Persistent Pandemics

•For countries Covid-19 cases/deaths positively related to deaths in 1918 flu pandemic.•For large US cities, mortality from the 1918 influenza is positively related to Covid-19 today.•Mechanisms: lower trust from past pandemics; multi-generational health shocks; fading collective memory. We ask whether mortality from historical pandemics has any predictive content for mortality in the Covid-19 pandemic. We find strong persistence in public health performance. Places that performed worse in terms of mortality in the 1918 influenza pandemic also have higher Covid-19 mortality today. This is true across countries as well as across a sample of large US cities. Experience with SARS in 2003 is associated with slightly lower mortality today. We discuss some socio-political factors that may account for persistence including distrust of expert advice, lack of cooperation, over-confidence, and health care supply shortages. Multi-generational effects of past pandemics may also matter.