The full title of this book is The Great Influenza – The Story of the Deadliest Pandemic in History. I started reading it during the COVID-19 pandemic. It was a book I’d been meaning to read long before COVID hit, and now seemed like a very appropriate time to start.
The influenza pandemic happened about 100 years before the COVID-19 pandemic did. There are so many similarities between how people back then reacted to influenza and how people today are reacting to COVID-19.
The book is not for everyone, particularly those who are already overwhelmed by everything involved with the COVID-19 pandemic. That said, I recommend the book to those who happen to enjoy reading about science, and health, and history.
The book is presented in a way that resembles a narrative. In other words, it is not just a dry pile of facts and figures.
John M. Barry did an excellent job of making scientists and doctors who were involved in trying to stop the spread of influenza into relatable, interesting, people. He noted their skill set, their personalities, and their quirks.
I learned a lot from this book. It was astonishing how little we have learned between the influenza pandemic and today.
The influenza pandemic was, at the time, referred to as the “Spanish Flu”. But, it didn’t start in Spain. Instead, it started in the United States, in rural Kansas.
The pandemic started just before the United States got involved in World War I. The governments of the countries that allied with the United States imposed strict rules about what could, and could not, be published in newspapers, played in movie theaters, or sung. The goal was to prohibit anything that might reduce to morale of the troops.
Spain stayed out of the war – or, at least, did not join it – for a long time. As such, the newspapers in the country were free to write whatever was newsworthy.
Many people first heard about the influenza pandemic after reading about it in Spanish newspapers. At the time, Spain was one of the countries that had been hit by the virus. People (outside of Spain) started calling the virus “Spanish flu”.
The book shows evidence that the influenza virus began in rural Kansas, and spread from there to Camp Funston in Fort Riley, Kansas. The enlisted went from there to other camps, some of which were in France. Young men, from different areas of the United States, were packed into quarters that were not designed to accommodate so many people. Influenza spread through the military very quickly.
Today, the (impeached) President of the United States calls COVID-19 “The Chinese Virus“, or “Kung Flu“. It is clear that the COVID-19 virus began spreading in Wuhan, China. But, that’s no excuse for the President to refer to the virus in such racist terms.
The hospitals during the influenza pandemic were as overloaded as the ones today that were hit by a surge of COVID-19 patients.
In both cases, people did not understand what they were seeing when it started. Back then, the doctors thought their patients had pneumonia, or that it was “only influenza”. They had no way of knowing how bad this particular strain of influenza actually was, but understood that most influenza cases were mild.
Today, doctors diagnosed many patients with pneumonia, when it turned out they most likely had COVID-19. Some were turned away from hospitals (in the United States, for sure, perhaps in other countries) because they weren’t considered sick enough for a bed.
Access to testing was problematic, and there are many people who had COVID-19 but were never tested. Meanwhile, the (impeached) President Trump has asked his “people” to slow down the testing.
Back then, doctors and nurses were dying as they attempted to provide care for overloaded wards of influenza cases. Today, doctors and nurses are getting sick with COVID-19 as they beg their governors, representatives, senators, and (impeached) president to provide them with enough PPE to keep them safe.
Sadly, back then and now, morgues were filled to capacity and hospitals had to find other places to store bodies. In both cases, casket makers were unable to make enough to keep up with the need.
Then, and now, people were dying at home. In 1918, part of the problem that people were afraid to help neighbors who had influenza. This was especially true in places where there was a high death rate.
It should be noted that President Woodrow Wilson was strongly emphasizing that hospital beds should be reserved for the troops. Doctors and nurses were recruited and sent to camps to help treat enlisted men who had caught influenza. The result was that American civilians were dealing with a doctor and nurse shortage.
There was also no infrastructure set up to properly remove the bodies of the deceased. Some families placed the bodies of their dead loved one on the porch. Others had no option but to put the person in a corner, or leave them on the bed they died in. Spouses were sleeping on that bed, and I cannot imagine the level of trauma that caused.
Today, there are people dying at home from COVID-19. Their family members are calling paramedics, but the person dies before the ambulance can arrive.
In 1918, cities sent out wagons which were used to collect the dead. Police came to the door of the houses of the deceased and put the bodies into the wagon. Again, coffins were scarce, so some bodies were in bags. A few were in boxes that were definitely not coffins.
