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Looking back a century ago for clues about the future of COVID

Two Maine medical experts say the 1918 Spanish flu pandemic offers hints at the possible course of COVID-19.

PORTLAND, Maine — Looking to his desk, crowded with medical articles and implements from earlier times, Dr. Richard Kahn thought about COVID 19 and about the Spanish Flu.

“Epidemics have always been with us, and I think we will still have epidemics," he said. 

Kahn is a retired physician, a medical historian, and he has written several books and dozens of articles for medical journals.

He said there are a lot of parallels between COVID-19 and the 1918 Spanish flu, a disease that caused tens of millions of deaths worldwide, and 5,000 in Maine, according to an article from Mercy Hospital in Portland.

Kahn said local and state leaders at the time took steps similar to those used to try to control COVID, especially social distancing.

Businesses closed or cut back the number of workers. Churches, which typically drew large congregations then, canceled services to prevent the spread of the deadly virus.

Like COVID, he said, the Spanish flu had several peaks or surges, and the worst of it lasted for about two years.

How and why did that pandemic end?

“It just petered out. I think that’s what happened,” Kahn said, adding that there were no official declarations it was over. “I think the number of cases decreased, and at some point they said, ‘We will open the theaters.’ And the churches opened.”

At the University of New England, Dr. Meghan May agreed.

“And it just drifted into a form we could live with,” she said.

May is a microbiologist who teaches about infectious diseases at the UNE medical school. She said there was never a moment when people said the Spanish flu was actually gone.

“The H1N1 [virus] continued to circulate for years after, but it didn’t cause the same level of infection because there was some level of population immunity to it,” she said.

May said people were able to develop some degree of natural immunity to the Spanish flu, which helped to slow the spread.

 The same, she said, does not happen with the virus that causes COVID-19.

“Your natural immunity, not just with COVID but most coronavirus diseases, is very poor,” she said.

The big question for both: Is COVID fading away, as Spanish flu did?

Neither thinks that is happening yet.

“I don’t think we have a basis for predicting whether it will be more or less virulent at this point,” May said. “And if people are saying that, I respectfully disagree. We don’t have enough information to say that confidently. “

Kahn wasn’t ready to make a bold prediction, either.

“I think we’re heading there, but I’ll hedge my bets,” he said.

He said the virus itself and the attitude of people are hard to predict.

“Because whether Omicron will become another Greek letter that jumps out is possible. The science, medical on one hand and then social-political. … It may be people say, ‘I’ve had it. I’m not going to wear a mask, not have my kids wear a mask. Whatever happens, happens.’”

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