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U.S. COVID-19 deaths have now surpassed the 675,000 estimated deaths that occurred during the H1N1 influenza pandemic of 1918, but SARS-CoV-2 hasn't exacted as heavy a toll as that pandemic.

With a national population of around 103 million people at that time -- about a third of the current total of 330 million Americans -- the 1918 pandemic killed roughly 1 in 150 people in the U.S.; COVID has killed 1 in 500 Americans.

Globally, the 1918 flu wrought more havoc than COVID, too, infecting about 500 million people, or a third of the world's population at that time. It killed about 50 million people globally, .

SARS-CoV-2 has infected nearly 230 million people around the world and killed some 4.7 million of them.

There are many reasons for the differences in infection and mortality. The 1918 pandemic hit while the world was enmeshed in World War I and international travel was frequent; hospitals didn't have the same medicines and technology at their disposal to treat patients; the cause of the illness was unidentifiable and therefore a test, targeted treatment, or vaccine was impossible.

During the COVID-19 pandemic, global travel came to a halt and public health measures such as social distancing and masking were implemented relatively rapidly, vaccines were produced in record time, and treatments were investigated in real-time with a few proving helpful (with more still in development).

Still, misinformation and disinformation campaigns stymied the effectiveness of some of those approaches in the U.S., and the virus threw humanity a curveball with the far more transmissible Delta variant.

"Since May, [more than] 100,000 Americans unnecessarily lost their lives because they chose not to get vaccinated," , of Baylor College of Medicine in Houston. "They fell victim to the vile yet unopposed antiscience aggression from 3 sources: The far right including members of U.S. Congress, Governors, conservative news outlets; the 'disinformation dozen' ; and Russian propaganda."

With the U.S. now averaging some 2,000 deaths per day, and the potential for sustained, high levels of transmission to spawn another variant, SARS-CoV-2 can still wreak much more havoc. Whether that ever reaches 1918 H1N1 proportions remains to be seen.

The comparison to the 1918 flu pandemic also serves as a reminder of the risk that influenza poses. Since 1918, three other influenza pandemics occurred in the U.S.: H2N2 in 1957, H3N2 in 1968, and H1N1 in 2009. These pandemics were all than the first H1N1 pandemic. But that doesn't mean another killer flu -- or another deadly coronavirus -- outbreak is off the table.

A reflection on the progress made since the 1918 pandemic by two CDC scientists for the 100-year anniversary of that outbreak concludes: "Philosopher George Santayana pointed out, 'Those who cannot remember the past are condemned to repeat it.' We are no doubt more prepared in 2018 for an infectious disease threat than in 1918. But it is critical to remember that preparation only stems from a global commitment to share data about viral isolates, support innovative research, and dedicate resources to assess the pandemic risk of new and emerging influenza viruses from zoonotic reservoirs."

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