Today, there is a man in Houston, Texas, who is collecting the bodies of the dead. He has a contract with the county, the police, and various funeral homes.
The idea of wearing a mask to prevent the spread of a virus seems to annoy some people. That was true one-hundred years ago, and sadly, is true today.
Back then, the Red Cross, which was an extremely helpful force in fighting the influenza pandemic, had women make gauze masks. The surgeons at the time wore gauze masks. So, the prevailing thought was the gauze masks would also help other people to prevent spreading the virus.
It should be noted that this effort began after the influenza pandemic had spread widely across the United States.
Members of the Red Cross set up tables and tried to hand masks to every un-masked person who walked by. Police at the time were allowed to insist that a “mask slacker” wear a mask. Those without masks had to pay a fine, and could be arrested.
Today, a quick glance at social media will reveal that we have plenty of “mask-slackers” who like to gather together in large groups, unmasked, and not engaging in social distancing. They are clearly much more aggressive about their resistance to mask wearing than were like-minded people in 1918.
To my knowledge, there aren’t any places in the United States today where people can be fined or arrested for refusing to wear a mask. It is possible that some states or counties are considering it.
Today, we wear masks when we want to shop at a grocery store. Back then, people stood outside the store and shouted their order loud enough for the shop workers inside the store to hear them. Another option was to write down a list of what they wanted to buy, leave the list near the door, and wait.
Science Takes Time
The most frightening thing I learned from this book is how long it can take for scientists to develop a vaccine. The scientists of one-hundred years ago had disadvantages to overcome. Few had managed to create a vaccine – for anything. They had to start from scratch while trying to develop an influenza vaccine.
Meanwhile, some doctors still believed that it was “only influenza”, and assumed the virus wasn’t very serious. My assumption is, as the death toll rose, at least some of the doctors realized they were mistaken about how dangerous influenza actually was.
Shortly before the influenza virus started infecting people, a huge change was made in regards to the determination of who could be considered a doctor. The medical universities in the United States started out as for-profit. Today, we would probably call them “diploma mills”.
The purpose of these schools was to create revenue, which was used to pay the professors salaries. Medical students learned from lectures or books, but never once actually saw a patient. Heaven help the first patient those doctors attempted to treat!
Those who truly wished to practice medicine in the United States traveled to Europe to attend their medical schools. Those schools actually taught students the knowledge and skills they would need as a doctor. These students worked on cadavers and, eventually patients, before graduating.
In short, what happened was the “diploma mills” were examined by someone who not only had plenty of knowledge about medicine, but also had no qualms about giving the schools the bad grades they deserved. Many closed after that, unable to meet the new criteria. Some merged with real medical schools. Johns Hopkins was formed around this time.
Today, as I write this book review, we are approximately six months into the COVID-19 pandemic. We have some wonderful doctors and nurses, but they are suffering from not being able to obtain the PPE that they need in order to prevent catching the virus.
There are several different companies that are attempting to develop a COVID-19 vaccine. Science takes it own time, however, and there is no way to be certain when a vaccine will become available.
Meanwhile, the death toll continues to rise.
The version of The Great Influenza that I read was published in 2005. It includes a new Afterword that I found to be extremely informative. It delves into SARS, H1N1, and other corona viruses.
In addition, John M. Barry offered advice about what the United States should do in order to be prepared for a new pandemic. At the time, Barry stated that we were not prepared at all.
He recommended that the United States start making their own vaccines, and not depend upon other countries to supply us with it. In 2004, the United States was relying on Great Brittan for vaccines, and faced a problem when Great Brittan cut the total doses available outside of their country by 50%.
Berry also emphasized “surveillance” in the form of what we may recognize as contract tracing. The earlier we identify a new virus, he wrote, the better chance we have to develop and distribute a vaccine.
My hope is that the next President of the United States will take the time to read The Great Influenza and learn lessons from it. There is potential that we could have a new President in January of 2021. That person will have the opportunity to put plans in place to prepare for the next pandemic – while continuing to fight this one.
Based on what we have seen, the current (impeached) President has little to no interest in protecting Americans from COVID-19.
The Great Influenza – by John M. Barry is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.
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