Impact of 1918-1919 Pandemic on U.S. Economy

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steve roy
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Impact of 1918-1919 Pandemic on U.S. Economy

Post by steve roy »

Sergio Correia, Stephan Luck and Emil Verner -- fact-based academics from the Federal Reserve and MIT -- have written a paper titled "Pandemics Depress the Economy, Public Health Interventions Do Not: Evidence from the 1918 Flu"

In short, they represent that:
"Our analysis yields two main insights.

"First, we find that areas that were more severely affected by the 1918 Flu Pandemic see a sharp and persistent decline in real economic activity. Second, we find that early and extensive NPIs (Non Pharmaceutical Interventions) have no adverse effect on local economic outcomes.

"On the contrary, cities that intervened earlier and more aggressively experience a relative increase in real economic activity after the pandemic. Altogether, our findings suggest that pandemics can have substantial economic costs, and NPIs cannot only be means to lower mortality but may also have economic merits by mitigating the adverse impact of the pandemic. ..."
In other words, in 1918-1919, the U.S. cities that shut down businesses, quarantined people, and didn't allow large gatherings (and also did face masks) had fewer deaths and ultimately better long-term economic results than cities that didn't.

Between 500k and 675k of the citizenry died in '18-'19. (There were three viral "waves") This was when the U.S. population was 102 million. There was little federal direction or coordination back then, kind of like now.

https://papers.ssrn.com/sol3/papers.cfm ... id=3573145
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by InvestingGeek »

I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

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Gosh, didn't the roaring twenties follow?
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by fatFIRE »

WW1 happened during that time too... I'm sure that affected things.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Dottie57 »

fatFIRE wrote: Sun Apr 12, 2020 10:34 am WW1 happened during that time too... I'm sure that affected things.
+1. Think of loss of young men in war. I would think loss of labor would have been inflationary.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Valuethinker »

Dottie57 wrote: Sun Apr 12, 2020 10:39 am
fatFIRE wrote: Sun Apr 12, 2020 10:34 am WW1 happened during that time too... I'm sure that affected things.
+1. Think of loss of young men in war. I would think loss of labor would have been inflationary.
The American Expeditionary Force arrived in WW1 too late for its combat casualties to make a significant dent in the total. In the context of the entire American labour force? Not significant. (When it was engaged it suffered casualties similar to other combatants at that late stage in the war - i.e. grievous. They had stopped charging machine guns across No Man's Land a la 1916, but they hadn't stopped dying in the shells, gas & barbed wire).

France definitely suffered post WW1 from the loss of young men-- over 3 million men dead or severely injured on a population of c 60m. Germany too. And probably some eastern states. Britain as well no doubt.

For the USA the great flu would have had as big or bigger an impact - c 575k deaths. But remember that was in the context of a population of well over 100m, and a partially agrarian one.

This wasn't like a plague that only killed software engineers. It killed people who would have worked on farms or in factories, and could be replaced by other people (they were busily turfing women out of factory jobs at the same time). Nonetheless as I note in my comment below it is conceivable that there were effects on the economic performance of some cities vs others.

The social changes WW1 wrought on America were probably significant. Economic? Much less so except in the sense that it strengthened American industry and left repressed spending power which would contribute to the 1920s boom.
Last edited by Valuethinker on Sun Apr 12, 2020 11:02 am, edited 2 times in total.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Ferdinand2014 »

steve roy wrote: Sun Apr 12, 2020 9:25 am Sergio Correia, Stephan Luck and Emil Verner -- fact-based academics from the Federal Reserve and MIT -- have written a paper titled "Pandemics Depress the Economy, Public Health Interventions Do Not: Evidence from the 1918 Flu"

In short, they represent that:
"Our analysis yields two main insights.

"First, we find that areas that were more severely affected by the 1918 Flu Pandemic see a sharp and persistent decline in real economic activity. Second, we find that early and extensive NPIs (Non Pharmaceutical Interventions) have no adverse effect on local economic outcomes.

"On the contrary, cities that intervened earlier and more aggressively experience a relative increase in real economic activity after the pandemic. Altogether, our findings suggest that pandemics can have substantial economic costs, and NPIs cannot only be means to lower mortality but may also have economic merits by mitigating the adverse impact of the pandemic. ..."
In other words, in 1918-1919, the U.S. cities that shut down businesses, quarantined people, and didn't allow large gatherings (and also did face masks) had fewer deaths and ultimately better long-term economic results than cities that didn't.

