HJBR May/Jun 2020

38 MAY / JUN 2020 I  HEALTHCARE JOURNAL OF BATON ROUGE COLUMN INSURANCE CORONAVIRUS REMINDS US TO LEARN AND IMPROVE— AND WE HAVE. The 1918 flu pandemic ended the lives of approximately 50million people globally – half amillion in the U.S. alone. As of March 31, 2020, more than 39,000 lives around the world have been claimed by COVID-19. Though these pandemics are a century apart, the parallels between the two are clear – and so are the lessons learned. The 1918 Flu Pandemic The 1918 flu pandemic was caused by an influenza A (H1N1) virus, which was first detected among U.S. military members serving in World War I. As the men re- turned home, they brought the virus with them – and it spread quickly. The flu came in three waves beginning in the spring of 1918, and ending a year later. Over this 12 months, the death toll exceed- ed the total number deaths during World War I, and the average life expectancy in the U.S. dropped by 12 years. The pandemic was propelled by the lack of preventive treatments at the time. Though doctors knew viruses existed, the flu virus itself had not yet been discovered. No flu vaccine existed, no laboratory tests were available to characterize the virus, and there were no antibiotics to treat sec- ondary bacterial infections associated with influenza infections. The tools that were available consisted primarily of Non-Pharmaceutical Inter- ventions (NPIs), such as basic hygiene and crowd avoidance, and these interventions were inconsistently applied. In Philadelphia, for example, even as ci- vilian infection rates rose, the city moved forward with a planned parade that at- tracted several hundred thousand resi- dents. Within three days, all 31 of Phila- delphia’s hospitals were full. Over 2,500 residents were dead by the end of the week. In contrast, in St. Louis, even before the first case of the virus was reported, local physicians were already advising patients against attending public gatherings. When the virus did arrive, the city immediately closed schools, theaters, and pool halls, and banned public gatherings. Because of these early interventions, St. Louis suc- cessfully “flattened the curve” and pre- vented the flu from reaching the explosive levels it attained in Philadelphia. The COVID-19 Pandemic The coronavirus emerged in China late in 2019, and by the end of January, the U.S. announced its first case in Washington state. By mid-February, the World Health Organization (WHO) was reporting mul- tiple deaths due to COVID-19 around the globe. Infections with SARS-CoV-2 are now widespread, and as of mid-March, 121,564 cases had been confirmed in over 110 countries, with 4,373 deaths. SARS- CoV-2 is the seventh coronavirus known to infect humans; SARS-CoV, MERS-CoV, and SARS-CoV-2 can cause severe disease, whereas HKU1, NL63, OC43, and 229E are associated with mild symptoms. Individual states began promoting NPIs, including increased handwashing and so-

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