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546 pages, Paperback
First published February 9, 2004
In Europe, governments, universities, and wealthy donors helped support medical research. In the United States, no government, institution, or philanthropist even began to approach a similar level of support. As the Hopkins medical school was opening, American theological schools enjoyed endowments of $18 million, while medical school endowments totaled $500,000…
Macrophages and “natural killer” cells – two kinds of white blood cells that seek and destroy all foreign invaders… – patrol the entirety of the respiratory tract and lungs. Cells in the respiratory tracts secrete enzymes that attack bacteria and some viruses (including influenza) or block them from attaching to tissue beneath the mucus, and these secretions also bring more white cells and antibacterial enzymes into a counterattack; if a virus is the invader, white blood cells also secrete interferon, which can block viral infection.
All these defenses work so well that the lungs themselves, although directly exposed to the outside air, are normally sterile.
But when the lungs do become infected, other defenses, lethal and violent defenses, come into play. For the immune system is at its core a killing machine. It targets infecting organisms, attacks with a complex arsenal of weapons – some of them savage weapons – and neutralizes or kills the invader.
The balance, however, between kill and overkill, response and overresponse, is a delicate one. The immune system can behave like a SWAT team that kills the hostage along with the hostage taker, or the army that destroys a village to save it.
In 1918 an influenza virus emerged — probably in the United States — that would spread around the world, and one of its earliest appearances in lethal form came in Philadelphia. Before that worldwide pandemic faded away in 1920, it would kill more people than any other outbreak of disease in human history. Plague in the 1300s killed a far larger proportion of the population — more than one-quarter of Europe — but in raw numbers influenza killed more than plague then, more than AIDS today ...
And they died with extraordinary ferocity and speed. Although the influenza pandemic stretched over two years, perhaps two-thirds of the deaths occurred in a period of twenty-four weeks, and more than half of those deaths occurred in even less time, from mid-September to early December 2018. Influenza killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in twenty-four weeks than AIDS has killed in twenty-four years.
In 1918 the lies of officials and of the press never allowed the terror to condense into the concrete. The public could trust nothing and so they knew nothing. So a terror seeped into the society that prevented one woman from caring for her sister, that prevented volunteers from bringing food to families too ill to feed themselves and who starved to death because of it, that prevented trained nurses from responding to the most urgent calls for their services. The fear, not the disease, threatened to break the society apart. As Victor Vaughan — a careful man, a measured man, a man who did not overstate to make a point — warned, "Civilization could have disappeared within a few more weeks."
So the final lesson, a simple one yet one most difficult to execute, is that those who occupy positions of authority must lessen the panic that can alienate all within a society. Society cannot function if it is every man for himself. By definition, civilization cannot survive that.
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.
Don’t be lax, Vax!
People write about war. They write about the Holocaust. They write about the horrors that people inflict on people. Apparently they forget the horrors that nature inflicts on people, the horrors that make humans least significant.