Skip Navigation
Explore our COVID-19 Resources and Updates
CHS blue logo square
Home > Our Work > All Publications > 2001


Our publications keep professionals working across the public, private, and academic sectors informed on the most important developments and issues in health security and biosecurity.

Find an article or report by keywords:

Find an article or report or see all by area, author, or year:


"Hospital's Full-Up": The 1918 Influenza Pandemic

Monica Schoch-Spana
Date posted:
July 15, 2001
Publication type:

Public Health Rep 2001;116(Suppl 2):32-33

Association of Schools of Public Health
Available through publisher
See also:

Full article as PDF • Watch video


Curtailing the human suffering associated with a catastrophic infectious disease outbreak presents two key operational challenges for health professionals: caring for the sick and dying and halting the outbreak. In providing for these two central activities, one can assume a manager’s point of view, aptly engaged in a calculus of supply and demand. If x grams of anthrax, then y numbers of the sick and dying and z amounts of hospital beds, vaccines, antibiotics, and so on. Such a perspective is necessary in thinking through the range of potential effects and best- and worst-case scenarios and providing for the optimum protection of populations. A  complementary point of view is that of the historian who attempts to understand an outbreak as it unfolds in real human time, discerning the complex effects of infectious disease as it works its way through the lives of individuals, families, and institutions.

In the event of a catastrophic epidemic initiated by a biological attack, would we be able to tend to large numbers of ill and dying people? Although the U.S. health care system has never faced a scenario so chilling, history affords us a sobering glimpse of the burdens associated with a large-scale, lethal epidemic.

In 1918 and 1919, the Spanish influenza outbreak sickened one of every four Americans and caused more than 500,000 deaths in this country alone and more than 40 million worldwide. This devastation resulted from a disease with an estimated case mortality rate of 2.5%. The possible effects of a biological attack involving the agents of greatest concern are even more grim: The estimated mortality rate for untreated pneumonic plague approaches 100%; untreated inhalation anthrax, 90%; and smallpox, 30%.

Full article as PDF • Watch video



Our Mission

To protect people’s health from epidemics and disasters and ensure that communities are resilient to major challenges.