Explore the vast range of titles available.

The architectural history of healthcare in South Africa remains greatly understudied, as do the consequences of the 1918–19 Spanish Flu, which ravaged its population. Yet that pandemic had great consequences for South African society, spatial planning and the development of healthcare, of which the latter two were still in their infancy at the time. This article explores the link between disease and design in South Africa through the presentation of the histories of selected hospitals, maternity homes, orphanages and a special care school designed by émigré Dutch architects from the 1920s to the 1970s. It is the product of desktop and archival research, site visits and interviews undertaken in both South Africa and the Netherlands. It outlines the disparity of care that was provided for different groups and is a first attempt to identify healthcare ideas transposed into the subcontinent fuelled by the tragic experiences of the Spanish Flu pandemic. Due to this health crisis, communities – structured in terms of language, faith and race – attempted to develop their own facilities for the care of their own. Where communities had no means of their own, charitable organisations tried to fill the void. Over the course of the twentieth century, public healthcare was centralised, but many of the community and charitable institutions persist. By chance or choice, émigré Dutch architects made a disproportionately large contribution to the development of healthcare facilities in South Africa, not only in the number and range of facilities they designed, but also by introducing contemporary ideas into South African healthcare design.

The global spread of the coronavirus pandemic has prompted inevitable comparisons with the flu pandemic of 1918–1920. However, in order for such comparisons to be fruitful, it is necessary to acknowledge the similarities between the two outbreaks and their differences. This paper compares different aspects of the “Spanish” flu and coronavirus pandemics in Ireland and the UK during the two periods. The first part of the paper provides a general overview, taking account of the nature of the two diseases and the contexts in which they occurred. The following two sections explore the extent to which both outbreaks exposed underlying social and economic inequalities and the measures taken by central and local government, as well as civil society, to combat the spread of disease. The final section examines the extent to which both pandemics highlighted existing failures and sparked demands to “build back better.”

The Spanish Flu was one of the disasters in the history of Iran, especially Southern Iran, which led to the death of a significant number of people in Iran. It started on October 29, 1917, and lasted till 1920 – a disaster that we can claim changed the history. In one of the First World War battlefields in southern Iran in 1918, there was nothing left until the end of World War I and when the battle between Iranian warriors (especially people of Dashtestan and Tangestan in Bushehr, Arabs, and people of Bakhtiari in Khuzestan and people of Kazerun and Qashqai in Fars) and British forces had reached its peak. As each second encouraged the triumph for the Iranians, a flu outbreak among Iranian warriors led to many deaths and, as a result, military withdrawal. The flu outbreak in Kazerun, Firoozabad, Farshband, Abadeh, and even in Shiraz changed the end of the war. In this article, we attempt to discuss the role of the Spanish flu outbreak at the end of one of the forefronts of World War I.

It is 1918 and the end of WWI. Millions have died, and the world is exhausted by war. But soon a new horror is sweeping the world, a terrifying virus that will kill more than fifty million people - the Spanish flu. Using dramatic reconstruction and eyewitness testimony from doctors, soldiers, civilians and politicians, this one-off special brings to life the onslaught of the disease, the horrors of those who lived through it and the efforts of the pioneering scientists desperately looking for the cure. Narrated by Christopher Eccleston, the film also asks whether, a century later, the lessons learnt in 1918 might help us fight a future global flu pandemic.

Background In the spring of 1918, the “War to End All Wars”, which would ultimately claim more than 37 million lives, had entered into its final year and would change the global political and economic landscape forever. At the same time, a new global threat was emerging and would become one of the most devastating global health crises in recorded history. Main text The 1918 H1N1 pandemic virus spread across Europe, North America, and Asia over a 12-month period resulting in an estimated 500 million infections and 50–100 million deaths worldwide, of which ~ 50% of these occurred within the fall of 1918 (Emerg Infect Dis 12:15-22, 2006, Bull Hist Med 76:105-115, 2002). However, the molecular factors that contributed to the emergence of, and subsequent public health catastrophe associated with, the 1918 pandemic virus remained largely unknown until 2005, when the characterization of the reconstructed pandemic virus was announced heralding a new era of advanced molecular investigations (Science 310:77-80, 2005). In the century following the emergence of the 1918 pandemic virus we have landed on the Moon, developed the electronic computer (and a global internet), and have eradicated smallpox. In contrast, we have a largely remedial knowledge and understanding of one of the greatest scourges in recorded history. Conclusion Here, we reflect on the 1918 influenza pandemic, including its emergence and subsequent rapid global spread. In addition, we discuss the pathophysiology associated with the 1918 virus and its predilection for the young and healthy, the rise of influenza therapeutic research following the pandemic, and, finally, our level of preparedness for future pandemics.

