On coronavirus vs the flu pandemic of 1968

This post was inspired by a recent article published by the AIER titled Woodstock Occurred in the Middle of a Pandemic.

The author reports that a flu pandemic spread from Hong Kong to the United States, arriving here in December 1968 and peaking a year later, ultimately killing 100,000 Americans. Also according to the author, “we might be looking at a quarter million deaths today from this virus” accounting for population increases and health/demographic changes since then.

He also speaks to how this flu pandemic barely made an imprint on American psyche or society at the time. Schools weren’t closed, stock markets didn’t crash, there were no “shelter in place” orders, no rise in unemployment, face mask ordinances, etc.

Living through the COVID-19 pandemic, this seems hard to comprehend. How could such a terribly fatal virus barely make stirs in the late 1960s when a virus that has so far killed fewer Americans cause such disruption to our daily lives?

So, I decided to investigate.

The CDC indeed confirms 100,000 estimated American deaths from the flu pandemic of 1968. However, the author is incorrect that those deaths would equate to a quarter million deaths today.

According to my math, once you adjust for population growth (199M vs 327M) and an older US population distribution, it seems that the 1968 influenza virus would have killed at least 288,671 Americans if unleashed on today’s population. This doesn’t even account for today’s higher rates of chronic health conditions like obesity, cardiovascular disease, etc. which would likely drive the fatality rate higher.

We’ll see if COVID-19 ultimately claims more than 288,671 American lives this year, but it seems likely the death toll will be far less given that it now stands at about 74,000 and the virus seems to be past its peak.

While mitigation strategies (social distancing, travel restrictions, etc) may have kept COVID-19 fatalities lower to date than they would have been otherwise, it’s notable that no such mitigation strategies were attempted in 1968 even when their flu pandemic was on pace to claim many more lives on a population and age-adjusted basis.

So, clearly something in the environment must have changed between 1968 and 2020. But what?

I have a few theories:

Mainstream Media

In 1968, mainstream news media was much less fragmented, sensationalized, instantaneous, and global.

Americans weren’t getting hourly buzzes in their pockets notifying them of ‘breaking news’ and certainly not about people dying overseas. There were no real-time trackers of influenza cases or fatalities. There was no Google to lead people down the 1968 influenza pandemic rabbit hole.

People got their information from newspapers, magazines, radio, and a small handful of television news programs, none of which used Daily Active Users and Click Through Rates as business metrics. Digital media consumption didn’t yet exist and overall media consumption was much lower than today.

While there was certainly news coverage of the 1968 pandemic and many Americans were aware of it, news of it didn’t infiltrate their lives as COVID-19 news has in 2020. News shapes our perspectives and attitudes, and in 1968 mainstream media wasn’t startling as it is today.

Social Media

This term didn’t even exist in 1968, much less the technology that enables it.

It’s been well-documented that social media creates an “echo chamber” that is difficult to escape from. Since I grew up in conservative Georgia but have lived in liberal San Francisco for the past 8 years, I get to straddle two such bubbles, and can attest to their reality. It’s easy to see from my Facebook newsfeed that my Georgia and San Francisco friends live in much different worlds.

Once panic is introduced into a social media echo chamber, it just reverberates and reverberates, as do conspiracy theories, political beliefs, truths and mistruths.

Had social media existed in 1968, perhaps Americans would have been much more alarmed by the flu pandemic.

Politics

This one is hard to disaggregate from the media categories above because they shape it.

American politicians have always tried to create policies that please their constituents, as their reelection depends upon it. But in 1968, the people weren’t clamoring for protection from the flu pandemic because mainstream and social media didn’t compel them to, so state and local leaders didn’t face pressure to “do something”. Even if a radical politician wished to implement a mass quarantine to slow the spread of the virus, their constituents wouldn’t have complied without a requisite degree of fear.

Also, in the case of COVID-19, I think another sort of echo chamber developed between politicians, their constituents, and other politicians.

This virus happened to emerge from China, which is lead by a totalitarian regime. To slow the spread of the virus (or perhaps to demonstrate its own power?) the Chinese government instituted a strict lockdown of the Wuhan province and eventually the entire country. This set a precedent for the rest of the world by normalizing a policy response that is objectively radical and authoritarian, and never before attempted in human history, even during much worse pandemics.

People around the world observed this policy response by the one country that ostensively knew more about the virus than anyone else, and concluded it was the only way to contain the COVID-19 threat. This set off a chain reaction of popular support for lockdowns, which lead to more countries and states implementing them, which lead to more fear and popular support for lockdowns, which lead to more countries and states implementing them…

I wonder how history might have been different if the virus had emerged in Sweden?

Economics

In 1968, the idea of mandating that most Americans remain locked down in their homes for months would have been quickly dismissed as economically unviable, even if epidemiologically advantageous.

However in 2020, we have remote-working technology that allows many white-collar workers to continue to be productive and earn an income while working from home, and it is many of these workers who have been advocating for lockdowns most fervently.

In each era, there are many blue-collar workers who cannot earn an income remotely, but in 2020, they have much less relative wealth due to widened income inequalities, and therefore less political influence. Perhaps they also have more confidence today in the government’s ability to support them economically while their income is sacrificed.

Also in each era, there are many businesses that cannot remain economically viable in a lockdown (restaurants, hotels, theme parks, etc). However in 2020, there is a belief that government subsidies in the form of corporate bond purchases, EIDL loans, PPP loans, etc. can help those companies weather the storm. While we’re yet to see if these businesses will survive, the belief that government relief will save them has been sufficient for lockdown policy to persist, along with a federal government that is willing and able to provide these subsidies.

Culture and Attitudes

This one is harder to pin down, but I think there has been a shift in attitudes towards mankind’s relationship with nature since the late 1960’s.

I wasn’t yet alive then, but my perception is that infectious disease was viewed more as just a part of the human experience. Antibiotics and vaccines were already invented and widespread, but perhaps there wasn’t yet a cultural notion that humans should be able to conquer all threats that nature throws our way. It was simply understood that old people and unhealthy people might get sick and die, despite our incredible technological advances on the infectious disease front.

I don’t know when this attitude might have shifted, but do recall my beloved Nana (my paternal grandmother) dying a decade ago from a respiratory virus that she caught in a hospital. She was 80 years old at the time and generally in good health, save for a recent lung cancer diagnosis that was still treatable.

I was very close to her, and despite the incredible grief I felt when she passed, I don’t remember feeling anger towards the virus that took her life. I understood that life has a beginning, a middle and an end, and that contracting a virus in old age was a perfectly normal ending.

I don’t recall thinking that young people should have stayed in their homes to prevent this virus from spreading to my grandmother, or fear that it would spread to my young body if I were physically close to her, or that my government should do something about it. I just accepted it.

Perhaps this is the biggest difference between 1968 and today.

Techie and investor. Founder at Rebel Fund and previously Pioneer Fund. Chairman of Infosurv/Intengo and CrowdMed (YC W13). Former Bain consultant. Data nerd.