The Spanish Flu of 1918 infected one of three people on Earth. But it is not reported on like the world wars of the 20th century, even though it may have killed more than the two wars combined. (WW1 killed 17 million, WW2 killed 60 million.) The Flu killed between 50 and 100 million people, or between 2.5 and 5 percent of the global population.
Wars and plagues are remembered differently. War memories seem to be almost immediate. With wars, there is a victor, and the victor writes the history and revels in it. With a pandemic there is no victor, only the vanquished. With the Flu of 1918, it was a humiliation for medicine, which wasn’t able to triumph over it.
After the 1918 pandemic, few studied it. However, since the late 1990s, the Spanish Flu of 1918 has been a hot topic of research. This book by Laura Spinney, takes that academic research and weaves the tale of the pandemic. The subtitle is The Spanish Flu of 1918 and How It Changed the World. The first part of the book tells the story up until 1918. The next section, and the bulk of the book, are about the pandemic itself. The final section is about the legacy the pandemic left and how we still live with it.
Flu, like any virus, is not alive and must find a host in order to reproduce. It spreads by mucus flying through the air and being breathed in by another person. The advent of large cities brought with it ‘crowd diseases.’ These include measles, smallpox, tuberculosis and influenza. These burn through the population in a city.
The first person, at least in the U.S., to come down with the Flu of 1918 was a cook on an Army base in Kansas on March 4, 1918. More than a hundred followed later that day. There would eventually be 5 million more. There were three waves of the flu, the middle wave being the worst in terms of being the most lethal. It was over by March 1920.
For most who caught the Spanish Flu, their symptoms were like most flus: sore throats, fever, headache. Most who became ill in spring 1918 recovered. Some died, like every year, but it was rare. When the second wave came in August, it was completely different. The flu was worse, and it was often accompanied by pneumonia. Bacterial pneumonia was the actual cause of most of the deaths. People got mahogany-colored patches on their cheekbones, which then spread to the rest of their face. About the same time, black skin started in the extremities and proceeded up the limbs and eventually to the torso. Once the black had set in, death was almost inevitable within hours or days. Doctors had difficulty telling Blacks from Whites.
The first challenge with a new disease is to name it. Then the enemy can be clear, and a cure can be sought. In 1918, the flu was occurring everywhere, but most countries weren’t aware of what was going on elsewhere. Much of this was due to secrecy because of the ongoing war. The WHO now has protocols for naming diseases, but this didn’t exist in 1918. Mostly, the flu was named for other places, places where countries thought it came from. In the end, it was named Spanish flu, even though it had been in America two months prior to Spain.
Because flu is caused by a virus and the microscopes of 1918 couldn’t detect a varus, it was impossible to be sure what the cause was. The symptoms of the first wave seemed to be the flu. But the second wave was worse than the flu and worse than almost every other disease.
Quarantines, which were started in the 15th century, and other disease containment strategies place the wellbeing of the collective above that of the individual. When the collective is large, containment has to be enforced top-down. But this causes problems because of conflicts. The first conflict is the need or desire to make money. The second is when the individual liberties are trampled on, especially if the authority abuses the measures placed at its disposal.
It is noted that democracy is unhelpful in a pandemic. The demands of national security, a thriving economy and public health are rarely aligned, and elected representatives defending the first two undermine the third. In France, national authorities closed theaters, markets and other public spaces, but local officials would not enforce the measures for fear of annoying the public. In Japan, mass gatherings could not be banned without giving the public reasons. But in Korea, at the time a Japanese colony, all mass gatherings were banned including worship.
This book, published in 2017, tells of a scientific report that estimated a 20 percent chance of four more pandemics in the next 100 years, with a high probability that one would be flu. We didn’t have to wait long to have our first of the four pandemics. Coronavirus is not flu, but it is similar.
I’ve left out reviewing a few sections of the book that I found weak. One was the rise of national healthcare systems in many countries, in response to the Flu of 1918. Another was a chapter where the author laments the lack of a trail in the arts as part of the Flu’s legacy, then goes on to detail the affects in the arts. And I’ve left out the effect the Flu of 1918 had on the outcome of World War 1.
Still and all, this is a book I recommend to you. It is an interesting read and instructive for our current pandemic and future pandemics we are sure to experience.
The name of the book? Katherine Anne Porter wrote Pale Horse, Pale Rider, after catching the flu. Her black hair fell out. When it came back in, it was white.
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