Public health officials say lessons learned from what is commonly known as the “Spanish flu” and other pandemics of the last century are being put into action today.
More than 40 million people are believed to have died from the worldwide influenza epidemic in 1918-19. Included in that number are the 550,000 who perished in the United States.
Dr. Megan Quinn, an associate professor in East Tennessee State University’s Department of Biostatistics and Epidemiology, said a 2007 article in JAMA — The Journal of the American Medical Association — noted the effectiveness of “non-pharmaceutical interventions” put into effect by many U.S. cities in 1918.
Researchers found “early and sustained” efforts to isolate and quarantine helped to mitigate the mortality rate in this county from the Spanish flu, which was a H1N1 strain.
“In the United States, we reduced activities in communities and limited gatherings of large groups,” she said.
She said many of those interventions would be used again to deal with other global health concerns.
Figures show nearly 3% of the world’s total population died from the 1918 flu. By comparison, 0.001 to 0.007% of the world’s population died in the 2009 influenza pandemic.
The 1956-58 Influenza Pandemic
Also known as the “Asian flu,” this strain of H2N2 was an avian flu that killed nearly 2 million people globally, including 60,000 to 70,000 in the United States. By the time this pandemic hit in the 1950s, a global response was possible with the creation of the World Health Organization and the Centers for Disease Control and Prevention.
In the two decades before this pandemic, researchers had successfully developed flu vaccinations. As a result, Quinn said there was “a window of opportunity” for vaccinations that helped to reduce the mortality rate between 1956-58.
“There were nowhere near the deaths seen in 1918,” Quinn said.
The 1968 Influenza Pandemic
In the 1960s, the U.S. surgeon general began recommending people in high-risk groups and over the age of 65 receive an annual flu vaccination. Those precautions were in place for the 1968 flu pandemic.
The CDC estimates 100,000 people in the United States, and 1 million worldwide, died from the H3N2 strain.
“At this point the United States had increased its surveillance and statistics for influenza,” Quinn said.
It was also about this time that the CDC put into place its 122-city reporting system to track the mortality rate of influenza and other epidemics.
“We were able to monitor the 1968 pandemic as a result of a better reporting of statistics,” she said.
Quinn said better reporting, along with advancements in developing vaccines, may have played a part in preventing the 1970 H1N2 flu outbreak at Fort Dix in New Jersey from becoming a pandemic.
She said a vaccination was developed and people were inoculated quickly for the strain.
First detected in central Africa in 1976, human immunodeficiency viruses were first recognized globally in 1981. Health officials say as many as 36 million have died from HIV since that time.
HIV can progress into acquired immunodeficiency syndrome, AIDS.
“It was very novel at the time,” Quinn said. “Nobody knew then what it was or how it was transmitted.”
An understanding of how the virus is transmitted, new treatments and better public education of HIV have resulted in a dramatic drop in new cases worldwide. Officials say 7.8 million people died from HIV in 2004. That number was down to 770,000 in 2018.
The 2002 SARS Pandemic
Severe acute respiratory syndrome was a novel coronavirus pandemic first discovered in southern China in 2002. There were 8,096 suspected cases of SARS reported in 29 countries, and was responsible for 774 deaths.
Few cases, less than eight, were confirmed in the United States
It was quickly contained, Quinn said, thanks to personal hygiene and isolation precautions learned from other outbreaks of coronavirus.
The 2009 Flu Pandemic
Like the pandemic of 1918, this global flu outbreak in 2009 was also a H1N1 strain. The CDC said there were 60.8 million cases reported in the United States, of which 274,304 required hospitalization.
There were also 12,469 deaths in this country from the pandemic. Officials said 80 percent of those deaths were people under the age of 65.
Quinn said the 2009 flu was remarkable in that it affected younger people more than it did older Americans. The opposite is generally the rule in pandemics.
“People over the age of 60 had greater immunity, perhaps because they had been exposed to an earlier strain or built up antibodies over the years,” she said.