As the hysterical coronavirus overreaction crashes our economy, I can’t help but think of the Spanish flu, which took some 675,000 American lives in 1918 and 1919. Adjusting for the difference in the size of the American population then and now, that number would be equivalent to two million deaths today. I’ll be surprised—I’m writing this in late March—if COVID-19 takes as many as 50,000 American lives, or proportionally 1/40th of the lives lost to the Spanish Flu. Even some of the current projections of 100,000 or more deaths would still be only a small fraction of those who died of the Spanish flu.

The Spanish flu has been called America’s forgotten epidemic. It was not forgotten in my family. My mother was one of 11 children and the age range from youngest to oldest spanned 20 years. When my mother and several of her sisters were still in their single digits, two of their older brothers were already cops and the oldest sister was married with a son. That sister and her husband died in the Spanish flu epidemic. Their toddler son was taken in by my mother’s family and raised as a little brother. Until I was five or six, I thought he was another one of my uncles—he was of the right age—and not, as I learned, my cousin.

The origin of the Spanish flu is greatly debated, but it is universally agreed that it did not originate in Spain. However, Spanish newspapers were the first to report an influenza virus wreaking havoc in their own country, and also decimating Allied troops during 1918. Spain was neutral during World War I and her newspapers were not subject to censorship, unlike newspapers of the Allies, whose countries didn’t want anything published that would frighten people and lower morale. By the war’s end more troops were becoming casualties of flu than of bullets or bombs.

It’s probably best left to virologists and epidemiologists to debate the true origins of the Spanish flu, but China is one likely candidate. A respiratory virus hit China during the fall of 1917 and ravaged thousands. It was later determined to be identical to the one causing the Spanish flu.

This bug was then brought to Europe by nearly 100,000 Chinese contracted by the British and French to perform labor behind the war’s front lines. These Chinese workers were far less affected by the virus than were the British and French, simply because they had already been exposed to it the year before and had built up immunity. A variation on this explanation says the virus came with the Chinese on a ship that put in at Boston and that the virus mutated there before the Chinese carried the new mutated version with them to Europe.

There is also an argument that the virus originated among farmers in Kansas who contracted it from their hogs or poultry in January 1918. The farmers then carried the virus to the Army’s Camp Funston, which had an influenza epidemic in March. However, there were soldiers at Funston who had returned from Europe to train fresh troops, and they could have brought the virus with them.

Whatever the source, the virus spread rapidly at Funston among the thousands of doughboys who trained and lived in crowded conditions. Eleven hundred soldiers required hospitalization and 38 died. The flu spread as the soldiers were transferred to other camps before deployment to Europe, not only at other Army bases but also at towns near the camps.

There is no question that Camp Funston had an influenza epidemic. But whether this was the Spanish flu has been questioned, principally because not enough soldiers died. Everywhere else, the Spanish flu was even more deadly. Moreover, the argument that the Spanish flu originated in Kansas doesn’t account for the appearance of the virus in China six months before it struck Camp Funston.

The first American cities to feel the full effects of this virulent flu were the East Coast seaports. The Navy barracks at Commonwealth Pier in Boston held thousands of sailors in cramped quarters. In late August 1918 sick bays began filling up with sick soldiers. About 50 sailors fell desperately ill and were immediately transferred to the Chelsea Naval Hospital. They were isolated in an attempt to contain the virus, but it was already too late. Early in September sick civilians began arriving at Boston City Hospital.

Meanwhile, in late August at Camp Devens, some 30 miles northwest of Boston, soldiers began falling ill with what was thought to be pneumonia, meningitis, or some unknown virus. Nothing much could be done but to quarantine the camp and isolate the patients. By the third week of September, a fifth of the soldiers were infected and many were dying, and some doctors and nurses were dying as well.

By October the flu had spread through the population of Boston. Boston City Hospital alone treated 2,300 patients, mostly in September and October, but new cases were still arriving in November and December. Of the patients treated, 675 died. The virus took a toll on the medical staff at the hospital as well. Nine nurses, two physicians, and four other employees died. Altogether, Boston lost more than 4,000 residents to the Spanish flu before the end of the year.

