In what may amount to an exercise in self-imposed masochism, I’ve been reading John M. Barry’s The Great Influenza about the 1918-1919 “Spanish flu” pandemic (which, like the “China Virus,” is a complete misnomer). It has been surreal to ping pong back and forth between events from a century ago and real-time headlines about the coronavirus. But the book was recommended by a trusted friend just as the current pandemic was beginning and I tried to find in its pages some lessons for our current reality, In truth, while there are many differences between then and now, there are also striking similarities. Indeed, caution flags abound.
Since the influenza pandemic occurred even before my parents were born, I had little first-hand understanding of its impact on the lives of so many in the shadow of the Great War. A new strain of flu, for which there was no treatment nor any vaccine (like today’s Covid-19), ravaged the world shortly after the US entered the War, its spread emerging during the rapid buildup of our military capacity to fight on the side of the allies.
President Woodrow Wilson, who had won the 1916 election on the promise of keeping the US out of the war, altered course less than a year later because of increased aggression by the central powers led by Germany. When the US finally entered the war in April 1917, Wilson directed a full-blown mobilization effort that touched all of America. Troop numbers were swelled by a patriotic fervor and were jammed into overcrowded cantonments (barracks) that became a fertile breeding ground for this new type of flu.
After a spring outbreak in 1918 was confined mostly to armed forces personnel, there was a summer lull. But, the virus returned with a vengeance in the fall. People were terrified. Without effective drugs, quarantine was the only defense, leaving people isolated and afraid. This invisible killer brought death to whole households. Suffering was horrible as individuals gasped for air, drowned in their own mucus and sometimes turned deep blue—a coloring so dark that health care workers could not tell if the dying person had been black or white.
Often, young and vigorous individuals were well in the morning and dead by nightfall. Later estimates would claim that between 50 and 100 million died worldwide. The death toll in the US, which had a population roughly one-third of today’s, reached 675,000—with most deaths occurring in a 12-week period in the fall of 1918. Subsequent waves hit in 1919 and 1920.
Meanwhile, Wilson’s focus on the war effort trampled dissent. Perhaps at no time in US history, before or since, was freedom of speech so dramatically curtailed. Nothing could risk endangering the national will to fight and so it was considered unpatriotic to even speak about the flu. Wilson never spoke publicly about it, but he contracted the virus while negotiating the Treaty of Versailles in the spring of 1919. The illness ravaged his body, markedly diminishing his effectiveness as a world leader and likely contributing to the rise of the Third Reich less than two decades later.
Today, we are engaged in the debate over when and how to “re-open” the US in light of Covid-19 just as scientists warn about the possibility of a second wave of the virus in the winter. Are there lessons to learn from 1918? The flu pandemic did not die out in the fall of that year; it only receded in its ferocity. As we consider the best path forward, we need to be mindful that, as Dr. Anthony Fauci has warned, the virus sets the time table.
In 1918-1920, multiple new waves of influenza erupted and a beleaguered nation was forced to re-fight a war it thought it had already won. If we resume activity too early and if we don’t effectively plan for a new outbreak, we run the risk of repeating mistakes of the past. More, more sorrow and pain, more suffering and death, more economic displacement will follow. Those who forget history are condemned to repeat it.
Leadership in a crisis is critical. At a time when the Trump administration repeatedly tries to deny, deflect or exaggerate, Barry’s concluding words (p. 461) burn brightly for our time: “In 1918 the lies of officials and the press never allowed the terror to condense into the concrete. The public could trust nothing and so they knew nothing…The fear, not the disease, threatened to break society apart…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…Leadership must make whatever horror exists concrete. Only then will people be able to break it apart.”