Lessons Learned: COVID-19 vs The 1918 Spanish Flu

April 8, 2020

Team Raskin pushed their analyses in a number of directions this week, but one notable piece involved digging into a couple of reports (JAMA via National Geographic & New York Times) that attempted to use various data from The Spanish Flu epidemic of 1918 to understand our current situation with COVID-19.  In particular, Josh and team liked the framework for understanding the variables that can impact the severity and duration of viral outbreaks such as COVID-19.  Their key takeaways:

• Cities that implemented social restrictions earlier both delayed and lowered their peak mortality. Among the 43 cities analyzed, the JAMA study found a clear inverse relationship between public health response time and the length of time until the first mortality peak (correlation of -0.74). In addition, there was a moderately positive relationship between response time and the magnitude of the first mortality peak (correlation of 0.31).
• Deaths rates were generally lower for cities that implemented preventative measures early on. The JAMA study found a moderately positive relationship between response time and cumulative excess death rates (correlation of 0.37).
• Cities under longer periods of social restrictions had lower mortality AND a stronger economic rebound. According to data compiled by the New York Times, the cumulative mortality rates in Minneapolis, Cleveland, and Los Angeles were all lower than their regional counterparts due to longer periods of social intervention. These cities also saw higher growth in manufacturing employment from 1914-1919.
• Premature relaxation of social restrictions could lead to a relapse in infections. During the Spanish Flu, several cities chose to remove or reduce social restrictions as their death rates began to improve. Many of these cities saw a second wave of high death rates.

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