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.
History of Germany
The total of German war dead was 8% to 10% out of a prewar population of 69,000,000, or between 5.5 million and 7 million people. This included 4.5 million in the military, and between 1 and 2 million civilians. There was chaos as 11 million foreign workers and POWs left, while 14 million displaced refugees from the east and soldiers returned home. During the Cold War, the West German government estimated a death toll of 2.2 million civilians due to the flight and expulsion of Germans and through forced labour in the Soviet Union. This figure remained unchallenged until the 1990s, when some historians put the death toll at 500,000–600,000 confirmed deaths. In 2006 the German government reaffirmed its position that 2.0–2.5 million deaths occurred.
At the Potsdam Conference, Germany was divided into four military occupation zones by the Allies and did not regain independence until 1949. The provinces east of the Oder and Neisse rivers (the Oder-Neisse line) were transferred to Poland, Lithuania, and Russia (Kaliningrad oblast); the 6.7 million Germans living in Poland and the 2.5 million in Czechoslovakia were forced to move west, although most had already left when the war ended.