Between 500k and 675k of the citizenry died in '18-'19. (There were three viral "waves") This was when the U.S. population was 102 million. There was little federal direction or coordination back then, kind of like now.

https://papers.ssrn.com/sol3/papers.cfm ... id=3573145
To say that there was little direction or coordination at the federal level back then as now, is completely inaccurate. There was zero. Zero acknowledgment of the pandemic by the President 1918-1920 - as to avoid panic in the midst of WW1. There was no social safety net, no federal central bank intervention, no checks in the mail, small business forgivable loans, bailouts or medical support of any kind. There was no national defense act, coordinated FDA, CDC or national repository effort at providing and procuring supplies, no hospital ships, prefab hospitals, or hospital financial support. I could go on. We have no idea how good we have it in this country compared to 1918.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by SimpleGift »

It seems rather remarkable that the impacts of the 1918 Pandemic on the U.S. stock market were not more consequential (second chart below of Dow Jones Average) — though market performance is complicated by the First World War.
The Dow was down about 10% at the peak of the pandemic, stayed down through late 1918 and early 1919, and then completely recovered within about four months. Not quite what one would expect from such an enormous pandemic.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by steve roy »

Good points. Could well have left that last sentence out. The lack of current robust testing was what I was trying ... and failing ... to get at.
Last edited by steve roy on Sun Apr 12, 2020 11:18 am, edited 2 times in total.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Valuethinker »

nedsaid wrote: Sun Apr 12, 2020 10:18 am Gosh, didn't the roaring twenties follow?
Yes, but the point of the article is about the recovery rate of different cities. Rather than the US national economy as a whole.

(The economy of urban America boomed in the 1920s - cars, radios, electric lights, universal streetcars etc. From about 1924 (or 1926?) America's farm economy was in a slump)

It is a reasonable guess that since the 1918-19 flu tended to kill young people (18-35) their deaths might have retarded the economic recovery of the cities in which they lived.

Also I don't think the psychological shock value should be underestimated.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Dottie57 »

Valuethinker wrote: Sun Apr 12, 2020 10:47 am
Dottie57 wrote: Sun Apr 12, 2020 10:39 am
fatFIRE wrote: Sun Apr 12, 2020 10:34 am WW1 happened during that time too... I'm sure that affected things.
+1. Think of loss of young men in war. I would think loss of labor would have been inflationary.
The American Expeditionary Force arrived in WW1 too late for its combat casualties to make a significant dent in the total. In the context of the entire American labour force? Not significant. (When it was engaged it suffered casualties similar to other combatants at that late stage in the war - i.e. grievous. They had stopped charging machine guns across No Man's Land a la 1916, but they hadn't stopped dying in the shells, gas & barbed wire).

France definitely suffered post WW1 from the loss of young men-- over 3 million men dead or severely injured on a population of c 60m. Germany too. And probably some eastern states. Britain as well no doubt.

For the USA the great flu would have had as big or bigger an impact - c 575k deaths. But remember that was in the context of a population of well over 100m, and a partially agrarian one.

This wasn't like a plague that only killed software engineers. It killed people who would have worked on farms or in factories, and could be replaced by other people (they were busily turfing women out of factory jobs at the same time). Nonetheless as I note in my comment below it is conceivable that there were effects on the economic performance of some cities vs others.

The social changes WW1 wrought on America were probably significant. Economic? Much less so except in the sense that it strengthened American industry and left repressed spending power which would contribute to the 1920s boom.
As an aside, the following is an interesting display of census data from starting at 1900. The link is from census.gov. Click on a year to see the graphic for that year.

https://www.census.gov/dataviz/visualizations/055/
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by willthrill81 »

I would not try to draw any conclusions from what happened with a pandemic over 100 years ago. The markets are too different, the Federal Reserve is too different, etc.
nedsaid wrote: Sun Apr 12, 2020 10:18 am Gosh, didn't the roaring twenties follow?
Yeah, and that party ended well, right? :wink:
Last edited by willthrill81 on Sun Apr 12, 2020 11:08 am, edited 1 time in total.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Valuethinker »

SimpleGift wrote: Sun Apr 12, 2020 10:53 am It seems rather remarkable that the impacts of the 1918 Pandemic on the U.S. stock market were not more consequential (second chart below of Dow Jones Average) — though market performance is complicated by the First World War.
The Dow was down about 10% at the peak of the pandemic, stayed down through late 1918 and early 1919, and then completely recovered within about four months. Not quite what one would expect from such an enormous pandemic.
Top chart is United Kingdom?

