Coronavirus: 1918 Spanish flu might offer insight into what children born during pandemic can expect
Over 500 million people were infected, about a quarter of the world's population, from January 1918 through December 1920. The death toll is estimated to have been anywhere from 17 million to 50 million
At the time of writing, there are 246,020 confirmed cases of COVID-19 (novel Coronavirus) across the world, with 10,049 confirmed deaths due to the infection, with Italy having overtaken China in the number of fatalities.
Recently, reports emerged of a newborn in London testing positive for the virus within minutes of arrival. While studies are ongoing whether the virus can transmit through the womb, the baby most likely contracted the virus during birth.
As the number of confirmed cases rise, expectant mothers are worried for a myriad of reasons, starting with contracting the virus directly and passing it on to their unborn child. Moreover, concerns are rising with overcrowded hospitals and limited resources as health workers across the world are stretched thin trying to flatten the curve.
Many are wondering what this means for expectant mothers and the babies born during the pandemic and may look for a comparison to what happened during the 1918 influenza pandemic that lasted till 1920. Over 500 million people were infected—about a quarter of the world's population—from January 1918 through December 1920. The death toll is estimated to have been anywhere from 17 million to 50 million and possibly as high as 100 million, making it one of the deadliest epidemics in human history.
A number of studies have been done to study the effect of the pandemic on the effects of babies born during the 1918 pandemic. Some studies showed that children born in 1919 who were exposed to the H1N1 virus in utero experienced worse health and higher mortality in older ages. Researchers found that people who were born in the US just after the 1918 flu pandemic - when the disease was at its peak - had a higher risk of a heart attack in their adulthood than those born before or long after the pandemic.
Moreover, studies also indicated that those who were exposed had lower educational attainment, higher rates of physical disability, lower-income attainment, lower socioeconomic status and a higher dependence on social welfare than surrounding birth cohorts. These results were seen in the United States, Switzerland, Brazil, Taiwan, and Sweden.
However, other studies found weaker effects if any at all. A study of 24 countries found that overall mortality did not differ systematically for in utero–exposed cohorts relative to surrounding cohorts and another study found no consistent long-term effects of influenza exposure on education, employment, or disability outcomes and concluded that the evidence on long-term economic effects of the Spanish flu is likely a consequence of publication bias.
Readers also have to consider that those born during the 1918-20 pandemic grew up between the two world wars and experienced the Great Depression that started in 1929 and went through to the late 30s. Moreover, the virus that caused the 1918-20 pandemic belongs to the Orthomyxoviridae family of viruses while the COVID-19 virus belongs to the Coronaviridae family.
Viruses from the Coronaviridae family are generally seen not to be transmitted in-utero as seen during the Middle East Respiratory Syndrome (MERS) outbreak as well as the Severe Acute Respiratory Syndrome (SARS) outbreak. However, one study found that "SARS during pregnancy is associated with high incidences of spontaneous miscarriage, preterm delivery, and intrauterine growth restriction."
A study conducted in Wuhan, China during the current pandemic has indicated that vertical transmission (infected mother transmitting to baby in-utero) could be unlikely. However, since the COVID-19 is a new virus and research is still in its early stages, conclusive evidence is still awaited.
Dr Ariane Bertogg, a postdoctoral researcher at the University of Konstanz in Germany, told MEAWW, "I find it too early to make a forecast how birth rates, early childcare arrangements and new mothers' (and fathers'!) behavior will change due to the COVID-19 crisis. As it seems, we are yet only in the take-off phase, and the peak is not yet reached."
Another aspect to consider is a potential baby boom within the next nine or twelve months, as increased measures of self-isolation and quarantine lead people to spend more time indoors. Unexpected population-wide stretches of isolation at home sometimes result in a boom in births nine months later. Such a bump happened in Maine and New Hampshire after the 1998 ice storm that shut down parts of the Northeast. Similarly, CBS News reported East Coast hospitals reporting an increasing number of births nine months after superstorm Sandy.
However, in the current situation, the opposite might be observed considering we are dealing with a pandemic. There may be a reduction in sexual activity amid measures to contain the virus.
But what of the babies born during the pandemic? Those who were born during the 1918-20 pandemic belonged to the generation called the "Greatest Generation," who were characterized by values of "personal responsibility, duty, honor, and faith," - characteristics that them to defeat Hitler, build the American economy, make advances in science and implement visionary programs like Medicare, according to Tom Brokaw.
Brokaw wrote, "They have given the succeeding generations the opportunity to accumulate great economic wealth, political muscle, and the freedom from foreign oppression to make whatever choices they like."
The babies born during the 2019-20 Coronavirus pandemic will belong to Generation Alpha, which includes those born from the early 2010s through to the mid-2020s. This generation may exhibit similar qualities if the above can be proven, having experienced gun violence, and multiple recessions in addition to the pandemic. Millennials and Generation Z, notably, would have experienced two major recessions (including the 2008 recession and the recession expected as a result of the current pandemic and falling oil prices), and other major events such as the 9/11 attack.