If this pandemic occurred in 1920 instead of this year, how many more deaths would there have been? How much worse would it get? We would have no hope for a vaccine in 1920, what does the final outcome look like 100 years ago?
Do we assume overall population, urban population concentration, regional and international travel, and other such factors to be as they were in 1920? We have a lot of medical technology going for us, but up until now we haven’t had a vaccine (and virtually no one has received it yet). Meanwhile, we have a lot more people, more densely packed in urban pockets, I think, than we had in 1920, and folks travel a whole lot more. Overall, I think COVID killed more folks in 2020 than it hypothetically would have in 1920. The following years 2021 and 1921 might be a different story, with the vaccine perhaps playing a major role. But wait a minute, why would we have had no hope for a vaccine in 1920? It’s not like we didn’t know how to do vaccine yet. Dr. Jenner, effectively the inventor of vaccination, had died 100 years earlier. We knew less than we know now, so presumably it would take longer… but not outside of the realm of possibility?
The direct and obvious analogue is the Spanish Flu [or, if we follow Trump’s lead in laying blame - the Kansas Flu].
It was a lot more fatal across different age groups, but the mechanics of uncontrolled spread, and public health measures generally coming too late to be effective are very reminiscent of what is happening in the US now. It hit in perhaps four waves [and these were proper waves with genetically shifted strains, not just lazy journalism].
For a long time the rule of thumb was that many more people died of the Spanish Flu as in the Great War [i.e. guesses in the order of 20-50ish million people]. However, more detailed research in epidemiological blackspots, which includes large chunks of Africa and Asia, suggests that a figure closer to 100 million is plausible. That represents something in the order of 5% of the globe’s population [from a 1920s estimate closer to 1-2%].
Extrapolate away!
Interestingly, this is the second thread that asks a variation of this question, both seemingly forgetting that IT ACTUALLY DID happen. Just look to history.
And Covid-19 would most likely have been just as deadly as the Spanish Flu since they did not have the treatment options or hospital capacity we have today. For example, while they may have had ventilators they would not have been in widespread use, most likely used by the army that had to deal with gas attack victims not the general population.
They definitely would not have had the Presidential level of cocktail drugs that are just now being used. It would have been just as horrific as the Spanish Flu if not more so.
Supportive care being as relatively primitive as it was then (no antibiotics of note or effective drugs to treat secondary infections, lack of supplemental oxygen or ventilatory care etc.), the mortality rate of a Covid-19-like outbreak in 1920 would have been far greater than what we’ve seen in 2020. Without large numbers of troops returning home (as was the case in 1918), spread likely would have been slower.
Jackmannii, the Psychic Epidemiologist
This would be somewhat offset by the fact the population in 1920 was younger on average than our population now; and had fewer comorbidities (high blood pressure, diabetes, obesity).
Well the life expectancy rate was lower as well due to such illnesses not being diagnosed properly or at all. I’ve seen a lot of photos from back then and there were quite a number of obese people, especially men with big bellies. Being hefty was seen as being healthy, not a major medical issue.
And without modern medical care who is to say that it would not have affected younger people more than it is doing today? It’s safer to assume that their outlook would be worst, not the same or better than it is now.
The vast majority of young(-ish) people have none or very minor symptoms from COVID-19. They require no medical care at all, just a couple of days at home in bed. The same cannot be said for the Spanish Flu, which affected young and healthy people disproportionately. In some areas a third of the population died as a result.
IANAEpidemiologist, but I believe that if COVID-19 were allowed to go around the world unchecked, a LOT of old and vulnerable people would die, but most people would probably survive. Maybe I’m completely talking out of my ass, but IMHO the standards of the times concerning death and illness have changed so much that society is just no longer willing to accept the massive losses that a pandemic of this scope causes, so we take much more extreme measures to stop the spread than people 100 ago would have or could have done.
Moderator Note
Keep political jabs out of GQ (or QZ.)
Colibri
Moved to the Quarantine Zone from GQ.
That’s my impression as well- it would have been horrific among the elderly, but not really anyone else.
I wonder if they’d even manage to distinguish it with the technology of the time from just pneumonia or influenza? Symptoms-wise, it seems like they’re similar enough to be confused by the doctors of the time. They didn’t know it was a virus- just that people got a specific set of symptoms and the disease followed a certain progression. COVID seems similar enough to do the same thing.
