The Great Influenza: The Story of the Deadliest Pandemic in History

Excellent history of the 1918+ influenza epidemic; well written, easy to read, well documented. The mistakes made to not control the epidemic, mainly partisan politics as well as some irrational fear, were repeated with the Covid Pandemic. Leaves one sad that nothing was learned and/or remembered, with little hope for the next epidemic which will surely come sooner than later.In and of itself, I recommend it as a great read. A copy should be given to every local, state and federal politician.

Way, way back in 2005, President George W. Bush read John Barry’s book, a copy of which was given to him by HHS Secretary Leavitt. Came to work a few days later and asked his staff what plans America had for combating the next pandemic. Nada. Bush might not have learned anything from the Vietnam War he strove to miss, when he decided to charge into Iraq, but he SURE seems to have learned something from history, thanks to Barry, and insisted the United States be prepared for the next pandemic. Wags in the West Wing started calling Barry’s book by the subject line, since that is how much the overall plan would cost. Dr. Fauci, just last Sunday, said on “Face the Nation” that he would be “astounded” if there was not an “autopsy” on America’s appalling response to the COVID Pandemic. Certainly, a good starting point would be what happened to the seven-billion-dollar plan.This is such an impressive book and is the one essential book that we all should read, now almost two years into the latest pandemic. The thesaurus of superlatives is quickly exhausted in describing this book. Barry says that it took him seven years to write this. There are 60 pages of references at the end. Few authors have that unique ability to meld the science and the human drama. His style is crisp and lucid.It is one thing to write a biography; Barry did the research for seven to ten. He then distilled that knowledge into concise and lively portraits, with the quirks, rivalries, and warts of the leading medical people who would confront the pandemic. I had heard of none of these individuals, apparently due to my wandering in the wilderness too long. There is William Henry Welsh, the one man who largely transformed how medicine was practiced in America, trying to get the practitioners educated and the snake oil off the shelves. Oswald T. Avery, a private in the Army during WWI, would do brilliant work at the Rockefeller Institute. William Park, Anna Wessel Williams and Rufus Cole made substantial contributions. There is the brilliant and troubled Paul Lewis, whose story may have helped inspire portions of Sinclair Lewis’ (no relation) “Arrowsmith.” Paul Lewis would die in Brazil, in 1929. Barry posits: “And whether his death was a suicide or a true accident, his failure to win what he loved killed him. One could consider Lewis, in a way meaningful to him, the last victim of the 1918 pandemic.”Philadelphia was particularly hard hit by the influenza outbreak. Barry provides an excellent account of all the relevant factors and the role of the Edwin Vare’s political machine, and how, when the “terror” of the flu took hold, the ol’ Blue Bloods, the Wartons, Biddles had to take charge. Wilson was hell-bent on getting the Doughboys over There, to Europe, with devastating effects on military bases in the USA, due in particular to overcrowding. Barry relates what happened at Camp Devin in MA., in detail.With pitch-perfect tone, Barry uses the ironic refrain throughout the book: “It’s just the flu.”As Barry relates, it was not until the late 20’s, that Lewis’ protégé, Richard Shope proved that it was a virus, and not a bacterium that had killed something like 50 million people.The book was originally issued in 2004; Barry did an Afterword in 2018, just before all hell broke loose on what we did NOT learn. In the Afterword, hauntingly, in light of what has transpired, he said:“So, the problems presented by a pandemic are, obviously, immense. But the biggest problem lies in the relationship between governments and the truth…But as horrific as the disease itself was, public officials and the media helped create that terror- not by exaggerating the disease but by minimizing it, by trying to reassure. A specialty among public relations consultants has evolved in recent decades called ‘risk communication’. I don’t much care for the term. For if there is a single dominant lesson from 1918, it’s that governments need to tell the truth in a crisis. Risk communications implies managing the truth. You don’t manage the truth. You tell the truth.” Amen, from that eponymous corner.I live in New Mexico, which, thanks to our Governor, has imposed some of the more restrictive measures to control the spread of the disease and I am all in favor of that. Nonetheless, several of our major hospitals have imposed “crisis standards of care,” a fancy phrase for that dreadful French word: triage. It is required to wear masks indoors, and I do, though I think it only improves my changes of not contracting COVID by 10-20% as compared to no mask. Therefore, I found Barry’s quite dismissive rejection of the efficacy of masks in preventing COVID supportive of my own beliefs. In fact, looks like Barry would consider 10-20% far too generous:“Surgical masks are next to useless except in very limited circumstances, chiefly in the home” (P. 477). “The masks worn by millions were useless as designed and could not prevent influenza. Only preventing exposure to the virus could” (P. 358-59).In my idiosyncratic rating system, for books or movies I really like, I provide a 6-star rating, sometimes adding a “plus” for the truly great ones. For the 7-billion-dollar book that took 7 years to write, and is written so well, on such a complex subject and is so relevant for our lives today, I am providing it my very first 7-star rating.

