Editorial: Clues about COVID-19’s future can be found in 1918 flu

Published 12:01 am Sunday, January 23, 2022

As the Salisbury-Rowan community, North Carolina and the nation learn to live with a continuing COVID-19 pandemic, it’s worth considering whether the coronavirus could follow the same path as the 1918 Spanish flu.

When COVID-19 came to the Salisbury-Rowan community in March 2020, attitudes varied from terrified to believing it was only as dangerous as the flu. But the community largely responded to stay-at-home orders and school shutdowns, believing they were the best way to mitigate spread. When shutdowns and gubernatorial executive orders dragged on, support waned — particularly because a view persisted the public would be finished with COVID-19 in a few months. It’s far surpassed that now.

Our current position is unlike anything we’ve experienced before — cases are higher than ever, employers across the spectrum are in dire need of employees, many of those still on the payroll are out sick with the coronavirus, everyday items are more expensive or harder to find and rules used in previous pandemic phases are few and far between. The community and country faced multi-faceted problems that all have roots in the pandemic and how people have reacted.

Masks being mandatory in schools could make a return with cases at new peaks. The Rowan-Salisbury Schools Board of Education will receive a recommendation Monday from administrators that masks should be mandatory again. The discussion had been set to occur last week, but winter weather interrupted those plans.

Mandatory masks are still the right call, but it’s important to recognize there’s been a change in guidance since the last time masks were mandatory. While any mask is better than none, the Centers for Disease Control and Prevention says loosely woven cloth masks provide the least protection and recommends wearing the most protective masks. Guidance updated Jan. 14 states it’s most important to wear a well-fitted mask that is comfortable and provides good protection. Translated: that means run-of-the-mill cloth masks are not recommended for protection against COVID-19.

An ideal situation would involve Rowan-Salisbury Schools using some of its federal relief money — of which there’s still plenty to go around — to buy the most effective masks for students, educators and staff if it intends to require them.

The “new normal” is the one we’re living in. The world around us has changed too much and we’ve lost too many of our friends, neighbors and acquaintances to return to early 2020. The world also has far surpassed any possibility that the pandemic might end in just a few months.

A 2009 article in the New England Journal of Medicine may offer clues about the next normal. The article — authored by Dr. David Morens, Jeffrey Taubenberger and the well-known Dr. Anthony Fauci — stated the descendants of the 1918 Spanish flu persisted in humans long after the official pandemic ended. The world is in a pandemic era that began around 1918, with descendants of that virus causing other “pandemic-like events” in 1947, 1951, 1997 and 2003, the article stated.

“The original virus and its progeny have continually donated genes to new viruses to cause new pandemics, epidemics, and epizootics,” the article stated.

The authors continued, “If there is good news, it is that successive pandemics and pandemic-like events generally appear to be decreasing in severity over time. This diminution is surely due in part to advances in medicine and public health, but it may also reflect viral evolutionary ‘choices’ that favor optimal transmissibility with minimal pathogenicity — a virus that kills its hosts or sends them to bed is not optimally transmissible. Although we must be prepared to deal with the possibility of a new and clinically severe influenza pandemic caused by an entirely new virus, we must also understand in greater depth, and continue to explore, the determinants and dynamics of the pandemic era in which we live.”

As health care professionals from Fauci to Rowan County Health Director Alyssa Harris have surmised, it’s likely COVID-19 will become endemic or regularly found in American society just like the flu. Those predictions are not incompatible with the fact that action now can determine what our community looks like in the future. Believe it or not, we’re still in this pandemic together. That means following best practices, including getting vaccinated to guard against severe illness and deaths and wearing high-quality masks to shield against contracting the virus at all.