Covid pandemic, a replay of the Spanish Flu?

By September 2021, mortality had risen again on both sides of the Atlantic (AFP)
By September 2021, mortality had risen again on both sides of the Atlantic (AFP)


The current pandemic’s pattern echoes the one a century ago, though it’s far less lethal and the global context differs vastly

The accompanying table has aggregated official mortality trends of 32 major countries, accounting for about 70% of the global population and 85% of covid deaths, as recorded, at six weekly intervals since the beginning of the covid pandemic from around March 2020. Analysing these trends, this writer had concluded at the end of July 2021 that the pandemic appeared to be either petering out or a third wave was still to manifest itself. Covid mortality had declined across the board, but not for the first time. Europe and Asia had already had two distinct waves of the pandemic, whereas the Americas had had an extended first wave.

This was around the time the Delta variant of the Sars-CoV-2 virus was generating global fear, and the Omicron strain had not even evolved. How have things panned out?

By September 2021, mortality had risen again on both sides of the Atlantic. Europe was in the throes of a third wave, and the Americas in their second. The second wave is now rapidly waning in the Americas, and mortality continues to drop in Asia, even as the third wave is yet to peak in Europe.

Where might things go from here?

This is difficult to predict. Not only do we still not know enough about the coronavirus, but viruses in general remain a continuing puzzle for science. There is still no consensus on whether viruses, which can survive for extended periods in a dormant state, are a form of life or not. Apart from their zombie-like existence, they tend to mutate rapidly, so vaccines offer only limited protection that often wanes over time. Sars-CoV-2 has mutated repeatedly, which can be ascribed partly to global vaccine inequality that makes it hard to stamp out the pandemic. The best health care systems have struggled. Unusually, mortality is much higher in advanced countries than in Africa. Within Africa, the relatively prosperous South Africa has higher mortality than the poorer parts.

The current pandemic’s pattern echoes the one a century ago, though it’s far less lethal and the global context differs vastly
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The current pandemic’s pattern echoes the one a century ago, though it’s far less lethal and the global context differs vastly

What we do know about viruses is that they tend be very lethal or highly infectious, but not both. However, every now and then, an extremely transmissible virus comes along that’s also deadly, such as during the Spanish Flu pandemic a century ago. If it is difficult to predict the future trajectory of the ongoing covid pandemic, might the experience of the Spanish Flu provide pointers?

Some pointers are superficial. Despite the name, Spain was not the epicentre of the Spanish Flu, and covid mortality is not very high in China, from where the virus is widely believed to have originated. But the covid outbreak so far has broadly tracked the course of the Spanish flu. Like the latter, covid has had a deadly second wave, followed by successively less lethal waves. The Spanish Flu petered out over time without really going away. While the initial mutations were deadly—hence the lethal second wave—they became milder over time. The long-term objective of viruses is to thrive within their hosts and not mutually assured destruction. Omicron may well turn out to be the barking dog that did not bite.

The US, the wealthiest country in the world, has had very high relative mortality, just as it did during the Spanish Flu. Its serving presidents were infected on both occasions, which may have altered the course of history. Woodrow Wilson staunchly opposed the Treaty of Versailles until he was debilitated by the flu, following which he ceased to be an active player at the Potsdam negotiations. The Treaty paved the way for the rise of Hitler and World War II. Trump’s inept handling of covid turned the electoral tide against him in the 2020 White House race that he had appeared to be winning, marking a major defeat for a rampant American Alt Right movement.

The world has changed greatly since the days of the Spanish Flu. Though viruses remain mysterious, the vastly improved quality of healthcare since has reduced mortality. The consensus estimate of aggregate global mortality is around 20 million for the Spanish Flu, compared to about 5 million so far for covid. Controlling for the population base effect translates into mortality of just 7 per 1,000, compared to about 100 for the Spanish Flu.

The rapid spread of the internal combustion engine and jet travel has vastly increased human mobility. A virus can now get transported across the globe within hours, rendering border controls ineffectual. Denser urban populations compound the problem, especially in poorer countries where lockdowns amplify physical proximity instead of attenuating it. The reason why the Spanish Flu spread rapidly despite the relatively backward state of transport at the time was the unusually large cross-border (indeed transcontinental) troop movements facilitated by various states at the tail end of World War I. This is the reason why India suffered very high mortality from the Spanish Flu. These troops then travelled back home to the interiors. This time around too, India, along with Indonesia, has the highest pandemic mortality rate in south and east Asia.

The communication and information revolution has spawned a vibrant civil society and social media. A pandemic is fertile ground for the spread of false information quickly and globally, causing outbreaks of mass anxiety and depression, and copy-cat policy responses by governments unrelated to their own situation, leading to policy mistakes that can aggravate underlying problems. Our acceptance of illness and death is far less than was the case a century ago, when public health infrastructure did not exist and the deaths of those aged 40-50 in war or from illness were seen as painful but tolerable acts of God. The prospect of dying even at an older stage of life is much more intolerable now.

Alok Sheel is RBI chair professor of macroeconomics, Indian Council for Research on International Economic Relations

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