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Pale Rider: The Spanish Flu of 1918 and How It Changed the World

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In 1918, the Italian-Americans of New York, the Yupik of Alaska and the Persians of Mashed had almost nothing in common except for a virus--one that triggered the worst pandemic of modern times and had a decisive effect on the history of the twentieth century.

The Spanish flu of 1918-1920 was one of the greatest human disasters of all time. It infected a third of the people on Earth--from the poorest immigrants of New York City to the king of Spain, Franz Kafka, Mahatma Gandhi and Woodrow Wilson. But despite a death toll of between 50 and 100 million people, it exists in our memory as an afterthought to World War I.

In this gripping narrative history, Laura Spinney traces the overlooked pandemic to reveal how the virus travelled across the globe, exposing mankind's vulnerability and putting our ingenuity to the test. As socially significant as both world wars, the Spanish flu dramatically disrupted--and often permanently altered--global politics, race relations and family structures, while spurring innovation in medicine, religion and the arts. It was partly responsible, Spinney argues, for pushing India to independence, South Africa to apartheid and Switzerland to the brink of civil war. It also created the true "lost generation." Drawing on the latest research in history, virology, epidemiology, psychology and economics, Pale Rider masterfully recounts the little-known catastrophe that forever changed humanity.

332 pages, Hardcover

First published June 1, 2017

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Laura Spinney

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Profile Image for Paul Bryant.
2,194 reviews9,461 followers
March 1, 2020
Revived review as a public service during the current Coronavirus outbreak.

The Spanish Flu epidemic of 1918 is the gold standard of modern epidemics and this book is a solid account of what happened. It was really bad and it happened before medical science understood what was causing it. So should you be wondering what a REAL epidemic looks like, this was the big one.

Original review follows.


This wasn’t the jolliest read, but heck, my friendly GR poppets, life is not all ha-ha-ha, hee-hee-hee.

When she was around 11 or 12 I used to play a game with my daughter called WHO WOULD WIN? I’ll give you an example – the first player says something like “who would win in a fight between a lion and a polar bear?” Each player then tries to find the best reason why one or the other would win. But of course our imaginary fights swiftly became more outlandish – “who would win in a fight between Brenda (who is Georgia’s grandmother, an elderly lady) and The Queen?” In this case it was : The Queen would win because although she is very old and frail, Brenda would be too scared to clobber her, because she’s The Queen. If she wasn’t The Queen Brenda would win easily. Bam! One punch. Over and out. We had a million imaginary fights between strange opponents (who would win in a fight between President Obama and the cast of Glee?) but we never thought of this one :

Who would win in a fight between the Spanish Flu pandemic of 1918-19 and World War One?
The answer is : Spanish flu.

It wasn’t Spanish (it might have been Chinese or – how about this – from Kansas!) but it killed more people. WWI killed around 38 million. Spanish flu killed between 50 and 100 million. Actually World War One gave Spanish flu a great boost :

It would be hard to think of a more effective dissemination mechanism than the demobilization of large numbers of troops … who then travelled to the four corners of the globe where they were greeted by ecstatic homecoming parties.

Human life is grotesque. The differences between one time and another, one place and another, are so vast it makes your head hurt. The huge meaning some human deaths acquire - here's three examples -

In 1972 British troops killed 13 Irish people in Derry in an event known as Bloody Sunday. The official inquiry into that event lasted 12 years and cost £195 million.

In 1993 a black teenager was murdered by racists in London There was an official inquiry into that, at a cost of £4.2 million.

In 2007 Madeleine McCann, aged 3, disappeared whilst on holiday with her parents in Portugal. The police investigation into that has so far cost over £5.5 million.

So, the 50 million (minimum) who died during 1918-19 - Who spent millions on an official inquiry about that disaster? Nobody. Ever. Well, they had other things on their mind, it’s true.

But I think this pandemic gives a conclusive answer to the Buddhist question: if a tree falls in a forest where there are no ears to hear, does it make a sound?

Answer: no.

The pandemic broke out when people were just getting used to the germ theory of contagion, so they figured the flu was caused by bacteria, but it was actually caused by a virus, and this was only discovered decades later. No one had heard of viruses in 1918. It wouldn’t have mattered anyway because there was NO TREATMENT for the flu. The ONLY thing a doctor could do for you, according to this book, was ENSURE YOU DID NOT BECOME DEHYDRATED.

Laura brings us good news - when you study how people acted during this disaster it’s most heart-warming, because mostly people acted with humanity towards each other . But alas, that didn’t do them much good because the more people helped the sick and dying, the more people caught the flu.

Your best chance of survival was to be utterly selfish. Assuming that you had a place you could call home the optimal strategy was to stay there… not answer the door (especially to doctors), jealously guard your hoard of food and water, and ignore all pleas for help.

Western medicine found itself equally as useless as all other types of medicine. Doctors prescribed aspirin, but sometimes in such large quantities that one researcher has suggested “aspirin poisoning might have contributed to the deaths of a sizeable proportion of the flu’s victims”. It seems they were ignorant of the poisonous effects of overdosing with aspirin. My God, they were ignorant of so much! Quinine was overprescribed in Brazil and one historian later wrote

To the symptoms of the disease now had to be added those caused by the panacea : buzzing in the ear, vertigo, hearing loss, bloody urine and vomiting

The great majority of medicine taken by the millions of flu victims had only a placebo effect. Laura Spinney explains that placebos can, as we know, be very beneficial – but only if the patient believes in them (this is how homeopathy works, when it does work, for instance).
And she adds

According to some estimates, 35-40 percent of all medical prescriptions today are not much more than placebos.

Controversial!! But then – if the patient loses faith in the medicine then the placebo can become a NOCEBO – which was a new word to me. A nocebo aggravates your symptoms because you believe it will. She does not explain why anyone would continue taking a medicine they thought was rubbish.

So : one in three human beings on the planet caught the flu in 1918 and one in ten – maybe as many as one in five – died. One of the deceased was a German immigrant to America. As a prudent husband and father he had taken out life insurance so the company paid up to the widow and son. The son prospered and the son’s son is Donald Trump.

