Persistent Pandemics

Abstract

We ask whether mortality from historical pandemics has any predictive content for mortality in the Covid-19 pandemic. We find strong persistence in public health performance. Places that performed worse in terms of mortality in the 1918 influenza pandemic also have higher Covid-19 mortality today. This is true across countries as well as across a sample of large US cities. Experience with SARS in 2003 is associated with slightly lower mortality today. We discuss some socio-political factors that may account for persistence including distrust of expert advice, lack of cooperation, over-confidence, and health care supply shortages have. Multi-generational effects of past pandemics may also matter.

BCG and SARS-CoV-2—What Have We Learned?

“…Although the outbreak of a pandemic was predicted to be an event that was only a matter of time, the emergence of the SARS-CoV-2 virus in 2019, especially the speed at which it reached the pandemic status, came as a big surprise and laid bare the level of unpreparedness for this type of situation [ 1 , 2 , 3 ]. While the earlier emergence of respiratory viruses—coronavirus causing severe acute respiratory syndrome (SARS-CoV) in 2002 (first reported in the Guangdong province in southern China), which infected 8098 people in nearly 30 countries and killed 774 of them [ 4 , 5 ], and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 (first identified in Saudi Arabia), causing 850 cases in over 20 countries [ 6 ]—can be read as a harbinger of events to come, this does not alter the fact that determining the precise timing and location of the coronavirus outbreak that led to the current pandemic remains a virtually impossible task.…”

The 1968 Influenza Pandemic and COVID-19 Outcomes

“…While many have looked to the 1918 influenza pandemic for insight into the ongoing epidemiological and economic effects of the COVID-19 pandemic (Beach et al 2020; Peter Z Lin and Meissner 2021), fewer have explored a far more recent public health crisis with a similarly global footprint. In September 1968, the US was confronted with a novel H3N2 influenza virus that originated in China and was dubbed the ‘Hong Kong Flu’ or ‘Mao Flu’ 1 .…”