A pandemic “identical” to the Spanish one. So said the WHO Deputy Director, Ranieri Guerra, yesterday on the debate on the danger posed by the Coronavirus pandemic. A strong historical parallel, given the dramatic numbers that recorded the Spanish between 1918 and 1920. But what was the Spanish influence? What similarities are there with the Covid-19? We talked about it with Professor Vittorio A. Sironi, professor of the University of Milan Bicocca, where he directs the Study Center on the history of biomedical thought.
Professor Sironi what was the Spanish influence and where did it start?
«The Spanish one was an epidemic linked to a flu virus, it was discovered over time, which affected the whole world between 1918 and 1919. It was a particular period. Medicine did not have the same characteristics as today and we were in the course of the First World War. In reality, this epidemic breaks out in the United States, with initially very nuanced symptoms. But the main epidemic outbreak is, in fact, linked to a religious holiday that was held in Spain, a country not involved in the war and where newspapers had started talking about this widespread flu form. Hence the term “Spanish” ».
How many waves of Spanish epidemic have been?
“Two. The first, the most attenuated if we can say so, occurred in the months of March-April 1918. Then there was a second wave, which began in late August and which developed in September-October, with a greater involvement , greater virulence and greater mortality. Around the world, it is estimated that between 50 and 100 million people died. Even in the first phase, the infected were many, and often also paucisymptomatic or almost asymptomatic, with a relatively lower or unrecognized mortality. When everything seemed calm, and the institutions had given signs of tranquility, a decidedly more violent, massive second wave arrived, with a more serious symptomatology against which the medicine of the time could do little ».
Are there any similarities between this Coronavirus and the Spanish flu virus?
«They are two different viruses. That was a flu virus, this is a Coronavirus. From a biological point of view they are different. The analogies are that, despite being different viruses and independently of the pathogen, the two pandemic episodes have similar characteristics: a fairly widespread spread, a mortality that can vary and the fact that these viruses often have attenuation phases, or better yet, adaptation, with subsequent re-explosions. This is what happened for the Spanish epidemic and which, we hope, does not happen for Covid-19, but which in theory we cannot rule out. This, however, must not create alarm, but the lesson of history, which serves this purpose, must put us on notice ».
Professor, is it true that the Spanish flu, unlike Covid-19, was more lethal for young people?
“This is true. The Spaniard had mainly involved young people, also because an easy way of transmission in that period was the involvement of people who came in contact also for war reasons, and who were mainly young people. However, the diffusion rate was completely different from today. Once it took a few weeks to go from one continent to another, today it only takes a few hours. The virus travels faster today. Which also means that there may be the involvement of a different population group, also because, as mentioned, in Spain the diffusion was more tied to the conditions of the war period. However, we have seen in recent times that, albeit with a less pronounced symptomatology, young people have also been involved in Covid-19 “.
Was a Spanish flu vaccine found?
“No. At the time, the culture of vaccines, even though they originated at the end of the 18th century, was very different. There were no technical possibilities to do it. Today there are 140 candidate vaccines for Covid-19, we can develop the vaccines very quickly, so to speak, because in spite of everything it will still take its time and I’m not sure that by the end of the year there will be a vaccine. But we certainly burn times, which in the 1920s was absolutely impossible ».
How did the Spanish flu disappear?
«Here, this is another mystery of history. We even managed to identify the genome, which was confirmed to be an H1N1 flu virus. Corpses were found in the ice of people who died from Spain a few years ago, and it was possible to isolate the virus and understand that it was a variant of the flu virus. The Spaniard disappeared fairly quickly, just as she had arrived. We don’t know the exact reason. It is possible that there was, after the most virulent and dramatic phase, a further variation of the virus, and that it disappeared after killing all, or a large part, of the subjects who had contracted it, or that it has further varied and become less lethal. From a microbiological point of view, it is not known exactly “.
What does the 1918 epidemic teach us? What mistakes were made then and which should not be made now?
«The first mistake that emerged then, which must be today’s first lesson, is that while not dramatizing the situation, we must not even minimize it. The truth must always be told completely. Unfortunately, in recent weeks we have witnessed the fact that many nations, many heads of state, have tried to minimize the pandemic phenomenon. This is an aid that we give to the virus. The lesson of the Spaniard is that the truth must always be said clearly, without terrifying but not even minimizing. The second teaching is linked to the fact that, although today medicine has certainly greater diagnostic and therapeutic possibilities than there were at the time of the Spanish, we must still have an attitude of prudence: wearing a mask is not a trivial thing, so how to keep your distance or resort to the old quarantine. ”
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