The Bad Cat, whose site for some reason does not use capital letters, which I think makes it less serious, but someone pretending to be a cat, would not care, makes a very interesting observation about the over-blown nature of pandemics, in particular, the Spanish Flu epidemic that hit during World War I. The odd thing was how the Spanish flu killed otherwise healthy soldiers in a few days, but other people, not so quick, or not at all. “The unprecedented overall mortality and the mortality rate among young adults during the 1918–1919 influenza pandemic is incompletely understood. Deaths in the United States peaked with a sudden spike in October 1918. Later, Wade Hampton Frost studied surveys of 8 US cities and found that, for every 1000 persons aged 25–29 years, ∼30% were infected with influenza virus, and 1% died of pneumonia or influenza. This 3% case-fatality rate has been called, “perhaps the most important unsolved mystery of the pandemic.”
One hypothesis for why this occurred, is that the higher mortalities of the soldiers was iatrogenic, doctor caused. In 1918, aspirin was first marketed, and Big Pharma was keen to push its new wonder drug. Doses of 8-31 grams were given to sick soldiers. It is known today that the daily dose of aspirin should never exceed the level of mgs, even in exceptional circumstances, and doses are far, far lower to avoid toxicity, and other side effects. But, the even higher doses would likely produce the rapid declines and deaths that were observed. Bad Cat cited some peer reviews papers that support his idea.
If this proves correct, then it shows that there are important lessons here in the need to have an independent check upon the brews that Big Pharma delivers, with regulatory bodies not having financial contributions from Big Pharma, or taking in former Big Pharma employees through a revolving door. Even if the drugs work, there are often unknown side effects, and it is socially desirable to work out what these are before creating another health disaster.
“beyond very minor levels, it’s been 100 years since one was. there has NEVER been a seriously dangerous global pandemic in the post antibiotic era. there have barely been any that even warranted notice and pretty much no one living can recollect a shred of the last one.
and the odds on bet appears to be that had we not swerved around covid as though it were a tyrannosaur in the road instead of a squirrel, covid would almost certainly not have been one either.
let’s unpack.
as was the case in the spanish flu, perhaps the last truly high excess death global pandemic to bedevil humanity, much of the damage was done by horrible reactions. and the parallels may be more poignant than people realize.
one of the enduring causes of fear during the 1918 flu was the way that it seemed to be killing otherwise young and healthy people (especially soldiers) in a matter of days. they would be a bit sick then suddenly die of massive organ failure and “wet hemorrhagic lungs.” the progression was incredibly fast, seemingly irreversible, and was stacking people who really ought to have been low risk in mortuaries like cordwood. this made risk, CFR, and IFR look horrifying and fear near universal.
if it could do this to a soldier in his prime in a matter of days, every last one of us should be terrified.
but this is simply not a realistic outcome. in a modern society (even pre-antibiotics) it basically doesn’t happen. these are not the pre-sanitation/most people do not get enough calories days of the black death.
diseases that kill at high percentages tend not to spread because killing the host is evolutionarily maladaptive. it’s like trying to conquer the world by burning down your own house and car. even the really nasty historical killers like smallpox were only infecting ~400k people a year by the late 1800’s and excursions above 1 death/year per 1,000 population during outbreaks were very rare not in spite of, but because the fatality rate was so high.
but respiratory diseases are different and tend to spread far more. fatality rates are low. claimed spanish flu CFR was always suspicious in this regard. and there may be a reason:
there is actually quite a lot of convincing evidence that many of the “young, healthy deaths” in spanish flu were iatrogenic.
this is a word that’s going to come up a lot and a topic that’s going to be the big field of debate around covid going forward. it’s probably one of the most important scientific questions in the world right now.
loosely put, iatrogenic death is when the doctor kills you. and there is a long and unpleasant history on that one from benjamin rush bleeding george washington to death to killing “witchy” cats to stop a plague carried by the fleas of the very rats they were eating to (and especially) new “wonder drugs” that are poorly understood but that rapidly go into widespread use.
and one of those drugs was aspirin.
aspirin had just come into widespread availability in 1918 (and bayer was rushing it to market for the pandemic). it was the new wowie-zowie drug and doctors (and especially militaries) all over the world fell in love with it. they prescribed it widely to those with spanish flu. in doses ranging from 8 to 31 grams per day. oopsie.
a typical aspirin today is 325mg and max dosing per day is ~4 grams.
a toxic dose is 200-300mg/kg of weight. that’s about 20g for a 180 pound person.
31g is “you’re going to die really, really fast and there is not a damn thing anyone can do to stop it once you take that dose.”
this is why incredible caution should be exercised around large departures from tested and true medical practice and new pharma modalities and products.
The unprecedented overall mortality and the mortality rate among young adults during the 1918–1919 influenza pandemic are incompletely understood. Deaths in the United States peaked with a sudden spike in October 1918. Later, Wade Hampton Frost [2] studied surveys of 8 US cities and found that, for every 1000 persons aged 25–29 years, ∼30% were infected with influenza virus, and 1% died of pneumonia or influenza. This 3% case-fatality rate has been called, “perhaps the most important unsolved mystery of the pandemic” [3, p 1022]
this case fatality rate has never looked even remotely plausible for flu. you simply do not get a respiratory disease like that in a modern (or possibly any) society, especially not in young, healthy people. it’s just not a thing.
but widespread poisoning by well meaning medical professionals who have no idea how dangerous the products and procedures they are playing with is.
Official recommendations for aspirin were issued on 13 September 1918 by the US Surgeon General [64], who stated aspirin had been used in foreign countries “apparently with much success in the relief of symptoms” (p 13), on 26 September 1918 by the US Navy [29], and on 5 October 1918 by The Journal of the American Medical Association [31]. Recommendations often suggested dose regimens that predispose to toxicity as noted above. At the US Army camp with the highest mortality rate, doctors followed Osler’s treatment recommendations, which included aspirin [48], ordering 100,000 tablets [65]. Aspirin sales more than doubled between 1918 and 1920 [66].
again, anyone starting to pick up a bit of a rhyme in the history here?
the similarities to recent events are more than a little striking. (bold mine)
Autopsy reports by pathologists of the day describe extremely wet, sometimes hemorrhagic lungs in early deaths. On 23 September 1918 at Camp Devens in Massachusetts, 12,604 soldiers had influenza, and 727 had pneumonia; after examining the lungs of a dead soldier, Colonel Welch concluded, “This must be some new kind of infection or plague” [48, p 190]. What struck E. R. Le Count [49], consulting pathologist to the US Public Health Service, as most unusual was the amount of lung tissue actually “pneumonic” seemed “too little in many cases to explain death by pneumonia.” He saw a thin, watery, bloody liquid in the lung tissue, “like the lungs of the drowned,”
and as ever, bigger hammer theory tends to rise to the fore and the terrible tenet of “it’s not working so do it harder” comes into play.
and this is not some “quaint delusion of doctors that wise men of modern medicine have exceeded and no longer fall prey to.”
this EXACT mindset was a massive killer in covid.
the widespread rejoinder to “covid deaths are massively overcounted using an absurdist methodology and definitions” is “oh yeah, well then explain the excess deaths!””