More than 90 years ago, the first pandemic of the last century was initially observed in the early spring of 1918. It was quickly followed by much more fatal second and third waves in the fall and winter of 1918-1920, causing an estimated 50 million deaths [3] . It still proves to be a major dilemma for the scientific community to understand what had happened precisely, how it had happened, and why it was in several ways unlike any other influenza pandemic in recorded human history [3] . Several studies have focused on quantifying the global impact of that pandemic, either by using records of cases and mortality of the affected countries (e.g., [4] [5] [6] ), or by using vital statistics data from the affected countries to estimate the excess mortality of these countries. For example, Murray et al. [6] estimated the excess mortality rate of each affected country and extrapolated to conclude that an estimated 62 million people would be killed in a similar pandemic in 2004. However, to the best of our knowledge historical healthcare records had not been used to directly assess the excess healthcare burden during a pandemic.