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Pandemic: How A Virus Changed The World In 1918. Aired 7-8p ET

Aired December 25, 2020 - 19:00   ET



ANNOUNCER: The following is a CNN special report.


ANDERSON COOPER, CNN HOST (voice-over): April 1917, the United States joins allies France, Britain, and Russia in their battle against Germany.

They call it the Great War, a war to end all wars. All over the United States, Americans prepare to join the fight overseas.

But there was another fight about to take place right here on American soil, one that would eventually kill more people than the Great War itself. It was the influenza pandemic of 1918, known back then as the Spanish flu.

You said you can't understand how America with the influenza pandemic in 1918 without understanding World War 1?

KENNETH DAVIS, AUTHOR, "MORE DEADLY THAN WAR": Because everything about the pandemic was related to the war. And everything about the war at that time was related, in a sense, to the pandemic.

COOPER: Historian Kenneth Davis says an early outbreak of flu was reported at Camp Funston, part of Ft. Riley in Kansas.

Young men arriving for training and deployment were suddenly becoming sick.

The outbreak in 1918?

DAVIS: March 4th, 1918, we know the date. And doctors are starting to notice a strange influenza that doesn't look like anything else they've ever seen.

COOPER: What were the first symptoms they started to see?

DAVIS: Very high fever. Tremendous body aches. Like back-breaking body aches. Then as it progressed, these very otherwise healthy young men, who had just reported for duty, were on their backs in tremendous pain. People would talk about it like being hit by bats or something, that's how bad it was.

COOPER: Within weeks, more than 1,000 soldiers were in the hospital. At least 38 died. These were men who should have recovered if it was a normal flu.

Dr. Anthony Fauci says that's when doctors began to realize, this was a new pathogen.

The fact that it was young, healthy people who early on were getting it, was that a sign that this was a new influenza?

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: This was devastating even to young people. So quantitatively in who were affected was really extraordinary and unprecedented. And this was something very special. It occurred in a way that crept up on us.

COOPER: You called the 1918 pandemic the mother of all pandemics.

FAUCI: The global impact it had was unprecedented in recognizable history. It was a pandemic that gripped the planet. It was truly an enormously devastating pandemic.

COOPER: In 1918, the CDC didn't exist, and there were no requirements for doctors to report flu outbreaks to any officials. But by the end of March, the cases in Kansas were so unusual, a local doctor decided to report what he called an influenza of severe type to the U.S. public health service. The virus quickly spread.

Historian and author John Barry says it was traced to other army camps where it flourished among the men housed in close quarters. It also spread onto troop ships heading to Europe.

JOHN BARRY, AUTHOR, "THE GREAT INFLUENZA": Roughly half the military camps in the spring in 1918 did have significant outbreaks. And according to a Nobel laureate who spent most of his life studying influenza, you could follow the disease with American troops crossing the ocean and arriving in France.

DAVIS: "Over there", that's what everyone was singing, "over there, the Yanks are coming."

By May of 1918, a million young men, doughboys as they were called, land in France. That's when the flu really exploded.

COOPER: Looking back, historians can actually trace of spread of flu to the movement of troops?


DAVIS: Absolutely. The port of Brest in France, which is where most of American troops landed, became like a ground zero for the spread of this.

And the speed with which it spread was breathtaking. The reason why what would have been a localized epidemic, perhaps, became truly a worldwide pandemic was because the war was going on. Millions of soldiers going from the United States to Europe carrying infection. COOPER: This would turn out to be just the first wave of the

influenza. And it would last through the beginning of the summer of 1918.

Where this outbreak originated is still unknown, though it wasn't in Spain. How it started is more clear.

Was it a zoonotic virus? Did it cross from animals to humans? Do we know the origins of it?

FAUCI: Yeah. Very extensive sequencing of the genetic makeup of the virus indicate very, very clearly that it is of avian origin. It's a bird-like flu, likely from a wild waterfowl. But the sequences very clearly indicate that it was zoonotic in and somewhere along the way jumped species.

