Patriarch of Pandemics | Hacker News Reader

Patriarch of Pandemics

demystifyingscience.com

109 pointsqqqqquinnnnn54 comments

> The Great War destroyed the stability of a generation, and took 20 million lives

That's an understatement. Rather two or three generations, since the Second World War is pretty much a direct consequence of how the First one ended.

The middle east is still a clusterfuck because of WWI.

That's fair, I do my best to avoid making broad statements that would then send me down the rabbit food of citation finding.

> The 1918 pandemic, deadly as it was, is still around today in the form of a mutated seasonal flu. Following global exposure and culling of the most vulnerable populations - middle aged adults that were most affected by the negative effects of the war - the lethality of the virus is significantly less.

OK, but was there some kind of seasonal flu before that? That is the real question to me.

Yes https://en.m.wikipedia.org/wiki/Timeline_of_influenza

Yes, but this just became the big dog.

Like how there were other hominids before us, but now it's just us.

Can we infer from this that flu prior to 1918 was less severe on average? Or is the result not that strong?

They likely followed the same pattern.

Severe initial outbreak when a new super strain appeared, then a gradual decline in severity as immunity developed and the strain continued to evolve.

Rinse and repeat.

1918 was the first time that a flu benefited from modern transportation speed and the massive movement of humanity to and from Europe because of the war.

So in the past an equally deadly flu would inadvertently be contained simply because infected carriers couldn't move to new, uninfected areas before they were dead or and beaten the virus.

so there definitely were other flus, this just happened to be a reassorted strain (evidenced by the swine and avian roots) that caused a greater immune response

Do babies inherit the developed immune systems of their parents? If not, how do the gained resistances from survivors pass on to the next generation?

I believe there is some heritability. What's more, long term human couples tend to have dissimilar immune systems [0], allowing their offspring to have a more diverse spread of immunities.

The fact that humans are somehow able to _detect_ properties of a potential partner's immune system is super interesting to think about.

[0] - https://www.amazon.com/Social-Animal-Sources-Character-Achie...

Wikipedia links for disassortative immunological mating:

https://en.wikipedia.org/wiki/Major_histocompatibility_compl...

https://en.wikipedia.org/wiki/Genetic_matchmaking

I did not know the name for this - thanks for sharing!

I've read that breastfeeding helps transmit some key factors to help build the child's immune system, but I don't remember the details and would like to see an answer from an expert in the area

Breastfeeding largely does two things: i) it transmits antibodies from mom to child, the maternal antibodies circulate for a while and so the mom's immune protection is temporarily conferred; ii) it contains potential antigens like peanuts, cow milk, basically anything the mom eats and so it tolerizes the infant's own immune system from common food antigens. There are leukocytes, neutrophils etc. in breast milk, but it is unlikely that they get through the gut lining into the infant.

They do! but how much, how long it is active for, and how effective it is are not yet clear to me. I'll do an article on it in the near future... after I'm done figuring out what the hell is going on in the virus world

Over the long run, natural selection is part of it. If a virus kills prevents reproduction through any mechanism, then resistance to the virus will be selected.

yeah that's an interesting point - resistance can have something to do with simply not having the right receptor on your cell surfaces and little to do with your immune system

Well, you can select a more efficient immune system too. I wouldn't say it's one thing and not the other.

interestingly, a more effective immune system can often be a bad thing. have you heard about "cytokine storms" as a mechanism for why the mortality rate is much higher is certain groups? that's the immune system eating the host, basically

I don't think there is consensus that this is the main problem with this virus. Cytokine storms have been cited as the cause of death when a virus disproportionately strikes folks in their 20s and 30s when the immune system is strongest. On balance tho a stronger immune system seems to be better.

If so, then over the next 100 years it has killed many more than 40M.

The World Health Organization estimates that worldwide, annual influenza epidemics result in about 250,000 to 500,000 deaths.

Yes, but it is not contagious as covid19 is.

That's not true. The problem is that a subset of persons require ventilation to survive more so than flu

Why Covid-19 is worse than the flu, in one chart https://www.vox.com/science-and-health/2020/3/18/21184992/co...

on edit: furthermore https://www.cdc.gov/flu/about/keyfacts.htm says the range of people catching the flu per season is 3% and 11% whereas the estimates for catching Covid-19 are generally around 40-70%

Flus are often widely deflected by inbuilt immunity. The advice didn't take that into account. It also doesn't take into account those numbers are based on pretty flimsy evidence.

the second number will decline after everyone catches it, obviously.

what is the second number you refer to?