This is a very solid account of a huge and hard-to-comprehend subject. Laura devotes chapters to aspects of it which I had no interest in (did it come from birds? Where did it actually begin?) and so I can only dish out three stars for me as a reading experience but if you’re a fan of pandemic historiography this might be a five star read for you.
Profile Image for Andy.
1,373 reviews465 followers
October 29, 2022
Update (July 2020): Please see comment stream below for interesting discussion, especially given situation with COVID-19.

Nerd addendum (Jan. 2018):
After my review below, the NY Times gave this book a favorable review as a science book and even made it an overall weekly "Editors' Choice." People can have different tastes in literature, but for science non-fiction, factual accuracy must override the esthetics of the storytelling. The mistake I pointed out below is something that a reviewer with some relevant scientific background should have noticed. It relates to the differences between exposure, infection, illness and death. Distinguishing these from each other is crucial for saying anything intelligent at all about a pandemic. I think that organizations like the Times Book Review have a responsibility to fact-check non-fiction books, and for science non-fiction they should have scientists check the scientific facts.

There are many books about the 1918 flu. This book has some updates on recent discoveries. Unfortunately, the science is sloppy: at the very front is a map of the world illustrating the flu's impact but the author makes a major error here confusing "death toll as % of population" with "case fatality rate" (see p. 168 of the same book). Given that many pages are dedicated to "counting the dead" this is not a trivial mistake. If the book had some amazing new thesis, I could maybe give it an extra star despite this shambolic start, but it doesn't; it's basically revisiting the same monster-virus narrative started by Crosby in 1976 and artfully retold by Barry. The Great Influenza: The Story of the Deadliest Pandemic in History
The Great Influenza The Story of the Deadliest Pandemic in History by John M. Barry
Profile Image for Occhionelcielo.
119 reviews39 followers
March 21, 2020
Letto in tempi tranquilli (marzo 2019) per due ragioni:
1) Nel biennio 1918/1920 l'influenza spagnola uccise tra 50 e 100 milioni di persone. Il dato relativo alle vittime è sicuramente superiore a quello della prima guerra mondiale (16 milioni), probabilmente a quello della seconda (60 milioni) e forse alla somma dei due;
2) Ciò nonostante, Worldcat, il più grande catalogo on line, elenca circa 80.000 opere sulla prima guerra mondiale e solo 400 sull'epidemia.
Direi che ce n'era d'avanzo...

Oggi (marzo 2020), nel pieno dell'emergenza Covid-19, diventa preziosissimo per due ragioni:
1) Fornisce il resoconto di ogni aspetto del precedente storico più affine e meglio documentato;
2) Nelle pagine centrali spiega in modo chiaro cosa è un virus, come vive, si riproduce e si propaga.
Per questi motivi, lo ritengo il libro da leggere in questi giorni di quarantena forzata.

P.S.: l'autrice Laura Spinney è un'esperta non improvvisata, oggi attivissima sulle pagine del Guardian e del New Statesman nel raccontarci la battaglia sul fronte decisivo dei laboratori.

P.P.S.: un plauso all'editore Marsilio per la splendida copertina, dipinto di Egon Schiele intitolato "La famiglia", raffigurante il pittore stesso, la moglie e l'immaginario figlio da lei atteso. Purtroppo, a causa dell'epidemia, la donna morì al sesto mese di gravidanza e l'artista la seguì tre giorni dopo, lasciando l'opera incompiuta.
Profile Image for Emma.
974 reviews975 followers
May 10, 2020
Like so many others, I'm understandably drawn to pandemic literature right now. It is fascinating to compare how people have tackled, experienced, explained times similar to those we are presently living, whether that be through fiction or non-fiction. When it comes to the 1918 'Spanish' Flu, it seems incredible that a virus which killed between 50-100 million people worldwide can be so excised from cultural memory. Whatever the true count, it represents a near unimaginable number of deaths, especially when compounded by the losses from WW1. Families and communities devastated by a little understood killer in a time period just over the edge of living memory, and yet until this outbreak, it was hardly more than a passing reference in most history books.

Here, Laura Spinney seeks to fill that gap. Written in a non-technical style for the general reader, she engages with aspects of the science and history in short, thematic chapters. In doing so she manages to cover a lot of topics but in a very light way. The experience was akin to reading a long Sunday magazine article and I'm struggling to come up with anything more about it than 'it was fine'. Considering it was written about a near apocalyptic event, it was way less gripping than you might expect: patchy, speculative, and often a chore to read.

ARC via Netgalley
Profile Image for Somormujo.
140 reviews84 followers
November 2, 2020

Leí este libro con muchas expectativas por la situación sanitaria actual. Y he de reconocer que cumple con su propósito, que es el de informar sobre la gripe de 1918, mal llamada “española”, desde diversos puntos de vista. De hecho, algunas de las historias con que ilustra el inicio y el recorrido de la pandemia son muy interesantes, aunque la profusión y menor entidad de otras resulta un poco cansina.

Si alguien espera referencias cruzadas con la situación actual provocada por el Covid-19, este no es el libro. Basta con comprobar que el libro se escribió en 2017 y que la primera edición española es de 2018, para rememorar el aniversario supongo. Obviamente las circunstancias sanitarias lo han llevado a multiplicar la atención que hubiera generado.

Con todo, creo que es un libro que cumple su cometido sin más ni menos, y de ahí mi puntuación ....
Profile Image for Jeanette.
3,275 reviews557 followers
November 17, 2017
It's a 3.5 star book. It's a 4 star book up until about page 250. I would have given it a solid 4 if she had ended it there with some summation of her research. But from "Melancholy Muses" onward- it was HER opinion, supposition, context correlations to possible cause and effects to epidemics of flu in the future and/or possible wild bird/ domestic bird/ domestic pig transfer of evolving viruses theories etc. And some of that was just about a 2 star. So I thought that the "fact" and the science became scrambled in finality instead of being clearly concluded to so much of "we do not know" that is much closer to the reality of flu "changes". Even in her "Aftermath".

But don't get me wrong. Please do not take this strange non-linear METHOD of telling this as reason for not reading it. That criticism coming first in my reaction is NOT the core of this book, nor should it keep you from this description and depiction of the first 2/3rds. NOT AT ALL. I put it first because I was disappointed the she went so far in that direction as she did. But please, DO take it with a grain of salt and no more so than in those areas of what she deems are "inputs" to weather, migrating bird patterns of cause and so much else here. All of that is far fetched guessing. Not only my own opinion. And it greatly aggrieves me when the science becomes mixed with such persuasions. She's clearly part social warrior (for governmental controls of populations for extreme "health" dictates too) and it still doesn't parse that she isn't absolutely correct and accurate about many of the past "cognition" of sick and endemic, epidemic diseases and their outcomes in masses when they occur as this Spanish Flu did in the period 1918-1920. Or in some of the other exposed first witness eyes (original source written material too) and various locales fatality rates in comparison to numbers that suffered the onsets etc.