Bottom chart is USA - Dow?

Be interesting to see the FTSE (might have been the FTSE 10, not sure if there was an index at that time).

WW1 definitely confuses the data. You had an immediate postwar slump and then jubilation when the final peace treaty was signed.

Woodrow Wilson's illness with the flu definitely hurt his plans for a postwar world. Against his warnings, Britain and France inflicted a punishing settlement on Germany that made Germany accept all blame for the war. That became a centre-piece of right wing propaganda in the 1920s, and the peace "settlement" dictated to Germany contributed to the rise of Hitler & fascism.

As a French general said at Versailles in 1919 - "This is not a peace. It is a 20 year ceasefire".

Historians 100 years from now will not talk about "World War One and Two" but "the European civil war" of the mid 20th century, broken into 2 halves. In the way we talk about "The Wars of Religion" in French history, or "The Thirty Years War" in German history.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by SimpleGift »

Valuethinker wrote: Sun Apr 12, 2020 11:07 am Top chart is United Kingdom?
Bottom chart is USA - Dow?
I expect the author of those two charts was just trying to show the timing of the 3 waves of the 1918 pandemic, and U.K. data was better or more available than U.S. data. U.K. statistical services were likely the best in the world in 1918.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by A-Commoner »

InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Mr. Rumples »

Valuethinker wrote: Sun Apr 12, 2020 11:07 am
SimpleGift wrote: Sun Apr 12, 2020 10:53 am It seems rather remarkable that the impacts of the 1918 Pandemic on the U.S. stock market were not more consequential (second chart below of Dow Jones Average) — though market performance is complicated by the First World War.
The Dow was down about 10% at the peak of the pandemic, stayed down through late 1918 and early 1919, and then completely recovered within about four months. Not quite what one would expect from such an enormous pandemic.
Top chart is United Kingdom?

Bottom chart is USA - Dow?

Be interesting to see the FTSE (might have been the FTSE 10, not sure if there was an index at that time).

WW1 definitely confuses the data. You had an immediate postwar slump and then jubilation when the final peace treaty was signed.

Woodrow Wilson's illness with the flu definitely hurt his plans for a postwar world. Against his warnings, Britain and France inflicted a punishing settlement on Germany that made Germany accept all blame for the war. That became a centre-piece of right wing propaganda in the 1920s, and the peace "settlement" dictated to Germany contributed to the rise of Hitler & fascism.

As a French general said at Versailles in 1919 - "This is not a peace. It is a 20 year ceasefire".

Historians 100 years from now will not talk about "World War One and Two" but "the European civil war" of the mid 20th century, broken into 2 halves. In the way we talk about "The Wars of Religion" in French history, or "The Thirty Years War" in German history.
That reflection has already started. I have seen several presentations on the worst time to be alive in civilization. The era of the black plague is one and the other is Europe in the 20th century; the two wars and the Russian Revolution are pretty much rolled into one long catastrophic event.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by cableguy »

100 years ago there was no dual incomes households, people bought things with cash in hand and didn’t finance dishwashers, 3 cars family vacations, etc. People, companies, and governments actually believed that supply and demand and debits and credits had actual meaning. Comparing then to now is fun......but makes no sense. Our economy today is a debt fueled bonanza with no real underlying economic principles. Today a person with no job can dress better than you, drive a better car than you, and go on vacation. The system is whacked!
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by nedsaid »

Valuethinker wrote: Sun Apr 12, 2020 10:58 am
nedsaid wrote: Sun Apr 12, 2020 10:18 am Gosh, didn't the roaring twenties follow?
Yes, but the point of the article is about the recovery rate of different cities. Rather than the US national economy as a whole.

(The economy of urban America boomed in the 1920s - cars, radios, electric lights, universal streetcars etc. From about 1924 (or 1926?) America's farm economy was in a slump)

It is a reasonable guess that since the 1918-19 flu tended to kill young people (18-35) their deaths might have retarded the economic recovery of the cities in which they lived.

Also I don't think the psychological shock value should be underestimated.
I knew somebody who lost much of his family during that epidemic.
A fool and his money are good for business.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Mr. Rumples »

One reason perhaps that we recovered is that we learned lessons from it in the area of public health, lessons that we perhaps forgot. Public health services after the pandemic were made robust and there was at least in VA a large investment in it. But during the pandemic, here in VA, life came to almost a standstill:

https://scholarship.richmond.edu/cgi/vi ... ers-theses

https://www.alexandriava.gov/uploadedFi ... aph(1).pdf

My grandparents lost two children in the pandemic, one sister-in-law lost an uncle. I had a great aunt who was so emotionally traumatized from it she did not leave her room until she died, my aunts remember having to go to take care of her daily.

