The long-run effects of pandemic influenza on the development of children from elite backgrounds: Evidence from industrializing Japan

Centenarians, semi and supercentenarians, COVID-19 and Spanish flu: a serological assessment to gain insight into the resilience of older centenarians to COVID-19

BACKGROUND

Although it is well known that the older people have been the most susceptible to COVID-19, there are conflicting data on the susceptibility of centenarians. Two epidemiological study have shown that older centenarians (> 101 years old at the time of the 2020 pandemic peak) are more resilient than the remaining centenarians, suggesting that this resilience might be linked to the 1918 Spanish Flu pandemic. To gain insight into this matter, specifically whether the resilience of older centenarians to SARS-CoV-2 infection is linked to the Spanish Flu they had been affected by, we conducted a retrospective serological study. This study examined serum samples from 33 centenarians, encompassing semi- (aged > 104 < 110 years, N = 7) and supercentenarians (aged > 109 years, N = 4), born between 1905 and 1922, against both SARS-CoV-2 and 1918 H1N1 pseudotype virus.

RESULTS

Anamnestic and laboratory data suggest that SARS-CoV-2 infection occurred in 8 centenarians. The infection appeared to have been asymptomatic or mild, and hospitalization was not required, despite 3 out of 8 being between 109 and 110 years old. The levels of anti-spike antibodies in centenarians infected and/or vaccinated were higher, although not significantly, than those produced by a random sample of seventy-year-old individuals used as controls. All centenarians had antibody levels against the 1918 H1N1 virus significantly higher (almost 50 times) than those observed in the quoted group of seventy-year-old subjects, confirming the key role in maintaining immunological memory from a priming that occurred over 100 years ago. Centenarians whose blood was collected prior to the pandemic outbreak demonstrated neutralising antibodies against the 1918 H1N1 virus, but all these subjects tested negative for SARS-CoV-2.

CONCLUSION

This retrospective study shows that older centenarians are quite resilient to COVID-19, as they are capable of producing good levels of neutralising antibodies and experiencing mild or asymptomatic disease. This could be attributed to the 1918 Spanish flu pandemic through mechanisms other than the presence of cross-reactive antibodies between the 1918 H1N1 virus and SARS-CoV-2. Another possibility is that the association is purely temporal, solely correlated with the advanced age of resilient centenarians compared to those born after 1918, since older centenarians are known to have better control of immune-inflammatory responses.

Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient

In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not "younger centenarians", have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.

Pandemic influenza and gender imbalance: Mortality selection before births

This study uses data from the 1918-1920 influenza pandemic in Japan along with newly digitized and complete census records on births and infant deaths to analyze mortality selection in utero. I find that fetal exposure to the influenza pandemic during the first trimester of the pregnancy decreases the proportion of males at birth. The results from mechanism analysis suggest that this decline in male births is associated with the deterioration of fetal and infant health. This result supports a wide range of existing literature on the long-run adverse effects of pandemic influenza.

Long-lasting effects of pandemics: The case of the 1918 influenza pandemic in Argentina

The 2019 novel coronavirus disease pandemic poses a serious threat. While its short-term effects are evident, its long-term consequences are a matter of analysis. In this work, the existence of long-lasting negative effects derived from exposure in utero to a great pandemic -1918 influenza pandemic- is analysed for the Argentine case. Outcomes of interest include educational achievement and unemployment status in adulthood -50 years after the pandemic. Based on a regression analysis, temporal differences in the spread of the pandemic and between close birth cohorts are exploited. The results indicate a significant reduction in educational achievement for people exposed in utero to the pandemic. In the region with the highest incidence of cases (Noroeste), this reduction is 0.5 years of education. There are no significant changes in the chances of being unemployed. In the context of climate change, these results constitute a call of attention for the implementation of child protection policies from gestation.

Assessing the effects of autarchic policies on the biological well-being: Analysis of deviations in cohort male height in the Valencian Community (Spain) during Francoist regime

This article aims to assess the impact of autarchic policies on the biological dimensions of human well-being during Francoist regime in Spain. This is done by examining the nutritional status of the population through the study of male adult heights. Our case study is the Valencian Community with the focus on the period 1940-59 which witnessed the implementation of such policies. The heights of 21-year old draftees born between 1900 and 1954 from nine municipalities (N = 87,510) were analyzed in the light of inter-cohort deviations from a secular trend established for cohorts that were not exposed to autarchy-related hardships. Height was regressed on infant mortality as a way to control for infection and therefore approach the net effect of nutrition on height outcomes. Contrarily to what was displayed by cohort height trends in themselves, the results reveal a significant worsening of the nutritional status of the male population at the time. Deviations from the expected height trend across municipalities ranged between -0.5 and -3.4 mm per year. The effects of malnutrition are found to be larger among cohorts born in the period 1920-34 in coherence with a longer exposure to autarchy hardships during adolescence. Pre-autarchy nutrition levels observed among the cohorts of 1900-14 were not regained until the cohorts 1945-49. The results also show that malnutrition had an unequal impact with the large industrial towns of our sample experiencing the poorest height outcomes. Overall, these results invite to revise conclusions obtained from the sole evidence of height trends and they question the efficiency of intervention policies implemented in Spain during the 1940s.