More people died of this JUST IN INDIA than died in the entire WWI. But that's a minor stat compared to some of these numbers. Most final numbers are UNDER estimated because of dozens of reasons within that time period's medicine, literacy, communications rates and far more that never insured any rural OR urban counts were near to accurate. So many people died that an entire year of crops or working output was also lost, never started or never completed. Which caused famine and further death. And also many were transporting home (underfed and with other diseases from their war experiences) after a war which horrendously increased exposures of the disease around the entire earth in waves (3 waves of repeat).

The photos were great (a picture/ visual DOES equal a thousand words) and then, IMHO, toward the end of the book became rather bizarre.

So- we had a great start and she did warn you that she was going to tell this like the African women do. They name the original event and describe it. Then in after effect circle every aspect of it and going around and around it, over the years, fill out the core to add and add and make it the ENTITY of tale that it becomes. Well, for this level of science in a causal factor that is 20 times smaller than a bacteria- that is NOT the best way to relate.

How it is named? What endemic diseases it entwined with for a much higher fatality rate? What the state of medicine was in all these various places and how official control reacted? What it WAS that they understood it WAS? Then, and now. How it has returned and the waves it will now and again insure to a changed viral state? All kinds of different cultural mindsets to "offend" it to leave or to keep it away/ from catching it too on an individual stand point? Much more IS here in minutia of detail. But it is also highly anecdotal in majority and the research and notes considerable but YET many of them are made by "eyes" that little understood what they were seeing as "same" or "not same".

Well worth the read. And if you never understood what H1N1 or H5N2 or any of those designations mean for the particular period's or year's flu shot, or ANY of the vaccination questions? PLEASE read it, then.

Just from my own point of view! She has an entire section or two or three on the W or U or V curves (by age or ethnic background etc. etc.)for standard deviations and other recorded patterns for age or gender in the fatality stats too. And why the ages of 25-35 were such horrid, horrid outcomes considering that group is usually the strongest population for nearly any kind of infection. As excellent as all those suppositions could be in study, they are NOT strongly backed with pure science testing. Certainly not to a duplication sense level. So some of those "reasons" are also not written in stone. And I really did laugh and started counting on my fingers, almost at once. Because she had multitudes of "science" explanations here about pregnant women and the babies born of those months. The women who were pregnant who did not die. She gives stats on height, IQ etc. etc. for "flu" babies. My Dad was one of those babies, born May 21, 1919. And my grandmother (lived to 99 and was VERY sick a goodly portion of her life) was surrounded by this flu and not only had IT but had diptheria during that year. And my Dad was 6 foot tall and top of his class at a h.s. in another country. So this entire section, I VERY much doubt all is all as she implies.

The thing I will remember the most about this book was the percentage of fatality charts on the world map. I had NO idea about Alaska, nor the Italian-Americans of NE USA. And also that artwork of the nudes done by that poor man. Heart-breaking. So much misery and heartbreak in the family and town stories!

That there is so little of this MAJOR world event in the literary world too? Think of all the WWI and WWII literature. And all of those dead soldiers. There are MORE dead for this and it is not a factor in more than a handful of books- regardless of the written language or cultural bent. A great study would be one in which this aspect for the psychology of humans is analyzed to why this "forgetting" occurs. Again and again and again. How an "event" or a set of real life outcomes becomes obscured by a lesser set of "real"? I can think of about 5 urban dense living realities for this in crime and murder rates too. Exactly the same phenomena. We always crusade or hype the "lesser number" evil outlier "thing", IMHO. But I'm sure I am in the minority for evaluating in that manner. For the last decades life "truth" is what is "advertised as happening" now- and most times not at all what actually occurs within damage or negative results.

Truth gleamed from this:

Flu has the worst outcomes in most densely situ homo sapiens populations. But that is surely coupled with the living and health (other diseases)conditions WITHIN that particular density and the other present cultural habits/ conditions of that exact population at the same time as exposure. But a flu that can have this immense immune system over-reaction whole body response (that is what killed most of these victims) within the human body is still deadly, deadly once it's "here". Anywhere "here" is.
Profile Image for Debbie Zapata.
1,785 reviews35 followers
April 3, 2020
April 1 ~~ Review asap.

April 2 ~~ This is not exactly escapist reading these days, but I have had this book on my radar for months and naturally have become even more interested in the topic recently so I decided that I would risk virus overload and read it while I could compare in real time what was done then to what is being done now.

Each section of the book dealt with a different topic, such as a general history of influenza over the years, how we as individuals and as a society react to a pandemic, to what was done then and what should be done the next time around.

Numbers are staggering here. "50 to 100 million people died worldwide. 500 million people had the disease. The pandemic raged between early March of 2018 and March 1920." There were at least three waves of the flu, and the second was much more devastating than the first. More men caught the flu and more men died from it. Doctors prescribed aspirin in higher doses than is considered safe these days, causing some researchers to declare that many deaths in first world countries where that new miracle drug was available could have been due to aspirin poisoning rather than the actual flu.

Oh, and you know how certain people are touting the malaria drug quinine as a possible cure in the current coronavirus pandemic? Doctors in 1918 gave that to their patients without any proof of whether or not it even worked against the flu. So besides suffering from influenza, many patients had to try to cope with medical side effects such as 'buzzing in the ear, vertigo, hearing loss, bloody urine and vomiting'. (Per Pedro Nava in Brazil.)

Well, my mother is anxious to begin reading so I will quit looking through and finding the bits and pieces I wanted to cite in this review. I will just say please read this book if you can. Even though it deals with influenza and not coronavirus, it will help you understand and cope with what is going on.

Take care, everyone. Stay safe and healthy. Find something each day to make you smile. We will get through this!

Profile Image for StMargarets.
2,818 reviews471 followers
May 3, 2020
Published in 2017, this was an interesting look back (and forward) into the previous pandemic the world endured in 1918.