Past influenza pandemics appear to be characterized by multiple waves of incidence, but the mechanisms that account for this phenomenon remain unclear. We propose a simple epidemic model, which incorporates three factors that might contribute to the generation of multiple waves: (i) schools opening and closing, (ii) temperature changes during the outbreak, and (iii) changes in human behaviour in response to the outbreak. We fit this model to the reported influenza mortality during the 1918 pandemic in 334 UK administrative units and estimate the epidemiological parameters. We then use information criteria to evaluate how well these three factors explain the observed patterns of mortality. Our results indicate that all three factors are important but that behavioural responses had the largest effect. The parameter values that produce the best fit are biologically reasonable and yield epidemiological dynamics that match the observed data well.

The present coronavirus crisis caused a major worldwide disruption which has not been experienced for decades. The lockdown-based crisis management was implemented by nearly all the countries, and studies confirming lockdown effectiveness can be found alongside the studies questioning it. In this work, we performed a narrative review of the works studying the above effectiveness, as well as the historic experience of previous pandemics and risk-benefit analysis based on the connection of health and wealth. Our aim was to learn lessons and analyze ways to improve the management of similar events in the future. The comparative analysis of different countries showed that the assumption of lockdowns’ effectiveness cannot be supported by evidence—neither regarding the present COVID-19 pandemic, nor regarding the 1918–1920 Spanish Flu and other less-severe pandemics in the past. The price tag of lockdowns in terms of public health is high: by using the known connection between health and wealth, we estimate that lockdowns may claim 20 times more life years than they save. It is suggested therefore that a thorough cost-benefit analysis should be performed before imposing any lockdown for either COVID-19 or any future pandemic.

In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not “younger centenarians”, have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.

The 1918-19 influenza pandemic disrupted Irish society and politics. Stilling cities and towns as it passed through, it closed schools, courts and libraries, quelled trade, crammed hospitals, and stretched medical doctors to their limit as they treated hundreds of patients each day. It became part of a major row between nationalists and the Government over interned anti-conscription campaigners. When one campaigner died days before the 1918 general election, Sinn Fein swiftly incorporated his death into their campaign. Survivors interviewed by the author tell what it was like to suffer from this influenza; families of the bereaved speak of the change to their lives. Stacking the coffins is the first Irish history of the disease to include statistics to analyse which groups were most affected. It also draws on the memories of child sufferers telling their stories.

The 1918-20 pandemic influenza killed 50-100 million people worldwide, but mortality varied by ethnicity and geography. In Norway, areas dominated by Sámi experienced 3-5 times higher mortality than the country's average. We here use data from burial registers and censuses to calculate all-cause excess mortality by age and wave in two remote Sámi areas of Norway 1918-20. We hypothesise that geographic isolation, less prior exposure to seasonal influenza, and thus less immunity led to higher Indigenous mortality and a different age distribution of mortality (higher mortality for all) than was typical for this pandemic in non-isolated majority populations (higher young adult mortality & sparing of the elderly). Our results show that in the fall of 1918 (Karasjok), winter of 1919 (Kautokeino), and winter of 1920 (Karasjok), young adults had the highest excess mortality, followed by also high excess mortality among the elderly and children. Children did not exhibit excess mortality in the second wave in Karasjok in 1920. It was not the young adults alone who produced the excess mortality in Kautokeino and Karasjok. We conclude that geographic isolation caused higher mortality among the elderly in the first and second waves, and among children in the first wave.