John M. Barry, The Great Influenza: The Story of the Deadliest Pandemic in History. Viking Press, 2004.
It’s hard reviewing a book you haven’t read.
That remains true even if you have heard the entire book read aloud as an audiobook, listening to it on an iPod as you took the early morning walks that are your main exercise ever since your gym closed at the beginning of the COVID siege that’s now in its sixth month. It’s difficult, though not impossible, to go back and look up passages you think you remember, to see if you’ve remembered them correctly.
You worry: are you being fair to the author’s arguments? You thought you were following them closely–but were you distracted for a moment when your neighbor from down the street, careful to keep a 6+ foot distance, waved to you and asked how you were? (And maybe said a few other friendly words that didn’t make it past your earbuds.)
So maybe I’m not being 100% fair to John M. Barry’s 2004 best-seller The Great Influenza: The Story of the Deadliest Pandemic in History, which I bought from Audible to get some historical perspective on what we’re going through now, and some sense of how much longer we’re likely to be going through it. For the one thing that’s absolutely certain about the so-called “Spanish flu” of 1918-19 is that it didn’t last forever. Without a vaccine, without any adequate treatment options, the pandemic did pass away, to be followed by one of the great economic booms in American history and the period that’s come down in our collective memory as “The Roaring Twenties.”
How did this happen?
Those who don’t remember history, the philosopher Santayana is supposed to have said, are condemned to repeat it. To which we must add the qualifier: those who do remember history usually wind up repeating it as well.
Yet history can guide us, give us some sense at least of what we can expect to happen, what we need to brace ourselves for.
So what do we learn from the “story of the deadliest pandemic in history”?
Much of it is a horror story, and Barry does nothing to cloak the horrors. He begins with a vivid picture from September 1918: young men dying, blood streaming from their noses and even their ears. But he’s careful to add that his tale involves a great deal more than gruesome death. It’s also the story of the medical scientists who struggled valiantly, though without any real success, to contain and combat the killer disease. (By the time they discovered that the culprit was a virus and not a bacterium, the pandemic had been over for years.) So the early chapters of The Great Influenza are a compact and absorbing history of medical science itself, from Hippocrates and Galen onward.
The pivot of Barry’s narrative is 1876: the opening of the Johns Hopkins University in Baltimore. 19th-century medicine in the United States, as Barry depicts it, had been a shockingly primitive affair. Qualifications for getting into medical school were low to non-existent; hardly any doctors had any training in the laboratory sciences. But a rigorous scientific medicine was being developed in Europe, particularly Germany, and the founding of the Hopkins marked its triumph in this country as well. Its graduates, and those trained or influenced by its graduates, were the heroes of the war with the influenza a generation and a half later.
Was there also a villain? Aside from the virus itself–whose malevolent qualities I’ll return to presently–the closest thing to an evil presence in Barry’s story is the president of the United States.
His name was Woodrow Wilson. He was reluctant at first to get the US tangled up in the purposeless bloodbath of the Great War. But once he brought us in, he did so with a fanatic, authoritarian ruthlessness that wouldn’t rest until it had squashed all dissent, censored all speech. It became the patriotic duty of the newspapers not to let a word appear on their pages that might damage morale. So of course they dared not speak of the ghastly, unidentifiable plague that, in the fall of 1918, seemed to be spreading everywhere.
In the silence, in the deceptions, grew a terror just as deadly.
Ironically, Wilson was himself a victim of the influenza during its third wave the following year, and through him the entire world fell victim to its consequences.
He had come to Paris for the postwar negotiations among the victors, resolved not to let the peace turn into an orgy of righteous vengeance. But ill and frail, hardly able to move from his sickbed, he gave in, let the French have everything they wanted: to leave Germany shackled, humiliated, ground into the dirt. Receptive, a dozen or so years later, to the message preached by one Adolf Hitler …
And so the wheel kept turning, and history, whether remembered or forgotten, repeated itself with millions more corpses chalked up to its account. Climaxing at Hiroshima and Nagasaki, and the casting of the nuclear shadow that hangs over us to this day. All this is our inheritance from the Great Influenza.
For Barry, the lesson to be drawn from the 1918-19 pandemic is: this above all, to tell the truth.
During the worst of the pandemic, the newspapers almost everywhere, government officials from the lowest to the highest–well, almost the highest; Wilson himself hadn’t a word to say about the influenza–committed themselves to spreading lies. All was well, all was under control, no need to panic. (“Because of all we’ve done, the risk to the American people remains very low”–Donald Trump, February 26, 2020.) Yes, quite apart from the national obsession with wartime “morale,” it’s the task of government to reassure the people. But false reassurances were vastly worse than none at all.
As the corpses piled up, in every home in your street and in the apartment above you and in your own conjugal bed, these false comforts fell away and there was no real comfort to be had. Those whom you trusted had betrayed you; trust itself was an impossibility; in the darkness and silence, you were alone. The natural fear, of the monster that’s indeed fearful but at least visible by the light of day, became the unreasoning terror of the Thing that lurks in the dark. (The horror-movie comparison is Barry’s, and I think it’s very apt.) This was the harvest of systematic lying, and it was bitter indeed.
