Vicziany, M.; Piterman, L.; Wattanapenpaiboon, N. Is COVID-19 as Lethal as the Spanish Flu? The Australian Experience in 1919 and 2020 and the Role of Nonpharmaceutical Interventions (NPIs). Int. J. Environ. Res. Public Health2024, 21, 261.
Vicziany, M.; Piterman, L.; Wattanapenpaiboon, N. Is COVID-19 as Lethal as the Spanish Flu? The Australian Experience in 1919 and 2020 and the Role of Nonpharmaceutical Interventions (NPIs). Int. J. Environ. Res. Public Health 2024, 21, 261.
Vicziany, M.; Piterman, L.; Wattanapenpaiboon, N. Is COVID-19 as Lethal as the Spanish Flu? The Australian Experience in 1919 and 2020 and the Role of Nonpharmaceutical Interventions (NPIs). Int. J. Environ. Res. Public Health2024, 21, 261.
Vicziany, M.; Piterman, L.; Wattanapenpaiboon, N. Is COVID-19 as Lethal as the Spanish Flu? The Australian Experience in 1919 and 2020 and the Role of Nonpharmaceutical Interventions (NPIs). Int. J. Environ. Res. Public Health 2024, 21, 261.
Abstract
PURPOSE: Our research interrogates Professor Peter Doherty’s warning to Australians in April 2020 that ‘COVID-19 is just as lethal as the Spanish flu’.
METHODS: We identified the epicentres of both pandemics, namely metropolitan Sydney in 1919 and metropolitan Melbourne in 2020. Using original sources, we compared the lethality of COVID-19 in these two cities. Lethality was measured by the number and rate of hospitalisations and deaths per 100,000 of population. Using these two measures, we diagnosed the waves of infection, their severity at various points in time and the cumulative impact of the viruses by the end of our in-depth study period, i.e. 30 September in 1919 and 2020.
RESULTS: Spanish Flu in 1919 was more than 30 times more lethal than COVID-19 in 2020. The hospital admission and death rates of COVID-19 in Melbourne in 2020 constituted a small fraction of the devastation wrought by the Spanish Flu in Sydney in 1919. The patterns and lethality of the pandemic waves were also strikingly different.
DISCUSSION AND CONCLUSION: Both pandemics broke out with the arrival of unknown pathogens against which vaccines and antivirals did not exist. Professor Doherty’s warning was perhaps taken seriously and that partly explains the findings of this study. Containing infection in 1919 and 2020 threw the burden on nonpharmaceutical interventions (NPIs) such as ‘protective sequestration’ (quarantine), contact tracing, lockdowns and masks. We discuss the effectiveness of these. Despite the failures of genomic analysis and the weaknesses of the contact tracing system due to mismanagement, it was persistent and detailed contact tracing that provided the best explanation for why NPIs in 2020 were more effective than in 1919 and therefore contributed to the lower lethality of the COVID-19 pandemic in its first year.
Public Health and Healthcare, Health Policy and Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
