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World War I, which lasted from 1914 to 1918, resulted in an estimated 40 million deaths, including military personnel and civilians caught in the crossfire. This conflict marked a turning point in modern warfare, with trench warfare and new technologies leading to unprecedented carnage. World War II, occurring from 1939 to 1945, stands as the deadliest conflict in human history, with death toll estimates ranging from 50 to 85 million people globally. This staggering figure includes not only military personnel but also millions of civilians who suffered due to genocide, bombings, and widespread famine. The war saw significant battles across Europe, Asia, and the Pacific, highlighting the horrors of total war. Notwithstanding the direct effect of the Atom Bomb during World War Two, approximately80,000 people were killed as a result of the blast on August 6, 1945 (Hiroshima ). This included immediate deaths from the immense heat and blast wave (around 60% from burns, 30% from falling debris).

The Vietnam War, which spanned from the late 1950s until 1975, claimed millions of lives, including more than 58,000 US military personnel and millions of Vietnamese soldiers, including civilians. This conflict showcased the brutal impacts of guerrilla warfare and the devastating consequences of prolonged military engagement, leaving lasting scars on both American and Vietnamese societies. In addition to the direct casualties from these major wars, the spread of epidemics during wartime—propagated through airborne transmission or biological agents—led to increased mortality rates.

On New Year’s Day in 1925, America was beginning to recover from the Great Influenza Pandemic and World War One. The devastating influenza outbreak of 1918-1920, commonly known as the Spanish Flu, was caused by the H1N1 virus infecting a third of the world’s population and resulting in the deaths of50 to 100 million people, recorded as the deadliest epidemic in U.S. history.

In 2009, the United States experienced a significant public health challenge with the emergence of the H1N1 Swine Flu pandemic. This pandemic was triggered by a novel strain of the influenza virus, which caused a variety of symptoms typical of a seasonal flu, such as fever, cough, and body aches. The initial outbreak was first identified in California in April 2009, leading to widespread concern as the virus quickly spread throughout the country.  By June of that year, the World Health Organization (WHO), recognizing the severity and rapid transmission of the virus, officially declared it a pandemic. The impact of the outbreak was indeed profound, resulting in nearly 274,000 hospitalizations across the nation and approximately 12,469 fatalities, significantly affecting healthcare systems. 

 Interestingly, this particular virus had a disproportionate effect on younger populations, which was somewhat atypical for influenza viruses that commonly pose greater risks to the elderly. The situation was exacerbated by the delayed availability of vaccines, which only became accessible later in the peak phase of the pandemic. Over time, as the population developed immunity and vaccination efforts increased, the H1N1 virus gradually transitioned into a strain that is now incorporated into the seasonal flu vaccine, allowing it to coexist with other influenza viruses during flu seasons.

This new strain was capable of spreading easily from human to human in the pandemic of 2009.  Although it could infect human cells efficiently, it did not have markers indicating high virulence. Consequently, while it caused widespread infection, the illness was generally milder compared to the 1918-1920 pandemic of the “Spanish Fl.“

Between the early 1990s and 2009, the world witnessed the emergence of strains of H1N1 influenza, commonly referred to as Swine Flu. This virus became a significant public health concern in 2009, when it swept across the globe, infecting approximately one-third of the world’s population, with estimates suggesting that between 50 and 100 million people died as a result of this infectious disease. 

In late December 2019, a notable increase in patients presenting with unusual health issues was observed in Wuhan, a bustling city in Hubei Province, China. This alarming trend prompted health officials to launch an investigation to uncover possible common factors, including environmental exposures or underlying risk factors.  Patients were exhibiting symptoms characteristic of pneumonia, such as severe shortness of breath and high fevers, yet their conditions were not responding to conventional medical treatments. By December 31, 2019, the World Health Organization (WHO) Country Office in China received reports highlighting several cases of pneumonia of unknown origin.  Initial investigations revealed that many of these cases were connected to the Huanan Seafood Wholesale Market, a prominent hub known for a wide variety of seafood and exotic animals. The identification of this market as a potential focal point was crucial, as it raised concerns about a possible infectious outbreak and the need for immediate public health measures to prevent further spread of the illness.

In January 2020, a new and formidable virus emerged in the United States, quickly identified as COVID-19 (Coronavirus Disease). The first cases were reported in the picturesque state of Washington, sparking a wave of concern and urgency. COVID-19 is attributed to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), and it shares a symptom profile with the troubling cases that had previously surfaced in Hubei Province, China. SARS-CoV-2 is a positive-sense, single-stranded, enveloped RNA virus that belongs to the intriguing family of “Coronaviridae“. Its name, “coronavirus,” is derived from the Latin word “corona,” meaning “crown.” Under the scrutiny of electron microscopy, the viral envelope takes on a dramatic crown-like appearance, adorned with small bulbous projections, known as spike (S) peplomers, that give it a distinctly fearsome visage. This virus unleashed a global pandemic, dramatically altering lives and communities from 2020 to 2023. While most people who contracted COVID-19 experienced symptoms resembling the common cold or flu, for some, the infection escalated into a severe and life-threatening illness, leaving a lasting impact on health systems and societies worldwide.

Determining the exact number of deaths in the ongoing war between Russia and Ukraine is challenging due to the secrecy of both sides and the continuous nature of the conflict. Estimates from international organizations and intelligence sources suggest that there have been hundreds of thousands of military casualties and over 15,000 confirmed civilian deaths since the full-scale invasion began in February 2022. In the war involving Israel, Hamas, Hezbollah, and other Palestinian factions, as of late 2024 and early 2025, more than 72,500 people have been reported killed across various fronts. This includes over 70,000 Palestinians in Gaza, more than 3,900 people in Lebanon, and approximately 1,200 people in Israel.

Americans owe a profound debt of gratitude to our active-duty military personnel and veterans who have bravely served across all branches of the armed forces. Among their ranks are countless individuals who faced harsh realities of viral infections, such as influenza, which can strike unpredictably and with devastating effects. The invisible nature of these pathogens makes them a relentless enemy, capable of invading our bodies without warning, often leaving little chance for survival. Considering the long history of widespread epidemics and the lessons learned from past outbreaks, it becomes imperative for us to adopt stringent health precautions. We must take proactive measures—such as vaccination, sanitation, and public awareness campaigns—to shield ourselves and our communities from the severe consequences of these insidious viruses. History bears witness to the impact of airborne diseases, underscoring the critical importance of safeguarding human life against these unseen threats.

References

(no author). 10/07/2025. Coronavirus Disease, Published by the APIC Association for Professionals in Infection Control and Epidemiology. Permalink: https://apic.org/covid19/?gad_source=1&gad_campaignid=23025236530&gbraid=0AAAAACZzVYHM-DpdDbx6NRblO6t2cnoIL&gclid=Cj0KCQiAgbnKBhDgARIsAGCDdlfxFcM9-MlHllzZUjLoS_9Ycix74V5zvQ69b8qd_tQiJU1ORJuxa0QaAjQAEALw_wcB

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