Friday 25 September 2020

The 1968 Global Flu Pandemic v COVID19

The word “unprecedented” is much overused, said Nadia Whittome last week on Peston, but, she went on to say, the current COVID19 pandemic is actually unprecedented. But, of course, it isn't. So, far, COVID19 has killed 982,000 people, globally. The 1918 Spanish Flu killed around 50 million people, the equivalent of more than 150 million in today's terms. The 1957 Asian Flu killed 1 million people, the equivalent of around 3 million in today's terms, whilst the 1968 Hong Kong Flu, which, long before Trump, was dubbed by the racist tabloids “Mao Flu”, killed 4 million people, the equivalent of around 10-12 million people in today's terms.

Of course, despite the fact that, during these previous pandemics, society did not have the benefit of modern medicine there was no moral panic created by these events, no calls for society to be locked down, and global economic chaos to be created by such action. Indeed, the fact that few people, today, have heard of these previous much bigger pandemics – perhaps with the exception of the Spanish Flu – even those that lived through them, and so believe that there is something unprecedented about the relatively few deaths that have resulted from COVID19, illustrates precisely that point, that no one made much of them, compared to the hype and moral panic that has arisen in relation to COVID19. So, why is that? Is it just that the current generation are a bunch of snowflakes that have been spoiled and molly-coddled, and who need to grow a pair compared to the baby-boomer generation that coped with the aftermath of World War, and the remnants of rationing, as well as the continued ability of lethal diseases, like polio and diphtheria to lay waste to populations? No, of course there is more to it than that.

The 1957, Asian Flu had started in China in the Winter. By the following April, there were 250,000 cases in Hong Kong, and soon after 1 million cases in India. It wasn't long before it hit Britain with cases being reported in all four countries. Unlike COVID19, which does not seriously affect young people, and almost exclusively targets the elderly, the Asian Flu, like all Flu viruses was indiscriminate in its targets, but was particularly more lethal for the young.


“General practitioners were “amazed at the extraordinary infectivity of the disease” and the suddenness with which it attacked younger age groups. Yet, while some members of the College of General Practitioners called for the UK Government to issue a warning about the dangers presented by the virus and coordinate a national response, the ministry of health demurred. Instead, the virus was permitted to run its course.”

In fact, there was no mass panic over this “Asian Flu”, and although it was covered in the media of the time, the main news stories were about the success of the USSR in putting Sputnik, the first artificial satellite, into orbit. But, in Britain, the Asian Flu killed 20,000 people, the equivalent of around 26,000 in today's terms.  In the US, 80,000 died, or the equivalent of around 150,000 in today's terms, compared to the 200,000 that have died from COVID19.

But, the 1968 Hong Kong Flu pandemic killed even more than the 1957 pandemic. It killed 30,000 people in the UK, equivalent to around 40,000 today, and, in the US, killed 100,000 equivalent to around 182,000 in today's terms. Yet, ask most people, today, about the 1968 pandemic and most will never have heard of it, including those that lived through it. Ask people what they associate with 1968, and they will say variously, the May '68 events in France, the Prague Spring, the anti-Vietnam mass demonstrations in Grosvenor Square, Red Lion Square and so on in London, the anti-Vietnam and civil rights protests in the US, or else the Summer of Love (1967), and Woodstock (1969), or else Manchester United becoming the first English club to win the European Cup.

So, its no wonder that, just as in 1957, and in 1918, there was no clamour for kids to be kept away from school, or for pubs and other places of entertainment to be closed down, let alone that workers should be told not to go to work. And, that is despite the fact that these flu viruses did actually mostly affect the young, and those that would be engaged in such activity, as against COVID19, which does not.

As The Lancet points out, the term pandemic only arose in the mid 19th century, as a result of the use of statistics to calculate excess deaths that arose as a result of flu epidemics compared to the normal rate of deaths. It also meant that physicians, at that time, identified influenza as a different type of disease, whereas, until then, many thought that it was just a suspect Italian term for what was just the common cold. In fact, we see the same thing with COVID19. The coronavirus – which is actually one of the viruses responsible for the common cold – has undoubtedly been around for a very long time, but was only identified as a virus in 1965. COVID19 is a form of coronavirus, and studies in Glasgow have shown that, in any year, around 14% of cases of what are described as “flu-like symptoms” are, in fact, people suffering from coronaviruses. Yet, in previous years, no one has tested any of these people so as to be able to identify the number of deaths or serious illness that was actually down to coronavirus rather than flu. It is only the panic that has arisen over COVID19 that has led to a focus in identifying its victims separately, and which has, in turn, fuelled a moral panic around it.

