Here's a look at the highest weekly 1918 Spanish Flu death tolls for the five most populous U.S. cities, based on data published by National Underwriter, an ALM publication, on Dec. 19, 1918.
5. St. Louis
Population: 799,9851
Worst Week: 375 (Dec. 7-13)
An ambulance crew helps flu victims in St. Louis in October 1918. (Photo: St. Louis Post-Dispatch/Wikimedia Commons PD)
4. Cleveland
Population: 810,306
Worst Week: 682 (Nov. 2-8)
The Colonial Hotel in Cleveland, in 1918. (Photo: Wikimedia Commons Public Domain)
3. Philadelphia
Population: 1.8 million
Worst week: 4,597 (Oct. 19-25)
Armistice Day in Philadelphia. (Photo: NARA)
2. Chicago
Population: 2.6 million
Worst Week: 2,367 (Oct. 26-Nov. 1)
The U.S. Government War Exhibition in Chicago, in September 1918. (Photo:: Kaufmann & Fabry Co./Library of Congress)

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1. New York
Population: 5.2 million
Worst Week: 5,222 (Oct. 26-Nov. 1)
An elevator operator wears a face mask in 2018 or 2019, to protect herself from the flu. (Photo: NARA)

(Related: Our Flu Vaccine Stockpiles Are Full of Expired Components: Tammy Baldwin)

This is Life Insurance Awareness Month, and October will be the centennial of when National Underwriter, a ThinkAdvisor sister publication, became aware that the “Spanish flu” was suddenly killing large numbers of insurance professionals, and large numbers of life insurance policyholders.

The pandemic ended up killing 500,000 of the 100 million people living in the United States in 1918, or one out of 200, in just a few months, and it may have killed about 50 million of the world’s 2 billion people, or about one out of 40, according to the U.S. Centers for Disease Control and Prevention.

The “pandemic,” or epidemic that spread just about everywhere, was one of the fastest-moving epidemics in recorded history, and it shapes how life insurance pricing actuaries and underwriters think of life insurance, even today.

Executives from publicly traded life and health insurers will often tell securities analysts that they think claims are moving in the right direction — then acknowledge that a bad flu epidemic could throw everything off. Life reinsurance companies routinely list “flu pandemics” as a reason direct writers of life insurance need protection against catastrophic risk.

The 1918 flu pandemic is one of the main reasons public health authorities recommend flu shots, and why they react with such concern when a new strain of the flu, or of some other new  or previously little-noticed virus, kills a few people in some place you’ve never heard of.

Some skeptics question public health authorities’ efforts, and suggest that, most of the time, the impact from flu shot programs is comparable to the impact of the flu. Public health officials respond by talking about 1918.

The pandemic also showed life insurance agents why what they sell matters, and why having life insurance now is better than going bare while deciding what to do.

We are commemorating the centennial by posting a package of articles about the topic in a  special Spanish Flu Pandemic Centennial web package.

We will also be publishing articles noting the centennials of specific events that occurred during the pandemic from now through the end of the year.

In an effort to give readers a taste of how the pandemic affected the lives of financial professionals in 1918, we have created a list of the highest weekly death toll from flu (and from cases of pneumonia that were probably caused by the flu) for the five U.S. cities with the most population in 1918.

The figures show that, during each city’s worst week, agents could expect anywhere from 1 in 2,000 of the people they knew, to 1 in 400 of the people they knew, to drop dead from the flu or pneumonia that week.

To see the peak weekly death tolls for those five cities, check out the data cards in the slideshow above.

— Read The Spanish Flu Centennial: A Look at Influenza’s Continuing Pandemic Riskon ThinkAdvisor.

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