Syndemic
The worst of the 20th century influenza pandemics was the 1918 pandemic, where between 20-40 percent of the world’s population became ill between 40-100 million people died. More people died of the so-called Spanish flu (caused by the H1N1 viral strain) pandemic in the single year of 1918 than during all four-years of the Black Death. The pandemic had devastating effects as disease spread along trade and shipping routes and other corridors of human movement until it had circled the globe. InIndia, the mortality rate reached 50 per 1,000 population. Arriving during the closing phase of the World War I, the pandemic impacted mobilized national armies. Half of U.S. soldiers who died in the "Great War," for example, were victims of influenza. It is estimated that almost ¾ of a million Americans died during the pandemic. In part, the death toll during the pandemic was caused by viral pneumonia characterized by extensive bleeding in the lungs resulting in suffocation. Many victims died within 48 hours of the appearance of the first symptom. It was not uncommon for people who appeared to be quite healthy in the morning to have died by sunset. Among those who survived the first several days, however, many died of secondary bacterial pneumonia. It has been argued that countless numbers of those who expired quickly from the disease were co-infected with tuberculosis, which would explain the notable plummet in TB cases after 1918.
German strategic bombing during World War I
On 28 January 13 Gothas and two Giants set off, six of the Gothas turning back because of poor visibility. Over a hundred defensive sorties were flown, resulting in one Gotha being shot down after being attacked by two Sopwith Camels from the 40 Squadron RFC, flown by Second Lieutenants Charles Banks and George Hackwill, the first victory for night fighters against a heavier-than-air bomber over Britain; both pilots were awarded the DFC. On the ground, 67 people were killed and 166 injured: the casualties included 14 dead and 14 injured in stampedes, when people queuing for admission to shelters were alarmed by maroons set off as a warning that a raid was expected; another 11 were injured by shrapnel from anti-aircraft fire. Many of the other casualties were caused by a bomb, which fell on the Odhams printing works in Long Acre, which was being used as a shelter.