1. The Spanish flu did not originate in Spain. They were just the first to report on it because they didn’t censor their press during the war. Those vulnerable were 20 to 40-year olds. Lots of dependents (children and elderly) were left without support.

2. Over three waves of infections, the Spanish flu killed around 50 million people between 1918 and 1919. It infected about 500 million people – so one in three people in the world alive at that time. The death toll could have been higher, due to likely under-reporting.

3. There was no reliable diagnostic test and no really good treatments. The disease was called many different things, which meant there was a problem counting the dead as well.

4. People were on the move, not only troops, but also civilians: refugees and displaced persons. Fastest modes of travel were ships and trains. Illiteracy was much higher than now, which had an impact because news was mainly transmitted by newspapers.

5. Australia could see it coming and took advantage of that to put in place maritime quarantine in 1918. Public health measures that really worked that year. But they lifted it too soon and the third wave of infection of early 1919 killed 12,000 Australians.

6. It was a time of eugenics-type thinking and it was perceived that those people who were more prone to the flu were somehow inferior, and that it was somehow their own fault. This thinking (mostly) disappeared later.

7. The West became disillusioned, and turned away from, science. Alternative medicine took off in America. China instead embraced science. Russia was the first after this, followed by Western European nations, to put in place socialized healthcare systems.

8. There was a realization that a pandemic was a global health crisis you had to treat at the population level. There was no point in blaming individuals. Socialized healthcare would protect the larger population from those who fell ill, as they would seek and receive treatment.

9. All these insights and more are outlined in science journalist Laura Spinney’s 2018 book Pale Rider: The Spanish Flu of 1918 and How It Changed the World. She wrote it when she realized how little people knew about the worst disaster of the 20th century.

10. But today she is also surprised that people keep comparing covid-19 with the Spanish flu. The 1957 Asian flu killed ~2 million. The 1968 Hong Kong flu killed ~4 million. They were much worse than our current outbreak to date. And yet they seem to have fallen out of memory.

11. For all our talk about how easy it is to spread information and keep people informed today, it sure seems to be an environment where it’s also all too easy to forget.

Read Kate Whiting’s conversation with Laura Spinney here: https://www.weforum.org/agenda/2020/04/covid-19-how-spanish-flu-changed-world/

12. This is relevant. To stop calling it the Spanish flu. On Wikipedia, in history books and public discourse this is often what it is called. People should know why. But we can do better going forward. It's the 1918 flu pandemic. https://twitter.com/MathAndCobb/status/1280141838427525122?s=20