Disease, downturns, and wellbeing: Economic history and the long-run impacts of COVID-19

How might COVID-19 affect human capital and wellbeing in the long run? The COVID-19 pandemic has already imposed a heavy human cost-taken together, this public health crisis and its attendant economic downturn appear poised to dwarf the scope, scale, and disruptiveness of most modern pandemics. What evidence we do have about other modern pandemics is largely limited to short-run impacts. Consequently, recent experience can do little to help us anticipate and respond to COVID-19's potential long-run impact on individuals over decades and even generations. History, however, offers a solution. Historical crises offer closer analogues to COVID-19 in each of its key dimensions-as a global pandemic, as a global recession-and offer the runway necessary to study the life-course and intergenerational outcomes. In this paper, we review the evidence on the long-run effects on health, labor, and human capital of both historical pandemics (with a focus on the 1918 Influenza Pandemic) and historical recessions (with a focus on the Great Depression). We conclude by discussing how past crises can inform our approach to COVID-19-helping tell us what to look for, what to prepare for, and what data we ought to collect now.

Season of birth, health and aging

We investigate how the season of birth is related to human health and aging. For this purpose, we use five waves of the Survey of Health, Aging, and Retirement in Europe (SHARE) dataset and construct a health deficit index for 21 European countries. Results from log-linear regressions suggest that, on average, elderly European men age faster when they were born in spring and summer (compared to autumn). At any given age, they have developed about 3.5 percent more health deficits. These differences due to seasons of birth are not mediated by body height and education. In a subsample of Southern European countries, where the seasonal variation of sunlight is smaller, the birth season plays an insignificant role for health in old age. In a subsample of Northern countries, in contrast, the season of birth coefficients increase. At any given age, elderly Northern European men born in spring have developed, on average, 8.7 percent more health deficits than those born in autumn. In non-linear regressions we find that the speed of aging is also associated with the birth season.

What explains cross-city variation in mortality during the 1918 influenza pandemic? Evidence from 438 U.S. cities

Disparities in cross-city pandemic severity during the 1918 Influenza Pandemic remain poorly understood. This paper uses newly assembled historical data on annual mortality across 438 U.S. cities to explore the determinants of pandemic mortality. We assess the role of three broad factors: i) pre-pandemic population health and poverty, ii) air pollution, and iii) the timing of onset and proximity to military bases. Using regression analysis, we find that cities in the top tercile of the distribution of pre-pandemic infant mortality had 21 excess deaths per 10,000 residents in 1918 relative to cities in the bottom tercile. Similarly, cities in the top tercile of the distribution of proportion of illiterate residents had 21.3 excess deaths per 10,000 residents during the pandemic relative to cities in the bottom tercile. Cities in the top tercile of the distribution of coal-fired electricity generating capacity, an important source of urban air pollution, had 9.1 excess deaths per 10,000 residents in 1918 relative to cities in the bottom tercile. There was no statistically significant relationship between excess mortality and city proximity to World War I bases or the timing of onset. In a counterfactual analysis, the three statistically significant factors accounted for 50 percent of cross-city variation in excess mortality in 1918.

Early-life exposure to weather shocks and child height: Evidence from industrializing Japan

In this study, we estimate the long-run effects of early-life exposure to weather shocks on the height of primary school children. To estimate the global impacts on almost the entire child population in an industrializing country, we utilize both a unique nationwide multi-dimensional longitudinal dataset of Japanese children aged 6-11 and official monthly statistics on meteorological conditions in the 1920s. We observe that the exposure to cold waves in early-life exerted stunting effects on both the boys and girls. In the coldest regions in the northeastern area of Japan, the stunting effects of cold weather shocks on the boys and girls are estimated to be approximately 0.8 and 0.6 cm, respectively. Our observation indicates that prenatal (postnatal) exposure is important for the boys (girls). Our results suggest that the marginal effects of cold waves are stronger in the warmer regions than in the colder regions.