The Great Influenza: The Epic Story of the Deadliest Plague in History, by John M. Barry (Penguin Books, 2004).
Finished reading John M. Barry’s 2004 book, The Great Influenza. It is about the 1918 influenza pandemic that killed an estimated 675,000 people in the United States, and perhaps 25 to 50 million people worldwide. Here are some things that stayed with me as I read.
1. Barry subscribes to the theory that the 1918 strain of influenza began in Haskell, Kansas, jumping from pigs to humans. Other contemporary scientists dispute this, offering Britain, France, and China as possible source sites. There’s no way to be sure.
2. Influenza killed about 675,000 Americans. The population then was one third what it is today.
3. It was called the Spanish Flu because Spain was the only Western country where journalists were free to write about the spread of the flu since Spain was not involved in World War I. All other countries censored newspapers on the subject because they feared it would hurt national morale. The name Spanish Flu has nothing to do with the origin of the epidemic.
5. Typical symptoms were severe headaches, high fevers, severe coughing that did not stop, severe fatigue, lungs fillings with fluid until breathing was impossible. “Blood poured from noses, ears, eye sockets; some victims lay in agony; delirium took others away while living."
6. About 45,000 American soldiers and seamen died of influenza and pneumonia in 1918-1919. Total American combat deaths in the War were 53,402. The military establishment was very slow to deal with the problem, often ignoring doctors and specialists even when the magnitude of the problem was clear. For months, commanders continued to concentrate soldiers and staff by the thousands in camps and trains despite the outcry from doctors and researchers. Colonel Charles Hagadorn took command of Camp Grant in Illinois on August 8, and ignored the entreaties of his medical staff not to move men into crowded barracks. By October 8, 452 men had died at Camp Grant. After hearing the current death toll on that day, Colonel Hagadorn, a soldier with a long career in the Army, ordered his subordinates out of the building to stand for inspection. He shot himself as they stood outside, waiting for him.
7. The influenza was especially hard on young healthy people, aged 20 - 40 years old, like those soldiers. They had relatively healthy immune systems, and something about that strain provoked a massive immune response which often overwhelmed the victim, even without pneumonia being involved.
8. In Philadelphia, the Director of Public Health, Dr. Wilmer Krusen, a political appointee, declared in early September 1918 that the victims that had up till then died had suffered from “old-fashioned influenza or grip.” There was no need for alarm. On September 28, officials promoted a Liberty Loan parade to sell war bonds. Hundreds of thousands attended. In the week of October 16, 4,597 people in Philadelphia died from influenza or pneumonia brought on by influenza. Probably many more died indirectly. Ghastly scenes. People dying in houses and apartments by the hundreds, bleeding from their noses and mouths, never making it to a hospital or doctor or nurse. Hospital wards impossibly overcrowded, corpses in the streets around the hospitals. Nurses and doctors dying themselves. Homeless orphans in every neighborhood. These assurances and scenes were repeated in many cities.
9. Many Americans saw the suffering right in front of them in 1918. In 2020, the very sick are quickly taken to hospitals and confined to ICU and Coronavirus wards. The vast majority of us now never see what the most severe patients go through.
10. Barry does not mention any organized protests against the quarantine measures that were eventually taken in the hardest hit cities.
11. Some of the most haunting scenes were from Alaska and other remote areas. “In Nome, 176 of 300 Eskimos had died…One doctor visited ten tiny villages, and found ’three wiped out entirely; others average 85% deaths…survivors generally children.'” Of course, all over the world, millions died in villages far from any doctor or nurse.
12. Woodrow Wilson was said to suffer from a stroke at the Versailles Conference which determined the peace terms for Germany. It is now believed by many researchers and historians that Wilson had influenza, which may have brought on his stroke. He was a changed man. After his illness, he abandoned his plans for an equitable peace with Germany, and completely acceded to the demands of French Premier Georges Clemenceau to harshly punish Germany. It’s often said that the punitive measures agreed to at Versailles sparked the beginnings of Nazism in Germany, and led to World War II twenty years later.
13. Pg. 396. “Whoever held power, whether a city government or some private gathering of the locals, they generally failed to keep the community together. They failed because they lost trust. They lost trust because they lied.”
14. Barry is summing up the strenuous work of the handful of best American scientists and doctors, and he mentions this: “They had always proceeded from well-grounded hypotheses...they had not given quinine or typhoid vaccine to influenza victims in the wild hope that because it worked against malaria or typhoid it might work against influenza. Others had done these things and more, but they had not.” Curious to read this echo from 2004 and 1918 to the recent controversy we’ve had with Chlorquinine.
15. Writing in 2004, Barry says in the Afterward, “The CDC estimates that if a new pandemic virus strikes, then the U.S. death toll will most likely fall between 89,00 and 300,000. It also estimates a best case scenario of 75,000 deaths and a worst case scenario in which 422,000 Americans would die…If a new pandemic struck, people suffering from ARDS [Acute Respiratory Distress Syndrome] would quickly overwhelm intensive care units.”
Next on my reading list: The Plague, by Albert Camus.
