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.
Canadian women in the World Wars
One of the greatest consequences of the First World War was the number of lives lost, missing, and wounded throughout the entirety of the battles. The Allied and Central powers felt immense casualties and losses with 22,447,500 and 16,403,000 (MIA, KIA, WIA), respectively. Nurses faced this reality throughout the war and even on rare instances, Canadian nurses lost their lives while on duty. The most prominent cases of this was the death of four nursing sisters on May 19, 1918, during the bombing raid on No. 1 Canadian General Hospital at Étaples, France, and the death of 14 nursing sisters and over 200 other service personnel on June 27, 1918, when the HMHS Llandovery Castle was sunk by the U-86 The HMHS Llandovery Castle was one of five Canadian hospital ships that served in the First World War. In total, 234 lives were lost with only 24 survivors. The sinking of the HMHS Llandovery Castle was one of the most significant Canadian naval disasters of the First World War, in terms of the overall death toll. By the end of the war, 47 Canadian nurses lost their lives while on active duty, victims of enemy attack or disease contracted from patients Overall, Canadian nurses dealt with the realities of war and were key assets to the Canadian military and Allied forces.