,

            For the record, and maybe Moses has picked up on this, the story I noted above about State Department Cables on the Wuhan Lab safety issue was by Josh Rogin and has now gotten lots of attention. I heard it being discussed on CBS radio this morning. Apparently US mdecial people visited Wuhan as part of a WHO team back in 2018 and were concerned by what they saw in this lab in Wuhan regarding safety procedures, and this is the lab that was working on vaccines for bat-originated diseases. So they wrote this up in cables to the State Department. I have no doubt that this is what Ignatius knew about when he wrote on April 2 about this in WaPo, but he did not reveal the sources.

            However, the bottom line remains that we really do not know for sure the source, and quite likely never will. Heck, people are obviously still arguing about the source of the Spanish flu.

            What is clear is that your original sneering about this story when I mentioned it above was utterly ridiculous and obnoxious for no good purpose other than to make yourself look like a creepy idiot.

    2. Moses Herzog

      @ dilbert dogbert (my spell check wants to call you dogcart, I’ve about had it on that)
      This is a dangerous question, but a good question. I think Chinese semi-proudly would acknowledge Chinese have a renown for eating exotic foods. Sichuan province (certainly known to people who didn’t spend the time in China I did) is the province that I always tied with being able to down many types of foods, or certainly spicy. North China (the section I was in) tends to be economically poorer than the South. My understanding was that around Guangdong is where you would see the more exotic type foods. Those more dangerous foods can be very expensive, probably because they are sold on “the black market”. It was one of many things Chinese wryly refer to as “an open secret”. That’s not to say they don’t eat some wild things in Wuhan, or anywhere in China, but my take was it was Guangdong was where the wilder fair was. I had a teacher friend from Wuhan, probably more like an acquaintance, but when we were in the office late I remember her sharing some very personal things with me, and to my great surprise crying in front of me discussing this personal thing. She was very attractive and I had some interest in her, but she was very close to an art teacher there who was very much my physical superior. But she was healthy and very sharp (the best in our office among the females at team volleyball), and I don’t remember her saying much about the food in Wuhan.

      My short answer to your question is, my understanding was this is more a general view Chinese had towards themselves, than necessarily a province. Similar to Americans would admit we eat too much “garbage” food or fast food. That it’s a general trait, rather than to a region.

  6. Wally

    Headline:
    “World Health Organization officials said not all people who recover from the coronavirus have the antibodies to fight a second infection. This raises concerns that patients don’t develop immunity after surviving Covid-19.”

    One might consider the ramifications of this on the ‘vaccine’ quest. (If true)

    1. baffling

      right now they simply do not know. it appears that many folks do acquire immunity, but for how long is another question as well. this is why trump needs to be supporting the cdc and who right now, as they are really the organizations that are best equipped to give us some of these answers. otherwise, we will continue to fly blind just like we have with our limited testing ability. time and knowledge are our most valuable assets right now, and need not continue to be squandered.

  7. joseph

    I know everyone has been anxiously awaiting Trump’s Council to Re-open America. And the winners are:
    Mark Meadows
    Ivanka Trump
    Jared Kushner
    Steven Mnuchin
    Larry Kudlow
    Robert Lighthizer
    Wilbur Ross

    The winners, a confederacy of dunces. That makes everyone else in America a loser, big time.

    1. pgl

      But they are all very qualified in kissing THE DONALD’s rear end. Which is all that matters it seems.

  8. Willem

    Menzie,

    You say “The 2018-20 pandemic waxed and waned.” Don’t you mean “The 1918-20 pandemic waxed and waned.”

  9. Edward Hanson

    Menzie

    You may not be a fortune teller, but you do tend toward being a panic monger.

    Case in point, never knew that the Spanish flu was coronavirus. Maybe, that is because it is not.

    While not being a doctor, a little research shows that there have been 7 identified coronaviruses causing human disease. 4 associated with the common cold, and 3 known for acute respiratory syndrome. These being MERS, SARS, and the covid-19.

    OF the first 6, none shows the the wax and wane you write of in the topic.

    That leaves covid-19. certainly the most deadly of the 7. I would rate a Spanish flu like wax and wane, far down as a possibility but still possible. More likely it won’t because the other coronoviruses have not shown that tendency.

    Take with grain of salt, as I am not a fortune teller either, but just writing opinion.
    Ed

  10. Edward Hanson

    Menzie

    You reported a 2006 paper on flu and attached a covid-19 speculation to the flu paper finding. You have every right to clarify that you did not say coronavirus is flu, but I have every right that point out your connection of covid-19 pandemic to a flu pandemic “waxed and waned”, is only a possibility and in my also non-expert opinion, not a high possibility. I consider your connection tantamount to panic mongering, even if you did not mean to.

