The 1918 Influenza Pandemic Versus COVID-19: A Historical Perspective From an Italian Point of View.

The ongoing COVID-19 pandemic has a major precedent almost exactly a century ago: the world-famous H1N1 influenza virus pandemic, sometimes known to the general public as the Spanish flu. From a history of medicine perspective, it is possible to underline many potential common traits between the two. In this article, hygiene and prophylaxis strategies are analyzed in a review of the most popular Italian general medical journals at the time of Spanish flu, Il Policlinico being the most representative of them. The analysis included 40 original journal articles as well as important references to the most influential coeval national manuals and international journals. The main issues in the context of public hygiene are prophylaxis with quinine and quinine derivatives, vaccinations, face masks, disinfection, and social distancing. We draw a comparison between these and the most recent international World Health Organization and Italian national guidelines on the topic. Sadly, little has changed since those times in terms of most of the prevention techniques, even with technical improvements, showing how shortsighted doctors and physicians can be when dealing with medical history. (Am J Public Health. 2021;111(10):1815-1823. https://doi.org/10.2105/AJPH.2021.306412).

Waiting for the flu: cognitive inertia and the Spanish influenza pandemic of 1918-19.

This study looks at public awareness and understanding of the Spanish flu in the United States between June 1918, when the flu became "Spanish," and the end of September when the deadly second wave reached the majority of the country. Based on an extensive reading of local newspapers, it finds a near universal lack of preparation or panic or other signs of personal concern among those in the unaffected areas, despite extensive and potentially worrying coverage of the flu's progress. The normal reaction to news of the inexorable approach of a pandemic of uncertain virulence is anxiety and action. The Spanish flu produced neither in the uninfected areas for a month. The most likely reason appears to be cognitive inertia-the tendency of existing beliefs or habits of thought to blind people to changed realities. This inertia grew out of the widespread understanding of flu as a seasonal visitor that while frequently unpleasant almost never killed the strong and otherwise healthy. This view of the flu was powerful enough that it blinded many in the unaffected regions to the threat for weeks even in the face of daily or near daily coverage of the pandemic's spread.

4-Aminoquinoline compounds from the Spanish flu to COVID-19.

In 1918, quinine was used as one of the unscientifically based treatments against the H1N1 virus during the Spanish flu pandemic. Originally, quinine was extracted from the bark of Chinchona trees by South American natives of the Amazon forest, and it has been used to treat fever since the seventeenth century. The recent COVID-19 pandemic caused by Sars-Cov-2 infection has forced researchers to search for ways to prevent and treat this disease. Based on the antiviral potential of two 4-aminoquinoline compounds derived from quinine, known as chloroquine (CQ) and hydroxychloroquine (HCQ), clinical investigations for treating COVID-19 are being conducted worldwide. However, there are some discrepancies among the clinical trial outcomes.Thus, even after one hundred years of quinine use during the Spanish flu pandemic, the antiviral properties promoted by 4-aminoquinoline compounds remain unclear. The underlying molecular mechanisms by which CQ and HCQ inhibit viral replication open up the possibility of developing novel analogs of these drugs to combat COVID-19 and other viruses.

[A new Spanish enemy; the Spanish flu in the Netherlands in the period 1918-1920]. / Een nieuwe Spaanse vijand.

The Dutch example shows that there are not only differences but also several similarities between COVID-19 and the Spanish flu, although risk of infection and death toll were much higher than they are now, especially at the end of 1918. These similarities include emphasis on the importance of hand washing, prohibition of gatherings (and disregard of these rules), disruption of public life, uncertainty about the nature of the cause, praise of and warnings against ineffective medication as well as debate on use and necessity of certain measures. There is also the social context in which the disease and the measures taken to combat it are happening, with the poor paying the highest price, now as well as then.

Lessons to be learnt from 100 year old 1918 influenza pandemic viz a viz 2019 corona pandemic with an eye on NTEP.

The article is about the 1918 H1N1 flu pandemic also called the "Spanish flu" which killed 50 million plus people worldwide, and the coronavirus pandemic (Covid-19) which has spread in the world at an alarming pace. As of now there are 11,327,790 cases and 532,340 deaths globally. Aim of this article is to draw conclusions and share knowledge from both the pandemics and apply these lessons in other health programmes.

Effects of reactive social distancing on the 1918 influenza pandemic.

