It’s a grim calculation, counting those Americans who have died in service to their country, as targets of terrorist attacks, amid natural disasters or as victims of pandemic disease. Here are major events from history that have inflicted a devastating toll on American lives.

In early 2020, the first reports circulated of a deadly and contagious new respiratory disease centered in Wuhan, China. The novel strain of coronavirus claimed its first American victims in February and COVID-19, as the disease became known, erupted into a full-blown public health crisis by March, triggering widespread shutdowns of U.S. schools and businesses, and stay-at-home orders in panicked states nationwide.

New York was the first to suffer an explosion of infections and deaths, registering more than 200,000 positive cases and at least 14,000 laboratory-confirmed COVID-19 deaths in the first three months of the pandemic. As public health restrictions were relaxed over the summer, the virus spread to new hotspots and steadily claimed more and more lives, reaching daily death totals in excess of the 9/11 attacks by late fall.

Funding and political will in the United States and around the world accelerated the development of vaccines to fight the virus and by December 11, 2020, the FDA issued an Emergency Use Authorization for the use of the first COVID-19 vaccine. A week later the government agency approved a second, and by February 2021, Americans had access to three FDA-approved vaccines. By March 2024, 81 percent of the U.S. population had received at least one dose of a COVID-19 vaccine.

Despite the new vaccines, COVID-19 cases and deaths continued as new variants of the virus emerged and some Americans remained reluctant to become vaccinated. By March 2024, more than 1.1 million deaths from COVID-19 had been reported nationwide since the start of the pandemic.

The awful death toll of the Civil War may never fully be known. For more than a century, the number was enshrined at 618,222 fatalities: 360,222 from the Union North and 258,000 from the Confederate South. But in recent decades, historians raised the number to an estimated 750,000 deaths, mostly blamed on the under-counting of Confederate casualties.

That higher figure, if it stands, represents 2.5 percent of the total U.S. population in the 1860s. If a similar war were fought today, it would claim more than 7 million American lives. The death and suffering inflicted by the Civil War is unequaled in U.S. military history.

In 1981, doctors began reporting mysterious cases of rare types of pneumonia and cancers among predominately gay men in New York and California. The condition, which was later found in blood transfusion recipients and intravenous drug users, was given a name by the CDC in 1982: acquired immunodeficiency syndrome or AIDS.

Researchers soon identified the virus responsible for AIDS (human immunodeficiency virus or HIV), but doctors struggled to treat the crippling symptoms of the disease, which included rapid weight loss, painful sores and susceptibility to lethal cases of pneumonia. At its peak in 1995, the AIDS epidemic claimed more than 50,000 American lives each year.

Thanks to safe sex campaigns and the advent of powerful antiretroviral therapies, HIV infections and AIDS deaths plummeted in the late 1990s, but AIDS-related deaths in the United States have held steady at between 10,000 and 15,000 a year. It’s believed that roughly 700,000 Americans have died during the more than 30-year span of the AIDS epidemic.

The 1918 flu claimed an unfathomable 50 to 100 million victims worldwide, including an estimated 675,000 Americans. Wrongfully labeled the “Spanish flu,” the first confirmed case of this virulent strain of influenza was actually a U.S. Army cook stationed in Kansas in March of 1918. Spring fatalities from the 1918 flu were similar to the seasonal flu, but after the virus followed troop deployments overseas during WWI, it resurged in the fall with deadly vengeance. October of 1918 was the worst single month of the pandemic, claiming almost 200,000 American lives.

Unlike the seasonal flu, which is most dangerous to the very old and very young, the 1918 strain cut down otherwise healthy men and women in the prime of life. Movie theaters and social gatherings were shut down to stem the spread of the virus, and face masks were mandatory in places like San Francisco, but without a vaccine the virus was left to run its deadly course by mid-1919.

The bitter terms of Germany’s surrender in World War I crippled the German economy and bred both contempt for the Allied powers and antisemitic conspiracies of a Jewish/communist plot to destroy Germany from within. Adolf Hitler and his National Socialist (Nazi) party rode to power in 1933 and put plans in motion to establish an “Aryan” German empire.

The United States, as it did during World War I, held back as England, France and other nations declared war on Hitler. But after the attack on Pearl Harbor in 1941, the U.S. declared war on both Japan and Germany, and joined the Allies in the heroic beach invasion at Normandy, in which more than 4,400 Allied troops were killed in a span of days. At the Battle of Okinawa, the deadliest single battle for the United States, more than 12,500 American troops lost their lives on the rain-soaked rock. In total, 405,400 U.S. servicemen died in World War II, the deadliest American war waged on foreign soil.

Europe slid into war in 1914, but the United States, under President Woodrow Wilson, vowed to remain neutral in the foreign conflict. But after German torpedoes sank the passenger ship Lusitania in 1915, killing 120 Americans, public sentiment began to shift. The U.S. declared war on Germany on April 6, 1917, and deployed hundreds of thousands of conscripted young men to the trench-scarred battlefields of Europe to face German bullets and bayonets, tank artillery, poison gas and disease.