I believe they meant the "40-70%" figure.

What tense are you using?

Over the next hundred years, meaning from 1918 to 2018, since there is an implied starting date from the subject matter. English is a high context language.

I think that "the following hundred years" would be clearer.

I also like “subsequent.”

Aren't "next", "subsequent" and "following" nearly synonyms?

yep, nearly synonyms, which is why reasonable people who are native English speakers are able to disagree about which is best-suited to fit this sentence.

I think reasonable people understood the sentence.

True. I did, and was being ironically pedantic.

Yes.

It's fantastic to me that pandemics were possible many centuries ago, though maybe the definition applied is different than to a current outbreak.

> The outbreak of influenza reported in 1173 is not considered to be a pandemic, and other reports to 1500 generally lack reliability. The outbreak of 1510 is probably a pandemic reported with spreading from Africa to engulf Europe. The outbreak of 1557 is possibly a pandemic. The first influenza pandemic agreed by all authors occurs in 1580.

people have been trading for a long time. the modern point-to-point connections didn't exist, obviously, but east asia and western europe have been indirectly connected through trade routes since ancient times [0]. as long as the disease wasn't virulent enough to kill most hosts in a single leg of transit, it could be spread across all of asia and europe. the world-wide spread would be slower, but intra-community spread would probably be even faster due to the lower standards of sanitation and medical understanding.

a truly global pandemic probably wouldn't have been possible with the lack of connectivity between eurasia and the americas.

[0] https://en.wikipedia.org/wiki/Silk_Road

The plagues were even more deadly. And very global. And, er, came from China. https://en.wikipedia.org/wiki/Black_Death

As soon as there was global trade, pandemics could spread. Colonist arrival to the americas was a semi-pandemic - but there were epidemics of the plague, of cholera, that spread from Asia to Europe and back for many years. there's an article on pandemics in antiquity: https://demystifyingscience.com/blog/2020/2/27/whats-in-a-pa...

Following links gets you to this article which tries to explain that the Neolithic decline happened also because of a plague.

https://en.wikipedia.org/wiki/Neolithic_decline

Very interesting how in a matter of days, the Spanish flu has been renamed to the 1918 flu. Cancel culture writ large. It’s actually impressive.

Calling it "Spanish Flu" is like calling oxygen phlogiston or saying that you get scorpions when you leave a few leaves of basil between two bricks. it's a colloquial name that results in confusion down the line. call things technical, scientific names so that you can trace back a historical line of thought. or don't and pick the opposite groupthink to cancel culture and keep the whole thing plowing along

The "Spanish" part has always been a misnomer, since it likely began in the United States.

Yeah I don’t care why. Theres a lot of things that are misnamed. I was just commenting on the power of the internet and outrage culture. I don’t use social media outside HN so I don’t feel the same sense of injustice.

It's never a bad thing to use more accurate terminology, or to update language as society and culture develop.

If my grandmother can learn a better word for "brazil nuts," you can learn a better name for the 1918 flu that started in Kansas.

This has nothing to do with accurate terminology. It’s 100% political.

what's political, not calling an epidemic that was carried by migrant workers and Frontline soldiers into Fort Funston Kansas thé "Spanish Flu?"

in the 90s i would imagine seeing a "Fun Fact" on the back of a cereal box saying "Did you know the Spanish flu actually started in Kansas?". And me going, "huh, mildly interesting"

These days people choose weird things to focus on. To the point where they will correct you if you say Spanish Flu like its offensive.

There's is definitely an effort to remove any instance of "The <country name> <disease name>". Regardless of accuracy. Renaming something isn't inherently political, but the choice of which misnamed things to rename is political.

It's more like people are talking about the Spanish flu a lot, and at the same time realizing that the "Spanish" part actually misinformed them.

I was talking to someone about the Spanish flu and they casually commented "oh last time it's Europe now it's Asia's turn". Took me a few more minutes to inform them it's not from Spain. Both of us now realized that's a bad name. It's also the first time we mention "Spanish flu" in our lives, there's no problem using a more accurate name.

I see this as a community effort to use a more convenient word. It's not that political, no political party or government agencies are actively pushing for it.

I'd also add that there is a very real possibility of people using the origin of the flu for political purposes - and it's worth asking yourself if you want to play into that ugly game - left or right. Speak and think for yourself, and recognize that language is the only thing we've got. What kind of person do you want to be? What do you want your legacy to look like?

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