Other than for the specific conditions that arose in relation to COVID19, the current pandemic would probably have been simply put down to being just the flu pandemic that has been anticipated for some years, and would have been treated accordingly, as with the flu pandemics of 1957 and 1968. In fact, given that the 1968 Hong Kong Flu killed the equivalent of around 12 million globally, and 40,000 in Britain, the 1 million deaths globally, and 40,000 UK deaths would have meant that people would have thought that the anticipated flu pandemic had not been as bad as might have been feared. In fact, given that half a million people die from flu globally, on average, each year, and given that in 2018, 17,000 people died from flu in Britain, the number of deaths from COVID19 would appear as nothing more than a bad flu season even in recent or average terms.  Certainly, compared to the 80,000 people who die every year in Britain from smoking related diseases, COVID19 is nothing exceptional, and certainly not the existential threat is has been made out to be by sensationalist headline writers.

There was another factor, and that was the development of communications. The end of the 19th century saw the development of the telegraph, and then the telephone. It had been thought that, as statistics had been able to forecast waves of influenza, so as to warn populations, and as these improved communications meant that such warnings could be delivered to populations more quickly and effectively, this would prevent the development of panic such as those that had arisen over other epidemics such as with cholera, typhoid and so on. In fact, it had the opposite effect. It led people to panic just at the thought that such a new “plague” was descending upon them. 

Of course, the difference then with flu, compared to cholera or typhoid, as today with COVID19 compared to say Ebola, is that the mortality rate from cholera, typhoid, or Ebola is enormous. For Ebola it is around 90%. For Flu it is only around 0.1%, and for COVD19, the latest data suggests it is much lower. If we look at the latest data for the UK, for example. We see reported cases from laboratory tests being around 6,000. Yet, we know that this represents only a small percentage of the actual new cases. It is only those that have been tested. The testing regime is close to collapse and deeply flawed. It misses around 30% of positive cases, even amongst those tested. But, its only those with notable symptoms who get tested, whilst more than 80% of the population who are infected are either asymptomatic, have only mild cold like symptoms or, even if they have worse symptoms, are not ill enough to seek attention. The number of actual infections is likely to be at least 5 times the number of reported infections, and perhaps as much as ten times the number. If the actual number of new infections is just 30,000 per day, then the current number of additional deaths at around 40, represents a mortality rate of just 0.07%, or just two-thirds the mortality rate for flu.

In fact, the rate is likely to end up lower than that, because the higher number of deaths in the first few months has everywhere been explained by the high number of deaths of elderly people in care homes and hospitals who were not adequately shielded from infection, many of whom, indeed, as with MRSA, in previous years, died as a result of being infected with COVID19 after having gone into hospital for treatment for other illnesses, and who were then sent back to care homes, carrying the virus with them.

But, today, compared to 1918, or even 1957 and 1968, the technological developments in communications have been qualitatively different. In 1918, communications networks transmitted news in a fairly bland and normative fashion, even though, obviously, when it came to reporting certain events they did so with the expected class bias. In 1957, most people still obtained news from newspapers, and from radio, with TV only just beginning to become widespread in households. It was 1958, before my parents obtained their first tiny black and white TV, rented from Rediffusion.

What of course, did not exist was the Internet, and so social media. Now, the optimistic might see this profusion of social media and instant communications as heralding a new age of empowerment, and egalitarianism, as everyone has access to vast libraries of information, now at their fingertips, but my experience, looking over people's shoulders at what they are actually doing on their smart phones, is looking at porn, endless cat videos or whatever the latest meme might be, swiping left or right, or exchanging endless trivia about what they have just eaten.

If it can't be encapsulated in 140 characters, its too heavy to be read, and too long to digest, encouraging already short attention spans to get shorter still, and meaning that anything that does not immediately grab the attention is ignored. But, what is also different compared to 1968, is that then, newspapers had mass circulations, and established readerships. At the same time, BBC had a monopoly over radio, and a near monopoly over TV, with just one commercial rival – ITV. In 1968, BBC had only just begun BBC2, and it was no longer the case that TV viewing stopped at just after ten o' clock, with the introduction of the Midnight Movie, though it was still the case that, other than at weekends, there was no day time TV, other than for Schools Programmes.

It was only in the late 1970's that day time TV began. So, there was no pressure on the media to engage in sensationalism in the way there is today, in order to garner audiences required for commercial survival. Certainly, there was no requirement to compete with the Internet and social media that was still more than thirty years into the future. In the 1960's, and 1970's, the news was still just the news and not entertainment. Newsreaders were still rather sombre characters. On April 18th 1930, a BBC radio news reader had reported, “There is no news”, before the rest of the 15 minute segment was filled with piano music (There is no news).

Into the 1960's, the only day time TV news programme was a lunch time news broadcast, with news broadcasts at 6.00 p.m., and a final one at 9.00 p.m., on BBC, or 10.00 p.m., on ITV. Newsreaders were just newsreaders, and that was that. At best they also wrote newspaper columns. Compare that to today. We have 24 hour news channels that repeat the same stories ad nauseam every 15 minutes, all day long. Even so, it frequently requires two very highly paid newsreaders to perform this function. To keep the audience figures up, the newsreaders themselves must be celebrities in their own right, and the news can no longer be just the news, but must itself be entertainment, not just in the fact that a large part of it comprises trailers for, or reporting on, actual entertainment, but that the distinction between the newsreader and the entertainer is itself hard to distinguish. What began with Angela Rippon dancing in a Tiller Girl's costume on a Morecambe and Wise Christmas Special, has today become every other newsreader appearing on some dancing or celebrity reality TV show.

