Most of the 1918 Spanish flu chronicles say the pandemic officially ended in the summer of 1919, when a third wave of respiratory disease finally subsided, having killed at least 50 million people worldwide.
However, the virus continued to kill. A variant that appeared in 1920 was deadly enough to be considered a fourth wave. Deaths in some cities even surpassed those of the second wave, which was responsible for the vast majority of deaths. The "fourth wave" of the Spanish flu also hit hard the countries in which the population already had a high natural immunity from the virus, after two years of contagions and despite the lethality had decreased.
The fourth wave
Most Western cities also imposed restrictions during the Spanish flu pandemic, which peaked in the fall of 1918, and many controls were also introduced the following year. In 1920, however, no city answered the call. Governments and ordinary people were tired of the flu. The newspapers were full of scary news, but nobody cared anymore.
The people of the time ignored the fourth wave, and so did most historians. Deaths did not return to pre-pandemic levels until 1921 and the Spanish flu virus turned into the normal seasonal flu, but the world had moved on months ago. We shouldn't repeat that mistake.
Let's not ignore the lesson of the Spanish flu
It's true, never before do we have every reason to be optimistic. First, why Omicron cases are decreasing in much of the world. Second, in the most affected countries (including mine, Italy) almost the entire population is now cured or vaccinated, and has a stronger "immune baggage" than in 2019. Third, although Omicron is extraordinarily adept at infecting the upper respiratory tract (which makes it more transmissible) seems less good at infecting the lungs than previous variants.
It is entirely possible and perhaps even likely that due to improved immune responses, the virus will continue to decline in lethality and, like the Spanish flu of 1918, may lose its ability to bind to lung cells altogether.
Yet, after two years of struggle, the dangers that come with it Omicron today they are overconfidence, indifference and tiredness.
It's time to hold on
Signs of fatigue (or excessive optimism) are practically everywhere. I will stay on the Italian case, but the example could easily be taken to all of Europe, or to the United States, or to the UK.
Although in Italy over 90% of the over 12 population is fully vaccinated, progress on the third dose is practically stagnant: to date a lower percentage, about 83%, has received the "booster" which helps protect against the more serious consequences of virus. Although the government has practically imposed the opening of all schools, only 20% of children between the ages of 5 and 11 have received a full cycle. (source updated on 8/2/2021 - https://www.governo.it/it/cscovid19/report-vaccini/)
And above all, people (understandably tired) are loosening their grip on precautions, encouraged by the media and measures that are perhaps slightly premature in the current situation.
This is handing over control to the virus
The result could lead to still high average deaths, and still too long. People, for the most part fragile, not numbers to be taken into account as inevitable "side effects".
The virus may not be over. While there is a good chance that future variants will be less dangerous, the only thing we can say with certainty is that if new variants emerge, it will be because they will develop the ability to evade our defenses. And this, regardless of lethality, could still make them very harmful.
This was the case with the fourth wave of Spanish flu, in 1920. But there is no need to dwell only on the Spanish flu, and on the mistake of underestimating its “tails”. This was a mistake repeated over and over again with the flu pandemics 1957, the 1968 and 2009. In the USA, 1960, a variant, which had yet to be completely eradicated, caused epidemic mortality that exceeded pandemic levels in 1957 and 1958. In 1968, a variant in Europe caused more deaths in the second year, although, again, it was a vaccination was available and many people had already been affected the previous year.
Spanish influence and subsequent years, always the same "Lassez-faire" mistake of politics and media
Also in 2009, variants emerged that caused serious diseases: a UK search revealed "a greater burden of serious illness among individuals over the age of 65" in the year following the outbreak, but "much less media awareness of the flu". According to the study, the government's attitude was to blame. The public health response had been "very active" in providing information in the first year. In the second year, however, the strategy was “laissez-faire”. As a result, the study concludes, “there were a large number of deaths and ICU admissions even of people without other diseases, and of working age”.
These precedents should make us more cautious, and remain cautious even in the face of the "sirens" that promise us an unconditional surrender of the virus. We still need some time.
The Spanish flu teaches us that the war will only end on two conditions, and not immediately
Vaccines, the new antiviral drug paxlovid and other remedies will almost certainly end the pandemic, but only on two conditions: first, that billions of doses are widely available globally and that treatment with antivirals is possible even at home. Second and obvious, the virus does not develop resistance.
The end will not come tomorrow.
The immediate future is still in the hands of the virus, as we continue to fight with a better arsenal (vaccines, masks, room ventilation, antivirals andunique monoclonal therapy which works against Omicron).
Media and politics may also (legitimately) have an interest in making us abandon the most stringent measures for the (also legitimate) needs of economic recovery and social balance as a whole, without considering thousands more deaths as a simple statistical consequence.
