Published on : 03/20/2020 – 12:33Modified : 03/20/2020 – 12:33
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In one of his speeches to the nation, President Emmanuel Macron described covid-19 as the “most serious health crisis in a century”. 100 years ago, it was indeed the Spanish flu that raged around the world. However, are the two pandemics comparable?
Between 30 and 50 million deaths worldwide, or even 100 million for the highest estimates. The Spanish flu, which raged from 1918 during the First World War until 1919, marked history. In his speech to the nation Thursday, March 12, Emmanuel Macron referred to it by describing covid-19 as the “most serious health crisis in a century”.
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“Today everything is absolutely different”
Since the acceleration of the coronavirus crisis, there have been increasing comparisons between these two pandemics. “We are talking again about the Spanish flu today because at the time it was striking. It is the biggest health crisis the world has ever known in terms of demographic balance. There had indeed been the plague black, but it was world wide then [de 1347 à 1353, elle aurait causé entre 25 à 34 millions de victimes en Europe, NDLR]”recalls Anne Rasmussen, director of studies at the Graduate School of Social Sciences (EHESS).” But at the same time, it has nothing to do with covid-19. Today everything is absolutely different. You have to be careful not to use comparisons that would be more fearful than they would be explanatory, “said this specialist in the history of science.
The two pandemics first belong to different families of viruses. Spanish influenza is type A (H1N1), while covid-19 is a coronavirus. Both are respiratory infections with common symptoms like flu, runny nose or fever. “But what caused a lot of death in 1918 was pneumonia and festering pleurisy. People were suffocated. They felt like they were drowning,” said Anne Rasmussen. “Regarding the coronavirus, the director general of health Jérôme Salomon highlighted the differences between the influenza virus and covid-19. The clinical profile, the appearance of the disease, the severity, the biological signs and radiologies are not the same.
Covid-19 also does not appear to attack the same age groups. While the coronavirus, particularly affects the elderly or already sick, “the privileged population in the influenza mortality of 1918, was young adults. This is an epidemiological question which continues to intrigue. We are still trying to understand it above all that we now have DNA decryption of the 1918 virus “, explains the historian. “One element of the answer is that the flu had already circulated in particular during the epidemic of 1889. People who may have been in contact with this flu in their young years could find themselves thirty years later partially immunized”.
# 1J1P My soldier of the day, Louis Dumoulin, not yet 18 years old who died of “influenza pneumonia” (certainly Spanish flu) at the Besançon hospital on September 12, 1918. pic.twitter.com/S0CMiYVd7w
Hélène Urli (@helurli) December 13, 2017
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The Spanish flu virus was only identified in 1933
But one of the fundamental differences remains in the identification of the virus, according to Anne Rasmussen: “At the time, we did not know the pathogen of pandemic influenza. Without this knowledge, we did not have the possibility of designing vaccines, which has been the miracle solution since Pasteur [la première vaccination humaine fut celle d’un enfant contre la rage le 6 juillet 1885, NDLR]. We knew that we were dealing with a flu and that it was contagious, but we were not yet able to see the viruses because they were too small. We will have to wait for the electron microscopes. “
The Spanish flu virus was not finally identified until 1933. Today, scientific progress is considerable. “We have deciphered the RNA [Les coronavirus sont des virus à ARN simple brin enveloppé, une version en quelque sorte simplifiée de l’ADN, NDLR] covid-19 in a few days, while for AIDS it took a few years, “said the specialist in the history of medicine.
A century ago, when the Great War raged in Europe, the countries affected by the Spanish flu found themselves in a deep state of destitution. In a few weeks, the virus spreads and crosses the Atlantic. It is distributed in particular by the American expeditionary force which arrives as reinforcements on the European front.
In the space of a few months, it turns into a pandemic. After Europe, it affects the rest of the world in three different waves. The deaths are counted in millions. Medicalization is therefore not comparable to what it is today. Access to hospitals is not widespread and patients do not benefit from our modern resuscitation techniques or the antibiotics necessary to treat the complications caused by the disease.
“We are much more armed today”
Faced with this disaster, countries adopted very different behaviors. In France, where the Spanish flu will kill 240,000 people, there are some bans on gatherings or closings of public places, but nothing comparable to the current confinement. Priority is then given to the continuation of the war effort. “In 1918, they lived decisive moments with offensives or counter-offensives. One could not prevent from circulating because the authorities considered that it was impossible for the continuation of the operations. The troops and the permit holders had to be able to move” , says Anne Rasmussen. “On the other hand, there was this feeling that it was useless. The policy was more to an individual isolation of the identified flu”.
In the years that followed, when the world was at peace again, the parenthesis of the Spanish flu closed. Scientific research was undertaken in the inter-war period, but it was not until 1948 with the creation of the World Health Organization that surveillance networks developed on an international scale.
After this pandemic, of an unequaled extent, the world knows several: the flu known as of Singapore in 1957, that of Hong Kong in 1968 and that of A (H1N1) in 2009. “We learned a lot of lessons from each of these epidemics by having a monitoring system which is much more efficient. We are much more armed today “, insists Anne Rasmussen. “Let’s not add fear to fear. We are already in a fairly anxiety-provoking climate We have changed scales and worlds. There are reasons for hope, research and efficiency. We can hope to have therapeutic means in the short term against covid-19 “.
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