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COVID-19 has now killed nearly as many Americans as the Spanish flu pandemic of 1918-19 did – about 675,000.

A century ago the US population was just a third of what it is today, meaning the flu cut a much larger, more deadly swath through the country. But the COVID-19 crisis is by no means a major tragedy in itself, especially given the incredible advances in scientific knowledge since then and the failure to make the most of available vaccines this time around.

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“Large sections of American society – and worse, their leaders – have thrown it off,” Dr. Howard Merkel, medical historian at the University of Michigan, said Opportunity to vaccinate everyone who has been eligible so far.

Like the Spanish flu, the coronavirus may never completely disappear from our midst. Instead, scientists expect it to become a mild seasonal bug as human immunity strengthens through vaccination and repeated infections. It might take a while.

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“We expect it to be like freezing, but there are no guarantees,” said Emory University biologist Rustam Antia, who suggests an optimistic scenario in which it could happen in a few years.

For now, the pandemic is still firmly in its jaws in the United States and other parts of the world.

While the delta-fueled rise in infections may be peaking, US deaths are running at an average of more than 1,900, the highest level since early March, and according to a count kept by Johns Hopkins University, the country’s total toll is 675,000 on Monday. is at the top. However, the actual number is believed to be higher.

Winter could spark a new surge, with influential models from the University of Washington predicting an additional 100,000 or so Americans will die from COVID-19 by January 1, bringing the total US toll to 776,000.

The influenza pandemic of 1918–19 killed 50 million victims globally at a time when the population was one-fourth of the world’s population. Global deaths from COVID-19 have now exceeded 4.6 million.

Given the incomplete records from that era and the poor scientific understanding of the cause of the disease, the Spanish flu death toll in the US is a rough estimate. NS 675,000 figure Comes from the US Centers for Disease Control and Prevention.

COVID-19 may fluctuate when the virus mutates as it gradually weakens and more and more humans’ immune systems learn to attack it. Vaccination and live infection are the main methods of improving the immune system. Breastfed babies also receive some immunity from their mothers.

1918: Nurses care for victims of the Spanish influenza pandemic among canvas tents during an outdoor fresh air treat, Lawrence, Massachusetts.  (Photo by Hulton Archive/Getty Images)

Under that optimistic scenario, schoolchildren would have mild illness that trains their immune systems. As they grow up, children have an immune response memory, so that when they are older and weaker, the coronavirus will be no more dangerous than the cold virus.

The same goes for today’s vaccinated teens: Their immune systems will be strengthened through shots and mild infections.

“We will all be infected,” predicted Antia. “What’s important is whether the infections are serious.”

Something similar happened with the H1N1 flu virus, which was the culprit of the 1918-19 pandemic. It afflicted many people who were immunized, and it also eventually became weakened through mutation. H1N1 still circulates today, but immunity acquired through infection and vaccination has triumphed.

Getting an annual flu shot now protects against H1N1 and many other types of flu. To be sure, the flu kills between 12,000 and 61,000 Americans each year, but on average, it is a seasonal problem and a manageable one.

Before COVID-19, the 1918-19 flu was universally considered the worst pandemic disease in human history. Whether the current crisis ultimately proves fatal is not clear.

In many ways, the 1918-19 flu – incorrectly named the Spanish flu because it first received widespread news coverage in Spain – was worse.

Spread by the dynamism of World War I, it killed large numbers of young, healthy adults. No vaccine existed to slow it down, and there were no antibiotics to treat secondary bacterial infections. And, of course, the world was much smaller.

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Yet jet travel and mass exodus threaten to increase the toll of the current pandemic. Much of the world is uninfected. And the coronavirus is full of surprises.

Merkel said she continues to be amazed by the magnitude of the disruption the pandemic has caused to the planet.

“I was amazed by the size of the quarantine” the Chinese government initially did, Merkel said, “and I’ve been gob-gob-smacked to the nth degree ever since.” The slow pace of US vaccinations is their latest source of astonishment.

Less than 64% of the US population has received at least one dose of the vaccine, with state rates ranging from as high as about 77% in Vermont and Massachusetts to 46% to 49% in Idaho, Wyoming, West Virginia, and Mississippi. is less. .

globally, about 43% of the population According to the data Our World has received at least one dose, some African countries have just started giving their first shots.

“We know that all epidemics are over,” said Dr., director of emergency care research at the National Institutes of Health. Jeremy Brown, who wrote a book on influenza. “They can do terrible things when they are furious.”

“If more people had been rapidly vaccinated, COVID-19 would have been far less fatal in the US,” Brown said, “and we still have an opportunity to turn that around.” “We often forget how lucky we are to take these things lightly.”

Current vaccines work very well in preventing serious illness and deaths from the types of viruses that have been exposed so far.

Antia said it will be important for scientists to make sure the ever-changing virus hasn’t changed enough to avoid vaccines or cause serious illness in unvaccinated children.

A Pfizer executive said Wednesday that if the virus changes significantly, a new vaccine could be developed in 110 days using the technology behind Pfizer and Moderna Shots. The company is studying whether annual shots would be needed along with the current vaccine to keep immunity high.

A plus: The coronavirus mutates at a slower rate than the flu virus, making it a more stable target for vaccination, said Ann Marie Kimball, a retired professor of epidemiology at the University of Washington.

So, will the current pandemic beat the 1918-19 flu pandemic as the worst pandemic in human history?

“You would want to say no. We have a lot of infection control, a lot of capacity to support the sick. We have modern medicine,” Kimball said. “But we have too many people and a lot of mobility. … Fear is ultimately a new strain around the goal of a particular vaccine.”

For those illiterate individuals who are relying on infection rather than vaccination for immune protection, Kimball said, “the trouble is that you have to survive the infection to gain immunity.” That said, it’s easier to go to the drugstore and get a shot.