How might COVID’s ‘second wave’ play out? 1918-19 Spanish flu pandemic offers bracing precedent

Members of the Swedish Army in the Olten Hospital. Credit: RDB/Ullstein Bild/Getty Images
Members of the Swedish Army in the Olten Hospital. Credit: RDB/Ullstein Bild/Getty Images

[An] interdisciplinary team [from the University of Zurich and the University of Toronto] compared the Spanish flu of 1918 and 1919 in the Canton of Bern with the coronavirus pandemic of 2020.

In the first wave in July and August 1918, the Canton of Bern intervened relatively quickly, strongly and centrally, including by restricting gatherings and closing schools. “We see from the numbers that these measures – similar to today – were associated with a decrease in infection numbers,” says co-first author Kaspar Staub of the Institute of Evolutionary Medicine at the University of Zurich. After the first wave had subsided, the canton lifted all measures entirely in September 1918, which led to a rapid resurgence of cases and the onset of a second wave after only a short time.

At the beginning of the second wave in October 1918, the Canton of Bern reacted hesitantly, unlike in the first wave. Fearing renewed economic consequences, the cantonal authorities left responsibility for new measures up to the individual municipalities for several weeks. “This hesitant and decentralized approach was fatal and contributed to the fact that the second wave became all the stronger and lasted longer,” says co-first author Peter Jueni of the University of Toronto.

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“While there are still considerable differences between the two pandemics, the steadily increasing parallels between 1918 and 2020 are remarkable,” Staub says. 

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