Saturday, April 08, 2006

Book Review - The Great Influenza

This week's book review is The Great Influenza: The Epic Story of the Deadliest Plague in History by 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.


At 12:38 pm, Blogger Susoz said...

I do have stories passed on from my grandparents, who would have been in their 20s at the time. They remembered people wearing face masks in Sydney streets.

I once saw a tv documentary about the impact of the flu in the US which was pretty overwhelming too.

At 4:59 pm, Anonymous Jennifer V said...

My maternal grandfather (b. 1906 and grew up in the then slummy parts of Sydney) used to tell a story about himself and some mates going to visit another friend with flu. They all ran away when he started hallucinating. I don't know whether the friend died or not. (It also seems odd in retrospect that they were visiting someone with a communicable and potentially deadly disease. My Pop did have a bit of a penchant for embroidering tales...)

In terms of sociological significance, I suppose that flu epidemics then took place against a background of higher morbidity and mortality (no antibiotics, no vaccinations available for anything much). A generation later, my mother remembers being told to avoid crowds during times of polio epidemics in the 50s.

At 9:58 pm, Blogger tigtog said...

I do remember one TV show from the UK which dealt with the 'flu pandemic. It was one of those multigenerational shows about the different classes interacting in a village where the toffs owned a v. successful factory. By the time of WW1 the factory was producing planes for the war effort, and there was half an episode of delirious joy at the end of the Great War before the 'flu hit.

I wish I could remember what that show was called. It dealt with lots of gritty stuff.

At 11:42 pm, Blogger Donald Beag said...

The man who was in charge of the music program in my high school, much later, was a survivor of the flu. He had not then got into his teens. I only heard about it in his obituary.
In our own area I several times went with my mother to visit the cemetery. A pair of graves of husband and wife caught my eye. They had died within a week or so of each other, and of influenza Mum thought, but not in the great epidemic. I don't remember her ever talking about those who died in the great epidemic. She identified two people I knew as the children of the unfortunate couple. They were immediately taken over by an aunt, who brought them up. I gather that they too were not into their teens when their lives were upended. They were in a state of shock with little reaction of any sort for several days and then suddenly they started eating everything visible in their range of foodstuffs as if food was going out of stock.
I cannot remember my Dad ever making a point about the flu, but he had been deeply involved in the competitive mayhem of the previous few years. There was a roll of honour in the local church. Those who served and returned outnumbered the dead by the expected 5:1 - I think. Those who did not return included numerous killed in action, one or two died of wounds and I think a couple who were listed as dying of otherwise unspecified sickness. The "great flu" would have been a description that Dad understood and used, but an overshadowed peril of that time.
It seems possible now that for those who survived that era the drawn out horrors of war made a deeper impression than a shocking visitation that came and went swiftly.

At 3:21 am, Blogger Elizabeth said...

This book has been on my to read pile for a while -- I should pick it up. Barry's book about the Great Flood of 1927 (Rising Tide) is excellent.


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