The 1918 influenza pandemic was characterized by multiple epidemic waves. We investigated reactive social distancing, a form of behavioral response where individuals avoid potentially infectious contacts in response to available information on an ongoing epidemic or pandemic. We modelled its effects on the three influenza waves in the United Kingdom. In previous studies, human behavioral response was modelled by a Power function of the proportion of recent influenza mortality in a population, and by a Hill function, which is a function of the number of recent influenza mortality. Using a simple epidemic model with a Power function and one common set of parameters, we provided a good model fit for the observed multiple epidemic waves in London boroughs, Birmingham and Liverpool. We further applied the model parameters from these three cities to all 334 administrative units in England and Wales and including the population sizes of individual administrative units. We computed the Pearson's correlation between the observed and simulated for each administrative unit. We found a median correlation of 0.636, indicating that our model predictions are performing reasonably well. Our modelling approach is an improvement from previous studies where separate models are fitted to each city. With the reduced number of model parameters used, we achieved computational efficiency gain without over-fitting the model. We also showed the importance of reactive behavioral distancing as a potential non-pharmaceutical intervention during an influenza pandemic. Our work has both scientific and public health significance.

La elaboración de vacuna y suero durante la gripe española en Argentina. Iniciativas estatales en la periferia de la ciencia (1918-1919) / The development of vaccine and serum during the Spanish flu in Argentina. State initiatives in the periphery of science (1918-1919)

En este artículo, estudiamos la elaboración de dos métodos para combatir la gripe española o influenza en la Argentina: el suero y la vacuna. Las investigaciones sobre el agente etiológico y la elaboración de estos instrumentos se llevaron a cabo en el Instituto Bacterioló-gico, institución estatal que al momento en que ingresó y se expandió la enfermedad estaba dirigida por el médico bohemio Rudolf Kraus y junto a él trabajaba una parte de la élite médica porteña y extranjera. Realizamos un análisis de las metodologías que se utilizaron tanto para la elaboración como en las pruebas que se desarrollaron a lo largo de los años 1918 y 1919. Consideramos que el mismo Estado que permitió y alentó la elaboración de ambos métodos de prevención y de cura, en especial de la vacuna, también fue un factor que, por su misma dinámica, impidió que se llevaran adelante las pruebas para validarla y aplicarla. El estudio se llevó a cabo a partir de diversas fuentes, como documentación estatal, artículos científicos y notas periodísticas, desde un análisis hermenéutico (AU)

Cuando la muerte viene a visitarte: el paso de la gripe de 1918-1919 por la ciudad de Segovia / When death comes to visit you: the passage of the flu from 1918 to 1919 through the city of segovia

El presente artículo tiene como objetivo estudiar la gripe de 1918-1919 en Segovia, explicando su origen, evolución, mortalidad diferencial, profilaxis y las consecuencias más importantes que se derivaron de ella. Con este fin, se ha trabajado con la documentación existente en el Archivo Municipal de Segovia, las partidas de defunción del registro civil, estadística municipal, provincial y nacional, el Boletín Oficial de la Provincia y los principales periódicos segovianos. En primer lugar, nos centramos en la aparición de la epidemia, propagación, llegada a España y las víctimas causadas, atendiendo a su sexo, edad, procedencia, localización, estado civil y profesión. Las medidas preventivas y paliativas se analizan desde varios puntos de vista: organizativas, control de población, transportes, higiene, comercio, personal sanitario y dependencias hospitalarias. En cuanto a las secuelas que dejó en la provincia, se abordan desde dos enfoques: por un lado, el económico, aquéllas relacionadas con la escasez y subida de los precios de primera necesidad, y por otro, las que afectaron al normal desarrollo de la actividad en general.(AU)

The objective of this article is to study the flu of 1918-1919 in Segovia, explaining its origin, evolutión, differential mortality, prophylaxis and the most important consequences. Several sources have been used for this article such as the existing documentation in the Municipal Archive of Segovia, the death certificates of the civil registry, municipal, provincial and national statistics, the Official Gazette of the Province and the main newspapers from Segovia. First, we focus on the appearance of the epidemic, spread, arrival in Spain and the death toll, according to their sex, age, origin, location, marital status and profession. Preventive and palliative measures are analyzed from several points of view: organizational, population control, transportation, hygiene, commerce, health-care staff and hospital units. The consequences of the pandemic of flu in Segovia are studied from two perspectives: on the one hand, the economic one, those related to the scarcity and rise of basic necessities prices, and on the other, those that affected the normal development of the general activity.(AU)

Acciones sanitarias en las enfermedades transmisibles. Un instrumento de la salud pública / Health actions in contagious diseases. An instrument of public health

Se describen las acciones sanitarias específicas que se realizan en la lucha contra las enfermedades infecciosas para evitar o disminuir su transmisibilidad y el contagio en la población, como instrumentos del modelo médico sanitario. Se hace referencia a la pandemias de 1918 y 2020, en las cuales se aplicaron estas acciones sanitarias. (AU)

The specific sanitary actions that are carried out in the fight against infectious diseases are described to avoid or reduce their transmissibility and contagion in the population, as an instrument of public health. Reference is made to the Pandemics of 1918 and 2020, where these sanitary actions were used. (AU)