Why Did the Spanish Flu Kill More People Than World War I?

1918 marked the inception of a global pandemic
that would go on to devastate the entire world, with the Spanish flu claiming more lives than
World War I itself. Although estimates range widely, the Spanish flu killed anywhere between
20 and 100 million people, with the Centre for Disease Control estimating that at least
50 million people died worldwide; compared to approximately 17 million people dying in
the First World War. The insanely high death toll from the 1918
pandemic begs the obvious question: why did the Spanish flu become so lethal? Before answering
this question however, a little background on the Spanish flu is needed. The 1918 influenza
pandemic is often referred to as the ‘Spanish’ flu because the press of neutral Spain was
the first to report on the pandemic. It was caused by a virus which spread from person
to person through the respiratory tract, with a high percentage of deaths resulting from
bacterial pneumonia caused by a secondary infection of the lungs, which had been debilitated
by the virus (Patterson 1983: 487). Crucially, in 1918, it was unknown what type of virus
was causing this pandemic. It was not until decades later that it was found to be an influenza
A virus, subtype H1N1, with genes of avian origin.
Spanish influenza swept across the world in three waves. Although the origins of the pandemic
are still debated by historians, some of the earliest reports appeared in the spring of
1918, at a US army training camp in Kansas. From Kansas, the virus rapidly spread to other
US training camps and then onto Europe, with many scholars arguing that the American Expeditionary
Force carried the disease across the Atlantic to the west coast of France. The first wave
of the virus was somewhat benign though, as the majority of patients only suffered from
shivers and a temperature for a couple of days – resulting in it being known as the
‘three-day flu.’ Over the summer however, the virus mutated and its virulence increased
exponentially, with it going on to devastate the globe between August and December of 1918.
The final – and far less virulent – wave of the pandemic occurred in the winter of
1918 through to the spring of 1919. The variables which explain why the Spanish
flu became so lethal are multi-faceted. One key reason was that the Great War created
an environment that was highly conducive to the rapid spread of viruses. In 1918, there
was a vast movement of people and goods – both within countries, and across the globe – which
created a perfect network of human carriers for the virus to quickly travel. Domestically,
within the US for instance, war mobilization resulted in the military expanding to occupy
every pocket of the country, producing a network of young adults which maximized the speed
at which the influenza could travel (Byerly 2010: 84). This expansion of the military
caused another problem, overcrowding in the barracks, which also contributed to the virus
spreading. On an international level, troops were constantly moving from one continent
to another, with hundreds-of-thousands of US soldiers crossing the Atlantic every month
after the US entered the war (Byerly 2010: 85).
The prioritization of war over adopting preventative measures is another reason why the Spanish
influenza became so deadly. Certain scholars argue that we can see this rationale in the
decision-making of the Army Chief of Staff, Peyton March, who refused to fully act on
the recommendations of the Acting Army Surgeon General, Charles Richard – although March
had an impossible juggling act to try and balance (Byerly 2010: 89 and 90). When the
devastating effects of Spanish flu became apparent, Richard recommended a one-week quarantine
of all soldiers prior to embarkation, in addition to halving the capacity of ships carrying
troops to Europe. March refused to implement the quarantine however, opting for the more
limited action of pre-board physical screening, whilst only agreeing to a ten percent reduction
in ship capacity, citing war concerns as his justification (Byerly 2010: 89 and 90). The
war played another important role in creating the conditions for the virus to spread like
wildfire. After four years of hardship, entire populations were weak, malnourished and highly
susceptible to contracting infections (Song 2014).
Aside from the war however, there were other important reasons why the influenza claimed
so many. One reason pertained to there being a critical lack of medical knowledge concerning
the causative agent of the virus, and the subsequent absence of an effective treatment
(Patterson 1983: 493). Obviously, the fact that the causative agent remained an enigma
had major consequences for authorities who were trying to prevent the transmission of
the virus. In New York for instance, officials had no way to scientifically test individuals
to determine if they were infected or not (Aimone 2010: 74). This lack of scientific
knowledge left a vacuum for speculative theories to arise pertaining to what caused and cured
this mysterious plague. Some reports from 1918 suggested that the virus may have been
a biological weapon deployed by German operatives, who could have released germs into theatres
and other crowded places. Even though the Spanish flu killed more people
than the First World War did directly, the two events are inextricably intertwined, as
the Great War provided the springboard for the influenza to become so deadly.

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