The 1918 influenza pandemic, described by experts as “the deadliest in human history”, had killed at least 50 million people worldwide, noted the Centers for Disease Control and Prevention. That is equivalent to 200 million in terms of present day’s population of the world.
And an estimated 675,000 of those deaths had taken place in the United States.
And the latest pandemic – the coronavirus pandemic, has killed more Americans than the influenza pandemic in just 18 months.
According to data collected by Johns Hopkins University, death of at least 675,446 Americans have been confirmed since the onset of the coronavirus pandemic till now. And the number continues to increase with each passing day.
While exceeding the 1918 death toll is a dubious distinction, experts have pointed out to key differences between both pandemics that one has to consider while comparing the impact of the two pandemics – especially when considering the much greater access to better healthcare options and availability of vaccines.
“These are two different viruses, two different times in history, at two different times of medical history, with what you have available to combat or treat it,” Howard Markel, professor of the history of medicine at the University of Michigan, told ABC News.
The 1918 influenza pandemic started during the spring of that year and lasted for two years or so. It was caused by the novel H1N1 virus which jumped from birds to humans. According to the CDC, that pandemic had either caused the death of or infected at about one-third of the global population at that time – about 500 million people.
However, Dr. Graham Mooney, assistant professor of the history of medicine at the Johns Hopkins University School of Medicine, says that the death toll in the 1918 pandemic was likely a gross underestimation due to non-registration, missing records, misdiagnosis or underreporting.
Similarly, some experts fear that the Covid-19 deaths could be undercounted because of inconsistent reporting of cases and deaths by states and localities as well as due to intentional exclusion of excess deaths in some countries or regions.
Experts like Markel also noted the differences in population in the United States between 1918 – which was at approximately 105 million, compared to the 2019 figure of 328 million, according to census data, compared to 328 million people in 2019.
The current Covid-19 case fatality rate is at 1.6% while the metric in the 1918 influenza was at 2.5% fatality rate for influenza in 1918, said Mooney.
Typically the fatality rate of flu is less than 0.1% and therefore the Covid-19 death rate in the U.S. is significantly lower than the one that was noted for the 1918 pandemic.
Hence, according to Christopher McKnight Nichols, associate professor of history at Oregon State University, the 1918 influenza pandemic was far deadlier compared to the coronavirus pandemic when comparison is made on a per-capita basis.
“The difference is that 1 in 500 Americans have died now, and about 1 in 152 died in 1918, although our number keeps going up,” Nichols told ABC News.
Nichols however notes that the roll out of Covid-19 vaccines had created a difference between the two pandemics even though the two were comparable initially.
“People were desperate for treatment measures in 1918. People were desperate for a vaccine,” Nichols said. “We have effective vaccines now, and so what strikes me in the comparison, if you think about this milestone, this tragedy of deaths, is that same number but we have a really effective treatment, the thing that they most wanted in 1918 and ’19, we’ve got. And for a lot of different reasons, we botched the response.”
There were no vaccines or treatment against the 1918 influenza, just like towards the beginning of the current coronavirus pandemic and hence people were unprotected. Hence, use of non-pharmaceutical interventions was critical for controlling the pandemic. Mooney said.
“The same kinds of measures — the so-called non-pharmaceutical interventions that were put on in 1918 — were the same that we saw last year: lockdowns, social distancing, hygiene masks, limits on gathering places,” Nichols said.
According to Markel, one of the biggest lessons learned from the 1918 pandemic was social distancing and had showed he world that if it was done early, and for a continued period of time, it can help spread of a pandemic.
(Adapted from Bloomberg.com)