Abstract
In commemoration of the centennial of the 1918 influenza pandemic, the American Journal of Epidemiology has convened a collection of 12 articles that further illuminate the epidemiology of ...that pandemic and consider whether we would be more prepared if an equally deadly influenza virus were to emerge again. In the present commentary, we place these 12 articles in the context of a growing body of work on the archeo-epidemiology of past pandemics, the socioeconomic and geographic drivers of influenza mortality and natality impact, and renewed interest in immune imprinting mechanisms and the development of novel influenza vaccines. We also highlight persisting mysteries in the origins and severity of the 1918 pandemic and the need to preserve rapidly decaying information that may provide treasure troves for future generations.
Abstract
Although much progress has been made to uncover age-specific mortality patterns of the 1918 influenza pandemic in populations around the world, more studies in different populations are ...needed to make sense of the heterogeneous death impact of this pandemic. We assessed the absolute and relative magnitudes of 3 pandemic waves in the city of Madrid, Spain, between 1918 and 1920, on the basis of age-specific all-cause and respiratory excess death rates. Excess death rates were estimated using a Serfling model with a parametric bootstrapping approach to calibrate baseline death levels with quantified uncertainty. Excess all-cause and pneumonia and influenza mortality rates were estimated for different pandemic waves and age groups. The youngest and oldest persons experienced the highest excess mortality rates, and young adults faced the highest standardized mortality risk. Waves differed in strength; the peak standardized mortality risk occurred during the herald wave in spring 1918, but the highest excess rates occurred during the fall and winter of 1918/1919. Little evidence was found to support a “W”-shaped, age-specific excess mortality curve. Acquired immunity may have tempered a protracted fall wave, but recrudescent waves following the initial 2 outbreaks heightened the total pandemic mortality impact.
The intensely political cultural production that erupted during Hungary's short-lived Soviet Republic of 1919 encompassed music, art, literature, film and theatre. Painting the Town Red is the ...little-known history of these developments. The book opens with an overview of the political context in Hungary after the First World War and how the Soviet Republic emerged in the chaotic months which followed the collapse of the Austro-Hungarian Dual Monarchy. It looks at the subsequent roles during the Soviet Republic of artists, film-makers, actors, musicians and writers, and the attitude of the newly established People's Commissariat for Education and Culture, in which the future internationally renowned Marxist Gyorgy Lukacs played a leading role. At its centre are the questions: why did so many prominent people in the arts world participate in the Soviet Republic and why did their initial enthusiasm later subside? Painting the Town Red is an important contribution to the lively debate about the interaction between art and politics.
The 2018-2019 period marks the centennial of the "Spanish" influenza pandemic, which caused at least 50 million deaths worldwide. The unprecedented nature of the pandemic's sudden appearance and high ...fatality rate serve as a stark reminder of the threat influenza poses. Unusual features of the 1918-1919 pandemic, including age-specific mortality and the high frequency of severe pneumonias, are still not fully understood. Sequencing and reconstruction of the 1918 virus has allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. This Review summarizes key findings and still-to-be answered questions about this deadliest of human events.
The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently ...triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic.
Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms.
The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications.
In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management.
El presente artículo tiene como objetivo estudiar la gripe de 1918-1919 en Segovia, explicando su origen, evolución, mortalidad diferencial, profilaxis y las consecuencias más importantes que se ...derivaron de ella. Con este fin, se ha trabajado con la documentación existente en el Archivo Municipal de Segovia, las partidas de defunción del registro civil, estadística municipal, provincial y nacional, el Boletín Oficial de la Provincia y los principales periódicos segovianos. En primer lugar, nos centramos en la aparición de la epidemia, propagación, llegada a España y las víctimas causadas, atendiendo a su sexo, edad, procedencia, localización, estado civil y profesión. Las medidas preventivas y paliativas se analizan desde varios puntos de vista: organizativas, control de población, transportes, higiene, comercio, personal sanitario y dependencias hospitalarias. En cuanto a las secuelas que dejó en la provincia, se abordan desde dos enfoques: por un lado, el económico, aquéllas relacionadas con la escasez y subida de los precios de primera necesidad, y por otro, las que afectaron al normal desarrollo de la actividad en general.
In the context of renewed interest in the 1918-1919 flu pandemic as a result of the development of COVID-19, this paper presents a reflection from the point of view of the social history of medicine ...on the transformation that the erroneously named “Spanish flu” brought to the working environment of health professionals in Spain, combining what happened in Madrid and in the country as a whole. Using as our sources monographs and the principal professional scientific journals of physicians, pharmacists and veterinarians, together with a selection from the general press and documentation from both houses of Parliament, we show how the daily activity of doctors was marked by the escalation of their clinical work as well as a considerable deployment of laboratory research in order to establish the aetiology of the flu and to prepare specific therapeutic and prophylactic measures. We show the difficulties this work encountered, and the interest of pharmacists and veterinarians in reproducing this new aspect of science and competing with doctors to achieve greater involvement in the bacteriological fight against infectious diseases. The paper also points out how, faced by the difficulty of controlling the pandemic, a section of the medical profession turned to the socioeconomic inequalities (poor working and living conditions, overcrowding, shortage and cost of food, medicine and basic necessities) in the working population and shortcomings in health care to explain its extreme seriousness, and proposed scientific medical and general measures to correct the situation in the future.
We study the impact of the 1918 influenza pandemic on short- and medium-term economic performance in Sweden. The pandemic was one of the severest and deadliest pandemics in human history, but it has ...hitherto received only scant attention in the economic literature--despite representing an unparalleled labour supply shock. In this paper, we exploit seemingly exogenous variation in incidence rates between Swedish regions to estimate the impact of the pandemic. The pandemic led to a significant increase in poorhouse rates. There is also evidence that capital returns were negatively affected by the pandemic. However, contrary to predictions, we find no discernible effect on earnings.
The 2019 novel coronavirus disease pandemic poses a serious threat. While its short-term effects are evident, its long-term consequences are a matter of analysis. In this work, the existence of ...long-lasting negative effects derived from exposure in utero to a great pandemic -1918 influenza pandemic- is analysed for the Argentine case.
Outcomes of interest include educational achievement and unemployment status in adulthood -50 years after the pandemic. Based on a regression analysis, temporal differences in the spread of the pandemic and between close birth cohorts are exploited.
The results indicate a significant reduction in educational achievement for people exposed in utero to the pandemic. In the region with the highest incidence of cases (Noroeste), this reduction is 0.5 years of education. There are no significant changes in the chances of being unemployed. In the context of climate change, these results constitute a call of attention for the implementation of child protection policies from gestation.
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