According to most stories of the 1918 influenza epidemic, which killed at least 50 million people worldwide, it ended in the summer of 1919, when the third wave of the contagious respiratory illness finally died down.
But the virus continued to kill. A variant that emerged in 1920 was lethal enough to warrant being seen as a fourth wave. In some cities, including Detroit, Milwaukee, Minneapolis and Kansas City, the number of deaths was even higher than that of the second wave, responsible for most deaths from the pandemic in the US.
This was despite the fact that the American population already has a lot of natural immunity against the influenza virus, after two years with several peaks of infection and the viral lethality having already decreased.
During the virulent second wave, which peaked in the fall of 1918, almost all US cities adopted restrictions. In the winter of that year, with the arrival of a new, less serious wave, some cities imposed restrictions again. But by 1920, virtually no locals reacted: people were fed up with influenza, and so were public officials.
The newspapers were full of scary news about the virus, but no one was listening. People at the time made light of this fourth wave, and historians ignored it as well. In 1921 the virus underwent further mutations, becoming the common seasonal influenza. But the world had stopped worrying about the pandemic long before that.
We cannot repeat this mistake.
It is true that at this moment we have every reason to be optimistic. For starters, the onomicron cases are on the decline in many parts. Second, pretty much the entire US population will soon have been infected or vaccinated, which will strengthen people’s immune systems against the virus as we know it today. And while the omicron is remarkably adept at infecting the upper airways, which makes it so transmissible, it appears less capable than earlier variants of reaching the lungs, so it is less virulent.
It is entirely possible — and perhaps even likely — that, in the face of a better immune response, the virus will continue to lose lethality. In fact, there is a theory that the influenza pandemic of 1889-1892 was actually caused by a coronavirus called OC43, which today causes the common cold.
For all these reasons, at this moment overconfidence, indifference or tiredness (after two years of fighting the virus and each other) represent a danger.
The signs that we are fed up — or with unwarranted hopes — are visible everywhere. While more than 70% of the adult population is now fully vaccinated, progress has stalled, and as of January 27, only 44% of Americans had received the booster shot, which offers vital protection against the risk of infected people becoming seriously ill.
While most of us (especially parents with children) want schools to stay open, only 20% of American children ages 5 to 11 are fully vaccinated. As was the case in 1920, people are fed up with taking precautions.
This indifference is handing control over to the virus. The result is that, although the omicron appears to be less virulent, the average daily deaths from Covid in the last seven days in the US has already surpassed the peak seen with the delta variant, in late September.
And there’s more: it’s possible that the virus hasn’t had enough of us yet. Despite the reasonable probability that future variants will be less virulent, mutations are random. The only certainty is that future strains that are successful will evade the protection afforded by the immunity we have today. They can become more dangerous.
This happened not only in 1920, with the last throes of the 1918 virus, but also in the 1957, 1968 and 2009 influenza pandemics. infected or vaccinated, one variant pushed the mortality peak to surpass the 1957 and 1958 pandemic levels. In the 1968 outbreak, a strain in Europe caused more deaths in the second year, despite once again a vaccine was available and many have already contracted the disease.
In the 2009 epidemic, variants also emerged that caused a large increase in infections. A UK study found “a greater burden of severe disease in the year after the pandemic” but “much less public interest in influenza”.
Scientists attributed this indifference to the government’s approach. In the first year, the public health response was “highly assertive”, mainly with the provision of information; there were no lockdowns. In the second year, the scientists discovered, “the approach was laissez-faire” (letting go). As a result, there were “large numbers of deaths, hospital and ICU admissions, often involving people of working age and otherwise healthy.”
In view of these precedents, we should be careful. Vaccines, the new retroviral drug paxlovid and others could end the pandemic once billions of doses are made widely available globally — and if the virus does not develop resistance to them. But the end will not come in the short term.
The immediate future still depends on the virus and how we use our current arsenal: vaccines, masks, ventilation, the antiviral drug remdesivir, steroids, the only monoclonal treatment that still works against the micron, social distancing and crowd avoidance. As a society, we have largely abandoned the public health measures on that list. As individuals, we can still act.
Source: Folha