I was amazed at the similarities between our reaction in 2020 to Covid-19 and the world's reaction in 1918.

Newspapers and governments tried to downplay it.
People turned away from science and embraced more emotionally satisfying rituals (prayer, scapegoating to name two).
Because of WWI, the disease spread to all corners of the world, but the death rate varied wildly. There was/is still no consensus on the actual numbers.
Malaria drugs and aspirin overdoses killed the patients they were trying to help.
People resisted quarantines and mask-wearing.
Those who locked-down had the best outcomes. (Australia wins the prize)
The rich fared better than the poor.

What has changed:
They didn't know anything about viruses back then.
It took until 2015 to come up the RNA sequencing for the Spanish Flu(they had it for Covid-19 in February).
The pre-existing conditions now versus the TB, malnutrition, cholera, etc of the past.
Death and illness was an expected part of life back then.

The author goes into great detail about all of these issues. She also covers the three possible patient zero scenarios (China, France or Kansas?) How birds and animals pass on viruses to humans and how difficult it is to make vaccines.

The chapters are short, so if you're not interested in what the flu did to Alaska in 1918, then you can easily skip it.

The author tries to show how the pandemic affected life after it was over, but it's very hard to prove that the exuberance of the 1920's came about because of pandemic and not recovery from a major war.

What the author can prove is that very few people talked about it when it was over. War is easier to create a narrative around. It's difficult to pin down a disease. Some victims had horrible deaths. Some survivors had lung and neurological problems. And others weren't affected at all.

There was a paradigm shift with hygiene. But all that misery was sweep under the rug for decades.

I wonder how our pandemic will play out? Looking back is helpful, but this book won't give that answer.
Profile Image for Anina e gambette di pollo.
78 reviews29 followers
March 6, 2018
Autore: britannica (1971). Saggio storia.

Sono pochi i libri in Italia sull’influenza spagnola.
Uno è La spagnola in Italia di Eugenia Tognotti, l’altro è questa traduzione della britannica Spinney. Almeno che risultino a me.

Tra i lettori qui presenti c’è un nerd statunitense, molto severo nel giudizio, che cita due testi di due storici che però ha potuto leggere lui, visto che sono del suo paese e non tradotti.
Secondo lui non è abbastanza scientifico.
Un’altra lettrice d’oltreoceano lo reputa scritto male e non sopporta le indicazione del tipo “come vedremo più avanti”.

Ho letto dei saggi bellissimi, su argomenti scientifici, che avevano il valore aggiunto di un’ottima capacità di scrittura. Anch’ io pretendo (!) che un saggio letterario sia ben scritto, ma in un altro genere sono un po’ meno pretenziosa.
Inoltre, vista la scarsezza nel nostro paese di testi che affrontino l’argomento, sono ancora meno pretenziosa.
La scrittura è quella di una giornalista e il “vedremo più avanti” spesso quasi inevitabile.

Il libro da una visione d’insieme di una pandemia senza precedenti e per fortuna senza episodi successivi. La Grande Guerra e i suoi morti coprono, nell’immaginario popolare, la valenza di ciò che produsse la spagnola. Male mondiale più della guerra, che colpì ogni parte del globo, fosse o non fosse coinvolta nel conflitto. In fondo la quantità di morti, spaventosa a livello globale, fu “relativa” in Europa.
I cambiamenti che portò nell’approccio sanitario furono sostanziali e diedero inizio a organismi nazionali e sovranazionali nella sanità pubblica.
Contemporaneamente le paure che si lasciò dietro portarono in auge comportamenti che il novecento credeva perduti nel passato.
A titolo di curiosità il virus è stato ricostruito e conservato in un’installazione superprotetta degli USA. Superprotetta come può fare l’uomo. Siamo in una botte di ferro. Purché non faccia ruggine, non venga rubata, qualche fanatico non la trapani, non galleggi sulle acque di un’alluvione etc etc

Lettura interessante anche se priva di tabelle statistiche o di stile aulico.

Profile Image for Ellie.
1,475 reviews372 followers
December 9, 2019
I generally prefer fiction to non-fiction but this work is a major exception. Spinney is also a novelist and, apparently, a good one if the smooth and engaging style of this book is an accurate example.

Ever since watching the (very) old series Upstairs, Downstairs in which a major character dies of the Spanish Flu, I have been interested in this (to me) unknown epidemic which apparently killed so many. Over the years, I have noted any references to it. But these references, according to Pale Rider, are surprisingly few. The Spanish Flu pandemic killed millions throughout the world, more (outside of Europe) than World War I, which was the "major" event at the time (1918-1919).

Pale Rider is as gripping and as much a page-turner as any mystery or novel I have ever read. The anecdotes illustrate the horror of this illness, mysteriously (to the people) appearing and wiping out families and, in some cases, entire villages and towns. It was more destructive than the Black Plague.

Spinney looks at the effect of the epidemic on the culture of the time. I enjoyed her many stories about and quotes from artists and writers. Although rarely referred to directly, the illness, along with the war, had a big impact on the arts which was often despairing, bleak, and death-centered. Sentimentality was finished. The War has been the force generally held responsible for this but Spinney makes a case for the influence of the Flu alongside the War for the general mood and preoccupations of the people.

The magnitude of the tragedy is staggering. From Alaska to Africa, the Flu raged and destroyed. It is a mesmerizing story.

In addition to describing the personal effects of the epidemic, Spinney examines the science of the virus, how it (possibly) mutated to become so lethal as well as why some people succumbed and died and others survived, often hardly touched by it, any more than any other seasonal flu. Although I'm not a great science reader, Spinney made the topic as interesting as the rest of the story. The virus becomes almost a character, a leading character, in this event. How the virus is transmitted also has implications for future epidemics.

Spinney discusses which public health measures were most effective and what needs to be in place to protect us from another such outbreak--something which is, she writes, almost guaranteed to happen in the near future.

The book is riveting--informative, exciting, fascinating. I can not speak to highly of it. I am grateful to my brother-in-law for gifting this to me; it is unlikely I would have sought it out on my own and would have missed this experience.

