The 1918 Spanish Flu Pandemic: Lessons and Comparisons

The 1918 Spanish Flu Pandemic: Lessons and Comparisons

Dive into our deep-dive into the history and impact of the Spanish Flu epidemic in 1918. A riveting look into one of the deadliest pandemics, its effects, and our responses.


This article discusses about:

  • Discussing Pandemic Measures
  • The Spanish Influenza
  • Scale of Spanish Flu Deaths
  • Importance of Spanish Flu
  • Government Response to the Flu
  • Downside of Misinformation
  • Where Did the Flu Originate?
  • Importance of Reliable Information
  • Factors Affecting Disease Severity
  • Seriousness of the 1918 Flu
  • Comparing Flu Pandemics
  • COVID-19 Situation and Impact
  • COVID-19: Case counting challenges
  • Importance of Quality Data
  • Response to Current Pandemic
  • Importance of Global Community


A young man walks into a hospital in San Francisco, 1918. Freshly returned from the trenches in Europe, he’s excited to see his family again. His mother, sending him to the hospital due to his persistent fever and fatigue, kisses him farewell on the cheek. Little does she know that in merely a few hours, her son’s skin will turn blue, and he will bleed from his ears and eyes. As he recalls the gruesome memories of his friends suffocating on chlorine gas in Belgium trenches, his lungs will fill with fluid. He drowns, cold and alone on a San Francisco hospital floor.


What was the Spanish Flu?

Today’s topic revolves around a specific viral outbreak. What measures did society take to slow its progression? Where did we fail? The situation outlined above paints a picture of the devastating Spanish influenza, often referred to as the Spanish flu, which according to numerous historians, was the most lethal pandemic in the history of mankind, even rivaling the Black Plague.

The Spanish flu traversed the globe in three waves. The first wave, in the spring of 1918, was relatively mild and limited in scope. However, the second wave that struck in August of the same year was deadlier and more far-reaching, having mutated into a far more lethal strain. Then there was a third wave at the beginning of 1919, but it was mostly contained to a handful of regions.

Death estimates linked to the Spanish flu range anywhere from 50 million to a staggering 100 million. Just to put this into perspective, the casualties of the Great War totalled around 40 million.


The Spanish flu is viewed as the worst pandemic in history.



The Plague vs the Spanish Flu

Notably, the Black Plague wiped out nearly 50% of the Eurasian population in a four-year span, which equates to approximately 75 to 200 million deaths. That’s the current population of the U.K., Germany, and France combined. As you can see, the number of deaths isn’t the sole factor in rating the severity of a pandemic. How it is managed and the historical context is equally critical.

Interestingly, the Spanish flu is more relevant to us today than the Black Plague because by 1918, germ theory was established, and our medical treatments were more advanced than in 1347. Thus, disease control stopped being about evil spirits, foul smells, and bloodletting, shifting to more scientific quarantine and hygiene measures.


The Lethality of the Spanish Flu

The 1918 Spanish flu pandemic was exceptionally lethal, killing more people in their late 20s than any other age group. One theory proposes that exposure to the Russian flu pandemic strain in late 1889 to 90 caused these young people to produce a faulty immune response. This fault line in their defense became fatal when confronted with the catastrophic Spanish flu strain nearly 30 years later.

By John Berry’s accounts, the U.S. Government used the same communication strategy it had established for war-time news to address the pandemic. Under this mandate, keeping up morale was paramount. Regrettably, this approach involved a significant degree of misinformation, truth cover-up, and outright lies. Chicago’s Director of Public Health opined at the time, “Worry kills more than the disease”. Sadly, this stance propagated mass fear and overstretched the health and social welfare system, with many people starved to death, not for lack of food, but out of fear of contagion.


Contrast with Other Pandemics and COVID-19

Let’s briefly compare the Spanish flu pandemic’s Case Fatality Rate (CFR) to other pandemics and outbreaks.

For instance, the 1957 flu pandemic, the 2009 H1N1 outbreak, and the seasonal flu strains all feature CFRs lower than 1%. SARS has a CFR of 10%, MERS is at 30%, and Ebola stands at a current CFR of 50%.

Fast forward to our current situation, COVID-19 has a CFR of approximately 5.1% (as of early April 2020), which appears twice as deadly as the 1918 flu pandemic. Notably, this is subject to a lot of variables such as healthcare funding, infrastructure, media coverage, and government responses. Consequently, a global fatality rate may not paint an accurate picture.

It’s critical to emphasize how large-scale pandemic reactions have improved since 1918 due to advances in healthcare systems, disease understanding and science in general. We are more globally connected than ever, which plays a significant role in disease spread. However, laying blame does nothing to foster collective health protection or care for loved ones.

Let’s remain vigilant, practical, and compassionate in the face of such daunting global health adversities.


Quick Takeaways!

Image concept by author via Dalle 2

This article discusses the Spanish flu of 1918, highlighting it as one of the worst pandemics in history, with death toll estimates ranging from 50 million to 100 million. The pandemic came in three waves, with the first mild one in Spring 1918, followed by a more deadly mutation in August that spread globally, while the third was contained in 1919.

Comparing it to the black plague, the Spanish flu is considered more relevant because of advances in germ theory and medical treatment in the 20th century versus the 14th. The author criticizes the American government’s approach to the pandemic, which prioritized boosting morale over public health measures.

The U.S. government’s misleading communication led to crippling absenteeism and public panic. It was also criticized for continuing to prioritize work productivity over citizen health. The author argues that the key lesson from the pandemic is the need for accurate and timely information to maintain public trust and implement health measures. He mentions that while Spain was unfairly blamed for the disease due to its lack of censorship laws, the pandemic’s origin remains uncertain. The Spanish flu was unique as it affected young adults more severely, possibly due to their exposure to a different influenza strain during infancy, which compromised their immunity.

The author also compares fatality rates of different pandemics and illnesses and notes that the current COVID-19 situation’s global fatality rate is inconsistent, varying between countries based on factors like healthcare, population density, and government action. He urges vigilance in interpreting such figures due to limited and biased data. He notes that today, the world is better prepared for pandemics owing to improved healthcare systems, scientific understanding, and lessons from history. However, our interconnected world also makes us more vulnerable, necessitating cooperation and unity to protect public health.