I am going to Richmond tomorrow to visit Hollywood Cemetery where five presidents are buried (grounds are open, tours are canceled). In addition I will visit the grave of John Langhorne Williams who died at the age of 15 from exhaustion helping flu victims in 1918.

https://www.findagrave.com/memorial/256 ... e-williams
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by delamer »

A-Commoner wrote: Sun Apr 12, 2020 11:23 am
InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
It’s my understanding that a large factor in the lower life expectancy back then was that so many young children died from now-preventable diseases/conditions. If you made it out of childhood, there was a good chance to survive to what we’d now call elderly (65+).
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by A-Commoner »

The other things that were not available in 1918 were the flu vaccine - the vaccine (in its annually changing iterations) which is now available to us every year and many people take for granted, even oppose (see the anti-vaxxer movement). There also were no antivirals like tamiflu that would have killed these viruses, and no antibiotics like penicillin (which only got discovered in 1928) to treat secondary bacterial pneumonias that developed on top of the flu-weakened lungs. These secondary bacterial pneumonias are likely what killed the Spanish flu victims, not the flu virus itself.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by A-Commoner »

delamer wrote: Sun Apr 12, 2020 11:53 am
A-Commoner wrote: Sun Apr 12, 2020 11:23 am
InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
It’s my understanding that a large factor in the lower life expectancy back then was that so many young children died from now-preventable diseases/conditions. If you made it out of childhood, there was a good chance to survive to what we’d now call elderly (65+).
I don't disagree with your statement. However my disagreement was with the other poster who said the Spanish flu primarily affected the young not the old. The 18-35 yr old demographic which was mentioned as the group mainly affected by the Spanish flu and calling that group "young' is likely not accurate by 1918 standards. That group was the biggest chunk and most representative of the US population at that time, and the Spanish flu hit them because they were the most numerous demographic group, not because they were young.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by delamer »

A-Commoner wrote: Sun Apr 12, 2020 12:06 pm
delamer wrote: Sun Apr 12, 2020 11:53 am
A-Commoner wrote: Sun Apr 12, 2020 11:23 am
InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
It’s my understanding that a large factor in the lower life expectancy back then was that so many young children died from now-preventable diseases/conditions. If you made it out of childhood, there was a good chance to survive to what we’d now call elderly (65+).
I don't disagree with your statement. However my disagreement was with the other poster who said the Spanish flu primarily affected the young not the old. The 18-35 yr old demographic which was mentioned as the group mainly affected by the Spanish flu and calling that group "young' is likely not accurate by 1918 standards. That group was the biggest chunk and most representative of the US population at that time, and the Spanish flu hit them because they were the most numerous demographic group, not because they were young.
I thought that a greater percentage of those age 20-40 died from the Spanish Flu than those in other age groups (although I can’t find a specific citation). That percentage would have translated into higher absolute numbers, if it was the largest demographic group.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Valuethinker »

A-Commoner wrote: Sun Apr 12, 2020 11:57 am The other things that were not available in 1918 were the flu vaccine - the vaccine (in its annually changing iterations) which is now available to us every year and many people take for granted, even oppose (see the anti-vaxxer movement). There also were no antivirals like tamiflu that would have killed these viruses, and no antibiotics like penicillin (which only got discovered in 1928) to treat secondary bacterial pneumonias that developed on top of the flu-weakened lungs. These secondary bacterial pneumonias are likely what killed the Spanish flu victims, not the flu virus itself.
"cytokine storm". The over-reaction of the immune system. That's why it killed young adults so effectively, unlike the normal flu.

