
Infectious Dose May Explain High Mortality of 1918–1919 Pandemic (2010) - Nuzzerino
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909907
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redis_mlc
> Conclusion

> The increase on the proportion of infectious persons as a proxy for the
> increase of the infectious dose a susceptible person is exposed, as the
> epidemic develops, can explain the shift in case-fatality rate between waves
> during the 1918 influenza pandemic.

I don't have the tuits to read and analyze the entire paper, but I pasted the
conclusion above.

My interpretation is that a longer period of "social distancing" would have
helped in 1918, though it was so infectious that it went global before
airliners.

As apparently people were still infectious after they felt better and left
their house, causing healthy people to become even sicker than expected with
the increased viral load from both pre-symptom and still recovering patients.

Can somebody study the entire paper and see if my interpretation is what the
paper is implying?

Also, for those not familiar with that pandemic, it was a subtype of H1N1 and
the highest in fatalities, killing 50-100 million people, and occurred near
the end of WW1, which also meant famine in parts of Europe. Like corona, it
affected the lungs.

[https://en.wikipedia.org/wiki/Influenza_pandemic](https://en.wikipedia.org/wiki/Influenza_pandemic)

A lot of nobility died in WW1 (machine guns killed soldiers and their
commanders alike), which ended the influence of European royalty outside
Britain.

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Nuzzerino
> As apparently people were still infectious after they felt better and left
> their house, causing healthy people to become even sicker than expected with
> the increased viral load from both pre-symptom and still recovering
> patients.

That is not how I interpreted it. If you are out of the house, you are more
likely to get a smaller dose of the infection (such as from a handrail or
something), and therefore your immune system is going to have a head start on
fighting it.

If everyone is home on the other hand, and one person in the house gets sick,
then everyone else in the house is more likely to get a higher dose of the
infection due to the repeated proximity to others in the house. And therefore
the infection is gaining a foothold and head start against the immune system.

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meowface
Could this partly explain why healthcare workers are being hit particularly
hard by COVID-19, including young ones?

~~~
Nuzzerino
Yes.

