[gmarx]

The Spanish flu really was very bad but would not have killed as many people if it occurred today. Malnutrition might have been a factor (though today's obesity rate might also be a problem) but the bigger thing was lack of antibiotics. Flu almost never kills you directly- it's the bacterial pneumonia you develop on top of it that does. Without antibiotics back then there would have been little they could do

[mrguyorama]

Bacterial Pneumonia was not the novel danger of the "Spanish" flu; They cytokine storm it caused in perfectly healthy people was horrifying, with perfectly healthy people who would normally fight off any flu dying from this one. A lot of young twenty somethings, strong people who were not malnourished died from it.

Hell, people got cytokine storms from COVID-19 and we still can only treat it if we catch it really early, otherwise it's still a great way to die for a normal person.

[gmarx]

That's a hypothesis. It is known that (supposedly) that strain can cause cytokine storm more than other flus do. I would not assume that means cytokine storm was the primary cause of death or even the primary cause of death in young adults. Based on my experience my guess is that the pneumonia was a much bigger cause of death than the storm

[mrguyorama]

Right I wasn't expressing the cytokine storm as the primary cause of death but rather a phenomenon that definitely pushed it above a normal flu, especially for healthy young adults.