Early in September 1918 a Navy ship from Boston with dozens of sick sailors aboard steamed up the Delaware River and docked at the Philadelphia Navy Yard. The next day two of the sick sailors died. Health officials told the public it was not the Spanish flu and, whatever it was, it would be confined to the Navy Yard. The next day 14 sailors and one civilian died. Day by day, civilians began falling ill. Nonetheless, Philadelphia forged ahead with a Liberty Loan parade on September 28. The war effort was paramount, and these parades were held across the country to encourage the public purchase of war bonds to fund the war. What would become the largest parade in Philadelphia history seemingly went off without a hitch, with thousands of spectators lining the parade route.

However, in the six weeks following the parade, some 12,000 Philadelphians died of the Spanish flu, most of them young and healthy until struck down by the virus. Archbishop Dennis Dougherty had his priests join the police in carrying bodies from stricken homes throughout the city. Piled high with corpses, death carts rattled down the streets. Local cemeteries were overwhelmed, and many bodies were dumped into mass graves. Thousands of children lost a parent or were orphaned. At Philadelphia General Hospital nearly 10 percent of the nurses died. Doctors were dropping as well. Three dozen cops died.

New York City was the principal port for soldiers sailing to and returning from the war in Europe, making any general quarantine of ships impractical. Col. J. M. Kennedy, the Army officer in charge of medical affairs for the district of New York, made it clear to public health officials during the summer of 1918 that the war effort would take precedence over the Spanish flu.

Without question, the virus was coming to the city and health officials decided to fight it the way they had fought tuberculosis. “When cases develop in private houses or apartments, they will be kept in strict quarantine there,” Health Commissioner Royal Copeland said. “When they develop in boarding houses or tenements, they will be promptly removed to city hospitals, and held under strict observation and treated there.” Ultimately, this policy meant New York’s hospitals weren’t overwhelmed as Boston and Philadelphia’s had been.

In addition, by the middle of September, New York City had a public education campaign in full swing. More than 10,000 posters describing sanitation and hygiene practices were placed in train and subway stations, on storefronts, police stations, and libraries, and in hotel lobbies. Health education materials were disseminated throughout the city, including the schools, which were kept open. There was also strict enforcement of the city’s sanitary code, which included a prohibition on spitting in public.

The measures New York City took saved lives, and it fared better than other cities, despite its exposure to the troop ships. By October, the Spanish flu was roaring through New York, but the city’s death rate of 4.7 per 1,000 infected was significantly better than Boston’s 6.5 or Philadelphia’s 7.3. Altogether, from September 1918 through January 1919, New York City lost 30,000 of its residents to the virus.

Meanwhile, the virus was spreading rapidly to other American cities, most often first appearing at such seaport cities as Baltimore, New Orleans, Los Angeles, San Francisco, and Seattle. From September 1918 to March 1919, San Francisco had some 3,100 of its residents die at a rate of 6.7. During the same period, New Orleans lost 3,500 at a rate of 6.5, Baltimore 4,100 at a rate of 5.6, Los Angeles 2,800 at a rate of 4.9, and Seattle 1,400 at a rate of 4.4.

Cities in America’s interior suffered also, but their death rates were lower than their coastal sisters’. Not surprisingly, the first cases of Spanish flu in Chicago appeared in September 1918 at a military facility: Great Lakes Naval Training Station.

The Navy reacted immediately by quarantining the base and isolating those who had contracted the virus. Nonetheless, within a week civilians were falling victim to the flu. Chicago would ultimately have a death rate of 3.7. St. Louis is often cited for its preparations for the arrival of the Spanish flu and for its practices once the flu arrived, but it still had a death rate of 3.6. The cities of Minneapolis, Milwaukee, Dallas, Grand Rapids, Indianapolis, Toledo, and Columbus all had death rates slightly under 3.0. There was a striking exception to these lower death rates for interior cities—Pittsburgh with a rate of 8.0. It’s thought that Steel City’s terribly polluted air in that era caused numerous respiratory problems, and made residents especially vulnerable to the influenza virus. The high rate of cigarette smoking in China today is also thought to have made their population more vulnerable to COVID-19, though it may be some time before we get the true death toll from China.

Any death from illness is upsetting. But given the current hysteria, the historical perspective provided by the exponentially more deadly Spanish flu of a century ago should help us keep our fears in check.