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Comparing different diseases at different times is helpful. It shows, on the one hand, human evolution and, on the other, how much remains for human beings to evolve. This means that the Spanish flu and Covid-19 can have the same destructive potential, but some situations have changed.
Patients hospitalized in a makeshift place: victims of the Spanish flu between 1918 and 1919 – Photo: R7 / Press release / ND
“The two diseases are caused by different viruses. Covid-19 is caused by the coronavirus family virus, which causes mild respiratory conditions up to severe respiratory failure. The Spanish flu is a type of influenza virus, which causes flu cases that are also mild, moderate or severe, “explains Silvia Regina Julian, an infectologist from the São Paulo city council, at the HIV and Viral Hepatitis Clinic.
She continues, detailing that “at different times when they occurred, both are potentially serious,” he says. However, the Spanish flu would be much less deadly today than in 1918.
Covid-19, however, despite the absence of a vaccine, has a similar fatal potential. However, it has caused fewer deaths (compared to the Spanish flu), due to the evolution of some aspects of medicine.
Fruit of the First World War
In those 10 years of the last century, the resources of medicine were smaller, the structure of a virus was hardly known. In addition to the fact that destruction and misery are prevalent in various parts of Europe, the disease has also spread due to contact between soldiers in the front from the First World War (1914-1918).
And to the roughly 20 million people killed in the fighting, possibly 40 to 50 million people were added later. They were victims of the Spanish flu, a number that represented 5% of the world population at that time.
Covid-19, in turn, has already reached some 3.5 million people, of whom around 250,000, less than 1%, have died.
Possible treatments
Infectologist Renato Kfouri, former president and current first secretary of the Brazilian Society of Immunizations, explains why the Spanish flu would now be much easier to control. As a result, it would do much less damage than Covid-19 and itself in 1918.
“The Spanish flu was caused by the influenza virus, against which we now have a vaccine and treatment. We have a specific antiviral medicine for influenza that is Oseltamivir (Tamiflu), Zanamivir and newer ones that are coming ”, he details.
The current scenario influences
For the infectologist, because of this, “probably an influenza epidemic today, even if it is a new variant, such as the H1N1 pandemic, in months we would already have vaccines, produced in large quantities, prophylactic, indeed. In this scenario with the vaccine and antiviral treatment, the situation of the Spanish flu would certainly be much better today, “he says.
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Despite its rigorous potential, it shows that the coronavirus has caused deaths with an even more intense spread. This is due to the globalization scenario, in which travel and population exchanges are much greater.
“The treatment at that time was empirical, based on the personal experience and intuition of the doctors, few resources, a minimal therapeutic arsenal, based for example on teas, hot compresses and absolute rest, they could not count on scientific research resources to help in treatment, “says Silvia.
According to the infectologist’s evaluation, even with medicine, at this time, powerless to prevent the spread of the disease, some treatments allow fewer deaths compared to the Spanish flu.
“As for Covid-19, the therapeutic possibilities are being studied and worked, we have proposals for pharmacological treatment and intensive support for the most serious cases. Research protocols in the field of treatment are being developed simultaneously in several centers, I think we will soon have more consistent responses in the treatment and prevention of this disease, “he adds.
Subjective comparisons
At the time of the Spanish flu, public health systems were just beginning. In addition, there was great disbelief and ignorance among the population and all this allowed the number of deaths caused by the consequences of the disease to be large, as Kfouri explains. It only differentiates the type of disease that results.
“At the time of the flu there were a lot of complications from bacterial pneumonia, a complication that we don’t see in the coronavirus,” he says.
It’s worth remembering that penicillin, an antibiotic discovered in 1928, did not yet exist. Kfouri, however, wishes to point out that, in general, it is difficult to draw parallels between the two diseases.
“These are completely different realities, completely different diseases, completely different viruses, completely different times, in terms of vaccines, in terms of drug treatment, in terms of population displacement,” he says.
Comparisons are really subjective. But, in an exercise in imagination, what would the impact of Covid-19 be like at the time of the Spanish flu? Silvia has a conviction. Which is also an image of the development of medicine over time.
“Given the culture of the time, beliefs, health conditions, medicine without any knowledge of the structure of the virus, without knowledge of molecular biology, much less intensive treatment (there were no respirators, ICUs, physiotherapy techniques ), I imagine it would have a devastating impact on the planet’s population. “
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