The Great Influenza

In 2020, nothing is more topical than a pandemic. Today, our lives, televisions, and Facebook feeds are dominated by news of COVID-19 and the necessary steps we must take to save lives. But author and historian John M. Barry understands that the coronavirus is not the only pandemic to hit America. In fact, during the great influenza pandemic of 1918, more than 5% of the American population lost their lives. And just as it is now, the virus was heavily politicized. This meant that — just as it is now — many unnecessary deaths occurred due to misguided mandates, bumbling government officials, and inadequate preparation. This is the story of our first deadly pandemic and the lessons it offers for the future.

When you think of deadly illnesses, what comes to mind? The bubonic plague, perhaps? The Black Death? (Or maybe, in light of 2020, the coronavirus?) Each of these viruses have been deadly in their own way. But when the influenza pandemic of 1918 struck, it was the single most horrific illness to ever hit the American people. The author observes that this is significant, given the fact that the early twentieth century was hardly a cushy time. If you’re familiar with US history, you might remember that the horror of World War 1 was well underway at this point, and the United States was still reeling from the loss of millions of sons, brothers, and fathers. As a result, when we think about the death tolls that shocked the nation in 1918, we typically attribute them to the war, and rightly so. But unfortunately, the amassed army and crowded barracks also created the perfect conditions to facilitate another type of travesty: death from a contagious disease.

However, the author remarks that no one was really concerned about contagion at this time. The first World War was the most shocking global military event the US had ever seen; when everyone was worrying about the end of the world, a pesky virus wasn’t high on the priority list. So, when soldiers at Kansas’ Camp Funston began to sicken in 1918, no one was terribly concerned. The army was aware that people often got sick during the winter and that it spread quickly when soldiers were sharing such close quarters, so everyone assumed it was nothing but a natural part of life. They would soon find out just how wrong they were.

That’s because the first few cases in the early winter of 1918 were only a trial run. Because viruses have the capacity to evolve and mutate as they spread from host to host, the first men infected had not encountered its worst form. The first wave was scary, certainly, and it spread rapidly — infecting the US, Europe, Asia, and Africa — but the worst was still yet to be seen. Indeed, without the onset of a world war, it’s likely that the virus would never have spread so quickly or so far. However, given the mass movementof thousands of men and the onslaught of attacks all around the world, every member of every army was a perfect host for a rapidly evolving disease. If everyone had immediately quarantined as we have now, perhaps the story would have ended differently. Perhaps the virus would have been quickly and effectively contained.

But alas, even though infection rates were steadily climbing, the war was still an ever-present danger. Leaders all around the world were continually pressured to lead the charge, to bring Germany to its knees, and end Hitler’s reign of terror. So, because the virus (at first) presented only as the normal flu, it was easier for military leaders to accept that a lot of people might just get sick. And indeed, at the time, it certainly appeared that this strain of the flu was no different from the typical flu symptoms that the American public usually encountered. Chills, fever, fatigue, and congestion lasting for several days before recovery seemed common enough. Sure, some might die — as some usually did, thanks to the spread of the common flu — but that was better than losing the war. And if that had been true, perhaps they might have been safe. Perhaps it wouldn’t have been so bad. But sadly, America’s leaders underestimated the virus. And when cases began to decrease slightly in April of 1918, they naively assumed that the virus must have died down. After all, the traditional “flu season” typically runs from late fall/ early winter into the spring. As far as they were concerned, the virus appeared to be following the typical pattern. Unfortunately, however, it was simply gearing up for a deadlier strike.

When the second wave hit, the American people weren’t prepared. They certainly weren’t prepared for a virus that caused its victims’ skin to turn blue or for their lungs to fill with fluid that rapidly suffocated them. Their window of time for treatment was also shockingly lower than that of the traditional flu. Rather than recovering within a few days or a couple of weeks, as was typical, victims were now perishing after only 12 hours of agonizing struggle. Those who fought especially hard — and endured the false hope of recovery — made it a few days. Unsurprisingly, the horrifying onset of the virus intensified the pressure to find a cure. And, just as is the case in 2020 with the terrifying onset of the coronavirus, no one knew what to do.

The Spanish Flu’s victims have historically been estimated at an alleged 20-50 million deaths worldwide. However, the author’s research has shed new light on the numbers and concluded that previous estimates are incorrect; in fact, the numbers are actually much closer to 100 million deaths or 5% of the entire global population. This means that, in 1918, more soldiers died from the pandemic than from being killed in battle. But now that we’ve considered the impact and the damage of the pandemic, let’s examine a little bit of background. Because today, we’re still asking the same questionsthat haunted researchers in 1918: where did it come from? How did it start? How can we contain it?