BARRY: In a sense, all influenza viruses are bird flu. Sometime prior to March of 1918, it might have been a few months, it may have been a couple of years, a virus jumped species from animals to humans, and it spread very rapidly and created a pandemic. It certainly wasn't the first influenza pandemic in history. And it's not going to be the last influenza pandemic.

COOPER: Troops overseas were getting infected as well, on all sides of the conflict. Though the death rate was relatively low, and most who got it recovered.

BARRY: It wasn't particularly lethal. People who did experience it, as a general rule, treated it with a shrug. The army even on the front lines in April, troops referred to it as three-day fever. They had a very different attitude when the virus turned much more virulent a few months later.

COOPER: Even though the infected were likely to survive, the huge numbers of sick soldiers began to impact the war.

DAVIS: It really did affect what was going on on the battlefield in Germany and in France. There was a major German offensive, for instance, that was supposed to take place in 1918. Half a million German soldiers were sick with the flu. They couldn't do it.

So it didn't change the outcome of the war, but it certainly affected it.

BARRY: And in fact, Ludendorff, the German commander, blamed the outbreak for the failure of the last German offensive, the last effort the Germans thought might win the war.

COOPER: The full impact of this first wave wouldn't be understood until much later. Countries involved in the war were censoring news about the influenza.

DAVIS: Nobody was actually talking about it. The newspapers weren't talking about it.

COOPER: Spain was neutral in the war, and their newspapers were allowed to report on this fast-spreading virus. It had even infected their king. That is how the influenza became known as the Spanish flu.

DAVIS: The first report of an epidemic comes out of Madrid. It's published, mysterious disease strikes Spain. The king of Spain was sick. It shut down the transit system in Madrid. That news report went to England, and from there on, that's May of 1918, it becomes the Spanish flu, at least in the English-speaking world.

COOPER: Historian Doris Kearns Goodwin says President Wilson was concerned about anything that would hurt the war effort.

You talk about how the influenza was barely mentioned when you read about Woodrow Wilson as president. Why is that?

DORIS KEARNS GOODWIN, HISTORIAN: Yeah, it's extraordinary that when you read about Wilson's presidency, the way he handled the flu, and even the flu itself, is hardly mentioned. Historians who have now studied the flu epidemic argue that he had two crises to face. The first was the flu, and the second was the war. And that the war went first.

And so that anything that he would say about the problem of the flu and the soldiers getting it in great in numbers in the barracks would hurt recruitment and hurt the war effort.

BARRY: Wilson wanted nothing to distract from the war effort or in any way hurt morale. Therefore, national public health leaders said things like, this is ordinary influenza by another name. Or, you have nothing to fear if proper precautions are taken.

COOPER: So there was no motivation for the president back then to get America focused on fighting this flu?

DAVIS: President Woodrow Wilson never mentioned Spanish flu.

COOPER: He never mentioned it?

DAVIS: He never mentioned it during his presidency.


For President Wilson, the war was all that mattered. And for most Americans, the war was all that mattered.

The war effort doesn't just mean sending troops over, it also means keeping factories going, really around the clock, making uniforms, making tanks, making airplanes.

COOPER: And raising money for the war?

DAVIS: And raising money. That's where this question of misplaced priorities is so important. There were misplaced priorities in 1918. The war was the priority, and that took precedence over everything.

COOPER: The war and the influenza would later directly impact Wilson personally in a way that may have changed the course of history. With summer and warmer weather, the new influenza seemed to die down.

A British Medical Journal even declared the epidemic over in August of 1918.

They were wrong. The death and misery had barely begun.

Did people know there was going to be a second wave?

FAUCI: They did not. The force with which it came just took everyone by surprise. And it was just totally devastating. The virulence of the virus, namely the capability of the virus to cause devastating disease, was really unprecedented.

COOPER: In September, an article in the Journal of the American Medical Association warned of a severe and rapidly spreading epidemic of influenza. It said it was undoubtedly the Spanish influenza, but warned of the new outbreak saying, it's often more severe, the complications are more frequent and serious, and it shows an extraordinary degree of contagiousness.

They concluded, we therefore have every indication that this outbreak will soon spread all over the United States. The second wave had arrived.



