A history of the 1918 flu pandemic as U.S. COVID deaths set to surpass century old death toll

KELOLAND.com Original

SIOUX FALLS, SD (KELO) — Another grim milestone lies on the horizon as U.S. deaths from the COVID-19 pandemic appear poised to overtake the total U.S. death toll from infamous the 1918 influenza. According to the CDC, the flu of 1918 cost around 675,000 lives in the U.S., while the official count of deaths from COVID-19 stands, as of Monday, at 672,738; a mere 2,262 American lives separating the two. As of September 19, the 7-day moving average of COVID-19 deaths per day in the U.S. was 1,353.

While it is easy to draw direct comparisons between some elements of the two diseases, it is worth noting their differences. First of all, while both are contagious respiratory illnesses, COVID-19 is a coronavirus while the 1918 influenza pandemic which spread worldwide from 1918-1919 was caused by an H1N1 virus, originating from avian genes.

The populations most affected also differ. While the propagation of variants has led to greater number of serious COVID-19 infections in young adults, the age group most seriously impacted by the coronavirus has been those in the 65+ category. Meanwhile, according to the BMJ, the 1918 influenza killed a disproportionate number of 25-40 year-olds.

The viruses also diverge in their methods of killing. Those suffering from the flu in 1918 died most often from bacterial pneumonia, whereas COVID-19 takes its victims by way of an overactive immune response resulting in multiple organ failure.

While the origin of the 1918 influenzas has been debated, the first cases were reported among U.S. soldiers in March 1918, at Camp Funston in Fort Riley, Kansas. More than 100 soldiers at the camp fell ill with flu-like symptoms, with the numbers of infected quintupling within a week.


The detail of the influenza’s appearance on a military base is a significant one. The outbreak began a year after the U.S. entered into World War I, at which time a draft was establishes, leading to the recruitment of soldiers who would be trained at 32 camps across the nation, each holding between 25,000 and 55,000 personnel.

This is not the first instance of war and pestilence going hand-in-hand. According to the Mount Vernon Library, during the course of the American Revolutionary War, a smallpox epidemic swept the Continental Army, lasting from 1775-1782, leading George Washington to institute the first mass immunization policy in American history.

The first mention of the 1918 influenza appeared in an April 5 weekly public health report referencing 18 severe cases, along with three deaths, in Haskell, Kansas. Following their training, hundreds of thousands of U.S. soldiers crossed the Atlantic to join the fighting in Europe, taking their disease with them.

In influenza would hit its second peak between September and November 1918, leading to the majority of U.S. deaths from the pandemic. During this period, some of the same mitigation tactics we see recommended today were in use, with the New York City Board of Health requiring all reported flu cases to isolate at home or in a city hospital.

Another prevention method shared between today’s population and those living more than a century ago; masks. According to The Hill, face coverings and masks were widely used during the 1918 pandemic. However, as with today, acceptance of such measures was not universal, with many refusing to mask-up and some arguing, just as today, about the constitutionality of mask mandates.


San Francisco’s Public Health Board required the use of masks for any public servants, and strongly encouraged the use of masks by all residents.

In October 1918, the CDC states that the flu killed an estimated 195,000 Americans, a toll not helped by a massive shortage of medical professionals due to the deployment of large numbers of nurses overseas and in military camps, as well as the failure to use the services of Black nurses.

During this period, cold-storage plants were used as temporary morgues in Philadelphia, and theaters, movie houses and night schools were closed in Chicago and other cities along with prohibitions of public gatherings.

November 1918 saw the end of WWI, leading to another surge of influenza as troops and civilians celebrated Armistice Day and the demobilization of soldiers. By the end of WWI, the U.S. military grew from a force of 378,000 soldiers to a total of 4.7 million.


By December 1918, public health officials had begun education programs to teach about the dangers of coughing and sneezing. In addition to this, the Committee of the American Public Health Association encouraged businesses to stagger shifts and operating hours, as well as recommending the people walk to work when possible to avoid crowing on public transportations.

In San Francisco, 1,800 new cases and 101 deaths were reported in the first 5 days of January 1919 as a third wave of the pandemic swept the nation. Residents of San Antonio, TX claimed new cases were going unreported, increasing the spread of the flu.

In February 1919, cases dropped in New Orleans, indicting the near eradication of the disease in that region, while Illinois passed a bill to create a one-year long course to become a nurse in order to address the shortage.

At the Versailles Peace Conference in April 1919, U.S. President Woodrow Wilson collapsed during negotiations over the end of the war, leading to speculation that he had contracted influenza. However, it is worth noting that Wilson also suffered from a series of strokes throughout his life and presidency, including one in October 1919 which left him severely incapacitated.

The Great War claimed an estimated 16 million lives overall, an immense loss of life and a terrible tragedy. While this number is large, it is dwarfed by the global death toll of the 1918 influenza, which is estimated to have killed 50 million people during its run, infecting up to a third of the global population.

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