If this book doesn't push you doesn't make you run out to get your flu shot, I don't know what will.
Profile Image for Ignacio.
1,065 reviews200 followers
April 25, 2020
Si hubiera leído El jinete pálido el año pasado me hubiera parecido que ver algo como la actual pandemia del COVID-19 sería imposible. Leído ahora, explica una parte de lo que estamos viviendo. Una consecuencia de nuestro olvido que las pandemias son algo más que un motor en historias de ficción, un ciclo aterrador que volverá a golpearnos en el futuro.

Spinney estructura El jinete pálido en capítulos en los que toca cuestiones específicas sobre una pandemia aplicadas a la gripe del 18 (cómo se desarrolló, dónde pudo estar el paciente cero, qué alentó y controló su desarrollo, qué tipo de población golpeó, los dificultad de diagnóstico en una época que los virus no se habían observado...), casi siempre adosadas a un relato concreto del bienio 1918-1919 cuando acontecieron sus tres olas. Estas historias personales no solo dan rostro humano a la tragedia. Permiten tratar cuestiones aledañas entre lo extravagante (los rituales populares para alejar la enfermedad) y lo dramático (la obliteración de culturas enteras, caso de la población yupik de Alaska y las aleutianas).

Pero la parte que más he disfrutado han sido sus últimas 100 páginas, el mundo tras la pandemia. Hay conjeturas un poco traídas por los pelos, como la que termina llevando a la Segunda Guerra Mundial por una serie de sucesos conectados con la gripe. Pero abarca multitud de aspectos sugerentes. Entre ellos, las escasas referencias directas en la creación artística de los años posteriores, aunque en aspectos implícitos se dejara sentir bastante más.
Profile Image for Atila Iamarino.
411 reviews4,361 followers
January 6, 2021
Para entender um tando mais da pandemia, resolvi buscar as mudanças trazidas com a Gripe Espanhola. Esse foi o melhor relato que encontrei. Spinney vai atrás de documentos históricos, notícias de jornais e até obras de arte para retratar o que mudou com a pandemia de 1918. De cara e o mais marcante foi entender que foi por conta dela que muitos países europeus criaram um sistema de saúde público com hospitais interligados. E como o Japão (e outros países tb) já tinha começado a adotar máscaras desde então.

As "coincidências" das mesmas soluções de máscaras e distanciamento são bastante impressionantes. Mas ela vai bem além disso, discute como cada região enfrentou o vírus, como as pessoas aceitaram ou não o que estava acontecendo, sequelas e até mudanças pós-pandemia. É um livro bem completo
Profile Image for Marta.
996 reviews100 followers
April 25, 2020
Pale Rider is educational, about an interesting and very timely topic, but the writing is not very engaging and the organization of the book feels rather haphazard, so it was just a so-so for me.

This was our book club’s selection at what appears to be the last supper for a while, in mid March. The Covid virus was just emerging and we all were interested in the topic. I got it on audio, since I usually like to listen to non-fiction. However I lost steam about two-thirdth in, possibly due to Covid news overload, but also because I just wasn’t that engaged.

I did learn interesting bits. The Spanish flu killed more people than two world wars combined, and most of its victims were in the poorer parts of the world. It left its mark on us in many ways: it influenced the outcome of World War I; led to the creation of national health systems; wiped out entire regions in remote areas; likely caused the wave of depression after the war in the form of after-viral fatigue. Yet we know very little about it, as it has not been studied systematically until recently.

The Spanish flu was not Spanish: there are several theories of origin. It could have possibly originated in China, Kansas, or in a French training camp. Either way, it spread very fast among soldiers who died en masse from the flu; then carried it home with them when the war ended. There were three waves: the first and last were relatively mild, but the second was extremely virulant and deadly. It killed people within a few days.

Spinney tells detailed tales of the flu in several spots in the world: Russia, Brazil, India, Alaska. Her selection is probably influenced by what she could find. These were interesting but seemed arbitrary. She also jumped around both in topic and time. This seems understandable as the topic is not linear; yet I still don’t see the logic of starting with the war, then moving on to later consequences, then returning to analyzing if it influenced the war’s outcome.

The book includes the newest research on the virus itself, as it has been reconstructed and its DNA was sequenced - and been found really scary. The last couple chapters on the possibility of a new pandemic and our preparedness were particularly interesting, in light of us currently living those scenarios. I could especially relate to the statement about how there are two camps: one accuses the other of being alarmist, the other accuses the first of stucking their heads into the sand. Sounds familiar?

Looking at other reviews, there are probably better organized books on the subject, however this one is newer and contains the latest research, so I would still recommend it.
Profile Image for Joy D.
1,893 reviews218 followers
July 15, 2021
This book provides a global perspective on the “Spanish” influenza of 1918 (which did not originate in Spain) that killed between 50 and 100 million people. Chapter One recounts the history of flu viruses, providing the context for the rest of the book. The middle chapters focus on the virus itself – where it originated (most likely Kansas, US), how it spread, and its impact throughout the world. The final chapter brings up the potential for future pandemics and what we can do to be prepared. It was released in 2017, so the “future” being described would include COVID-19.

It provides a logical, well-structured discussion of the science behind viruses, germ theory, genetics, disease transmission, and what was (and was not) known in 1918. It speaks of the three waves of the virus, and how they were staggered in the northern and southern hemispheres. It calls attention to the fact that viruses mutate – this is a normal progression and should not be considered surprising or alarming.

Content includes the importance of detection, tracking the spread, and compliance with safety measures (masks, limits on mass gatherings, social distancing, vaccinations). There is a decent discussion of how flu can originate in animals and be transmitted to humans (bird, horses, ferrets). The importance of attaining herd immunity is stressed.

I appreciate Spinney’s analysis, which is based upon a detailed review of historical and scientific documentation. It includes anecdotes from people around the world – Australia, Brazil, China, UK, US, Persia, Russia, Samoa, Spain, South Africa, Vanuatu, just to name a few. It outlines the groundwork being done in the scientific community to study these viruses and enable vaccines to be developed more quickly. This book is a great example of how we can learn from what has transpired in the past.