COOPER (voice-over): September 1918, World War I, the Great War, is in its final months. But the second wave of the influenza is just beginning. And now it's spreading faster, and it's far more deadly.

Historian John Barry says the virus may have mutated into a new strain.

BARRY: The 1918 virus combined to cells in the upper respiratory tract that made it easily transmissible. But it could also bind to cells deep in the lung. Many reports of people dying 24 hours after the first symptoms appeared. Some of the symptoms could be very unusual and very frightening.

COOPER: Whether it was a new strain or a new virus altogether, the effects were terrifying.

FAUCI: Well, the second wave was so deadly. You know, it's very interesting. We talk about the first and the second wave. We were presuming that the virus that hit us in the spring of 1918 was essentially the same virus that accounted for the so-called "second wave".

We knew there was disease in the spring of 1918. We knew there was a lull in the summer. And then we got hit very, very badly in October and November of 1918. Call it a second wave or what, it was a devastating wave of infection.

COOPER: In early September, an outbreak at Camp Devens outside of Boston was reported. Young healthy soldiers were getting infected and dying fasts. Scientists went to investigate.

DAVIS: And that's where four doctors, probably the best virologists, epidemiologists, in America at the time, go up. And they're seeing these men being brought in by the dozens, and then by the hundreds. That's when one of the doctors says, I think this might be a new plague.

COOPER: By the end of September, more than 14,000 flu cases were reported from Camp Devens, 757 people had died. The deaths were gruesome. Victims turned purple and black from cyanosis, a lack of oxygen.

BARRY: To give you a sense of what it was actually like, I'd like to read a letter that a physician at Camp Devens wrote to a colleague. Said, these men start with what looks like an ordinary attack of the grippe or influenza. But when brought to the hospital, they very rapidly develop the most vicious type of pneumonia that has ever been seen.

It is only a matter of a few hours then until death comes. It is horrible. It takes special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce. It beats any sight they had in France after a battle. Goodbye, old pal, God be with you until we meet again.

COOPER: Despite the alarming number of cases, servicemen from the Boston naval yard continued to deploy around the country.

BARRY: Those same ships from Boston also went to New Orleans, Chicago. They went out to the west coast. Every one of these port cities where boats from Boston docked, the flu exploded very quickly. It was extremely, extremely virulent. The infection rate was very high, and the mortality rate was very high.

COOPER: On September 7th, 1918, a navy ship from Boston arrived in Philadelphia. Public health officials there had downplayed the seriousness of the influenza. The city would soon pay the price for that.

BARRY: Philadelphia was one of the hardest-hit cities in the country. And I think that was closely related to the political and public health leadership.

COOPER: Philadelphia leaders had organized a Liberty Loan Parade, scheduled for September 28th, 1918. It was an effort to boost morale, but also a way to raise money for the war effort by encouraging Americans to buy war bonds. Parades like these were drawing large crowds throughout the war. Americans were eager to show their patriotism.

BARRY: The medical community was very, very concerned by that, urged the public health director to call the parade off.

COOPER: He allowed the parade to go on.

DAVIS: That's correct. And he had specifically been told in a meeting, two days before, by other doctors, not to allow it to go on.

He was a political appointee. Philadelphia had at that time a notoriously rather corrupt government.


And he was not willing to go up against the bosses. So he went ahead with this.

BARRY: There were hundreds of thousands of people in the street, packed close together, shouting and singing songs. And like clockwork, 48, 72 hours later, the disease exploded in Philadelphia.

DAVIS: Two hundred thousand people are in the streets. Days later, every hospital bed in Philadelphia was filled. And Philadelphia had a lot of hospitals.

COOPER: It became a super-spreader event?

DAVIS: It was the mother of all super-spreader events in 1918. And Philadelphia was probably the hardest hit. They knew it was coming. They should have seen it coming.

They shouldn't have allowed this parade. They did, because again, priorities. What were the priorities? The war effort, and selling these war bonds.

