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Comment by nostrebored | Hacker News Reader

The historical context also misses a lot of what we know about the impact of malnutrition and stress on the immune system. Was the spanish flu actually that bad, or was it actually a fairly bad flu that wreaked havoc on a war-torn population?

Reconciling modern information with historical events is hard. But I think it's completely necessary if we're going to make policy decisions based on history.

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> Was the spanish flu actually that bad

Yes.

> was it actually a fairly bad flu that wreaked havoc on a war-torn population?

No, because those affected worst by it were young adults in relatively good health. Small children and the elderly were proportionally spared. The prevailing theory for why Spanish flu killed more healthy young adults was because it was an over-reaction of the immune system itself that was most harmful:

https://en.wikipedia.org/wiki/Cytokine_storm

It is definitely the case that the war led to many young adults being moved around the world and kept in close quarters, which certainly exacerbated the spread and effect of the pandemic.

The Spanish flu really was very bad but would not have killed as many people if it occurred today. Malnutrition might have been a factor (though today's obesity rate might also be a problem) but the bigger thing was lack of antibiotics. Flu almost never kills you directly- it's the bacterial pneumonia you develop on top of it that does. Without antibiotics back then there would have been little they could do

Bacterial Pneumonia was not the novel danger of the "Spanish" flu; They cytokine storm it caused in perfectly healthy people was horrifying, with perfectly healthy people who would normally fight off any flu dying from this one. A lot of young twenty somethings, strong people who were not malnourished died from it.

Hell, people got cytokine storms from COVID-19 and we still can only treat it if we catch it really early, otherwise it's still a great way to die for a normal person.

That's a hypothesis. It is known that (supposedly) that strain can cause cytokine storm more than other flus do. I would not assume that means cytokine storm was the primary cause of death or even the primary cause of death in young adults. Based on my experience my guess is that the pneumonia was a much bigger cause of death than the storm

Right I wasn't expressing the cytokine storm as the primary cause of death but rather a phenomenon that definitely pushed it above a normal flu, especially for healthy young adults.

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