All ye who triumph at the ballot box, take notice.
When he comes to the question we’re all keen to know the answer to–how and why did the pandemic end?–Barry is disappointingly vague.
He begins chapter 31 of his book by comparing the influenza to the Martian invaders in H. G. Wells’ The War of the Worlds, published 20 years before the pandemic. The Martians are invincible; humanity is doomed. Yet, while all the weaponry at our disposal is helpless against our would-be destroyers, “natural processes” do what we can’t and eliminate them. (It’s a curious irony that in Wells’ novel these natural processes are … disease-bearing germs.)
So what natural processes put an end to the 1918-19 pandemic? Barry singles out two:
First, that the virus burned through its human fuel, until there was no one left for it to infect who hadn’t developed immunity to it. I suppose this is what we would call “herd immunity,” although Barry doesn’t use the phrase. By his accounting this immunity came quickly, though at horrendous cost. In an army camp, the pandemic would run its course in 3-4 weeks, 6-8 weeks in a city.
In Philadelphia, where the disease was a mass killer that nearly tore the city apart, nearly 4600 people died in the week ending October 16. But ten days later, the number of cases had dropped so drastically that public places were re-opened. The effect was not as it was here when we tried to re-open last spring: by Armistice Day, November 11, Philadelphia was practically influenza-free. If plotted out, says Barry, the curve of the pandemic would be chopped off right after its peak, falling away as abruptly as a cliff.
(Was this what Dr. Deborah Birx had in mind when she predicted, on April 25, that hospitalizations and deaths from COVID would be “dramatically decreased” by the end of May? We all know how well that prediction worked out.)
Second, the virus mutated. “There is a mathematical concept called ‘reversion to the mean,'” which means that just as the virus mutated at first in the direction of being dreadfully lethal, it was to be expected that it would mutate back in the direction of being an ordinary flu virus, which kills but not so massively. The virus wasn’t eliminated after its murderous second wave; a third wave, which hit in the winter of 1918-19, was dwarfed by its predecessor yet awful enough by any other standard. Flareups apparently continued into 1922, each one milder than those before it, until the virus at last assimilated to the ordinary, mostly non-lethal flu and stopped being an issue.
OK, Barry has done his duty. But I remain unsatisfied.
The Philadelphia catastrophe began with the Liberty Loan parade on September 28, 1918, when thousands of people, jammed together along the streets, spread the infection to one another. It reached its peak 18 days later, then fell off. If herd immunity requires that 60% or 70% of the population become infected, as most epidemiologists seem to believe, could the city have reached this threshold in two and a half weeks?
And if the conventional epidemiology is wrong, and the threshold is something more like 20%–if only that could be true!–I wish Barry had remarked on that.
There’s a sharp contrast between his vivid, often stomach-churning descriptions of how the influenza tore through Philadelphia, overwhelming and terrorizing, versus his hasty and pale account of how it suddenly disappeared. Perhaps this is part of a larger historians’ bias: fascination with how dictatorships gain power, less interest in how they lose it. But I can’t help thinking that the difference is that Barry understands very well how the virus established its dominion. I infect two others, who in turn infect four, who infect eight … How that dominion collapsed is an enigma, possibly, to him no less than to me.
And does the concept of “reversion to the mean” really make sense? I recall seeing somewhere on the web that viruses tend to mutate in the direction of mildness; it’s not a mathematical process but an evolutionary one. If the virus’s goal–allowing the absurdity that a virus can be said to have goals–is to spread itself as much as possible, this is better accomplished if its hosts aren’t too sick to be out and about. So it’s the pandemic’s having become more deadly between the first wave (spring 1918) and the second that’s the puzzle. Its subsequent easing is just what we’d expect.
Is that what happened a hundred years ago? Will it happen to COVID-19? Not anytime soon, seems to be the expert opinion. But the precedent of 1918 seems to suggest: any month now. This is one facet of the history I wouldn’t mind repeating.
I’ve just noted how inappropriate it is to credit a virus–a bit of matter that isn’t even truly alive, the way a bacterium is alive–with intention or purpose. I doubt if anyone will dispute me.
Yet, remarkably, Barry does just that at certain crucial junctures of his book. He speaks of the influenza virus, during the summertime lull between its first and second waves, as lying in wait for humankind, secretly evolving, growing in deadliness, as an enemy preparing its devastating assault. This grim fancy is surely linked to his comparison of the influenza with the Martians of The War of the Worlds. “Slowly and surely,” H. G. Wells wrote, the Martians “drew their plans against us”; and from Barry’s narrative it sounds very much as though the virus did the same.
Of course Barry doesn’t mean this literally. He knows as well as I do why it can’t be true. Yet at the unconscious level I believe he does mean it literally, and it is true.
The influenza virus was a century ago, and the coronavirus is now–16 years after the publication of The Great Influenza–an alien invader, cunning and resourceful, that’s humbled and hobbled the nation that prides itself on being the strongest and most capable on earth. That it’s done so without mind, without will, makes it all the more alien, its depredations all the more horrible.
And you’re looking for the reason why this COVID summer has been “the Summer of the Saucers”? Why since April UFOs have cropped up again and again in the news? Look no further.
by David Halperin
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