The Asian Flu of 1957-1958

[inertia]

"Public health experts did in fact consider school closures, business closures, and a ban of public events but the entire ethos of the profession rejected them. There were two grounds for this rejection: lockdowns would be too disruptive, disabling the capacity of medical professionals to deal competently with the crisis, and also because such policies would be futile because the virus was already here and spreading. "

Quote Reference: American Institute for Economic Research

Was history ignored, or do "we" know better now?

 

[The Pixie]

The report says it was all over in about three months, with a rather higher death rate, and infection rates in schools around 50%, so presumably similar thoughtout the popular, and yet:

"reports indicate that hospitals were able to adjust appropriately to cope with the patient loads"​

How is that possible? It just does not add up.

 

[inertia]

The report says it was all over in about three months, with a rather higher death rate, and infection rates in schools around 50%, so presumably similar thoughtout the popular, and yet:

"reports indicate that hospitals were able to adjust appropriately to cope with the patient loads"​

How is that possible? It just does not add up.

Well, according to the article, it was a combination of home care recommendations and instructing people to only go to a hospital -if- their symptoms worsened. That is how hospitals could adjust.

Other than the reported 116,000 deaths, there were issues with absenteeism at schools. The statistics varied from school to school but the highest rate of school absenteeism was in Manhattan showing 43% at one time during the peak of the infection. After a couple of weeks, it dwindled back down to normal levels.

- "The millions of people exposed to the virus developed antibodies and moved on".

A decade later a mutated version propagated throughout our population again and we responded in the same fashion.

Was history ignored when responding to COVID-19, or do we know more now and respond accordingly?

 

[The Pixie]

Well, according to the article, it was a combination of home care recommendations and instructing people to only go to a hospital -if- their symptoms worsened. That is how hospitals could adjust.

That is already the situation in the UK, and has been for nearly a year, and hospitals are at capacity.

If all that happened in 3 months, rather than over a year, there would be four times as many people needing hospitals than the hospitals can take.

Other than the reported 116,000 deaths, there were issues with absenteeism at schools. The statistics varied from school to school but the highest rate of school absenteeism was in Manhattan showing 43% at one time during the peak of the infection. After a couple of weeks, it dwindled back down to normal levels.

- "The millions of people exposed to the virus developed antibodies and moved on".

A decade later a mutated version propagated throughout our population again and we responded in the same fashion.

Was history ignored when responding to COVID-19, or do we know more now and respond accordingly?

I do not see any of that relevant to how hospitals could cope.

Is it possible they just did not worry about people dying so much? We could say that there are broadly two approaches:

1. Try to contain it as far as possible, to drag it out, so the load on hospitals is spread out across several months, and everyone gets proper care, and so has the best chance to survive.

2. Let it run its course, so it burns through the population as fast as possible, having the smallest impact on the economy, but with significantly higher deaths, because hospitals are unable to cope.

Which do you go for? It is not a simple question, because option 1 means a failing economy, which may even lead to more deaths in the long term.

 

[Manfred]

Well, according to the article, it was a combination of home care recommendations and instructing people to only go to a hospital -if- their symptoms worsened. That is how hospitals could adjust.

Other than the reported 116,000 deaths, there were issues with absenteeism at schools. The statistics varied from school to school but the highest rate of school absenteeism was in Manhattan showing 43% at one time during the peak of the infection. After a couple of weeks, it dwindled back down to normal levels.

- "The millions of people exposed to the virus developed antibodies and moved on".

A decade later a mutated version propagated throughout our population again and we responded in the same fashion.

Was history ignored when responding to COVID-19, or do we know more now and respond accordingly?

I would say history ignored, and the Media made king.

 

[inertia]

That is already the situation in the UK, and has been for nearly a year, and hospitals are at capacity.

If all that happened in 3 months, rather than over a year, there would be four times as many people needing hospitals than the hospitals can take.
...

Quick question: How did you calculate a factor of four?

According to the summary section in the author's reference paper:

Emphasis was placed on providing medical care to those who were afflicted and on sustaining the continued functioning of community and health services. The febrile, respiratory illness brought large numbers of patients to clinics, doctors’ offices, and emergency rooms, but a relatively small percentage of those infected required hospitalization.

If my doctor recommended home care and signed a note saying that I should stay home from school for a couple of weeks, I would follow his/her advice. The same would be true for going to work. School absenteeism is evidence of following doctor's orders at that time.

Is it possible they just did not worry about people dying so much? We could say that there are broadly two approaches:

1. Try to contain it as far as possible, to drag it out, so the load on hospitals is spread out across several months, and everyone gets proper care, and so has the best chance to survive.

2. Let it run its course, so it burns through the population as fast as possible, having the smallest impact on the economy, but with significantly higher deaths, because hospitals are unable to cope.