A sobering total of 116,516 Americans died in “the war to end all wars,” which concluded with an Armistice declaring Allied victory at exactly 11 am on November 11, 1918. “If the war had kept up a few hours longer, there wouldn’t be many of us left to tell about it,” wrote U.S. serviceman Harry Frieman in his journal entry for that fateful day.

America’s long and unpopular war with Communist North Vietnam began as a targeted military intervention and devolved into a decade-long war of attrition. As antiwar protestors took to the streets of America burning draft cards, millions of young men were shipped out to fight in the jungles and rice paddies of Southeast Asia against an unflagging enemy.

A total of 58,220 servicemen gave their lives in the Vietnam War. The worst and bloodiest fighting spanned 1967 to 1969, when more than 40,000 American soldiers were killed in the months and years surrounding the Tet Offensive. The United States ultimately withdrew from Southeast Asia, ceding control of Vietnam to the communists.

“Today, America can regain the sense of pride that existed before Vietnam. But it cannot be achieved by refighting a war that is finished as far as America is concerned,” said President Gerald Ford in 1975. “We, of course, are saddened indeed by the events in Indochina. But these events, tragic as they are, portend neither the end of the world nor of America’s leadership in the world.”

Dubbed “The Forgotten War,” the Korean War was a major conflagration between armed nuclear powers that ultimately cost the lives of 36,914 U.S. servicemen. The Korean War was the first test of the United Nations, which sent in troops to defend South Korea after a June 25, 1950 invasion by Communist North Korea backed by China and the Soviet Union. Nearly 2 million American troops were deployed during three years of fighting, which ended in a bloody stalemate, with neither side gaining or losing their pre-war territory divided at the 38th parallel.

While no atomic weapons were used, massive bombing campaigns (including napalm) killed an estimated 2 million civilians in North Korea alone. “[W]e eventually burned down every town in North Korea... and some in South Korea, too,” said retired U.S. Air Force General Curtis LeMay. “We even burned down [the South Korean city of] Pusan—an accident, but we burned it down anyway.”

The hurricane that battered the island city of Galveston, Texas with 150-mph winds and drowned it with 15-foot storm surges remains the deadliest natural disaster in American history. An estimated 8,000 men, women and children were killed during the Category 4 storm, which lifted thousands of houses off their moorings and smashed them to pieces on September 8 and 9, 1900.

The howling winds tore off roof shingles and transformed them into flying knives. Nuns at the St. Mary’s Orphans Asylum lashed themselves to the children in desperation, only to be swept out to sea when the walls collapsed. Galveston, which had been one of Texas’s wealthiest and most modern cities, was reduced to rubble and the bodies of countless victims continued to wash ashore for weeks.

At the turn of the 20th century, San Francisco was a Western boom town with a population of 400,000, many of them crowded into hastily constructed wood and brick tenements in the city’s poorer South of Market district. At 5:13 am on April 18, 1906, Northern California was jolted awake by a massive earthquake that ruptured 296 miles of the San Andreas fault.

The violent shaking, which lasted an agonizing 45 to 60 seconds, toppled buildings across San Francisco, including City Hall, which was reduced to a skeleton wearing a domed hat. But even deadlier than the earthquake and its aftershocks were the fires that tore through the overcrowded tenements and burned for four days. An estimated 3,000 people died in the disaster, which leveled 500 city blocks and left more than 200,000 San Francisco residents homeless.

Nothing about the clear blue skies on the morning of September 11, 2001 hinted that America was about to be the victim of the deadliest foreign assault ever on U.S. soil. Then at 8:46 am, the first hijacked commercial airliner slammed into the North Tower of the World Trade Center in New York City. As news cameras were fixed on the plume of black smoke pouring from the crippled North Tower, a second plane crashed into the South Tower with a terrific explosion. Next came the attack on the Pentagon followed by the heroic downing of the hijacked Flight 93 in Shanksville, Pennsylvania.

All told, 2,974 people were killed in the 9/11 attacks, which President George W. Bush called “evil, despicable acts of terror” and “acts of mass murder.” In the decades since, nearly 4,000 firemen and first responders have died from cancers and other 9/11-related medical conditions.

In the early dawn hours of December 7, 1941, a swarm of nearly 90 Japanese aircraft converged on the American naval base at Pearl Harbor on Oahu, Hawaii. The hours-long surprise attack destroyed several large American battleships still anchored in the harbor and killed 2,390 U.S. servicemen and civilians.

Nearly half of the American deaths were aboard the USS Arizona, which exploded into flames and sank after taking direct hits from the Japanese bombers. The “unprovoked and dastardly attack,” in the words of President Franklin D. Roosevelt, drew a reluctant United States into WWII.