Here in Hawaii, whole villages died. I talked to one person who remembers coming back to Hawaii after WWI (he was a merchant seaman), and he found that whole areas where he remembered communities were just abandoned. That’s why today you can find ruins of abandoned churches out in the middle of nowhere.
50 million may be more than any one of the waves of the Black Death, I’m no expert on the art of estimating the mortality totals in terms of raw numbers, but I’m pretty sure that several of the the Black Death waves, which stretched from China to Portugal in the least, took out a higher percentage of the world population.
I was doing some reading over the 1918 flu, and came to this one story that had occurred around the Baltimore area. Some guy came home in the late afternoon with a severe headache and aching pain...told the wife he was going to bed. Around sun-up, she tried to wake him, and he was dead. She didn’t want to alarm the two kids and just told them to go off to school. By mid-morning, she had a headache and bodyache. When the kids came home from school....she was dead.
If you read through the historical accounts, urban areas were the hardest hit. Rural areas were much less so.
It’s generally speculated that large numbers of people died and simply weren’t reported in the press, or noted dead in the 1920 Census.