Using data from U.S. cities, along with a sample of other countries, the authors find a negative correlation between the health outcomes (such as mortality rates) for the COVID-19 and Spanish flu pandemics. Places relatively unaffected by the Spanish flu in 1918 were more likely affected during the first few months of the COVID-19 pandemic and still have higher mortality months later. The authors also suggest that the political climate can affect health outcomes, specifically through preparedness and access to resources. As a lesson from history, places most affected by SARS in 2002, such as East Asian nations, learned the importance of pandemic preparedness, which appears to have positively influenced their preparedness for COVID-19.