I have an interest in both science and history, so I found it engaging. It is remarkable that the fallout we have seen in terms of social, cultural, political, and information delivery can all be correlated to what happened in 1918, but on a different scale due to less scientific knowledge and technological development. I think it is a good idea to read about influenza and pandemics in order to gain an understanding of the facts.
Profile Image for Grazia.
389 reviews155 followers
June 21, 2020
E' la distanza a conferire senso alle cose

Perché il ricordo di una pandemia impiega tempo a formarsi?
La memoria è un processo attivo, bisogna ripassare mentalmente i dettagli di un evento per trattenerli. Ma chi vuole ripassare i dettagli di una pandemia? Le guerre hanno un vincitore (e al vincitore va tutto il bottino, ovvero la versione dei fatti che viene tramandata ai posteri), mentre in una pandemia ci sono soltanto sconfitti.
Profile Image for Richard Derus.
2,890 reviews1,919 followers
April 21, 2022
Pearl Rule #8 of 2022 (7%)

I bought into the author's justification for not making the book one linear, beginning-middle-end story. The social parts and the science parts are very different and they interacted but were never remotely in sync, so trying to stay purely chronological sounds like a bad plan.

What I got instead was borderline incoherent, with paragraph-by-paragraph switches among authorial opinions, statements of fact unsupported by citations, and stodgy-wodgy bits of statistical stuff. This tiger of a topic was less ridden by the author than it rode the author. I felt frazzled by the time I realized I was not going to have a better experience later on...I flipped through some random spots and found that I was getting the same structure.

Not what I want, or what I will accept, from narrative non-fiction.
Profile Image for Jennifer.
778 reviews39 followers
October 27, 2017
One of these days, I'm actually going to write a story about an epidemic that will justify all the reading I've done on the subject. But in the meantime, I just find it fascinating. This is one of the better books about the 1919 epidemic that I've read. Laura Spinney goes into the history of humanity's interactions with influenza before talking about the events of that particular epidemic, and the way it affected the modern world.

As an interesting side note, one of the people she mentions shares a rather uncommon name with my own ancestors. Yesterday, my mom sent copies of this gentleman's journal and military service record from the Alaska State Archive. If I hadn't read this book, we might never have found out about him. Pretty cool!
Profile Image for Siobhan Johnson.
521 reviews2 followers
June 16, 2017
I really enjoyed this! A very interesting and comprehensive study of an often overlooked period of history, the Spanish Flu of 1918(-1920, roughly), and how it impacted the world.

I'll get the few problems I had with it out of the way first, just to be comprehensive.

Problem 1. There was too much focus on male voices for my liking. Granted, this is probably (as in, almost certainly) because that is the majority of evidence available. I still felt a little cheated, though - you can't open the book by dangling a female history of the disease over my head and then not deliver! That's not fair at all.

Problem 2. There was a little too much supposition. This is mainly a problem with the first section of the book, and also a bit of a problem with the historical non-fiction genre. The past 3 overviews of certain things I've read have started with vague supposition, and it's a tiny bit annoying to me. The unfortunate fact of the matter is that before a certain point in history we don't really know that much. We can make educated guesses, people probably didn't ride unicorns and design spaceships in 600BC for example, but until more research has been done they are only going to be guesses. It felt a little odd, flowing bumpily from vague supposition into an otherwise very rigorously scientific study.

These are only minor problems, though, and I still enjoyed this book a great deal. I stand by my decision to rate it five stars, and would definitely recommend it to people. It's definitely a discussion book, ask my poor fiance who has been patiently listening to me reading chunks out for the past three days, and I think that a lot of people would find a variety of interesting things to talk about.

The discussion of the social impact of the flu was a particularly strong area, and one that could provoke a variety of discussions. It's stated in the book that America and Europe actually got off the most lightly from the flu, and yet when the impact of it is discussed it tends to be purely in terms of the Western world. Not in this book. India and China were both discussed in great detail, and I found the sections on China especially interesting. The book highlighted a fundamental difference in worldviews, and also highlighted how that fundamental difference has changed over the past hundred years.

The medical side was also absolutely fascinating. I am not a scientist at all, my expertise with science extends to pointing at ducks and terming them cute (although they are apparently horrible flu carriers according to this book, so maybe I'll stop doing that), but I found the science in this book easily accessible and fascinating. My favourite section in the book was probably when the biology of the flu virus was described, and I also loved the explanation of how it interacts with its human host.

Possibly the greatest triumph of this book, though, was the work it did on historical context. The Spanish Flu is a frequently overshadowed pandemic. People tend, for justifiable reasons, to focus more on the First World War that overlapped with it or the Second World War that followed just twenty years later. This book challenges that, while still being very respectful of the lives lost in the war, and definitely succeeds in placing the Spanish Flu in a historical context. It points out how the disease probably led to the events of World War Two, just as surely as the aftermath of World War One did, and does so in an easily understandable and extremely interesting way.

So, yes! Overall I really enjoyed this book, and got a lot of pleasure out of reading it. It's not really a light read, the death of millions can never really be that, but it is an extremely interesting one that I'll probably be thinking about for a good while.
Profile Image for Lena.
1,144 reviews241 followers
March 2, 2020
“Though there had never been a flu pandemic like 1918 before, once 1918 had happened, scientists realised that it could happen again.”

This was a well rounded look at the time period, science, literature, sociology, and emotion surrounding the Spanish Flu.

It also gave me a better understanding of H.P. Lovecraft’s world: a place where big cities and the Middle Ages lived side by side, where war, plague, and revolution tore through civilizations, where eugenics was mainstream, and death was the will of the gods.

One factoid, in case you were wondering why Covid-19 was not pegged as the Chinese Flu:

In 2015 the World Health Organization issued guidelines stipulating that disease names should not make reference to specific places, people, animals or food.
Profile Image for Peter.
41 reviews
October 2, 2017
I wanted to like this book but I struggled to stay interested. Here and there it had some interesting sections but it often wandered off into places that lost my interest. It tried to do too much. It reads more like a Spanish Flu reader, like a collection of essays on topics related to the event. Chalk full of speculation, only to pull back and admit it is full of speculation.
Profile Image for Alex Sarll.
5,766 reviews231 followers
July 7, 2017

"Seven million people died in the great war
A bout of influenza quadrupled that score.
Why pimp to posterity?
Why should they admire us? All the heroes of Valhalla
Weigh less than a virus.”

