The SARS Covid pandemic has certainly spurred interest in previous pandemics and I have read many books and articles on that influenza epidemic but the best and most comprehensive so far is The Great Influenza by John Barry. An easy 5 star book. I almost always go to Goodreads or Amazon reviews just to get a feel for the terrain and the negative reviews did not really surprise me because there are parts of the book that anyone with no scientific background will likely struggle to follow. Disclaimer: Having a medical degree is definitely an advantage and his comprehensive history of the medical profession from Hippocrates through Galen to the present was fascinating to this reviewer.This book is the closest to a magnum opus so far on the 1918-19 pandemic.
At the outset I would like to urge my goodreads friends who have been toiling through lockdowns and social distancing to plan on reading John’s book if they can.
The structure of the book bears mentioning. This is not a Cliff’s notes summary of what went down and if you want a quick concise overview, you best look elsewhere and I will try to provide some suggestions. John Barry mentions that he had to change his outline when he realized that a narration of how and where the pandemic began and spread worldwide would be incomplete without giving a background to the history of medicine and the scientific revolution of the 2 centuries that preceded 1918. Barry also chose to emphasize the personalities and lives of the scientists and politicians throughout the book with an abundance of personal anecdotes as well as detailed descriptions of the lines of research followed from before the pandemic to the final triumph of sequencing the H1N1 influenza virus just a decade or so ago. Again, if you have little interest in science and medicine, just move along because there will be little here for you to savor. There is a whole lot more to the book of course than a medical detective mystery. There is an abundance of personal and structural societal details of how it probably originated as an avian or perhaps animal virus in Haskell County Kansas in the second decade of the Twentieth century The rapidity of spread by this exceedingly transmissible virus to the world was primarily due to the massive troop mobilization going on in the US and their conveyance to the trenches of France in sardine packed train and ship transports. Barry exposes the factors contributing to the stunning death toll in great detail. They include the propaganda and information and behavioral controls at the time on journalists and public opinion. The first casualty of war is of course the truth, and truth about the pandemic was ruthlessly suppressed to “protect morale” of the soldiers and the citizenry. The military demanded cannon fodder to throw into the fray against Germany and the generals wanted those young men there and NOW, no matter the consequences. Leaders at the time believed that “this was just influenza” and no reason to pause their sacred mission to save the world. Of course it was not “just influenza”, a virus endemic to the world even today. It was an entirely new and lethal variant which killed the young and the healthy viciously in as little as 6 to 12 hours. Many doctors thought that this was an entirely new disease or perhaps plague returning because the symptoms so little resembled the normal course and progression of “la Grippe,” that the world was used to. Barry catalogs the absence of effective response to the pandemic in the United States from pooh pooh denials of its severity to an almost total lack of governmental organization to contain the exponential spread until far too late. At the very worst of the outbreak, society was fraying and starting to break down as fear took hold in the country and people began dropping like flies. Bodies were piling up in homes, on porches and in the streets overwhelming hospitals and graveyards. And of course no one knew what was causing this suffering and it became apparent that there was no effective treatment whatever. The pandemic hit in several waves staring in the spring of 1918 , ebbed a bit throughout the summer and really exploded in the fall of 1918 just about the time of the end of the first world war. It continued into 1919 and in years thereafter albeit with much diminished mortality. President Wilson contracted influenza at the Allies conference at the cease fire and reparations in Paris and the normally sharp and decisive Wilson after a slow recovery became forgetful and mentally and psychologically impaired likely due to Influenza, eventually caving to the reparation revenge forced on Germany primarily by the allies under Clemenceau and Lloyd George. This contributed to the rise of Adolph Hitler and the Second would war only 20 years later.
There is obviously parallels to our current Covid pandemic with some of the antics and feckless responses of the last year almost carbon copies of what happened in 1918. This book was published in 2003 and could have been published last week. At the end of the book Barry summarizes the 1918 pandemic as well as later influenza outbreaks up to 2003 with recommendations on how the world should respond with the next pandemic. Some lessons were learned and many more forgotten. The expression that the only thing we can learn from history is that we don’t learn from history merits repetition.
This is a long and heavy book,546 pages. The main text is 465 well written pages with copious notes and bibliography and index along with some pictures, I would have liked many more. The book is exceedingly well edited despite some comments on Goodreads to the contrary. His editor Wendy Wolf did an extraordinary job in my opinion. The value of the book is not as a synopsis of the 1918 worldwide flu outbreak. This is a comprehensive story of the largely sorry history of American medical education which late in the 19th century underwent a rebirth just in time to confront the worst pandemic in terms of actual deaths ever to hit the world. I really think that John Barry either needs to issue a revised updated edition or perhaps a new chronicle of the current Covid pandemic we are all experiencing now.