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The 1968 Hong Kong influenza pandemic (hereafter the ‘Hong Kong flu’) was one of three influenza pandemics in the twentieth century. There is now a large and growing literature on the 1918–19 ‘Spanish’ influenza pandemic that killed upwards of 50 million people – and possibly twice that number.1 Much less attention, however, has been paid to the 1957 Asian influenza pandemic and to the Hong Kong flu that killed an estimated one million people worldwide.2
The experience of the COVID-19 pandemic provides a useful vantage for re-evaluating the history of these twentieth-century influenza pandemics and their roles in the broader development of global health.3 In January 2020, during the coronavirus outbreak in China’s central Hubei province, researchers and the international media drew frequent analogies between COVID-19 and the 2002–3 epidemic of severe acute respiratory syndrome (SARS). The two episodes appeared to have much in common, including the allegedly bungled responses by Chinese authorities, at least in the early stages. In both cases, evidence of human-to-human transmission was covered up, vital information was withheld from the international community, and ‘whistleblowers’ were silenced. The genetic similarity between the viruses was recognized by the International Committee on Taxonomy of Viruses when it named the new virus SARS-CoV-2.4 However, as the Hubei outbreak expanded globally and the number of COVID-19 related deaths began to climb steeply – far exceeding the 774 deaths from SARS – the earlier analogy was dropped and comparisons were increasingly drawn with the 1918–19 influenza pandemic.5
A comparison with the Hong Kong flu provides another perspective on COVID-19, and an opportunity to reassess the history of twentieth- and twenty-first-century pandemic responses. Today, many commentators are speaking of a new Cold War between the United States and the People’s Republic of China (PRC), noting the extent to which the COVID-19 pandemic is entangled in geopolitics. As China’s foreign minister, Wang Yi, declared in March 2020, the ongoing US–China trade war and the Trump administration’s politicization of the coronavirus – repeatedly dubbed the ‘Chinese virus’, or a variant of this term – ‘are taking China–US relations hostage and pushing our two countries to the brink of a new cold war’.6
COVID-19 has not only unfolded against the backdrop of a US–China...