Covid has now killed about as many Americans as the Spanish flu

Covid-19 has now killed about as many Americans as the 1918-19 Spanish flu pandemic – around 675,000.

A century ago, America’s population was only a third of what it is today, which means the flu swept across the country in a much bigger and more deadly way. But the Covid-19 crisis is a colossal tragedy in its own right anyway, especially given the incredible advances in scientific knowledge since then and the inability to make the most of the vaccines available this time around.

“Big pockets of American society – and, worse, their leaders – threw this away,” said medical historian Dr. Howard Markel of the University of Michigan, of the possibility of vaccinating all of them. people eligible to date.

Like the Spanish flu, the coronavirus may never completely disappear from our midst. Instead, scientists hope it becomes a mild seasonal insect as human immunity builds up through vaccination and repeated infections. It might take some time.

“We hope it will be like a cold, but there is no guarantee,” said Emory University biologist Rustom Antia, who suggests an optimistic scenario in which it could happen in a few years.

For now, the pandemic still has the United States and other parts of the world firmly in its jaws.

While the delta-fueled spike in new infections may have peaked, deaths in the United States still stand at over 1,900 per day on average, the highest level since early March, and the The country’s overall toll stood at just over 674,000 as of noon Monday, according to data collected by Johns Hopkins University, although the actual number is believed to be higher.

Winter could bring a new surge, with the influential University of Washington model projecting that about 100,000 more Americans will die from Covid-19 by January 1, bringing the overall U.S. death toll to 776,000.

The 1918-19 influenza pandemic claimed 50 million lives around the world at a time when the world had a quarter of its current population. Deaths from Covid-19 around the world now stand at more than 4.6 million.

The death toll from the Spanish flu in the United States is a rough estimate, given incomplete records at the time and poor scientific understanding of what caused the disease. The figure of 675,000 comes from the United States Centers for Disease Control and Prevention.

Reflux of Covid-19 could occur if the virus gradually weakens as it mutates and more and more human immune systems learn to attack it. Vaccination and survival from infection are the main ways to improve the immune system. Breastfed infants also acquire some immunity from their mothers.

In this optimistic scenario, the school children would contract a mild illness that would train their immune systems. Growing up, children would carry the memory of the immune response, so that when they are old and vulnerable, the coronavirus would not be more dangerous than cold viruses.

The same goes for vaccinated adolescents today: their immune systems would become stronger thanks to injections and mild infections.

“We are all going to be infected,” Antia predicted. “What is important is whether the infections are serious.”

Something similar happened with the H1N1 influenza virus, the culprit behind the 1918-19 pandemic. He encountered too many immune people and also weakened through mutation. H1N1 is still circulating today, but the immunity acquired through infection and vaccination has triumphed.

Getting the flu shot every year now protects against H1N1 and several other strains of flu. Sure, the flu kills between 12,000 and 61,000 Americans each year, but on average, it’s a seasonal and manageable problem.

Before Covid-19, the flu of 1918-19 was universally considered to be the worst pandemic disease in human history. Whether the current scourge ultimately turns out to be more deadly is unclear.

In many ways, the 1918-19 flu – which was mistakenly named the Spanish flu because it first received wide media coverage in Spain – was worse.

Spread by the mobility of World War I, it killed large numbers of healthy young adults. No vaccine existed to slow it down, and there were no antibiotics to treat secondary bacterial infections. And, of course, the world was much smaller.

Yet air travel and massive migration threaten to increase the toll of the current pandemic. Much of the world is not vaccinated. And the coronavirus has been full of surprises.

Markel said he was continually amazed at the extent of the disruption the pandemic has brought to the planet.

“I was stunned by the size of the quarantines” that the Chinese government initially undertook, said Markel, “and I have since been gob-gob-gob-slammed to the nth degree.” The delayed rate of American vaccinations is the latest source of his astonishment.

Just under 64% of the U.S. population has received at least one dose of the vaccine, with state rates ranging from highs of around 77% in Vermont and Massachusetts to lows of around 46% in 49% in Idaho, Wyoming, West Virginia and Mississippi. .

Globally, around 43% of the population has received at least one dose, according to Our World in Data, with some African countries just starting to get their first injections.

“We know that all pandemics end,” said Dr. Jeremy Brown, director of emergency care research at the National Institutes of Health, who has written a book on influenza. “They can do terrible things while they are raging.”

Covid-19 could have been a lot less deadly in the United States if more people had been vaccinated faster, “and we still have the opportunity to turn the tide,” Brown said. “We often lose sight of how lucky we are to take these things. For granted.”

Current vaccines work extremely well in preventing serious illness and death from variants of the virus that have emerged so far.

It will be crucial for scientists to ensure that the constantly changing virus has not changed enough to evade vaccines or cause serious illness in unvaccinated children, Antia said.

If the virus changes significantly, a new vaccine using the technology behind the Pfizer and Moderna injections could be produced in 110 days, a Pfizer executive said on Wednesday. The company is investigating whether annual injections with the current vaccine will be needed to maintain high immunity.

A plus: the coronavirus mutates at a slower rate than influenza viruses, making it a more stable target for vaccination, said Ann Marie Kimball, retired professor of epidemiology at the University of Washington.

So, will the current pandemic overturn the 1918-19 influenza pandemic as the worst in human history?

“You would like to say no. We have a lot more infection control, a lot more ability to support sick people. We have modern medicine, ”Kimball said. “But we have a lot more people and a lot more mobility. … The fear is that a new strain will end up bypassing a particular vaccine target.

To unvaccinated people who rely on infection rather than vaccination for immune protection, Kimball said, “The problem is, you have to survive infection to gain immunity.” It’s easier, she says, to go to the pharmacy and get the shot.

AP Health Writer Tom Murphy in Indianapolis contributed to this report.

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