By JOHN RICHARD SCHROCK
Over a year ago, no would have predicted that the death toll of this coronavirus would approach the influenza pandemic of 1918. That so-called “Spanish flu” was actually first identified in soldiers at Fort Riley in Kansas and spread worldwide by our crowded troop ships during the first world war. The CDC estimated “...about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.”
But we passed 500,000 deaths and added 100,000 deaths last month. The U.S. could surpass the numbers of deaths in 1918. Back then, average lifespan had been 54 for men and 48 for women. The CDC calculated the estimated 675,000 American lives lost lowered average life expectancy by 12 years.
But the U.S. population in 1918 was only 103 million, under one-third our population today. That does not make the pandemic less tragic, especially considering that modern medical care is considerably more advanced than a century ago and we still have this high death rate.
Before this pandemic, the U.S. was the first developed nation to experience a drop in life expectancy of a month—due to drug overdoses. Data now indicate Americans have lost one year of life expectancy. This is far less than the 12 years of life expectancy lost in 1918.
The severe impact of the 1918 influenza virus was the high death rate it caused for healthy adults in the 20–40 year range, along with children under five. In contrast, this coronavirus has a heavier impact on the elderly; many deaths result in fewer years of potential life lost. Nevertheless, there are still many cases of middle-aged healthcare workers and others without any underlying health conditions dying, as well as some young children who suffer from a massive inflammation called MIS-C.
A year ago, many political figures proclaimed this coronavirus was not worse than the common flu. But seasonal influenza that rapidly evolves new strains has a much lower fatality rate. In the last ten years, the total annual deaths from seasonal influenza have varied from 12,000 to 62,000.
Researchers eventually exhumed the 1918 flu virus from frozen graves in Alaska and examined its genetics, a story you can find on the CDC website. The 1918 flu was caused by an AH1N1 virus of avian origin. Now health officials worldwide monitor for various bird-borne influenza viruses, concerned that the 1918 strain could evolve and return to a population lacking immunity from the 1918 pandemic.
Viral diseases vary in the extent they evolve variants as they are replicated in their hosts. Smallpox was relatively stable and we were able to wipe smallpox from the wild by vaccination. Polio has only a few variants and we hope we are near the end of eradicating it as well.
But influenza evolves rapidly. Each year there is an educated guess on which new influenza strains will spread the following year. The CDC explains: “One influenza A(H1N1), one influenza A(H3N2), and one or two influenza B viruses (depending on the vaccine) are included in each season’s influenza vaccines. Getting a flu vaccine can protect against flu viruses that are like the viruses used to make vaccine.” When they predict correctly, the flu vaccine is very effective.
But can one vaccine be produced that triggers immunity against all variations of the influenza virus? Just reported in the March 3 issue of Science Translational Medicine, researchers have developed a potential universal influenza vaccine. When vaccinated nonhuman primates were subjected to a wide range of influenza strains, they appeared to have broad protection, suggesting it may be possible to produce a one-and-done flu vaccination that lasts.
The COVID-19 coronavirus is not fast evolving like the flu, but the variants do suggest that it may be necessary to modify the vaccines to stay within a window where we build effective immunity. This suggests that we may never reach “Covid zero” or eradicate the virus, as we did with smallpox.
However, one major discovery this last winter has been the near elimination of seasonal flu due to most persons wearing masks and keeping social distance. While in 2019, the CDC reported over 65,000 cases (not deaths) of influenza between September 29 to December 28, only 1,016 flu cases occurred in that period in 2020. These viruses are confirmed by a CDC-developed “multiplex test” that checks specimens for both the coronavirus and flu.
Some science illiterates spout that doctors just report flu as COVID-19. Unfortunately we lack a vaccine to cure science stupidity.
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John Richard Schrock has trained biology teachers for more than 30 years in Kansas. He also has lectured at 27 universities in 20 trips to China. He holds the distinction of “Faculty Emeritus” at Emporia State University.