One of the reasons the influenza pandemic thrived in 1918 was because of overcrowded living conditions. Though influenza viruses spread most efficiently in cool, dry environments, the 1918 flu thrived in the tropics because of dense populations. India was the hardest-hit nation: As many as 14 million people died in the British-ruled districts alone, with the death rate more than 10 times higher than in Europe. Our research shows that the most crowded areas suffered the highest losses.

With today’s response protocols in place, countries including Germany, Singapore and South Korea were able to rapidly enact measures to prevent contagion by enforcing lockdowns, shelter-in-place rules and social distancing orders. To date, these interventions have prevented or delayed about 62 million confirmed cases and averted 530 million infections across Asia, Europe and North America.

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