Momus' ‘Morality is Vanity’ was one of the reasons I was keen to read this new account of an insufficiently remembered hecatomb, the not-actually-Spanish* flu of 1918. And no, I have no idea why it’s not coming out for next year’s centenary, instead mingling with all the books marking a century since the Russian Revolutions. But that aside, this is a very good read – a smart collation and arrangement of material from all manner of specialist sources into a single account which, while it doesn’t pretend to exhaustivity, is certainly a good overview. Not least in being, for the most part, admirably clear about what we can and can’t know. Consider: the flu was especially harsh on pregnant women, who seemed especially likely to die and if not then to lose their offspring. Yet we can tell from statistical analysis of subsequent generations that those in utero who did survive maternal infection would ever after be a few millimetres shorter, a little more likely to be gaoled, than their peers. At the other extreme, we can't confidently narrow down the global death toll any better than somewhere between 20 and 100 million. And in some senses, when you’re dealing with numbers on that scale, it’s tough even to intuitively grasp the difference. They’re both just unthinkably huge.

There are some weaker chapters where this careful discrimination doesn’t quite hold, especially the one on art’s reaction to the flu. When it comes to physical consequences, Spinney astutely uses the control of neutral Norway to distinguish the war's effect from the plague’s; when she tries to tie particular developments in culture to one not the other, she's disentangling with a certainty the evidence can't support. As for the idea that it was the flu not the trenches which ended a century or more of Romanticism, we get this gem: "For the Romantics, disease was symbolic – a metaphor for the sickness of the soul.” Perhaps this was true of Byron and the club foot that chained his free spirit, but I think you’d struggle to get the theory past a close reading of the works of tubercular medical student John Keats, who was all too aware of the specifics. Similarly, while Spinney makes a compelling case that if the flu hadn’t got Sverdlov then the world might not have got Stalin, and that the virus was also largely responsible for the independence of (Western) Samoa, the arguments that the Spanish Civil War, Indian independence and the Second World War can all be attributed to it too feel a little less solid. You also get the odd cheesy turn of phrase, as one might expect from a writer whose bio lists the debased modern Telegraph - comparing the vagueness of the whole concept of a virus in 1918 to the Higgs boson ten years ago is a useful idea; comparing it to a leprechaun, less so.

But, Spinney has also written for the Economist and Nature, so glitches such as these are a rarity – there is also, blessedly for a modern work of non-fiction, no faintest trace of a personal sodding journey. Instead she circles back to the earliest outbreaks of what we now know as influenza, via its naming (somehow I’d never twigged the obvious connection of the words, but it was named because at the time a connection was assumed to the ‘influence’ of the stars) and on to modern research, but always coming back to the staggering catastrophe of 1918 – which, as befits a global event, she examines from many angles, almost all of them profitable. Often this will be a vignette of the plague in a particular locality, such as Zamora in Spain, which managed a far higher fatality rate than the rest of the country because it had an atypically popular, pious and pigheaded new bishop, who persisted in calling ever more gatherings of the faithful to pray away the divine wrath behind the epidemic, all the while crowing over the failure of science to save the day. “In a single issue of the Correo, an article approving the provincial governor’s decision to prohibit large gatherings until further notice appeared alongside the times of upcoming Masses at the city’s churches” - it’s up there with Brass Eye outrage facing ‘Hasn’t She Grown?’, isn’t it? But – as tempting as they always are – this isn’t just a story of the angrily ignorant faithful. In New Orleans churches closed but stores remained open – just one instance where the worship of Mammon was every bit as dangerous as the cult of that other bastard. And this takes us on to the wider point that, even if they approve drastic measures in general, everyone always has some important reason why their own organisation should be exempt – see also the way military requirements made matters much worse in New York, not to mention in the barracks and troop ships where the nation’s not-yet-symptomatic infected could be nicely gathered with all those potential new victims.

And of course, that’s just among the people who had a basic understanding of how diseases operate. Even leading scientists initially thought the outbreak could be traced to bacteria rather than a virus – and even once the latter was identified it remained visible only in its effects until the much later arrival of the electron microscope. It didn’t help that other infections – whether secondary, or just coexisting – often muddied the waters, and indeed were one of the leading causes of death. To which primitive medicine was also well-placed to lend a hand, and by ‘primitive' I don’t just mean non-Western, because in the West scientific medicine had only recently pulled ahead of quackery, and was still in a fairly lamentable state. An unknowable number of the dead may have been victims of the over-prescription of newfound wonder drug aspirin. Beyond that, mercury was still being used on syphilitics in 1918! And when they seemed to get off lightly, doctors figured what the Hell, and tried it for flu as well! Meanwhile, of course, quackery, on the back foot after recent advances, was happy for the chance of a second round. Brazilian anti-vaxxers pooh-poohed the official story as an excuse for a 'scientific dictatorship’. One doctor in poor Zamora blamed the contagion on blood impurities accumulated through sexual incontinence (and bear in mind, even in the 1980s nearly half of Americans thought AIDS was divine vengeance, so his kind are still with us). Often the flu was taken for a disease of insanitary conditions, which rapidly became an excuse to blame it on those already stigmatised for racial or class reasons. You know: the Other had brought upon themselves by their choice (what do you mean it’s not a choice?) to live in squalid slums. Or by simply being inferior, degenerate stock. Inevitably this would lead to countermeasures which were often as counterproductive as they were inhumane. The irony being that, as Spinney tells us, it has since turned out there really is a genetic component to flu vulnerability – just not one tied to such a scientifically meaningless category as race.
(I will note here that I would have liked a bit more on black Americans’ disobliging failure to suffer in anything like the same number as whites, which I can’t imagine went down terribly well in certain quarters)

I had best stop here, because just as the book can’t be exhaustive nor can a review – there’s just too much here. Suffice to say, it’s well worth a read. Certain details are going to stay with me, I can already tell – the way sufferers’ faces coloured alarmingly even as the colour drained from the world they saw, for instance. Which is almost neat enough for an allegorical fictional plague, isn’t it? A very good book. Ending with a very good afterword suggesting that, in the short to medium term, the reason epidemics are less memorialised than wars is that they're lacking those winners who famously write history.

Though perhaps don’t read it during hay fever season as I did, because people sneezing on the train will make you very twitchy.