    Ed

    1. Menzie Chinn Post author

      Ed Hanson: After finally finishing the immediate lectures, here you go for why I referenced material from the 1918-20 influenza pandemic:

      From Scientific American:

      “Past influenza pandemics give some sense of what the overall [trajectory] of a virus like this would be because the reproductive number of this virus”—defined as how many people each infectious person transmits the disease to in a completely susceptible population—“is pretty similar to that of a pandemic flu,” says Marc Lipsitch, a professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard University. Although it is difficult to determine exact figures for an emerging disease, reports put the reproductive number of COVID-19 between 2 and 2.5. The median reproductive number for the 1918 flu pandemic was around 1.8. Lipsitch estimates that between about 20 and 60 percent of the global population will ultimately become infected with the novel coronavirus, or SARS-CoV-2.

      Although every virus and resulting disease is different, a look at epidemic dynamics of both COVID-19 and the 1918 flu points to similar successful containment procedures. …”

      By the way, are you over your anti-log phase?

    2. Menzie Chinn Post author

      Bruce Hanson: Thinking about why Covid-19 might wax and wane – from EconoFact:

      Policies designed to reduce public interactions between people (“social distancing”) reduced mortality. In their research, Howard Markel, Harvey Lipman and J. Alexander Navarro collected and analyzed data on the weekly pattern of deaths in 43 of the largest US cities between September 1918 and February 1919. They augmented these data with the timing and duration of social distance measures, like closing schools and prohibiting large public gatherings. Both earlier enactment and longer duration of such measures were associated with lower overall mortality. They also showed that numerous cities had two peaks in their mortality rates during the fall of 1918, with the first often occurring while social distancing measures were in place and the second occurring after the social distancing measures were relaxed.

  11. Edward Hanson

    Menzie,

    possibly I missed it in the quick reading of Scientific American paper, I saw n reference to a connection of three waves to covid-19. But I did find the first line of the article quite appealing.

    “The 1918 influenza pandemic and 2002–2003 SARS outbreak suggest social distancing measures, communication and international cooperation are the most effective methods to slow COVID-19”

    International cooperation: In the case of a pandemic this may be the most important effective method. But it was China whose hid the breakout of covid-19 virus which led to weak international cooperation. Perhaps the slowest response, was the continuing air transportation to the US, and Europe, Australia and Africa. Instead of hiding the outbreak, immediate stoppage of flights would have saved 10 of thousands of lives. Note that the Spanish Flu hid the breakout which allowed worldwide transmission. Fortunately the US quick response stopping Chines flight awaken the us to the other methods of protection such as social distancing.

    Ed

    1. Menzie Chinn Post author

      Ed Hanson: China hid the outbreak so well that HK, Taiwan, South Korea took quick steps to respond. And US ignored all those articles in NYT because, well, because FAKE!

      1. baffling

        in january, china did NOT hide the fact that they were shutting down and isolating wuhan, and applying similar but less drastic measures throughout the rest of china. this information was available to the rest of the world. ed, don’t you think it is reasonable for china to expect the rest of the world to take this situation seriously as well, even if they do not write up a report and send it COD to the white house? the white house new EXACTLY what steps china was taking in its lockdown. apparently, that information was not sufficient for trump to take ANY action at the time. you want to blame china because they did not inform us? how much more clear of a statement needed to be made, ed? trump supporters are looking for a scapegoat to blame. when the water recedes from the coastline and everybody starts running for higher ground, people like ed think its all right to walk towards the ocean to see what is going on. and then blame others because he was not informed.

        on a more pleasant note, it appears we are getting some promising results with remdisivir.
        https://www.cnbc.com/2020/04/16/gilead-stock-surges-after-report-says-coronavirus-drug-trial-shows-encouraging-early-results.html
        now if this is replicated with the other trials, we are starting to get a gamechanger. people may still get sick, but now they will not die. and they leave the hospital rather quickly. for transparency, i do own some gilead. but this is far more encouraging than anything i have read about hydroxychloriquine.

  12. Baffling

    So we are a couple of months into the pandemic and the trump administration STILL cannot create a useful supply of testing, ppe and ventilators. What a dereliction of duty. Not much protection the nation has been provided by trump. Cannot restart the economy without testing, unless you want to sacrifice the lives of more americans.

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