GOODWIN: When I was reading about the parade in Philadelphia, this huge Liberty Loan parade that was going to be in 1918, I was thinking to myself, don't do the parade, don't do the parade! Then the week later, I think it's thousands of people die, perhaps 14,000 people.

And then you go to St. Louis, another city also had prepared a parade. They listened to the medical authorities. The next week, only 700 people died.

So when you're reading this as a historian and you know the end of the story, you want to say, stop, do the right thing!

COOPER: The day after the parade, the "Philadelphia Inquirer" printed this picture. The caption: Fighting men of Navy thrill vast crowds as they march along Broad Street." No mention of the influenza.

Less than a week later, the board of health finally begins shutting down the city.

DAVIS: In the streets of Philadelphia, people were actually dropping dead in the streets.

FAUCI: There was stories, rather well documented stories, Anderson, of people who would wake up in the morning feeling maybe a little bit under the weather. Get up and go to work starting to feel really very, very sick. And by the time the end of the day came, they were dying in bed and would die literally within a 24-hour period.

COOPER: It was that fast? FAUCI: Oh, absolutely.

COOPER: The situation was so dire, it couldn't be ignored any longer. This issue of the Philadelphia evening bulletin dated October 15th, 1918, reports entire families dying from the flu. It reads: Husbands and wives, mothers and children, brothers and sisters have died within a few hours of one another.

BARRY: They were using steam shovels to dig mass graves, at one point. You had priests literally driving horse-drawn carts down the street, calling upon people to bring out their dead. It sometimes would be a couple of days before a body could be disposed of, and you had to live with the body in your home. And the fear really emptied the streets.

COOPER: There were empty streets in cities across the country. All were experiencing the same fear and panic as Philadelphia. In the month of October, more than 195,000 Americans died from the virus, many of them in excruciating pain.

DAVIS: It was a terrible way to die. You can picture these young men, and eventually young women and nurses, family members, literally choking to death on their own body fluids, turning blue and dying. One of the doctors in one of the hospitals in New York said, they're coming in by the hundreds, they're turning blue, and they're dying.

One doctor says, I see them twice. Once when they check in, and once when I sign their death certificate.

COOPER: This is rare footage of an influenza patient being brought in for treatment. But there was little doctors could do. This was no way to treat the influenza. Doctors and nurses just had to watch their patients die.

This letter was written by a volunteer nurse in Washington, D.C. when I was in the officers' barracks, he wrote, four of the officers of whom I had charge died. Two of them were married and called for their wife nearly all the time. It was sure pitiful to see them die. I had to go to the nurses' quarters and cry it out. They couldn't treat the dying in 1918 because they didn't know what they were fighting. They didn't even know what an influenza virus was.

FAUCI: The doctors at the time, scientists, did not know what the pathogen was. Because the virus itself, influenza, was not discovered until more than a decade and a half, two decades, later, in the 1930s.

So what was likely going on, and again, we didn't recognize it because we did not have antibiotics, is it was not only the primary virus itself, unrecognized at the time, which turned out to be influenza-A, that it was causing devastating viral pneumonias, but superimposed upon it now when you went back and did autopsy examinations retrospectively, you found that very many of the people died from secondary bacterial infections.


In other words, they had a primary viral pneumonia, and superimposed upon that was a bacterial pneumonia that could have been, had we had antibiotics at the time, which we did not, that could have been treated with common antibiotics.

COOPER: So how do you treat a virus you don't understand?


COOPER: This Fox Movietone newsreel from the pandemic era shows two men walking to greet each other, not with a handshake, but with a salute, in order to avoid touching hands. Though they do walk away arm in arm.

It was an effort to educate the public on safe behavior during an outbreak. But these recommended measures couldn't stop the spread of the virus, because not everyone would listen.


FAUCI: The virus was spread clearly by the respiratory route. I think just even rudimentary epidemiology would tell you that, that the close contact with people.

There was congregant settings, people crowding together either indoors, in many respects sometimes even outdoors. It was very clear that this was person-to-person spread.

