How COVID-19’s death toll and social impact compares to past U.S. pandemics

The death toll from the COVID pandemic has put the U.S. at another tragic milestone — more than 675,000 Americans, overall, have died of COVID as of Monday. That number surpasses the number of lives lost to the 1918 flu. The U.S. is averaging more than 2,000 daily deaths. William Brangham takes a wider look at COVID's toll on the country.

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  • Judy Woodruff :

    The death toll from the COVID pandemic has put the U.S. at another tragic milestone. We are averaging more than 2,000 deaths a day lately.

    And, yesterday, the U.S. marked more than 675,000 Americans overall who have now died of COVID.

    William Brangham takes a wider look at this difficult period of our country's history.

  • William Brangham:

    Throughout this pandemic, it's been hard to keep perspective on the true scale of the losses caused by COVID-19.

    On the Washington Mall right now, artist Suzanne Brennan Firstenberg has planted an ocean of white flags, one for each life lost to the virus.

    Another metric is a comparison to the past, and, this week, the U.S. matched the death toll from another terrible virus, the 1918 influenza pandemic.

    For some perspective on then and now, I'm joined by Dr. Jeremy Brown. He wrote the book "Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History." And he is currently director of Office of Emergency Care Research at the National Institutes of Health.

    Dr. Brown, very good to see you again.

    We have now hit his awful bar in the U.S., where we have lost as many people to COVID as we lost to the influenza pandemic. But there are meaningful differences between the two, right?

    Dr. Jeremy Brown, National Institutes of Health: Yes, indeed.

    It is indeed awful to be speaking at this terrible milestone, 675,000 deaths, the same number as the people who died in the U.S. in the 1918 pandemic.

    But we must also recall that this pandemic is still far less deadly than that terrible one in 1918. The population in the U.S. in 1918 was around 100 million. Today, it's around 320 million. So, if we put these numbers into proportion, then those 675,000 deaths 103 years ago, relatively speaking, would be the equivalent of some two million deaths today.

    We are nowhere near that number, thankfully. But, still, today's numbers are still a reminder of just how deadly COVID is.

  • William Brangham:

    And, of course, another main difference, perhaps maybe the largest difference, is, we now have a vaccine to fight this virus, whereas, back then, we did not.

  • Dr. Jeremy Brown:

    That's right.

    Back then, not only was there no vaccine for influenza, but people didn't even know what it was that was killing them. This, I think, in many — in many ways, was perhaps the most frightening aspect of the disease. Fast forward 100 years later. We knew what COVID was. We knew its genetic makeup within about three or four weeks of the first cases.

    And then we developed this incredible series of vaccines in really record-breaking time.

  • William Brangham:

    Are there similarities, though, between then and now that have hit notes with you throughout this pandemic?

  • Dr. Jeremy Brown:

    Yes, there are a number of similarities.

    And I think, first of all, if we think about the ways that we can combat the disease, the simple, basic ways, those haven't really changed over 100 years, the call to mask up, to cover your face, to isolate when you're feeling unwell. Together, we have seen some really — breakthroughs that were unthinkable a century ago.

    So, we have these very high-tech innovations. And we also have some very low-tech, but no less effective ways for the majority of us to stay healthy.

  • William Brangham:

    And some of those protective measures that you mentioned, masking, distancing, and mandates and things like that, have caused incredible political strife in this country.

    I mean, even the vaccines, which are seen by many as the golden ticket, are a menace in the eyes of some. Does that aspect of our pandemic response surprise you?

  • Dr. Jeremy Brown:

    I think the virulence with which it occurred did surprise me.

    But anybody who's looked at pandemics over the last couple of hundred years will realize that all of these responses are actually not new. There has been an opposition to government-mandated vaccines ever since the smallpox vaccine was around in the late 1780s, and there were some quite virulent anti-vaccine movements both in England and here in the United States.

    But there is nothing really new about these behaviors, although, as I said, I think the number of people who have joined them, I think, is surprising, though, certainly, we didn't see numbers like this, for example, with the movement against smallpox vaccines a couple of hundred years ago.

  • William Brangham:

    Another striking aspect, as I have been watching this, is who has actually died from this virus.

    I know many people have been talking about this statistic of one in 500 Americans have died. But within that, racial minorities, Blacks and Latinos in America have suffered far worse. I mean, this has been a true tragedy in those communities as well.

  • Dr. Jeremy Brown:

    Yes, I think one of the mantras that we heard at the beginning of the pandemic is that we're all in this together. But the truth of the matter is, the pandemic has struck us all in very different ways, depending on where we live, what we do for a living, what our family situation is, and also just which families we are born into.

    We know that COVID has dropped the average life expectancy here in the U.S. by about a year-and-a-half. This is indeed awful. But for the African American community, life expectancy has actually dropped by almost three years, so, much higher than for the rest of the population.

    And this really shows us, again, that there are some tremendous disparities that we have, both in our — the availability of medicines and treatment therapies, and also in the way that we need to reach out to different communities and invite them to be part of the vaccine relief program.

  • William Brangham:

    When you look at 1918 America, compared to 2020 and 2021 America, is there something about the national psyches then and now that helps us understand how we have responded?

  • Dr. Jeremy Brown:

    I think this is a key point.

    A hundred years ago, we were at the end of the First World War. America was weary. There was still a war going on, and that coupled with the reality that pandemics were an everyday part of existence. People died from diphtheria and measles. People died from pneumonia. And I think we have forgotten just how lucky we are not to have these diseases.

    It's only really these tremendous advances that we have had both in the area of public health and on vaccines that have meant that we have the luxury of not waking up every morning and being afraid of polio, or being afraid of diphtheria.

  • William Brangham:

    I think it's fair to say that there's a real sense of despair in the country right now. I mean, for many people, they thought the vaccines were the light at the end of the tunnel, at least domestically, for this virus.

    But now deaths are up, hospitals are overflowing, Delta is everywhere in the country. Do you think that there is something that we missed at the beginning of this year, when we all thought, we're coming to the end of this, and it's turned out not to be the case?

  • Dr. Jeremy Brown:

    Well, I think what we have missed is nature's ability to surprise us.

    While we are indeed in the middle of a very bad run right now, there is no doubt that we have to bear in mind that all pandemics come to an end. This is true before antibiotics. This is true before there were vaccines. And this will be true of COVID as well.

    The question is, what can we as a society do to minimize the destruction and the deaths that is caused by COVID? So, whichever class or group of people you most identify with, I think there are very, very strong reasons for us now to turn to those last many millions of Americans out there and get vaccinated as quickly as possible.

    That is the one surefire way to make sure that we don't have another discussion in a few more months, you and I, about that death toll has risen to a new — to a new terrible marker.

  • William Brangham:

    All right, Dr. Jeremy Brown of the Office of Emergency Care Research at the National Institutes of Health, good to see you. Thank you very much.

  • Dr. Jeremy Brown:

    Thank you.

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