The most surprising part of our findings is the significant increases in the numbers of hospitalizations and treatments by the public medics for 1919, the year between the two waves when only the beginning of the second wave in December of 1919 had contributed 9 .24 (7.90, 11.12) *Excess deaths in 1918 are statistically significant (more than 2 SD). some initial influenza deaths over the monthly means of neighboring "baseline" years [9] . One possible reason for this is the contribution to hospitalization/treatment due to other diseases that were prevalent in 1919 (e.g., a cholera outbreak which led to 2,693 deaths in 1919 and 1,675 deaths in 1920 [14] ). However, limited by the retrospective nature of the study design, we are unable to identify or rule out other non-relevant diseases or conditions solely from our hospitalization/treatment data due to the lack of more detailed historical data.