BARRY: Pretty much everything was tried, even to the extent that one report in The Journal of the American Medical Association of a doctor who injected hydrogen peroxide intravenously, thinking that the oxygen would help the patient. And roughly half of his patients died. He actually claimed that this was successful. So people were quite desperate in trying absolutely everything.

COOPER: There was no federal plan and no real strong federal public health service in the U.S. at the time. So local states and cities took it upon themselves to fight a pandemic they didn't really understand. New York made it a misdemeanor to cough or sneeze without covering your mouth or nose in public. In Philadelphia, spitters were fined $2.30 for jeopardizing health. Open-air courts in San Francisco dealt with people who didn't wear masks in public. They were fined and in some cases, thrown in jail.

Back then, masks were not quite as controversial as they are now, but they also may not have been as effective.

These nurses are making masks out of gauze which they fold over four times. But gauze is porous, even with the layers, and in some cases didn't protect people from getting the virus.

The Journal of the American Medical Association in September of 1918 said the virus was infecting doctors and nurses in hospitals in spite of the use of gauze masks and other precautions by all those in contact with the patients. Watch this one group of nurses as they demonstrate how to wear the masks. First they wrap them around their mouths, but then fold them down to expose their noses. The nurse can infect through the nasal cavity. But still, a properly worn mask back then was better than no mask at


FAUCI: We know now from better analysis that masks are effective. They're not 100 percent effective. They likely are more effective in preventing a person who's infected from transmitting it, versus someone protecting themselves from getting infected. Even the recent data indicate that there is some degree of protection both ways. The fact that back then, individuals who were wearing masks, and even now with COVID-19, some people who wear masks can get infected. That doesn't mean that masks are not helpful.

COOPER: Despite these attempts at public health and safety, peep kept dying. Cities around the country who were hit later by the virus were learning the lessons of Boston and Philadelphia.

It's also interesting, because when you look at President Wilson, there was a war going on. So there wasn't a lot of talk by Wilson about the pandemic.

FAUCI: No, there was not. And that was the point. It was left up, in many respects, to the individual states, cities, and locations. And there wasn't that uniform type of coordination and communication about what worked or did not work in one city versus the other. They essentially were left on their own to do what it was that they wanted to do, and there was some stark failures, and there was some really notable successes.

BARRY: There were other cities which didn't even print the names of the dead. They were trying to pretend that this thing wasn't happening. That wasn't reassuring people, because they knew it was happening. It increased the level of fear, increased alienation. There were very few places where they did tell the truth. One was San Francisco.

And San Francisco, the mayor, the public health leaders, the leaders of the business community, leaders of trade unions, all jointly signed a statement. And this was printed in huge type in the newspaper. It said, wear a mask and save your life. And that was a very, very different message than, this is ordinary influenza by another name.

COOPER: San Francisco shut the city down. They banned mass gatherings, closed schools and movie theaters. And it worked, at least in the beginning.

BARRY: They have great success initially in the fall of 1918. They relaxed too soon.

COOPER: In November, they got rid of the mask mandate and reopened businesses.


BARRY: San Francisco went like this, down, and then up. And then when it started to go up, they tried to put the mask law back into effect.

But the people weren't having it the second time around.

The same arguments we're hearing today about wearing masks -- infringement on freedom, infringement on liberty. So all of the arguments that we've heard today about non-mask wearing they argued in San Francisco, and it was bad.

FAUCI: Go back 102 years to what happened in San Francisco to try and reopen maybe a bit too early or not without the kind of constraints that should essentially guide you as you try and reopen. Yet again, another example of lessons that could have been translated across more than a century.

UNIDENTIFIED MALE: The war is over. Into market street, the men and women of the city to celebrate --

COOPER: On November 11th, the war came to an end. All over the country, Americans celebrating, hoping for a new era of peace.

They were also hopeful the second wave was coming to an end.

Like the first wave, it seemed to have burned quickly through the population, only to die down as winter approached.

BARRY: One of the key questions is, what happened to the virus? I think two things ended the pandemic, really.

Number one, people's immune systems became used to the virus. They were much better able to deal with it than they were. Remember, this caused the pandemic because it was a brand-new virus that people had never experienced before. Once the immune system was able to recognize it, it was much better able to fight it. In addition, I think the virus itself probably continued its mutations and mutated in a direction of mildness.