In effect they died of sepsis.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Valuethinker »

delamer wrote: Sun Apr 12, 2020 12:27 pm
A-Commoner wrote: Sun Apr 12, 2020 12:06 pm
delamer wrote: Sun Apr 12, 2020 11:53 am
A-Commoner wrote: Sun Apr 12, 2020 11:23 am
InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
It’s my understanding that a large factor in the lower life expectancy back then was that so many young children died from now-preventable diseases/conditions. If you made it out of childhood, there was a good chance to survive to what we’d now call elderly (65+).
I don't disagree with your statement. However my disagreement was with the other poster who said the Spanish flu primarily affected the young not the old. The 18-35 yr old demographic which was mentioned as the group mainly affected by the Spanish flu and calling that group "young' is likely not accurate by 1918 standards. That group was the biggest chunk and most representative of the US population at that time, and the Spanish flu hit them because they were the most numerous demographic group, not because they were young.
I thought that a greater percentage of those age 20-40 died from the Spanish Flu than those in other age groups (although I can’t find a specific citation). That percentage would have translated into higher absolute numbers, if it was the largest demographic group.
Even adjusting for demographics it was a horrific killer of young adults. Hence the casualties in US Army recruits.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by Dominic »

delamer wrote: Sun Apr 12, 2020 12:27 pm
A-Commoner wrote: Sun Apr 12, 2020 12:06 pm
delamer wrote: Sun Apr 12, 2020 11:53 am
A-Commoner wrote: Sun Apr 12, 2020 11:23 am
InvestingGeek wrote: Sun Apr 12, 2020 10:09 am I think the conclusion is overreaching. The 1918 Spanish flu primarily affected the young, not the old. It makes sense therefore that cities that saved their young went on to thrive. It does not apply to all epidemics.
Life expectancy in the early 1900s was 48 yrs for an American male and 51 for an American female. There were very few "old people" as we define them today.
It’s my understanding that a large factor in the lower life expectancy back then was that so many young children died from now-preventable diseases/conditions. If you made it out of childhood, there was a good chance to survive to what we’d now call elderly (65+).
I don't disagree with your statement. However my disagreement was with the other poster who said the Spanish flu primarily affected the young not the old. The 18-35 yr old demographic which was mentioned as the group mainly affected by the Spanish flu and calling that group "young' is likely not accurate by 1918 standards. That group was the biggest chunk and most representative of the US population at that time, and the Spanish flu hit them because they were the most numerous demographic group, not because they were young.
I thought that a greater percentage of those age 20-40 died from the Spanish Flu than those in other age groups (although I can’t find a specific citation). That percentage would have translated into higher absolute numbers, if it was the largest demographic group.
It was most deadly among children and the elderly. However, it was much more deadly than a typical flu among younger adults. Here's a mortality graph by age (deaths per 100,000):

Image

So 20-40 year olds weren't the most at-risk group, but this disease was incredibly dangerous for that demographic regardless. This group experienced severe illness due to cytokine storms (the immune system overreacting). Those with healthy immune systems are believed to be more at-risk for cytokine storm complications.

As with a normal flu, I believe bacterial pneumonia caused most of the deaths for the other age groups.
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Re: Impact of 1918-1919 Pandemic on U.S. Economy

Post by A-Commoner »

Valuethinker wrote: Sun Apr 12, 2020 1:04 pm
A-Commoner wrote: Sun Apr 12, 2020 11:57 am The other things that were not available in 1918 were the flu vaccine - the vaccine (in its annually changing iterations) which is now available to us every year and many people take for granted, even oppose (see the anti-vaxxer movement). There also were no antivirals like tamiflu that would have killed these viruses, and no antibiotics like penicillin (which only got discovered in 1928) to treat secondary bacterial pneumonias that developed on top of the flu-weakened lungs. These secondary bacterial pneumonias are likely what killed the Spanish flu victims, not the flu virus itself.
"cytokine storm". The over-reaction of the immune system. That's why it killed young adults so effectively, unlike the normal flu.

In effect they died of sepsis
From what I see of people who have the flu and later die (I’m a physician BTW), many of them develop secondary bacterial pneumonia and die from that. Or they progress to sepsis and multi-organ failure and die from that. “Cytokine storm” is just a term used to describe what is expected to happen: an invader attacks the body, the body mounts an immune response and defeats the invader, or the body does not effectively defeat the invader and mounts an even greater response (releasing cytokines) that causes collateral damage to the body. These events occur in a continuum. From the initial event of flu infection to bacterial pneumonia to sepsis to multi organ failure in the setting of cytokine storm, these events are not mutually exclusive.
The mortality rate from the Spanish flu was high because of many factors, but from the medical standpoint, these factors were contributory: the absence of a flu vaccine in 1918, the absence of antivirals like tamiflu, the absence of antibiotics like penicillin, the absence of ventilators and other supportive measures to help the patient as he battles the flu and its complications. The Spanish flu did not have special predilection for the young, as defined. It attacked the vulnerable of all ages.
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