Pandemics are nothing new. It’s just that in the last 100 or so years, a lot of them have been avoided and/or mitigated in the western world due to greater understanding of how diseases spread and work.
So you are saying that all those young people now who are going into the hospital and getting treatment would be just as well off with 1920’s level of care? There would have been no increase in younger people dying? I just don’t buy that. I do believe that younger people do respond better to a lower level of treatment than the elderly, but to give them practically no treatment and letting them stay home and tough it out would raise the death rate. Both now and then.
From what I’ve read, not by much. The vast majority of young people are essentially unaffected; even myself, at a relatively ancient 48 and with hypertension and obesity have an almost zero chance of dying from it.
COVID’s lethality starts ramping up noticeably at about 50 years old, and increases dramatically from there. Someone in their 80s is substantially more likely to die than someone in their 70s, and the same is true for people in their 60s relative to 70s.
What I haven’t been able to tease out of the articles I’ve read is whether that’s a consequence of age, or if it’s a consequence of a greater load of at-risk conditions, or both.
I think the city of Wuhan was going through an expansion in the 1920s, but I’m not sure that the Chinese of that time ate as eclectically as they do today, so not sure this virus would have had the same trajectory. My WAG is that the virus would have had much less of an impact in 1920 because of the lack of rapid global travel. I doubt they would have even noticed it, just chalking it up to really bad pneumonia or respiratory disease, or maybe not even noticing it at all. Compared to some of the big killer diseases back then it might have simply been background noise. I don’t recall how hard China got hit with the pandemic flu, but this wouldn’t have been in the same league. The real issues with this disease were the early coverup and the massive and rapid global connectivity of people able to hop on a plane and fly around the world. Wuhan in 2019/2020 was a major hub for trade and travel, and this hit right when the Chinese traditionally travel in huge droves throughout the country. Couple that with the world travel and the fact that the early tracking and data was covered up, tossed out, or suppressed and you have the early part of the cluster fuck this became.
JMHO and all, but I think this one would have mainly flown under the radar of the time, at least in 1920. MAYBE down the road, it would have become widespread in the rest of the world, as it would have been out in the wild, so to speak, and perhaps become ubiquitous like the seasonal flu or cold, and eventually become yet another large killer as many diseases back then became…and eventually fought in similar ways.
True to an extent. Going 100 years further back, in 1820 Sydney finally received the strain of pandemic influenza that had gone through Europe in the mid-1780s, more than 30 years earlier. Steam-shipping would have sped that up, but the time embedded in long distance travel made a real difference. Nonetheless, once it hit, it would hit with full force.
What we think of as pandemics of new viral strains were usually characterised as just bad seasons of the prevalent seasonal influenza or epidemic catarrh. Differing symptoms and vulnerabilities were noted and remarked on but until you have a germ theory they don’t really have coherent explanation as to why.
In terms of percentages, there AREN’T “all those young people” getting hospitalized.
Here’s a chart of hospitalization rates by age. Take note that this is just among people who have tested positive for the disease. And since young people are disproportionately less likely to have reason to get tested, the true percentage is even lower.
• U.S. COVID-19 hospitalization rate by age | Statista
I saw this via a blogger this morning re global spread of pandemics back to 1889. The key chart below tells the tale: the 1918 pandemic spread faster worldwide than Covid even without modern mobility.
Twitter thread from the researchers here.
Sure, but it (the pandemic flue) spread so rapidly because it started in the US (probably) and due to the war. We are talking about a virus (Covid) from central China as a comparison, and one concerning a relatively small city in central China in 1920. Perhaps locally in China, it would have been more devastating…I’m not sure…but worldwide? Eventually, it would have spread out, for sure, but I don’t think you’d have seen as rapid a worldwide outbreak as we saw with the flu simply due to the fact that large numbers of central Chinese weren’t being shipped off to war in Europe. Granted, I don’t know the state of trade with respect to China in 1920, or how many high speed…for the time…steamships were traveling from China at that time, but it would be difficult to really spread as it has in our own time to every corner of the globe.
I agree it would be slow to get established in any given city. And the farther and less connected it was to Wuhan, the more that would be true.
But given the infectious-but-asymptomatic cases and the long duration of pre-symptomatic-but-infectious cases, once it was established in any city, or even well-connected country or region, it’ll spread widely and quickly.