four had multiple waves of infection outbreaks.

In some cases the second or third waves turned out to be far more severe than the first.

As governments around the world weigh the trade-offs between reopening their economies

and continuing lockdown restrictions, what can we learn from history?

The worst pandemic in modern history, the Spanish flu,

which is estimated to have infected a third of the world's population,

had three waves of infection.

The first wave was in the spring of 1918, while the second wave happened in autumn that year.

The third wave occurred a few months later, which lasted till the spring of 1919.

You can see the pandemic peaked in the highly fatal second wave,

which was responsible for most of the deaths.

Many health experts have said that history may repeat itself.

The World Health Organization has warned that the worst of the Covid-19 pandemic is yet to come.

But with widespread unemployment and many companies battling to stay afloat,

there are calls to end the social restrictions and reopen the economy.

Tesla CEO Elon Musk has also lashed out at government stay at home orders as “fascist”.

And that's a feeling shared by an increasing number of Americans.

You heard Elon Musk's comments. I think that reflects a growing sentiment

in this country where people want this to be over.

So that is going to tug against what the governors have to do.

They have tough decisions to face.

However, many analysts have warned against reopening the economy too soon,

which may derail current efforts to stem the crisis.

The island of Hokkaido in the northern part of Japan

was forced back into a lockdown after a second wave hit the region more severely than the first.

Singapore, which was lauded for its early efforts to stem the pandemic,

also recorded a second wave of infections in March,

mainly from imported cases and migrant workers living in packed dormitories.

A survey of more than 40 prominent economists in the U.S.

found that 80% agreed easing severe lockdown when infection risk remains high

would lead to greater economic damage.

As the debate over when to reopen the economy drags on,

the Spanish flu offers some clues.

In 1918, the U.S. had no coordinated pandemic plans at a federal level.

It was therefore left to local authorities to decide

how and when to intervene to prevent the spread of the disease.

The social distancing measures over a century ago are similar to the modern-day restrictions

such as the closure of schools, offices and the banning of mass gatherings.

Because tackling the infection spread was orchestrated at a local level,

the interventions varied widely. This led to the mortality rates

and the pace of economic recovery differing from city to city at the end of the pandemic.

In 1917, a year before the Spanish flu outbreak, Philadelphia and St. Louis had very similar

mortality rates from influenza and pneumonia. However, when the pandemic broke a year later,

the two cities had very different approaches to tackling the outbreak.

Philadelphia was very late to implement social restrictions

and even allowed a large street parade involving some 200,000 people

to go ahead in the middle of the outbreak.

Three days after the parade, every bed was filled in Philadelphia's 31 hospitals.

In contrast, St. Louis officials intervened quickly, resulting in a much lower death rate.

The evidence also shows that cities which intervened sooner and more decisively

saw their economies grow faster after the pandemic was over.

For instance, this graph shows how cities with stricter social distancing measures

recovered faster one year after the 1918 pandemic.

However, cities in red, with more lenient measures generally performed worse.

In cities that implemented social distancing measures quickly and for longer,

manufacturing activity and banking assets also saw increased growth a year after the pandemic was over.

The evidence suggests that aggressive social distancing measures

not only reduced mortality rates but were also economically beneficial.

While there are important economic lessons to be learnt from the Spanish flu of 1918,

it's difficult to compare that pandemic, which occurred more than a hundred years ago,

with the coronavirus pandemic of today. Advances in technology, global supply chains,

the larger role of services and better communication tools may ease the economic fallout significantly,

which limits direct comparisons between the two pandemics.

However, the evidence does imply that decisive social restrictions

to reduce the severity of a pandemic plays a key role in the economic recovery process.

So how can both livelihoods and lives be saved?

While there are no easy answers, revisiting the past offers a glimpse into the future.

After all, a healthy economy doesn't happen without a healthy population.

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