I work at Oregon Health Health & Science University which is comprised of hospitals, medical schools, and research facilities. Each year we are encouraged to get our flu vaccines - even those of us with no clinical responsibilities. My physician also recommends I get a flu shot and I have for as long as I remember. As I was standing in line to receive my vaccine this year I got to wondering about influenza and remembered hearing about a deadly epidemic in 1918. I came across this comprehensive study of the disease. John Barry tells the story of the deadliest epidemic through three lenses: the development of modern medicine that was occurring at the time, the mechanics of the disease itself, and the impact of public health and public policy - or lack thereof.The disease is popularly known as the Spanish Influenza but Barry argues that it may have come from Kansas. As World War I was ramping up, the draft pulled thousands of young men into overcrowded camps for training. A couple of men came from an area in Kansas where people complained of influenza symptoms. "On March 4 a private at [Camp] Funston, a cook, reported ill with influenza at sick call. Within three weeks more than eleven hundred soldiers were sick enough to be admitted to the hospital, and thousands more - the precise number was not recorded - needed treatment at infirmaries scattered around the base." [Loc 1576]Within a matter of weeks "like falling dominoes, other camps erupted with influenza. In total, twenty-four of the thirty-six largest army camps experienced an influenza outbreak that spring. Thirty of the fifty largest cities in the country, most of them adjacent to military facilities, also suffered an April spike in 'excess mortality' from influenza, although that did not become clear except in hindsight." [Loc 2636]This was the first wave of the disease. Overall, through three waves "[e]pidemiologists today estimate that influenza likely caused at least fifty million deaths worldwide, and possibly as many as one hundred million."[Loc 149 ]Barry covers the technical details of the virus which invades cells that have energy and then, like some alien puppet master, subverts them, takes them over, forces them to make thousands, and in some cases hundreds of thousands, of new viruses" [Loc 1606] The influenza virus is incredibly nimble mutating very quickly. It would soon turn more deadly. "When the 1918 virus jumped from animals to people and began to spread, it may have suffered a shock of its own as it adapted to a new species. Although it always retained hints of virulence, this shock may well have weakened it, making it relatively mild; then, as it became better and better at infections its new hose, it turned lethal" [Loc 2767]It was up to humans to try to contain it. William Henry Welch led the charge. He was responsible for pulling medicine from the dark ages into the scientific era. "Welch had turned the Hopkins model into a force. He and colleagues at Michigan, at Penn, at Harvard, and at a handful of other schools had in effect first formed an elite group of senior officers of an army; then, in an amazingly brief time, they had revolutionized American medicine, created and expanded the officer corps, and begun training their army, an army of scientists and scientifically grounded physicians." [Loc 1457]Prior to modernization medical students did not perform autopsies or see patients; rather they took art of less than a year of lectures. [Loc 569]. Welch and his colleagues brought the scientific method to studying the disease. "It was the first great collision between a natural force and a society that included individuals who refused either to submit to that force or to simply call upon divine intervention to save themselves from it, individuals who instead were determined to confront this force directly, with a developing technology and with their minds." [Loc 168] This battle is the primary focus of the book; Barry does a wonderful job bringing these people to life.Although they were not immediately successful in stopping influenza, they did know how to combat its spread. Here we look through Barry's third lens on the disease. Caught up in war fever, the military and public officials paid no mind. Warned to quarantine transferring soldiers, the military changed nothing. This caused the spread of the disease to the camps and to the war in Europe.Public officials did little either. Often these officials were products of political machines such as Tammany Hall in New York who achieved their post due to connections rather than any skill. At the same time information was not published in the press for morale reasons. As a result people were fearful - they knew the disease was in their midst but there was no information on what to do - even though the scientists and provided information. "As terrifying as the disease was, the press made it more so. They terrified by making little of it, for what officials and the press said bore no relationship to what people saw and touched and smelled and endured." [Loc 5199]The head of the Public Health Service - made part of the military by Woodrow Wilson - "had done nothing ... to prepare the Public Health Service, much less the country for the onslaught." [Loc 4804] Even though the military draft was suspended, "Blue still did not organize a response to the emergency. Instead, ... [he] reiterated to the press that there was no cause for alarm." [Loc 4825]The second wave of the disease was much more lethal there were not enough doctors and nurses to treat the afflicted. Harriet Ferell recalled "an open truck came through the neighborhood and picked up the bodies. There was no place to put them, there was no room." [Loc 5082]Although the entire social system was on the verge of collapse and the industrial output of the country was in peril [Loc 5165] "no national official ever publicly acknowledged the danger of influenza." [Loc 5188]On the political front, Barry argues that Woodrow Wilson contracted influenza at the peace talks and his weakened condition caused him to give in to French demands for reparations thus setting the conditions for World War II. [Loc 6062]Influenza is serious and though we have vaccines to combat certain strains it still has the potential to kill hundreds of thousands of people in the United States. The Center for Disease Control says that the worst case scenario 422,000 Americans would die. [Loc 7064]John M. Barry deftly pulls together the three strands of history, the development of modern medicine, and the importance of public health policy to weave a fascinating story of this deadly period.Barry blames public officials for their ineptness at handling this pandemic. "Those in authority must retain the public's trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first, and best. Leadership must make whatever horror exists concrete. Only then will people be able to break it apart."[Loc 7230]Let me stand up a little higher on my soap box here. It is clear that influenza is different from the common cold virus. It is deadly. I often hear people tell me that they got sick even though they got their flu shot. Well, they may have gotten a cold; but they probably didn't get the flu. A few years ago I called the nurse advice line thinking I had the flu. The nurse asked if I could stand up; when I said "yes" she said, you don't have the flu. If you had the flu you probably wouldn't be able to make a phone call. Do yourself a favor; get the annual flu vaccine.As long as this reading report is, you probably figure I've covered it all or even transposed it. But I've only scratched the surface. Although this is a narrow subject it is a fascinating read.

