This week’s book review is The Great Influenza: The story of the deadliest pandemic in historyby John M Barry. The book is the story of the “Spanish Flu” – in 1918 and 1919 (depending on where you were in the world) a deadly influenza swept the world, killing between 50 million and 100 million people.
The book tackles this from a totally US angle, topping and tailing the main story with stories of how US medicine changed from being close to being based on folklore, to being a scientific enterprise understanding the immune system and the way in which bacteria and viruses work. But the main focus of the book is the way in which politics, both on a local, and a national scale, managed to make the government responses not just inadequate, but, in many cases, contributory to greater death rates.
The outbreak started towards the end of world war I, which meant that US troops were packed like sardines into troop trains, ships, and training camps, creating the best possible environment for the spread of the deadly disease. And the focus on winning the war meant that almost always, anyone who tried to stop the transport of troops was howled down as being unpatriotic. And in many towns and cities, censorship and the desire to avoid panic meant that newspapers totally downplayed the epidemic, or said that the worst was over, at the same time as people were dying in every neighbourhood, and cities were running out of coffins – Barry argues that the contradictions made people panic worse.
I found it riveting, and terrifying. Surprisingly (as it’s been years since I read a book about actually doing science), I found the bits about basic medical science fascinating, and it made me want to read more (always the sign of a well-written book). And the disaster stories were just the right mix of broad sweep of history and the individual tragedies. The story of someone having to hand the body of their 8 year old son wrapped in a sheet (no coffins available) to a wagon collecting dead bodies was almost impossible to read. But the stories with statistics of the various army camps and the number of deaths they had in impossibly short periods of time were unputdownable.
It made me wonder why this whole episode doesn’t live in the collective memory the way World War I does. I’ve never read a fiction book that mentions it; I’ve never had parental or grandparental stories handed down, it’s almost as if it happened much longer ago.
Barry has some theories about that too – mainly that the whole thing was just so unbelievably horrible that nobody could bear to write about it. While it was happening, everyone was too busy, and afterwards, you just wanted to forget it had ever happened.
Barry mentions in passing that the Australian experience was much milder than the US one (because we managed to quarantine the country for long enough that when it finally got in, the virus had mutated to a milder version), but because our experience was post-war related censorship, there was far more press about it. He also mentions in passing a story about Wellington, NZ being completely deserted and every hospital totally overwhelmed, so it certainly hit both the countries where I’m likely to get folk memories from.
Depending on where you were, and when the virus hit your area (it took 6-12 months to get around the world, and varied in virulence during that time), as well as how much you had been exposed to influenza in the past, the death rates varied from well under 1% (very early or late in the epidemic) to up to 25% (obscure pacific islands at the height of the epidemic) of the population. Some Inuit villages in Alaska were completely wiped out, as the people who didn’t die starved to death because they were sick for too long to get food. Individual city episodes generally lasted around 2 months. I imagine if you had better public health (i.e. close the schools, etc at the first sign of infection) that the death rates would be lower, but the episode would last longer.
It seems, from the research, that this is the worst strain in the last 400 years or so, so we’d have to be pretty unlucky to have an experience this bad again. Influenza is still a pretty scary disease, though.