When San Francisco lifted the bans on public gatherings and rolled back its requirement that citizens wear masks in public, the people were overjoyed.
“Take off your flu mask as quick as you can and smile, smile, smile,” Annie Laurie, a reporter for the SF Examiner, wrote to her fellow San Franciscans who quite literally tossed their masks into the streets. “That’s the song for these days.”
Flash forward a century, and the mood is significantly more anxious. Some retailers are moving to curbside pick-up as part of Governor Newsom’s second step for “reopening” California — but small businesses worry about keeping their employees safe and their jobs afloat in a lackluster market.
It’s a stark contrast compared to 1918 when, restless after a month without live entertainment, people flooded theaters and other places of “public amusement.” The Orpheum was sold out, and the Curran and Alcazar theaters were similarly packed by crowds “with a keen appetite whetted by twenty-nine days of total abstinence,” the San Francisco Chronicle reported. (In the present day, theaters have cancelled their programming out of safety concerns.)
San Franciscans were ready to celebrate the end of feeling “smothered and breathless” from their masks (and presumably, the constant looming threat of an epidemic): “S.F. Rapidly Shakes Off ‘Flu’ Grip,” read one headline; “San Francisco Wins Victory in Its Battle With Influenza,” another proclaimed.
In reality, the fight was just starting. Just two weeks after the mask ordinance was lifted, the flu came roaring back, resulting in 5,000 new cases in December. The true end to the pandemic did not come until February 1919. In total, 45,000 were sickened and 3,000 died.
If we don’t learn from our own mistakes, we are doomed to repeat them.
Out of eight major pandemics in the past three centuries, seven of them have experienced a second “substantial” wave after the first, according to a recent report on COVID-19 from the Center for Infectious Disease Research and Policy. This report notes key differences between the flu and coronavirus: the flu’s incubation period ranges from 1 to 4 days, while COVID-19’s ranges from 2 to 14.
COVID-19 also has a higher rate of asymptomatic cases compared to the flu and it is suspected that “presymptomatic viral shedding” may be common. That means that right before someone with the coronavirus shows symptoms, they’re very infectious.
These differences make it challenging to fight this current pandemic, especially because a vaccine isn’t expected until 2021 at the earliest — barring any further complications.
Three scenarios are likely, based on past flu pandemic history, according to CIDRAP:
One: COVID-19 will return in smaller waves through 2021.
Two: We’ll experience an even larger peak of COVID-19 cases in the fall, then a few more smaller peaks in 2021. This is what happened in the 1918 flu epidemic, and it could happen again.
Three: There’ll be a “slow burn” with no clear pattern, and cases and deaths still likely. This hasn’t happened with past flu pandemics, but CIDRAP isn’t ruling it out as a possibility.
CIDRAP wants government officials to protect our healthcare workers, to anticipate any resurgences with action plans, and to be flexible about reinstituting protective measures — like shelter-in-places or masks requirements.
If COVID-19 isn’t going away anytime soon, then we need to envision our next steps for keeping each other safe without a vaccine. History warns us to prepare for the worst.