The Great Influenza: The Epic Story of the Deadliest Plague in History

by John M. Barry

Planners prepared for a Category 5 hurricane. The 2009 H1N1 swine flu pandemic, not even a tropical storm, threw them off-balance. This pandemic, the mildest ever known, taught new lessons, including some that required rethinking NPI policy. The 2009 pandemic killed “only” an estimated 150,000 to 575,000 worldwide, with probably about 12,000 U.S. deaths. (However, if one looks at the 2009 pandemic in terms of total years of life lost, not just deaths, it was much more severe: the average age of victims was only forty, and 80 percent of victims were younger than sixty-five. In seasonal influenza, only 10 percent of deaths occur in those under sixty-five.) By comparison, ordinary seasonal influenza kills up to 650,000 people worldwide annually, and in the United States the disease kills between 3,000 and 56,000 a year, depending mainly on the virulence of the virus and to a lesser extent on the efficacy of that year’s vaccine.