Library of Congress
In this 1918 file photo made available by the Library of Congress, volunteer nurses from the American Red Cross tend to influenza patients in the Oakland Municipal Auditorium, used as a temporary hospital. Image Credit: AP
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Washington: In the years between two lethal pandemics, one the misnamed Spanish flu, the other COVID-19, the world learned about viruses, cured various diseases, made effective vaccines, developed instant communications and created elaborate public-health networks.

Yet here we are again, face-masked to the max. And still unable to crush an insidious yet avoidable infectious disease before hundreds of thousands die from it.

As in 1918, people are again hearing hollow assurances at odds with the reality of hospitals and morgues filling up and bank accounts draining. The ancient common sense of quarantining is back. So is quackery: Rub raw onions on your chest, they said in 1918. How about disinfectant in your veins now? mused President Donald Trump, drawing gasps instead of laughs over what he weakly tried to pass off as a joke.

This Library of Congress
This Library of Congress photo shows a demonstration at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918. Image Credit: AP

In 1918, no one had a vaccine, treatment or cure for the great flu pandemic as it ravaged the world and killed more than 50 million people. No one has any of that for the coronavirus, either.

Modern science quickly identified today's new coronavirus, mapped its genetic code and developed a diagnostic test, tapping knowledge no one had in 1918. That has given people more of a fighting chance to stay out of harm's way, at least in countries that deployed tests quickly, which the U.S. didn't.

But the ways to avoid getting sick and what to do when sick are little changed. The failure of US presidents to take the threat seriously from the start also joins past to present.

A nurse takes the pulse
November 1918 file photo: A nurse takes the pulse of a patient in the influenza ward of the Walter Reed hospital in Washington. Image Credit: AP

Trump all but declared victory before infection took root in his country and he's delivered a stream of misinformation ever since. President Woodrow Wilson's principal failure was his silence.

Not once, historians say, did Wilson publicly speak about a disease that was killing Americans grotesquely and in huge numbers, even though he contracted it himself and was never the same after. Wilson fixated on America's parallel fight in World War I like "a dog with a bone," says John M. Barry, author of "The Great Influenza."

The suspected ground zero of the 1918 flu ranges from Kansas to China. But it was clear to US officials even in 1918 that it didn't start in Spain.

This Library of Congress photo
This Library of Congress photo shows a demonstration at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918. Image Credit: AP

The pandemic took on Spain's name only because its free press ambitiously reported the devastation in the disease's early 1918 wave while government officials and a complicit press in countries at war - the U.S. among them - played it down in a time of jingoism, censorship and denial.

Like COVID-19, the 1918 pandemic came from a respiratory virus that jumped from animals to people, was transmitted the same way, and had similar pathology, Barry said by email. Social distancing, hand-washing and masks were leading control measures then and now.

Medical advice from then also resonates today: "If you get it, stay at home, rest in bed, keep warm, drink hot drinks and stay quiet until the symptoms are past," said Dr. John Dill Robertson, Chicago health commissioner in 1918. "Then continue to be careful, for the greatest danger is from pneumonia or some kindred disease after the influenza is gone."

But there were also marked differences between the viruses of 1918 and 2020. The Spanish flu was particularly dangerous to healthy people aged 20 to 40 - the prime generation of military service - paradoxically because of their vibrant immune systems.

US Naval History and Heritage
In this October 19, 1918 file photo provide by the US Naval History and Heritage Command a sign is posted at the Naval Aircraft Factory in Philadelphia that indicates, the Spanish Influenza was then extremely active. Image Credit: AP

When such people got infected, their antibodies went after the virus like soldiers spilling from the trenches of Europe's killing fields.

"The immune system was throwing every weapon it had at the virus," Barry said. "The battlefield was the lung. The lung was being destroyed in that battle."

Young soldiers and sailors massed at military camps in the U.S., sailed for Europe on ships stuffed to the gunwales with humanity, fought side by side in the trenches and came home in victory to adoring crowds. The toll was enormous, on them and the people they infected. The Spanish flu could just as easily have been called the US Army or US Navy flu instead. Or the German or British flu, for that matter.

Among those who died in the pandemic was Friedrich Trump, Donald Trump's paternal grandfather. Among those who contracted it and recovered were the wartime leaders of Britain and Germany as well as of the United States, British and Spanish kings and the future US president, Franklin Roosevelt, when he was assistant Navy secretary.

But the toll was heavier on average people and the poor, crowded in tenements, street cars and sweaty factories.

They could not all live by the words of the 1918 US surgeon general, Rupert Blue: "Keep out of crowds and stuffy places as much as possible. ... The value of fresh air through open windows cannot be overemphasized. ... Make every possible effort to breath as much pure air as possible."

An estimated 675,000 Americans died in the pandemic, which is thought to have infected one-third of the global population.