International Death Toll: Black Death, Spanish Flu, and COVID-19

Deathcare Abroad DISCOVER Funeral Industry News September 14, 2021
Black Plague

We believe that every funeral director should have the tools to succeed. With the help of our field-leading partners, we publish daily funeral industry news and provide free tools to help our readers advance their careers and grow their businesses. Our editorial focus on the future, covering impact-conscious funeral care, trends, tech, marketing, and exploring how today's funeral news affects your future.

International Death Toll: Black Death, Spanish Flu, and COVID-19

The challenge to deal with excessive death on a practical level has been met before. You’d expect that humanity, having weathered the Black Plague and Spanish Flu, would by now be in a better position to dispense of the remains of pandemic victims in great numbers. After all, nowadays we’re much better off. We have modern medicine, do we not; we have science. Sanitation. Technology, research.  It was literally the Middle Ages when 2 of the 3 forms of Black Plague killed everybody who caught them, and you had a whopping 20% chance of survival if you were lucky enough to catch the good strain, the bubonic one. 

Estimates of the number of dead from the Black Plague are somewhere from 75-200 million victims worldwide.  Records and reports vary, because Middle Ages, but even that lowball 75M is an extreme number.  So where’d all those bodies go, back then when nobody knew any better what to do during the serious business of a plague?  What about the 50 million Spanish Flu corpses from 1918-19?  And where are today’s 4.55+ million COVID bodies going?


That’s American COVID fatalities as of this writing, the first week of September 2021 (and we’re averaging 300+ deaths daily).  Higher than the other two leading causes of death in America — heart disease (659,041) and cancer (599,601), COVID deaths show no sign of abating any time soon, as waves of infection, variants, and lack of vaccination supply ample opportunity of perpetuation for the virus.  (The annual total of deaths in the United States in 2019 – last year of data pre-COVID – was 2,854,838.)

Maybe managing the mortal carnage of a pandemic isn’t a new problem in recorded history, but it’s certainly a learn-as-we-go process for every generation, with pandemics being kind of the worst unicorns ever.  Even so, the more things change, the more they stay the same — timelessly, in some parts of the world, one of the most obvious answers to the problem of mortal backlog and body volume is cremation.  It’s been true the world over, from America to the Middle East to Russia and China, from the Middle Ages to the present day.

Global Potter’s Field

Overall, the current scene is a lot like pandemic scenes in previous times.  There were – and are — also mass graves (in previous lives called “plague pits”) happening now, even in America. The US has shortages of supplies. We have trouble keeping up, long waits for caskets, cremation, services, and burials, and temporary interments. We have banned services, limited gatherings, refrigerated trucks and trailers lining the driveways and parking lots of hospitals and funeral homes.  But overall, even if it takes longer, we’ve been largely able to deal with our dead in the usual way: one at a time, albeit very slowly, except for in the very worst-hit areas.  In Madrid, at one point, funerals were conducted on a drive-through basis.

It is largely the same everywhere.

The more things change

Historically in Europe, when the church was central to community life, it was common to bury the dead in churchyards, and this tendency didn’t change during epidemics with high mortality; but after a certain point, graves got larger and more populated as things progressed. Ultimately, bodies were laid together in pits dug for the purpose, then layered with earth and more bodies repeatedly until there was no more room.

In other places today (as discussed in our previous article) mass cremations and burials, sometimes anonymously, are taking place. In some areas the government has taken charge of what can happen with the COVID dead, as in Pakistan. Government officials may be the only ones to attend the services provided. In Pakistan, also, it may be that families have no rights or say in the processing of the body of their loved one. The same thing applies in Malaysia. From a paper of the process: “Due to the different legal requirements and mortality rates between countries, there is no one-size-fits-all approach to the management of the dead. Whenever possible, every opportunity and assistance must be given to families to mourn their loved ones, even in times of crisis or an outbreak, in order to sustain an appropriate level of dignity and respect.”

The great equalizer

What’s actually happening to COVID dead abroad, in a pandemic that hasn’t reached the level of devastation of a Black Plague or a Spanish Flu, is as unpredictable as it is here on American soil.  There’s no consistency but inconsistency. In large part it depends on a nation’s government, infrastructure, the population’s infection rate/special vulnerabilities, whether a vaccine is available, and the economy.

Which is to say…

No comparison

Despite the almost same number, it isn’t fair to compare between the number of American dead from the Spanish Flu (675,000) and the number of American COVID dead (666,600).  Although both reflect spreading in a time period of roughly the same duration, the overall population of the United States at the time of the Spanish Flu (about one hundred five million) must be considered to get a true sense of the real devastation of that death toll of 675,000.  Today, the US population is over 333 million.  To claim we’re dealing with death on the scale of the Spanish Flu, we’d need a death count about 4 times its current value.

Likewise, American COVID isn’t the same as COVID in Italy.  It isn’t the same as COVID in India.  COVID in Africa is not COVID in Australia, and we might as well be dealing with The Black Death because humanity demonstrates better than ever that there has been no process of learning from history, and there is no real leg up, here… unless it’s developing the vaccine.  At least that’s a win.

As of September 3, 2021, COVID-19 is present on six continents.  4.55+ million are dead in 215 countries and territories. 

With emerging variants and inconsistent vaccination, we may reach Spanish Flu death numbers yet.

Thanks to Connecting Directors writer Jennifer Trudeau for this great piece!