If you want to know how research and medicine evolved in the world, and what enticed great minds to drive to understand the how and why diseases/nature can lead to pandemics and just about every malady related, this is the book to read.The men and women talked about in this book saved your life while risking their own, over 100 years ago.The people and their discoveries explained in this book are amazing, without any one of them, the human race would not be, as we know it today.This not a bedtime story, just the facts, just the way it happened and just in time.

Libro in inglese. Stupendo! Ci ricorda la storia della scienza medica in ogni singola pagina ed approfondisce gli aspetti sociali della pandemia piu` devastante della storia. Insegna molto

Am Beispiel der weltweiten Epidemie 1918/20 können wir Heutigen alle Fehler und Versäumnisse studieren, die Staat und Verwaltung begehen können. Und teilweise 2020 wieder begehen! Das Buch sollte dringend auf Deutsch erscheinen und allen Coronaleugnern und Querdenkern zur Pflichtlektüre gemacht werde. Auch damals sagte viele, o, bloß eine Grippe! Weltweit waren viele Millionen Tote das Ergebnis. Heute wissen wir zwar mehr, dass es ein Virus ist, haben Impfstoffe, und verhalten uns nicht viel klüger. Händewaschen! Abstand! Isolieren! Impfen!Die Darstellung geht sehr ins Detail, das müsste in einer deutschen Ausgabe nicht sein. Doch ist der Text gut lesbar und das Englisch nicht schwierig.

I bought this one based on Gates Notes recommendations. The book is a great, very detailed and a truly historic account of the medical profession and scientific community in the US. It also provides an accurate account of the 1918-20 Influenza Pandemic and its intertwining with the relevant historic events of those years. It is a bit too detailed and repetitive throughout and somewhat lacks sistematization which would make it easier to follow at times. Nonetheless it is a good book but it is worth to consider if your interest in the subject truly justifies such a detailed, long book.

I bought this book for my husband's birthday. It seemed relevant at this time of covid-19 being around. He is finding it absorbing and keeps quoting from some of the pages, comparing what went on in the early 20th century to what's happening right now. The writing is detailed and interesting; I have a feeling the book will be shared around many friends due to its topicality. A highly recommended read.