1918 Grip Pandemisi Kıssasından COVID-19 Pandemisine Hisseler

Year 2020, Issue: Special Issue on COVID 19, 63 - 78, 20.03.2020

M. Kemal Temel , Hakan Ertın

https://doi.org/10.21673/anadoluklin.716868

Cited By: 15

Abstract

Yirminci yüzyıl başından bu yana dünyada respiratuvar virüslerden kaynaklanan beş pandemi gerçekleşmiştir. Bunlardan ilk dördü grip (İnfluenza A) virüslerinden kaynaklanmışken halihazırda sürmekte olan COVID-19 pandemisi bir koronavirüs suşundan ileri gelmiştir. 1918 tarihli “İspanyol gribi” pandemisi dünya genelinde yaklaşık 500 milyon kişiyi kapsamış ve 40–100 milyon ölümle sonuçlanmış olup, bugün respiratuvar viral pandemiler için olabilecek “en kötü senaryo” kabul edilmektedir. Halihazırdaki COVID-19 pandemisi de Aralık 2019’dan bugüne (Nisan 2020), >1,2 milyon vaka ve >60 bin ölümle sürmektedir. Bu pandemide, virüsün türü (yeni ve pandemik bir SARSr-CoV suşu) ve konağın yaşı (>50–60 yaş) temelinde daha yüksek mortaliteli, yeni bir “koronavirüs hastalığı” gözlenmekte olup tıp (başta epidemiyoloji ve halk sağlığı) tarihinde yeni bir sayfa açılmıştır. Yanı sıra, 1918’de olduğu gibi yüz yıl sonra bugün de halen efektif bir anti(korona)viral tedavi bulunmamakta ve bu çaresizliğin klinik, sosyolojik, psikolojik ve makroekonomik sonuçları dünyada ve ilk resmi vakanın 11 Mart’ta kaydedildiği Türkiye’de şimdiden derinden hissedilmektedir. Ayrıca, yine 1918 pandemisinin mortalitenin giderek arttığı üç dalga halinde seyretmiş olduğu gibi, COVID-19 pandemisinde de gelecek haftalarda daha sarsıcı bir epizodun başlaması endişe edilen ihtimaller arasındadır. Bu yazıda katastrofik 1918 pandemisi esnasında yaşananlardan hareketle önümüzdeki COVID-19 sürecinde yaşanabilecek olanlara dair bir mukayese yapmak ve sonuçlar çıkarmak, önümüzdeki risklerin (başta virülansı ve dolayısıyla mortaliteyi artırabilecek bir viral mutasyon) ciddiyetini vurgulamak ve böylece T.C. Sağlık Bakanlığı başta olmak üzere pek çok ulusal ve küresel sağlık otoritesi tarafından çeşitli medya kanalları aracılığıyla yinelenmekte olan sosyal izolasyon çağrısını desteklemek amaçlanmıştır.

Keywords

COVID-19, grip pandemisi, İspanyol gribi, koronavirüs, pandemi, 1918 pandemisi

Lessons from the 1918 Influenza Pandemic for the COVID-19 Pandemic

Abstract

Since the early 20th century, the world has seen five pandemics caused by respiratory viruses. While the first four of these were caused by flu (Influenza A) viruses, the ongoing COVID-19 pandemic is due to a coronavirus strain. Now considered a “worst-case scenario” for respiratory viral pandemics, the “Spanish flu” of 1918 afflicted 500 million people and resulted in 40–100 million deaths worldwide. Since December 2019 to date (April 2020), the current COVID-19 has been confirmed in >1.2 million cases and >60 thousand deaths around the globe. A new “coronavirus disease,” with a higher mortality based on the type of the virus (a novel, pandemic SARSr-CoV strain) and host age (>50–60 years), has been identified during this global health crisis, opening a new period in the history of medicine, particularly epidemiology and public health. Furthermore, today, one hundred years after 1918, there is still no effective anti(corona)viral treatment, with its clinical, sociological, psychological, and macroeconomic impacts being already felt around the world and in Turkey, where the first official case was reported on 11 March. Also, there is the worrisome possibility that the COVID-19 pandemic may develop into an even more serious problem in the following weeks, similarly to the 1918 pandemic that occurred in three waves marked by increasingly higher mortality. In this study, we aimed to infer from the experience of the catastrophic 1918 pandemic for the rest of the ongoing COVID-19 calamity, highlight the imminent risks (most notably, viral mutation that could result in higher virulence and mortality), and thus support the calls for social isolation, repeated through various mass media by many global and national health authorities, particularly the Turkish Ministry of Health.

Keywords

coronavirus, COVID-19, influenza pandemic, pandemic, Spanish flu, 1918 pandemic

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