While both the 1918 influenza (aka Spanish flu) and the 2020 COVID-19 pandemics were devastating, the 1918 influenza pandemic was considered worse. Its origins are still debated, but it was first identified in the United States at Fort Riley, an Army base in Kansas. According to the Centers for Disease Control and Prevention (CDC), an estimated 500 million people (or one-third of the world's population) became infected with this virus. An estimated 50 million people died worldwide with about 675,000 deaths occurring in the United States. This number of U.S. dead would be the equivalent of about 2 million people in relation to the present day population. In this article, a detailed comparison of the 1918 and 2020 pandemics reveals some striking similarities as well as big differences in health care measures and the federal government response.