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One in three people around the world were infected.
When this new strain of influenza first hit Europe in early 1918, it spread throughout military camps on both sides of World War I. Despite this, the governments involved in the war kept it a secret because they feared that acknowledging their troops were sick could help the enemy.
That's where Spain came in. Since it was a neutral country, it had no need to hide the truth when its people got sick, so the Spanish government and media reported what was happening. Later, when the flu was everywhere, Spain's early candor made everyone think it originated there, but that wasn't the case.
Historians have theories, but nothing has ever been established definitively.
As World War I entered its fourth year (1918), the US government was intent on keeping up morale. So there was a lot of pressure to stifle negative news, and that included news about the virus. Wilson made no statements about the virus, and the surgeon general told Americans there was "no cause for alarm."
In September of 1918, 300 sailors returned to the Philadelphia Navy Yard, and within two weeks, 600 sailors were hospitalized with the flu. Local physicians called for a quarantine, but there was a military parade coming up — one the government hoped would help improve sales of war bonds — so no quarantine happened.
Two hundred thousand people attended the parade on Sept. 28. Within three days, 117 Philadelphians were dead from influenza.
It's believed that young people at that time in history hadn't been exposed to earlier influenza viruses, so they didn't have antibodies that would help them fight the virus.
However, the 1918 flu was of avian origin (or, in plain speak, it came from birds instead of pigs).
There was a desperate need for more nurses, and as the number of sick grew, the Red Cross even used untrained volunteers in many situations (despite the fact that there were many trained black nurses who could've helped but weren't asked).
Later, hospitals were so overtaxed that makeshift hospitals sprouted up at schools, private homes, and other buildings.
Pandemics like the 1918 flu have taught us that remaining vigilant about prevention and not loosening precautions too soon is key to saving lives.