COOPER: But the virus wasn't completely gone. A third wave would soon emerge.

And while it wasn't as deadly as it had been during the dark months of the fall, it was still claiming victims, including one whose illness would have an impact at a crucial moment in history.



COOPER: March 1919. The mood in Paris is joyful. World leaders, including President Woodrow Wilson, are meeting in France to negotiate a peace treaty. The war is finally over.

But the pandemic is not. It's now in its third wave and spreading in France. This warning printed in "The Journal of the American Medical Association" states the epidemic of influenza, which had declined, has broken out in a new and most disquieting manner. But that was overshadowed, this time in the fierce negotiations between the heads of the United States, Great Britain, France, and Italy.

Known as the big four, they were trying to negotiate how to settle peace terms with Germany.

When the war ended and peace talks were approaching, what was Wilson's stance on the Germans going into these talks? Because he famously talked about peace without victory.

GOODWIN: Woodrow Wilson talked continually about peace without victory. He wanted no real retribution against Germany, no humiliation against Germany. He just thought that would just set off perhaps in somebody's head a century of war.

So he went into those peace talks hoping he could persuade the European nations of moving in that direction. It would have been a hard job to do so, because the war had been fought on European soil. Millions of Europeans had been hurt by it. And that desire for exacting retribution was already there.

So he was already coming up against a difficulty when he came there, but he was hope tag he would get it through.

COOPER: On April 3rd, as the peace talks continued, President Wilson collapsed. He was so severely ill so suddenly that his doctor suspected he may have been poisoned.

But it turns out it was likely the influenza. And it may have affected him both mentally and physically. This is a private letter from Wilson's doctor in Paris dated April 14th, 1919. He wrote: The president was suddenly taken violently sick with the influenza at a time when the whole of civilization seemed to be in the balance.

BARRY: Had a temperature of 103, violent coughing. Standard symptoms of influenza. And as he started to recover, everybody around him from Irwin Hoover, who was the White House usher, to Herbert Hoover, the later president, commented that his mind simply didn't work.

He couldn't remember things that had happened a few hours earlier. He got paranoid, thought there were French spies behind the furniture. You know, some very, very strange things. And he insisted on returning to the negotiations, physically weakened, and while his mind was still not working.

COOPER: Doctors and historians now believe the influenza may have had a profound effect on patients' brains.

BARRY: Just like COVID-19, the 1918 virus had very significant neurological manifestations.

FAUCI: Certainly, there were neurological sequelae in some individuals that could possibly have been due to infection with this pandemic flu. Again, not completely proven, but suggestive.

COOPER: After Wilson recovered from the worst of his illness, he went back to the talks. But observers said he was changed. And he caved in on what he was fighting for before he'd been infected.

BARRY: The result was a peace treaty that, again, violated the principles that he said the U.S. had gone to war over. It was a long way from a peace without victory. Germany was blamed for the war, reparations were demanded.

There were deals made between countries trading territories. All these things that Wilson had stood up against, he just caved in. He himself told someone that if he was a German, he wasn't sure he would sign the treaty.


And essentially, every historian of the 20th century believes and has said that the peace treaty agreed to in Versailles in 1919 was a significant contributor to the rise of the Nazis, because it gave the Germans good reason to feel that they had been taken advantage of unfairly.

COOPER: It is a fascinating idea, that whether something like the flu changed the course of history in terms of the rise of Nazism. If Germany hadn't been punished so punitively, would there have been such dissatisfaction and anger in Germany.

GOODWIN: History is something that is a cycle of events. So the fact that the treaty of Versailles had such draconian provisions, the fact that it demanded so many economic sanctions and humiliation, really, for Germany, they argue, historians do, that it contributed to the rise of nationalism and the rise of Adolf Hitler.

Then if you go back and you unroll that and you make some new arguments about whether the flu and its impact on Wilson affected the treaty of Versailles, if you go back and look at Wilson and argue that maybe his having the flu affected his behavior in the negotiation of the treaty of Versailles, then it unrolls even more.

