October 13, 2021: Another Great Pandemic -

I’ve been reading John M. Barry’s book, The Great Influenza, a popular history of the 1918 influenza pandemic (Penguin Books).  It is copyright 2004, (but was updated in 2009 to add a bit on Swine Flu), and was a New York Times best seller.

But best seller or not, I don’t like it much, and I don’t think I would have liked it much even when it came out. It’s written in the style of a Victorian thriller. In fact, the style bugs me so much that I have really been skimming it, not exactly reading. I was interested in how that pandemic compared to ours.  

Lest you think I’m just being finicky about the style, I’ll share two snippets. In the prologue, Custer’s forces are defeated at Little Big Horn by a band of primitive savages, and I thought, WAIT, where are your quotation marks? Is that YOU speaking, Mr. Barry? Are YOU saying, “primitive savages,” or are you somehow channeling the lingo of Custer’s times? Are we supposed to supply the quotation marks ourselves?

Not channeling, turns out. He was just racist and dated. Even subtracting all of that, here he is at his purplest:

“Nature chose to rage in 1918, and it chose the form of the influenza virus in which to do it. This meant that nature first crept upon the world in familiar, almost comic, form. It came in masquerade. Then it pulled down its mask and showed its fleshless bone”

I’ll stop with the quotes. But I do want to ponder, in no particular order, things that caught my attention.

They had a war going on in 1918. (I know, soldiers were a vector for spreading the disease, but I’m going somewhere else with this.) And there was a tremendous pressure from the government for everyone to keep up morale, to the point where newspapers were discouraged from reporting on the pandemic, or even listing the names of those who had died. Americans were expected to be brave, plucky, self-sacrificing, and patriotic. They had to buy war bonds, and shame their neighbors who were not buying war bonds. And god forbid there should be a panic.

Influenza was just the grippe! Editorial after editorial said so!

But reality always wins, and forbidding papers to report deaths only meant that those deaths were reported via grapevine, which is a great way to spread panic.

Minimizing the pandemic, equating a stiff upper lip with patriotism, somehow reminded me of those memes from our recent past, a la:  CNN: Pandemic death toll surpasses 200,000; (other news sources, same headline, same headline….); Fox: How to make festive Halloween lollipops.  (If you want to make FHL’s that article is out today, and I found it on my first visit to the Fox site!)

Speaking of duty-shaming, when the 1918 pandemic laid Philadelphia low, a great cry went out that all women with any nursing skills were needed to pitch in and help in local hospital wards. Then the cry went out to all women who didn’t have “other duties,” even if they had no nursing skills. Then there were editorials excoriating women who weren’t nursing their sick neighbors, or taking in neighborhood children whose parents were too ill to feed them.

I get it, we were in an age when privileged women didn’t work, but were Angels in the House. And again, that’s not where I’m going. I’m struck by the strange attitude toward contagion. In our era, there has been a lot of tension between helping by showing up and helping by staying home and distanced. We did some duty-shaming about staying HOME, please. If you don’t have to go anywhere, Don’t Go. If your vaccinations are not yet two weeks cooked, WAIT.  There didn’t seem to be much lockdown awareness in 1918.

Speaking of contagion, there’s a part of the book where the author tracks the arrival of the pandemic in small towns in the Mountain West. “So far, Town X had been spared, but by nightfall..." It’s written like a movie montage. One town puts armed guards on the road so no travelers can get in, and “ironically,” that town is touched but lightly.  

That “ironically” threw me. Did our author not understand travel bans? Pods? This time around, New Zealand wouldn’t let anybody in, and they were touched but lightly – that’s why they did it! There was nothing ironic about it.

Anyway, eventually I found a spot where the author reports that the 1918 flu was contagious from one to three days after symptoms appeared. And then I Googled around, and our current influenza can spread pre-symptomaticallly, so - as a proud American, one of millions who have earned our honorary MDs online during this pandemic! - I’m going to say that perhaps the 1918 flu could spread pre-symptomatically too. Maybe we just didn’t know that in 2004, when this book appeared? Maybe the author doesn’t know what “ironically” means? Beats me.

There’s a very long section on the search for the pathogen that caused the flu, and it’s the one part of the book I’d recommend. It’s full of dead ends and competing labs and scientific fits and starts, and it’s a nail-biter even though we know how it will eventually end. It made me, if possible, even more grateful that we have a vaccine, and less frustrated with the moments when we’ve heard opposing views from experts. It was ever thus.