What does it mean if we "soften the measures" too early? A look at what happened during the Great Depression of 1918

As debates have begun as to whether we should prioritize health or the economy - and when and how to mitigate measures imposed by coronavirus - we need to keep this in mind.

Studies of the Great Depression of 1918 concluded that cities that adopted "non-pharmaceutical intervention" measures earlier and kept them in place for a longer period of time did better, both in terms of health and economics.


Specifically, they had fewer deaths and their economies 'recovered' faster, writes Business Insider, reports Telegrafi.

In other words, in 1918 it was not about "health or the economy" - it was about "health and the economy".

Different cities approach the 1918 epidemic differently, as a 2007 study by Howard Markel, Harvey Lipman and J. Alexander Navarro shows.

And various experiences include a warning of what might happen if we reopen too early.

St. Louis, Denver and San Francisco, for example, adopted "distancing" measures in the beginning, which helped mitigate the initial wave of the epidemic.

However, the three cities eased their measures early. And then saw second waves.

In St. Louis and Denver, these second waves were worse than the first. While the second wave "took place", the cities resumed the measures, but it was too late.

The same thing happened in San Francisco, as Business Insider's Katie Canales points out in a live photo essay.

In 1918 - as in 2020 - San Francisco was one of the first cities to close, and it brought the epidemic under control.

However, five weeks later, as the number of cases dropped, the city declared victory very early and reopened very quickly.

(Literally. As Katie reports, "a whistle blew and people took to the streets to celebrate, throwing their masks")

But a few weeks later, the cases started to grow again. San Francisco tried to close again, but many irritated citizens resisted orders, Business Insider further writes, the Telegraph reports.

The second wave continued for months, as this chart by National Geographic shows.

Meanwhile, other cities took a different approach, keeping their initial restrictions in place for longer.

New York City laid down basic rules of isolation and quarantine earlier than other cities and then kept them in place until the death rate returned to a very low rate.

The city saw only one major wave of infections, and its overall death rate was at the lowest end of the U.S. interval.

More importantly, despite its initial rules being enforced for longer, New York restrictions were only in effect for half the total time like those in St. Louis. Louis and Denver.

The rush to reopen those cities, in other words, led to the second closure that lasted as long as the first.

Another lesson from the 1918 experience is that restrictions are not "all or nothing."