But again, I think that's something that historians will be studying for many decades to come.

COOPER: Some historians say Wilson may have experienced a different strain of flu, not the strain that caused the pandemic back then. But there's no dispute that President Wilson's behavior changed after his illness.

DAVIS: People who knew Wilson then and had been with him for a long time said he was never the same after that flu. There is a suggestion by quite a few historians that the flu might have affected Wilson's judgment, his reasoning, his willpower.

COOPER: We'll never know for sure what was going on inside President Wilson's mind.

Historian John Barry puts it this way.

BARRY: I'm not a real believer in alternative histories. So it's -- you could argue that Wilson would have given in on all these things even if he had stayed healthy. Can't be certain.

All you can be certain of is that he did have influenza. His mind and spirit were seriously impacted by the disease. He did cave in. And the Nazis did rise. (COMMERCIAL BREAK)


COOPER: The great influenza of 1918 lingered on until 1920 before finally going away. By the end an estimated 1/3 of the world's population had been infected by the virus. And the death toll in America and across the globe was stunning.

DAVIS: Six hundred and seventy-five thousand Americans in the space of a year, that's more than all of the men who have died in World War I, World War II, Korea, and Vietnam put together. The numbers around the world are even more astonishing.

FAUCI: Within the realm of recorded history there were anywhere from 50 to 100 million people died. And in a population of the world that was at that time in 1918 about 1/3 of what the population of the world is today. You could just imagine and do the math of in today's time what that would have meant. That would have meant anywhere from 150 million to 300 million people dying from this.

BARRY: So even the worst, worst case projections for COVID-19 are absolutely nothing like what occurred in 1918, fortunately.

COOPER: The death toll in this current pandemic may never reach the levels of the influenza of 1918, partly because in this outbreak there is the promise of a vaccine.

FAUCI: That's going to be the game changer, and that's going to be the difference that separates us from the 1918 ultimate impact to the ultimate impact of what we're seeing now. As bad as it is right now, we have within our power the capability to turn it around.

That does not lessen the fact that we're going through an extraordinary challenge with this outbreak. The thing that I believe, Anderson, is going to prevent us from creeping up on the numbers of 1918 with correction for population numbers is the vaccine that we now have that our counterparts in 1918 did not have.

COOPER: It's been 102 years since that pandemic started and more than a century later there are still many similarities between then and now. Many of the same mistakes were repeated.

In 1918 and in 2020, we saw crowds gather when they shouldn't, only to lead to more infections and deaths. In 1918 and in 2020, we saw cities shut down early, only to reopen too soon. In 1918 and in 2020, we saw people refusing to wear masks even though it would protect others. In 1918 and 2020, we saw leaders ignoring the science, downplaying the severity of the virus because they wanted the public's attention focused elsewhere.

Were the lessons of the 1918 pandemic, were they forgotten?

FAUCI: You know, in some respects they were. And again, when historians right about this and juxtapose 2020 with 1918, they're going to see there were things that should have been learned in 1918 that 102 years later somehow, corporate (ph) memory got lost and things were not used in the sense of a storing of knowledge from back then that could have been applied today.


BARRY: I think the chief lessons from 1918 are pretty clear. The first is to tell the truth.

DAVIS: If you don't tell people the truth, you are going to cost lives. It happened in 1918. I believe it happened again to us in this pandemic.

GOODWIN: Leadership is central in a crisis. There's a saying from Robert Sherwood, who worked for FDR, that most of the time you can keep the president in a little portrait on your desk. You don't have to worry about what he's doing.

But in a time of crisis, when people need somebody in leadership other than themselves, and they need to band together, that's when leadership is essential.

And obviously this was a crisis. The flu was. The war was a crisis. We're having a crisis right now. And leadership is essential.

COOPER: These are some of the lessons that can and should be remembered from these two global pandemics, lessons that can be applied to help fight the next pandemic.

FAUCI: Without a doubt, the future will also hold for us pandemics. Exactly what that will be or when it will occur is without a doubt unclear right now. But it will occur.