Which do you go for? It is not a simple question, because option 1 means a failing economy, which may even lead to more deaths in the long term.

- Definitely not a simple question

 

[inertia]

I would say history ignored, and the Media made king.

Maybe. It seems improbable though since we have the results of historic records and make updated health decisions based on current research.

 

[Temujin]

That is already the situation in the UK, and has been for nearly a year, and hospitals are at capacity.

If all that happened in 3 months, rather than over a year, there would be four times as many people needing hospitals than the hospitals can take.


I do not see any of that relevant to how hospitals could cope.

Is it possible they just did not worry about people dying so much? We could say that there are broadly two approaches:

1. Try to contain it as far as possible, to drag it out, so the load on hospitals is spread out across several months, and everyone gets proper care, and so has the best chance to survive.

2. Let it run its course, so it burns through the population as fast as possible, having the smallest impact on the economy, but with significantly higher deaths, because hospitals are unable to cope.

Which do you go for? It is not a simple question, because option 1 means a failing economy, which may even lead to more deaths in the long term.

They didn't have the interventions which keep the very ill going. The better treatments get, the longer patients spend in hospital before they recover or eventually succumb. This applies to other conditions as well as Covid. A brutalist, simple regime without the sophisticated ventilator technology available now, would have a faster throughput.

As for your options, any country not taking option 1 would risk a massive backlash from its population. It might not produce the "best" result, (though it may) but is the most defensible.

 

[The Pixie]

Quick question: How did you calculate a factor of four?

Very simplistic, 12 months for COVID, 3 for the flu of 57/58.

According to the summary section in the author's reference paper:

I see Temujin has addressed this.

- Definitely not a simple question

Agree! Option 2 may seem attractive until it is your mother ill with COVID, and there is no room for her in hospital.

 

[inertia]

Very simplistic, 12 months for COVID, 3 for the flu of 57/58.

...and an unreal assessment as recorded in history.

"... relatively small percentage of those infected required hospitalization."

 

[inertia]

They didn't have the interventions which keep the very ill going. The better treatments get, the longer patients spend in hospital before they recover or eventually succumb. This applies to other conditions as well as Covid. A brutalist, simple regime without the sophisticated ventilator technology available now, would have a faster throughput.

As for your options, any country not taking option 1 would risk a massive backlash from its population. It might not produce the "best" result, (though it may) but is the most defensible.

In 1957, the Association of State and Territorial Health Officers (ASTHO) in the United States concluded that simple care at home was the best solution keeping the hospitals from overcrowding and that people should only seek medical attention when symptoms became unbearable.

The United States was not considered a "brutalist" or a "simple" regime by anyone judgement then. Ten years later the United States used the same procedure.

 

[Temujin]

In 1957, the Association of State and Territorial Health Officers (ASTHO) in the United States concluded that simple care at home was the best solution keeping the hospitals from overcrowding and that people should only seek medical attention when symptoms became unbearable.

The United States was not considered a "brutalist" or a "simple" regime by anyone judgement then. Ten years later the United States used the same procedure.

It is not brutal to fail to offer treatments that have yet to be developed. In the current crisis, the same regime is being carried out, yet hospitals are full. In the last week or so, a news team visited a large London hospital. Of the 15 floors, 13 were full of severely ill Covid patients. All other conditions were on the other 2 floors. Intensive care facilities have been expanded 5 fold, yet they are completely full. Medical staff are burning out. The situation is not good. There is already strong evidence that deaths at home from cancer or heart disease are increased, though it is probable that these deaths would otherwise have occurred in hospital.

This pandemic has been with us for a year now. Any possible lessons from other such events are by now fully absorbed where relevant. We have learnt the lessons of this pandemic and just need to apply them.

 

[The Pixie]

...and an unreal assessment as recorded in history.

"... relatively small percentage of those infected required hospitalization."

I was talking about 2020, not 1957-8.

It is a fact the hospitals in the UK are at capacity, despite the pandemic being spread out over about a year. If the same number of cases were compressed into just three months, hospitals would be over capacity approximately four-fold. I do not see how you can say that that is not at least approximately right.

 

[inertia]

It is not brutal to fail to offer treatments that have yet to be developed. In the current crisis, the same regime is being carried out, yet hospitals are full. In the last week or so, a news team visited a large London hospital. Of the 15 floors, 13 were full of severely ill Covid patients. All other conditions were on the other 2 floors. Intensive care facilities have been expanded 5 fold, yet they are completely full. Medical staff are burning out. The situation is not good. There is already strong evidence that deaths at home from cancer or heart disease are increased, though it is probable that these deaths would otherwise have occurred in hospital.

This pandemic has been with us for a year now. Any possible lessons from other such events are by now fully absorbed where relevant. We have learnt the lessons of this pandemic and just need to apply them.

Excellent points all around.