In the spring of 1918, influenza hit the United States, beginning, later historians would theorize, in a small town in Kansas and spreading through military barracks and then via troops to the battlefields of Europe.

The “first wave” was relatively mild, with the illness often lasting just a few days. Deaths attributed to the disease were only slightly above the average — some 75,000 instead of the 63,000 seen in 1915. (Today, by contrast, influenza deaths in the United States last year were estimated to be around 31,000.)

That same spring, Woodrow Wilson had gotten Congress to pass the Sedition Act, supposedly to promote patriotism and the war effort. Sweeping in both content and application, this act declared that there would be harsh penalties for anyone who “insulted or abused” the U.S. government, the flag, the Constitution or the military. That included the media.

As a result, virtually no public mentions were made of this disease, even while it was causing significant disruption to military action because so many soldiers were sick. After all, it was “just influenza.”

By late August, the influenza virus had mutated and had become a killing machine. John Barry, author of the 2004 book “The Great Influenza” and professor at the Tulane School of Public Health and Tropical Medicine, described nurses who would report for duty in the morning and who would be dead by the end of their shift, of streetcar conductors who keeled over in the middle of their route and of children who starved to death because their parents died and there was no one to check on them.

The disease, who many still dismissed as “just influenza” made it to every corner of the globe, from the Arctic to the Pacific, through Russia, China, India and Africa, every European country and North and South America. In fact, there were only two countries that had zero deaths from the disease: American Samoa and French Caledonia, both which had leaders that imposed strict blockades and kept them in place.

The death rate skyrocketed, although, like most pandemics, there was considerable variation in how high the death toll rose. Some Native Alaskan villages were completely wiped out. Lower income areas with higher population density and less access to existing health care suffered more disease and death. So did troops, crammed into barracks and transport ships.

And, instead of the U-shaped death toll that is most common in epidemics or pandemics, with the youngest and the oldest dying at the highest rates, it was W-shaped, with a huge swath of 18-45 year olds also dying. The very highest mortality was among pregnant women.

The disease was and is still seen as one of the deadliest in recorded history. This flu killed more people in 24 weeks in late 1918 than HIV/AIDS killed in 24 years. Blood would pour from people’s eyes, ears, nose and mouth. Victims drowned in fluid filling their lungs. Cyanosis — turning blue from lack of oxygen — could become so severe that one could not tell if a patient was Caucasian or African-American.

And yet — many continued to assert “It’s just influenza.”

In San Francisco, the “Anti-Mask League” was formed and included physicians, politicians and citizens who used two arguments: There was not enough scientific data to support mask-wearing and it was an infringement on one’s civil liberties. In the end, San Francisco would be one of the hardest hit by the 1918 influenza pandemic, with 45,000 cases and more than 3,000 dead.

By the time the disease exhausted itself in 1920, there were virtually no communities, no families left untouched by the disease. Its consequences lingered for years in those who had “recovered” but continued to suffer with mental and physical side effects including influenza-caused delirium and dementia and multiple birth defects in babies who were born during the pandemic.

Societally, the consequences were felt in long-lasting economic impacts, lack of trust in politicians and media who hid what was really happening and, some researchers believe, had a direct impact in the events that led up to World War II.

History is laid bare for us to see and more importantly, to learn from. Have we?

Holly Richardson

Holly Richardson is a regular contributor to The Salt Lake Tribune.