Books unpack deadliest pandemic ever
Documenting the scale of 1918 influenza that killed tens of millions
A century ago, a virulent, highly contagious flu infected an estimated onethird of the globe. Somewhere between 50 million and100 million people died. The1918 influenza took more lives in15 months than AIDS has claimed in 40 years, and buried more than the bubonic plague killed in a century.
A submicroscopic virus composed of just eight genes would turn out to be the killer, wiping out “more humans than any other disease in a period of similar duration in the history of the world,” as historian Alfred W. Crosby put it.
Very few witnesses remain among us, but a tower of books — including Crosby’s influential1989 “America’s Forgotten Pandemic” — have sought to document the scale of the horror.
British schoolchildren slumped dead at their desks, and German furniture vans hauled bodies scattered in the streets to the cemeteries. Panicked South Africans threw dying miners from trains to expire along the tracks.
Sometimes in days, sometimes in hours, the flu would start with a dull headache or burning eyes, then chills and fever. Almost all the infected would live, but for an unlucky
2.5 percent, the lungs filled with a reddish fluid, the lips and ears would turn dusky blue, and the victim’s feet would turn black.
The struggle for air produced a hellish cough that mimicked a duck’s quack. Doctors couldn’t stop it or treat it or even pinpoint its cause.
Jeremy Brown, a London-trained emergency room physician who now directs the Office of Emergency Care Research at the National Institutes of Health, turns indignant in his new book, “Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History,” at the quackery his field once perpetrated. His first chapter, “Enemas, Bloodletting, and Whiskey,” unpacks the nonsense — and harm — physicians threw at their patients, including killing many of them with aspirin overdoses.
“The flu is still a serial killer,” Brown notes, adding that it “is certainly not ‘the emperor of all maladies,’ as cancer was described by the oncologist Siddhartha Mukherjee, but it is the malady of all empires. It has been with us since the dawn of time, and it has afflicted each civilization and society in every corner of the globe.”
A second Brit, journalist Catharine Arnold, has timed her own flu retrospective to the centennial. “Pandemic 1918: Eyewitness Accounts from the Greatest Medical Holocaust in Modern History” is not above a lurid subtitle, but its author, who is also a psychologist, picks a better opener for her book.
She begins in an English churchyard10 years ago, where an Oxford don is exhuming the body of Sir Mark Sykes, a prime-of-his life British diplomat felled as he helped negotiate the peace in Paris after World War I. Buried in a lead casket, which delays decomposition, the corpse was hoped to yet retain enough soft tissue to enable scientists to extract the virus. (It didn’t work: The lead coffin had cracked.)
Grave excavations provide colorful anecdotes in both books. Most led to disappointments, but one — in Brevig Mission, Alaska — hit pay dirt in1997 when a 73-year-old Swedish scientist returned to the far-North permafrost. He found that the extra fat on an obese flu victim preserved enough of the1918 virus in one of the four samples he culled from her body to help unlock the virus’ RNA pedigree.
Brown tells this story with a welcome scientific crispness, but Arnold supplies the telling human details: the Swede names the silent donor “Lucy” in a nod to the famous hominid unearthed in Ethiopia.
Both of these books’ covers feature the same striking 1918 photograph, a cavernous, crowded emergency ward of stricken soldiers at Camp Funston in central Kansas. This photo also illustrates an excellent 2017 Smithsonian Magazine article on the pandemic from historian John M. Barry, as well as this review.
Readers wanting a briefer foray should find it online. “The Great
Influenza,” Barry’s 2004 book, is better written than either of the two new volumes. So is “Flu” by science journalist Gina Kolata.
The new works, then, must make fresh information their justification. Here Brown’s book is superior to Arnold’s meander through the archives. He depicts the shortfalls of big data in flu tracking, the pitfalls in our annual flu vaccinations and the scandalous medical politics bedeviling Tamiflu and similar treatments.
A century on, we know more — towns with teams in the Super Bowl will see an18 percent jump in elderly deaths because the virus can be spread during gatherings like football parties — but scientists still can’t prevent or cure the flu.
The shadow of this pandemic dogs us still.