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Clinical Laboratories and Pathology Groups

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Does the 1918 Influenza Pandemic Teach Us Anything About How and When COVID-19 Will End?

Experts weigh-in on the new Omicron variant, how pandemics conclude, and challenges ahead for clinical laboratories

Could studying how the 1918 influenza pandemic ended teach pathologists and clinical laboratory professionals how and when the current COVID-19 pandemic may end as well? And does the new Omicron variant indicate that the SARS-CoV-2 coronavirus has mutated into an endemic form of the disease?

According to the Centers for Disease Control and Prevention (CDC), the 1918 influenza (aka, the Spanish Flu) pandemic took place worldwide between 1918 and 1919. It was caused by the H1N1 virus (A/H1N1), a subtype of the Influenza A virus, and infected approximately 500 million people worldwide (a third of the human population at the time). Fifty million people died. Many were children or otherwise healthy individuals, but people from all age groups perished.

The CDC calls the Spanish Flu the “deadliest pandemic of the 20th century.” Past pandemics have generally concluded after 2.5 to 3.5 years. That’s how long it takes for new viruses to mutate and become endemic diseases, Healthline reported.

The COVID-19 pandemic has been around for about that long. It stands to reason the natural end of the COVID-19 pandemic may be just around the corner. But is it? And is the Omicron variant an indicator that the COVID-19 pandemic is winding down?

Fighting a New Coronavirus Variant

A recent McKinsey and Company report notes that, compared to the Delta variant, the new Omicron variant is:

  • 25% more infectious,
  • 25% better at evading immunity, and
  • 25% more likely to cause less severe disease.

“Our analysis suggests that in the US, this combination of characteristics would lead to Omicron replacing Delta as the dominant variant in the next few months and to a higher peak burden of disease than the country saw in the second half of 2021 (but likely below the peak reached in the winter of 2020-21),” the report states.

McKinsey analysts also acknowledged the possible impact of new therapeutics, COVID-19 vaccine booster doses, and public health measures on Omicron spread. “In the short term, an accelerated rollout of booster doses of COVID-19 vaccines is likely to be one of the best protections against an Omicron-fueled wave of the disease,” the analysts wrote.

Does How the Spanish Flu Came to an End Mirror the COVID-19 Pandemic?

Virologists and infectious disease experts explained that the Spanish Flu virus did what viruses still do: mutate and become less dangerous. Herd immunity also helped end the 1918 pandemic. 

“The 1918 influenza virus eventually mutated to the point of not having a high number of deaths—eventually over three years or so. We may very well be witnessing this process with ongoing variants of SARS-CoV-2,” virologist Rodney Rohde, PhD, Director of the Clinical Laboratory Science Program at Texas State University, told Healthline.

Todd Ellerin, MD

Today’s flu strains have “ancestral links” to the 1918 flu, and thus, the SARS-CoV-2 coronavirus will most likely also leave its mark, The Boston Herald reported. “The coronavirus will evolve and hopefully morph into a seasonal illness to which we pay little mind, but it’s still too early to tell,” Todd Ellerin, MD (above,) Director of Infectious Diseases, South Shore Health, South Weymouth, Mass., told The Boston Herald. (Photo copyright: Greg Derr/The Patriot Ledger.)

“If you think about the way viruses behave, biologically, their reason for living is to replicate and spread, and there’s really no advantage for the virus to kill the host,” infectious disease specialist Keith Armitage, MD, Professor of Medicine, Division of Infectious Diseases at Case Western Reserve University, told Healthline. “The hope is, that if the pandemic doesn’t go away, we will get new variants that are highly contagious but don’t produce much of a clinical illness,” he added.

In “2021’s Top 10 Lab Stories Confirm Important Trends,” Dark Daily’s sister publication, The Dark Report (TDR), posed a similar question in its number one story of 2021: “COVID-19: Will it Become Endemic and a Respiratory Virus that Shows Up Every Year like Influenza?”

“The question of whether SARS-CoV-2 is a pandemic that fades, as did SARS in 2003, or becomes endemic and a respiratory virus that shows up every season like influenza and the common cold, is of major concern to clinical lab administrators. That’s because clinical labs and pathology groups must continue to serve physicians and patients with the usual menu of routine, reference, and esoteric testing,” TDR noted.

Clinical Laboratories to Continue COVID Testing

It would be most helpful for medical laboratories and pathology groups to have some idea of when the pandemic will end. Unfortunately, such predictions would not be very useful.

“Since COVID-19 infections have a high number of asymptomatic transmitters, we may not fully understand how societal and environmental pressures—masks, distancing, remote working, etc.—on the virus will allow it to evolve,” Rohde told Healthline.

For now, clinical laboratories will need to continue to remain prepared as COVID-19 cases rise and people seek SARS-COV-2 tests, vaccinations, and treatments. COVID-19 testing is likely to be in demand throughout the coming year. The current surge in demand for COVID-19 tests is putting additional stress on the supply chain.

“We know pandemics end; it’s just a matter of time,” Sara Paton, PhD, Associate Professor of Epidemiology, Wright State University, told the Journal-News. “It could be in 2022, maybe later in the year, but I can’t say for sure. It could be 2023.” 

—Donna Marie Pocius

Related Information:

CDC: 1918 Pandemic

What Can We Learn from the 1918 Flu Pandemic as the Omicron Variant Spreads?

The 1918 Pandemic: A Timeline of Events

How Did the 1918 Pandemic End, and Could the Same Thing Happen with Coronavirus?

When Will the COVID-19 Pandemic End?

Will the Pandemic End in 2022?

2021 Top 10 Lab Stores Confirm Important Trends

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