Lifting the coronavirus lockdown too soon would risk a devastating second wave of death and disease, American history has proven.
San Francisco made that exact error in its battle with the Spanish Flu in 1918-19 and saw the virus surge after calling off a ban on public gatherings after just a month.
British Prime Minister Boris Johnson, returning to work today after recovering from COVID-19, was forced to make a statement warning the public that it was too soon for the UK to come out of lockdown and that now is the ‘moment of maximum risk’.
Chief scientists in the Government have confirmed that the peak of Britain’s outbreak has passed and the numbers of people being hospitalised is falling.
But experts say Mr Johnson must now resist calls to ease restrictions until the numbers of new cases, deaths and hospitalisations have hit rock bottom.
Meanwhile, Conservative ministers and donors are putting their weight behind calls for business to reopen so the economy can get back on its feet.
In San Francisco 100 years ago, officials ordered everyone to wear face masks and banned public gatherings amid soaring Spanish Flu infections. The restrictions worked and the numbers of cases and fatalities fell within weeks.
Encouraged by evidence that the disease’s spread had slowed down, the city’s politicians decided to end a ban on public gatherings and events, and to tell people face masks were no longer mandatory, after just four weeks.
The flu rebounded some three weeks after that and led to a longer outbreak than the first one, causing lockdown measures to be put back in place to public outrage. A prolonged second wave saw more cases and deaths than the first.
Scientists now say authorities managing COVID-19 lockdowns must learn from history and avoid slowing their efforts too soon.
More than 45,000 people were infected and around 3,000 died in San Francisco’s Spanish Flu outbreak in 1918-19 (Pictured: A policeman leads two men through the city by their arms)
San Francisco suffered a second peak of Spanish Flu cases and deaths after ending social distancing too soon, just a month after it was introduced
Masks were made mandatory in San Francisco in October 1918 as officials scrambled to stop the spread of the flu (Pictured: A policeman adjusts a man’s mask in public)
Authorities in New York did a better job of controlling the epidemic by waiting until the death rate was at rock bottom before they ended lockdown rules
London Breed, the current mayor of the California city, has told residents they must all wear face masks when they leave their houses to stop the spread of COVID-19.
She told NBC News: ‘Just because San Francisco is being praised for flattening the curve, we’re not there yet.
‘And so we cannot let up just because for some reason we believe that we’re in a better place.’
Boris Johnson said this morning in an address outside Downing Street: ‘I entirely share your urgency [to end lockdown].
‘And yet we must also recognise the risk of a second spike. The risk of losing control of that virus and letting the reproduction rate go back over one.
‘Because that would mean not only a new wave of death and disease but also an economic disaster, and we would be forced once again to slam on the brakes across the whole country and the whole economy, and reimpose restrictions in such a way as to do more and lasting damage…
‘I refuse to throw away all the effort and sacrifice of the British people and to risk a second major outbreak.’
San Francisco’s was hit by the Spanish Flu, known as H1N1, in September 1918 when soldiers were returning home from the First World War.
When officials realised what was happening they ordered the shutdown of ‘all places of public amusement’ on October 18.
Flu cases were soaring and, by October 21, people had all been ordered to wear a face mask in public or face jail and a fine if they were caught without one.
By the beginning of November the city had seen 20,000 cases of the Spanish Flu – which was the world’s last major pandemic – and around 1,000 people had died of it, NBC reports.
Data from St Louis, Missouri, shows the southern city also suffered a sharp second peak in its Spanish Flu outbreak after ending initial social distancing measures while the death rate was still high
Women are pictured sewing masks in San Francisco in 1918. People refusing to cover their faces could end up in jail or getting fined
Pittsburgh, although it didn’t suffer a second peak, saw the flu death rate remain high for months, possibly as a result of its short-lived social distancing measures
A TALE OF TWO CITIES: THOUSANDS DIED IN PHILADELPHIA BUT ST LOUIS LOCKDOWN SAVED LIVES
The Spanish Flu hit America in 1918 as soldiers returned from Europe after fighting in the First World War.
In Philadelphia, a parade was thrown in support of the war effort to disastrous results: the city’s hospitals were full 72 hours later and it would soon see 2,600 deaths.
Meanwhile, after the virus moved from the military to the civilian population, health officials in St. Louis immediately ordered closings and banned public gatherings, which kept the disease from ‘exploding overnight as it did in Philadelphia,’ according to History.com.
Philadelphia officials were aware of the disease and that it was running rampant through army and navy installations. Nonetheless, they informed the public it would be stopped before it spread to civilians. When the general population started becoming infected, Wilmer Krusen, the city’s public health director, insisted that the Liberty Loan Parade, which was to raise money through war bonds, move forward.
On September 28, 1918, around 200,000 people flocked to the city’s sidewalks to see soldiers and marching bands file down the street. Seventy-two hours later, every one of Philadelphia’s 31 hospitals was full and 2,600 people soon died.
St. Louis’ reaction to the virus was the exact opposite. Before a case of the influenza had been confirmed, the city’s health commissioner, Dr Max Starkloff, warned the public to avoid crowds.
Once public health officials knew the disease had jumped from military barracks and infiltrated the city’s population, Starkloff immediately closed schools, theaters and pool halls and public gatherings were banned.
In this way, St. Louis was able ‘to flatten the curve,’ which means a virus spread is slowed.
But the infection numbers and the obvious impact of the outbreak had begun to drop by this time after accelerating fast in October then slowing with social distancing measures.
Spurred on by the falling numbers, San Francisco’s politicians lifted all the restrictions – the public gatherings and the mask requirement – on November 21.
There were celebrations in the streets and people flocked to theatres and sports stadiums, according to eyewitness accounts, and the disease outbreak seemed to have stabilised.
But around a fortnight later, disaster struck and the outbreak began again. Cases of flu started to reappear and spread rapidly. Officials blamed people travelling into the city from elsewhere for the resurgence of the disease, Business Insider reports.
Just after January 1, 1919, around 600 new cases were diagnosed in a day and the city had once again to try and stop the outbreak.
Officials brought back in the rule that everyone had to wear face masks in early January. But this time many would not do it and an ‘Anti-Mask League’ was formed to protest against the returning measures.
Pressure from the public eventually led to the mask advice being abandoned altogether in February.
San Francisco eventually saw more than 45,000 cases of the flu and 3,000 people died – the statistics were more than double what had been recorded at the end of the first lockdown.
Other cities fared better and graphs showing the progress of their outbreaks represent how longer social distancing measures can suppress death tolls and prevent a second surge.
In New York, for example, social distancing was in place from mid-September until December, and wasn’t lifted until the day-by-day death rate was at its lowest, to lower than a tenth of what it had been at the peak.
It is exactly this devastating second peak which governments around the world must seek to avoid as they try to emerge from nationwide lockdowns triggered by COVID-19.
Lockdowns are considered less likely to work the second time around because of ‘crisis fatigue’, in which people lose faith in the measures and get bored of following rules.
Chief of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, said today: ‘As lockdowns in Europe ease with declining numbers of COVID-19 cases, we continue to urge countries to find, isolate, test and treat all cases and trace every contact, to ensure these declining trends continue.’