Why the second wave of the 1918 Spanish flu was so deadly

https://en.wikipedia.org/wiki/Sulfonamide_(medicine)

Mold, no?

Before that, people reasonably were suspicious of germ theory based on their understanding of chemistry. If you dilute a bad substance in the Thames, there is just no way it can be that deadly, dilution wins. They had no idea that the substance could self-replicate.

Dr. John Snow started out knowing nothing, but in a feat of science that still amazes, he helped the world learn a lot. His dogged persistence has saved billions of lives by now.

Fun Fact: After they realized London needed a proper sewer system, they knew that just digging up the streets would never again happen. So they built the sewer system at well above max capacity. Nearly 150 years later, London is now starting to think about improving that capacity.

Great overview here:

https://www.youtube.com/playlist?list=PL3jY7zdQgRU5EHJ_MMyEe...

According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan, many ultimately get killed off by bacterial secondary infection. Encouraging in some ways, under the horrifying circumstances, with the catch that in many parts of the world that secondary infection will be caused by multiple resistance bacteria.

I'd say this pandemic is going to be by far the biggest single consequence post to date for the antibiotic resistance problem, despite being driven by a pathogen that was never sensitive to the antibiotics.

Anecdotes != data, but I've had 1 'chest cold' in the intervening years, whereas as a child and teen most of my colds were chest colds and clearing my lungs was a major step in every recovery.

Plus, on top of all that tech the good old politics seems the same. Many countries botched testing, too little too late. So great we had its RNA code online in a matter of days, and even had success stories here and there if some dickheads can't mange the coordinated response.

I also think many countries could do something similar (ignoring technical progress) in 1918, given they had had ample practice in world war 1.

Not many countries (any?) have the capability to build things as fast as China does.

And even if a country has them, China is the source of so many supplies that they will simply keep them for themselves.

Let this be a lesson to avoid dependencies on a single entity.

While its a great feat--and China is prob the only country that can do it--that's nothing if we get hundreds of millions infected with a virulent version. 30 ICU units might serve a town with 35000 people

It's about intelligent use of strategic resources, not the fact that those resources exist at all.

It's not obvious that we're better at intelligent use of strategic resources than we were a century ago.

Our economic systems promote brutal winner-takes-all internal competition, not strategic cooperation, and that makes them ridiculously brittle when they have to deal with an unexpected stressor.

The antibacterial drugs we have nowadays are fundamentally different than the whole lack thereof in 1918.

Indeed I missed the mild cases which are not quantified but likely quite numerous.

Of course, if the originating factory is shut, then you're screwed - but that's true regardless of trade.

Also worth noting: it takes a tiny number of people to produce tons of food (calories). Maybe not true for artisanal salami but for bulk basics.

Sure, not comparable to the way are traveling today, but the numbers still were in the millions. And they were cramped into ships for weeks, as compared to aircraft. The Diamond Princess showed us that this a nice breeding ground for a virus.

EDIT:

Some numbers:

USA: 1.5 million men demobilized by February 1919, so it started right uring the second wave, in the US. Another roughly 2 million men in cramped demobilization camps in Europe. Later these US troops were moved from these camps to French towns and cities to ease tension among troop caused by crowded conditions. Also happening right during the second flu wave.

Germany: roughly one million men simply walked home after the armistice in Nov. 1918, leaving roughly 6 million men under arms. These were demobilized in the four month after the armistice. So you have 7 million men travelling across the German Empire. During the second wave of the flu.

Austria: No numbers found after a quick gogle search, except for 400,000 soldiers taken prisoner by the Italian during the desintegration of the Austr-Hungarian army. The demobilization in Austria collided with the desintagration of the Empire, so it was even more chaotic than the German one. Also taking place after the armestice in Nov. 1918 and during the second wave of the flu.

Great Britain: demobilized roughly 3 million men between the armistice in Nov. 1918 and late 1919. Mostly from the Western Front. During the second wave of the flu.

France: Demobilized 2.5 million men between Nov. 1918 and April 1919. Also from the western front, also during the second wave of the flu.

There we talk about young men, the demographic most ht by the flu. All war powers kept the flu under wraps during the war, that's why it's called the Spanish Flu, Spanish newpapers were the first to report it. All these men travelled, moreor less coordinated, across Europe and the US. Most of them coming from the Western Front, from cramped conditions with sometimes bad hygenic conditions. And they met up with the young female population upon return, for obvious reasons. All in the time frame of a couple of months.

The equivalent would be to move a large protion of our elderlies around the world now.

Source: https://encyclopedia.1914-1918-online.net/article/demobiliza...

EDIT 2: From the submitted article: "Historians now believe that the fatal severity of the Spanish flu’s “second wave” was caused by a mutated virus spread by wartime troop movements."

EDIT 3: It was much easier to find demobilization numbers thn mobiliztion numbers. The second wave hit before the Armistice in November. Demobilization is,if you want to call that, the return ticket of all these young people taking their trips to the western front. So they all moved there in the months before. And they travelled, from the trenches, to rear, on front vacation, to field hospitals, to hospitals elsewhere. They also travelled on the same ships that ran across the Atlantic, with much larger crews than we have today. The amount of traffic during the months before, and drung, the second wave was mind boggeling. Entente powers geared up for the huge, planned, 1919 spring offensive.

EDIT 4: Nice tid bit, not only for the second wave. "By the end of the summer the virus had reached the German Army. The virus created serious problems for the German military leadership as they found it impossible to replace their sick and dying soldiers. The infection had already reached Germany and over 400,000 civilians died of the disease in 1918." from here: https://spartacus-educational.com/FWWinfluenzia.htm.

I would have thought barbed wire, artillery, tranches, chemicla warfare and machine guns would have formed a nice barrier. Social contact, trenches have a lot of that, seemto be a much bigger factor it seems. Proves the point of avoiding gatherings, self-quarantine and sch things, IMHO.

"Not only was it shocking that healthy young men and women were dying by the millions worldwide, but it was also how they were dying. Struck with blistering fevers, nasal hemorrhaging and pneumonia, the patients would drown in their own fluid-filled lungs.

Only decades later were scientists able explain the phenomenon now known as “cytokine explosion.” When the human body is being attacked by a virus, the immune system sends messenger proteins called cytokines to promote helpful inflammation. But some strains of the flu, particularly the H1N1 strain responsible for the Spanish flu outbreak, can trigger a dangerous immune overreaction in healthy individuals. In those cases, the body is overloaded with cytokines leading to severe inflammation and the fatal buildup of fluid in the lungs."

What was said was - from epidimiology point of view, there's no point in telling everyone to stay at home right now when the spread is in the early stages. It will have a marginal effect, and the spread will continue anyway. By government's own estimates 80% of people in the UK will get infected, and imposing a quarantine right now won't change that. What would help is setting the quarantine for 14-18 weeks, and they know that people won't abide by that, so instead, they clearly said they will impose quarantine just before UK hits the predicted peak infections - to lower the stress on the NHS and to achieve the maximum effect of the quarantine. Like, it all made sense if you watched the actual conference.

So if you lock down a few weeks too soon, people start breaking isolation at exactly the point it's most important the lockdown is maintained. All of this was explained in the presentation.