So, its no wonder that, in order to win audiences, to cater for attention spans shorter than that of gnat, and the need to attract attention via sensationalism, the news, today, tells us that every event is “unprecedented”, meaning only that it hasn't happened in the last five years or so; everything has to be described in superlative terms of being the best, the worst, the biggest, the smallest and so on, even though it is usually nothing of the kind, but simply has to be described like that or no one would bother tuning in.

Its no wonder that COVID19 has to be described in apocalyptic terms that make it appear as though it is some existential threat to mankind like the Bubonic Plague or Ebola, when it is nothing of the kind, is, if anything, less deadly than a bad flu season, because all of the news media are now in a war with each other to win ratings, and that can only be done by being the most sensationalist purveyor of doom.

And, given the power and pervasiveness of that media to spread such sensationalism amongst a population that has lost the ability to read more than 140 characters without falling sleep, and has lost the ability to think critically in relation to facts that are often hidden below a mountain of trivia, and superficiality, and which now lives in a world of instant gratification, the immediate transference of information, right or wrong, by retweet, in a world governed by memes, its no wonder that people got whipped into a moral panic over COVID19, that they created a climate in which everyone was scared shitless, and where politicians felt the need of this pressure from the mass to act, in no matter how idiotic a manner, by introducing lockdowns that are both ineffective, and which have created far more harm than has the virus itself.

Its no wonder that the scientists advising those politicians, and themselves put up in the public square have been led to bend to that same public pressure that “something must be done”, and to demonstrate their admiration of the Emperor's New Clothes, all of which, of course, acts to instil even more fear amongst the mass, to provoke an even greater level of moral panic, and in which anyone who dares to simply point to the facts must be outcast and vilified, as has happened to various epidemiologists who have dared to point to the realities, and to declare that the Emperor is in the altogether.

But, that is not all. In 1918, welfare states were only just beginning to be created, with the first National Insurance Schemes, State Old Age Pensions, Unemployment Benefits and so on. In 1957, when the Asian Flu struck, welfare states were still relatively limited, providing a safety net for those who found themselves in need of them out of pure force of circumstance. And, in the 1950's and 60's, as employment increased markedly as a consequence of the fourth long wave upswing, and wages and living standards rose, most people continued to see things in terms of having to exercise some measure of personal responsibility for their actions, rather than believing that they could make choices without much consideration for the consequence, because the state would bail them out, if they made the wrong choice.

Instead, the state acted, in many cases, to limit the extent to which bad choices could be made. It imposed limits on pub opening hours; it put limits on the amount of consumer credit that could be issued, and who could issue it; it limited the amount that could be borrowed on mortgages to buy houses, and so on. It also put minimum standards on the size of houses that could be built, and ,via the planning laws, prevented the building of housing estates on flood plains, or otherwise unsuitable land. Of course, all of the limitations on personal freedom by the state were a bad thing, and as, particularly younger, people, in the 1960's, grew in economic and social power and status, they were right to demand that they be removed, such as the opposition to the blasphemy laws, and censorship laws.

The limitation on borrowing and credit prevented people making bad mistakes in that regard that would lead them into unsustainable debt, and which in the 1980's and after would lead to the creation of asset price bubbles, but they were again, not the right solutions to those problems, which requires a fundamental change in the economic system to resolve. So, when, in the 1980's, Thatcher removed all of these regulations, the result was not that people exercised individual responsibility, in their choices, but that they proceeded blindly. When the consequences of that manifested itself, the state intervened to bail people out, most notably with the bail-out of financial institutions, as asset bubbles that had been inflated, burst, but the same kinds of action was seen when the removal of the planning restrictions meant that builders built estates on flood plains, which then inevitably resulted in thousands of homes being flooded.

A culture has been created in which no one needs think for themselves, because someone, i.e. the paternalistic state will come along to put things right. In many ways this is a return to the kinds of paternalism that existed under feudalism. It breeds the idea that no one can suffer as a result of any action they take, no matter how reckless. It will always be someone else's fault, if only for not preventing them taking that action. Indeed, many see obtaining a big compensation claim against a third party, on such a basis, as one route to their fortunes, as a number of surveys have indicated. Its one reason that Councils had to close many playgrounds, cemeteries and so on, to avoid multi-million pound law suits from people being injured using, or misusing those facilities. So, no, the fact that millions have responded to COVID19 in a totally irrational manner that has no foundations in the facts, is not simply a matter of the present generation being a bunch of snowflakes compared to a much hardier baby boom generation built of better stuff. It is a consequence of a series of changes in material conditions, in the intervening period, and the social relations those changes have wrought, and the ideas they have promoted along with them.

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