You might also be wondering why it was called The Spanish Flu. (Or maybe you’re not wondering because you assume the answer is obvious: it originated in Spain). However, you might be surprised to learn that that assumption is not necessarily correct! Because the virus was a global pandemic, it was not centralized in one location; it was no more Spanish than it was American, British, or French. Rather, it earned its moniker because of the location of its primary news coverage. This is because freedom of the press — like so many other things — was heavily impacted by the first World War. Unlike many other countries, Spain was neutral during the war, and this meant that the country was not under pressure to censor its speech in accordance with wartime demands. While countries like the United States and Great Britain were not forbidden to report on the spread of the pandemic, they were aware that their people and troops were already under significant strain. For this reason, they believed that additional depressing news would cause more harm than good.

And while they might have been well-intentioned in attempting to keep their people from depressing news, human nature is timeless; as soon as you tell people they can’t have something, they simply want it more! So, the more people lacked access to the news, the more desperate they became for any word of the pandemic’s spread. And because Spain was under no pressure to boost morale in a war-torn country, they were free to report on the global disaster. So, people gobbled up news from Spain and began calling the virus “The Spanish Flu.” (Unfortunately, as you may have already seen firsthand, this quickly led to the perception that the virus originated in Spain. Hardly a nice way to repay their only news source, huh?) But if it didn’t come from Spain, where did it originate?

The scary truth is that nobody really knows. Because data collection and medical reporting policies were limited and primitive, it’s difficult to know if the data we have is accurate. The global nature of the pandemic also makes it difficult to pinpoint the precise origin of the virus, but — as mentioned in the previous chapter — we do know that the first reported case occurred at the military base Camp Funston in Fort Riley, Kansas. The first case was reported on March 11, 1918 and the virus had reached its peak mutation by mid-April.

Today, we think our fight against COVID-19 is pretty scary. (And there’s no doubt about it: we’re up against a truly terrifying invisible enemy). But what if you were trying to fight a global pandemic in an age without antivirals or vaccines? This was the bleakprospect our ancestors faced in 1918. Just like today, they had no idea what caused the virus, no idea how to stop it, and — even scarier — no idea where to start. So, they did the best they could with the limited resources they possessed. One thing they knew for certain was that the virus was airborne and highly contagious. The shocking death toll among the armed forces had also proved that it spread like wildfire whenever people were clustered in small spaces. As a result, medical practitioners instituted precautionary measures very similar to those we’ve put in place today. They advocated for closing schools and suspending all large gatherings. They warned people to cover their faces and prevent the spread of germs wherever possible.

Early in September, a doctor named William Gorgas begged military officials to quarantine their troops or disband them. Anything, he pleaded, that would stop them from marshalling and spreading death around the world. Unfortunately, however — as is the case today — government officials were reluctant to heed the warnings of scientists. So, when 100,000 American troops traveled to Europe in October, they brought a death sentence with them. Trapped like rats in the tight quarters of their ships, the men quickly sickened and died. Those who survived were so ill that they could hardly be any help to the European Allies they had come to relieve. Meanwhile, back in America, major cities like Philadelphia had come to resemble medieval representations of the plague. The idea of plague doctors and death wagons once sounded archaic. But when the death tolls rose to 800 in one day and then 4,500 in one week, no one was surprised by the mass collection of dead bodies.

Devoid of resources and adequate government aid, the future looked very bleak in 1918. There was no hope of developing a cure (though many people tried). Indeed, it seemed the only option was to wait the virus out, no matter how many lives it claimed in the process. And sadly, that was exactly what happened. By late October, the virus seemed to have suddenly disappeared. By 1920, it appeared to have been eradicated, almost as if it had never existed. At the time, no one knew where it went or what had happened, but today, we have a pretty good guess: herd immunity. Herd immunity occurs when a virus spreads throughout a population, mutating as it goes and infecting everyone until, at last, there are no new people to infect.

In this respect, it operates on a similar principle to vaccination; our bodies get a little taste of a harmful substance and develop a resistance to it. Eventually, enough people become resistant to a virus that it can no longer flourish in the bodies of new hosts. Vaccines, of course, are helpful because they speed up in this process in a safe and efficient way. Herd immunity can be naturally effective on its own, but it’s kind of like playing Russian Roulette with our health and saying, “Hmm… will I die from this or will I develop immunity? Let’s find out!” And sadly, that’s exactly what happened with theinfluenza pandemic of 1918. Although the virus did eventually die out on its own, millions of lives were lost in the process. To this day, the 1918 pandemic serves as a horrifying and tragic reminder of what happens when the world is unprepared for biological warfare on a global scale.

When we think of terrifying and contagious diseases in history, we might think about smallpox, the bubonic plague, or the Black Plague. (And today, in 2020, our minds are filled with nothing but COVID-19). But in 1918, a new disease struck, and it was deadlier than all of the plagues that came before it. The great influenza pandemic of 1918 stole the lives of 5% of the world’s population at that time. It passed before anyone could develop a vaccine. Because troops were constantly being deployed to fight the Nazis and because government officials refused to listen to scientific advice, the virus quickly spread around the world, unnecessarily taking millions of lives. Although its legacy has inspired us to hunt for a cure and develop new vaccines to prevent the spread of future diseases, its millions of victims serve as searing reminders of the tragedy.