*The generally acknowledged first case was an Army chef at the USA’s unfortunately named Camp Funston; modern thinking tends to place the real origin either near him in Kansas, in China, or in France.
Profile Image for iva°.
571 reviews87 followers
December 29, 2019
vrlo čitka, temeljita i opširna, ova knjiga dat će ti niz povijesnih informacija o španjolskoj gripi sa svih mogućih uglova - kako se razvijala, otkud je došla i kamo je išla, kakve je posljedice ostavila, kako je utjecala na politiku, koju umjetnost je iznjedrila, koliko ih je pokosila, kako je bila tretirana i, na koncu, koje su šanse da se u budućnosti tako nešto ponovi.

nemoj čitati ako si hipohondar.
Profile Image for Chris Steeden.
432 reviews
September 15, 2018
I don’t think I have had proper flu. You know the one where they say you feel so ill that you just cannot get out of bed. I have had flu-like symptoms for sure. Tiredness, aching all over, chill, fever etc. The Spanish flu is on another level. Have a read of this: ‘The Spanish flu infected one in three people on earth, or 500 million human beings. Between the first case recorded on 4 March 1918, and the last sometime in March 1920, it killed 50– 100 million people, or between 2.5 and 5 per cent of the global population’. Oh, my word.

So here we are. 100 years on from the Spanish flu and Spinney takes us on an influenza journey starting at the time of ‘Do no harm’ Hippocrates as he was the first to write a (probable) description of it. She writes that, ‘Understanding more about its origins might help us pinpoint the factors that determine the timing, size and severity of an outbreak. It might help us to explain what happened in 1918, and predict future epidemics’.

This book is not dry. It is written in such a way that my interest was piqued all the way through. Thankfully, all is explained in laymen’s terms. Full of fascinating facts and a lot of probable’s just due to the fact that not everything can be verified 100%.

I remember reading once about horror films and that they are really of their time be it the Vietnam war or the fear of a nuclear devastation to the current zombie genre which is really about the spread of viruses – Ebola and Zika for example. The flu is a parasite so needs a host and reading about how the Spanish flu was passed on to become a pandemic reminded me of those George A Romero films (just wait for the description of Rio de Janeiro once that gets hit). It was the time of the First World War and troop movements were a significant factor in transporting the flu. Around the world it went. Fast.

With stories of how different cities coped or did not cope with the waves of flu to the quarantine measures that were put in-place by the bigger cities like New York. I found it fascinating. With that many people dying or feeling extremely unwell then services begin to falter. Spinney gives the example of Odessa that ends-up being cut-off causing food shortages and as one person passing through in 1919 remembers it as a time of ‘insanely growing expense, hunger, cold, darkness, pestilence, bribery, robbery, raids, killings’. Among these stories are those of superstitions and rituals to ward off or stop the contagion. It sometimes feels like she is talking about a medieval time but you have to pinch yourself that it was only 100 years ago.

I have my flu jab (inoculation) coming up in October (I am writing this review in September 2018) where they will inject me with this year’s strain so I will be immunized. We hear about how this method came about. The author has completed a lot of research with quotes form many publications.

I knew nothing of the Spanish flu before reading this book but now feel a lot more enlightened on the subject. I felt the last couple of chapters could have been condensed as these were nowhere near as interesting as what went before but that is not say that I did not understand their relevance.
Profile Image for Cindy Leighton.
935 reviews22 followers
November 11, 2017
Horrified to learn that Donald Trump's family got their wealthy start from an insurance policy on his German immigrant grandfather who died from the flu, his widow and son investing his life insurance in property . . . oh how the world might be different today if Donald Trump's grandfather hadn't died of the Spanish flu.

I have a strange fascination with disease history - evolving understanding about the causes, mechanisms and cures of disease - fascinating! I have read more than I would care to admit. . .
As a teacher of US History, the Spanish flu is particularly fascinating to me, and this book promised a more global and more feminised view of the flu that infected one of three people on earth in two short years. And yet. . . it was boring.

Spinney no doubt did a ton of research, and as an anthropologist I appreciate that she tries to cover the entire world (wow) and the cultural factors and impacted the spread and understanding of the flu. But by and large it felt like encyclopedic knowledge - a bit like high schoolers write when they have done a ton of research and want to make sure they include everything they know, but aren't quite sure how to organize it or even if it is all relevant (it's not).

I did find fascinating the idea that universal healthcare (and here Spinney reveals her Britishness - "many of us take free healthcare for granted today" - alas) sprung largely out of the aftermath of this huge public health catastrophe. Also enjoyed the reactions against medicine and shift toward "natural" cures and religion and chiropractors as people lost some faith in western medicine for its failure to curtail the flu (although the alternatives didn't have any better success).
Profile Image for Jonny.
126 reviews66 followers
October 4, 2018
The captains and lieutenants who died while serving with the British Army – Vera Brittain’s ‘lost generation’ – numbered around 35,000.6 But six times as many Britons died of Spanish flu, and half of those were in the prime of life – young, fit men and women whose promise also lay ahead of them. They may therefore be considered more deserving of the label ‘lost generation’, though the flu orphans, and those who were in their mother’s womb in the autumn of 1918, may lay claim to it too, for different reasons.

Not so much a history, so much as an examination of science and society's reactions to and emergence from the flu pandemic. Interesting to see examination taking into account the diseases impact on China and India, and I was impressed especially with the chapters discussing the attempts to quantify the death toll, and the attempts to pin down the elusive Patient Zero. Not the book to go for if you're looking to follow the waves of flu round the world, but very good at telling you how the virus managed to do what it did, and some interesting theories as to what the flu's effects on society were.
Profile Image for Susan O.
276 reviews97 followers
January 13, 2018
Pale Rider is a book that covers a topic that has emerged from our collective memory of WWI over the last 20 years or so. Although the flu pandemic of 1918 killed far more people than the war it is only recently that it has been talked about, written about and analyzed. In the final pages of the book, Spinney explains why we are just now beginning to understand this phenomenon - the lack of attention to the pandemic and to its wide consequences for the past, present, and future generations. We must understand it, because its underlying biology will occur again, in fact has already (in 1957 and 1968) although with less drastic consequences. If we are to be prepared we must analyze the past as well as current conditions.

Spinney does an excellent job with the global history of the pandemic as well as explaining the underlying science. I highly recommend this to anyone interested in the history of medicine, epidemiology, or social science.
Profile Image for Emma Sea.
2,184 reviews1,064 followers
October 8, 2018
The "how it changed the world" part was mostly around the development of germ theory, epidemiology, and public health. There was very, very little on lived experiences of the flu, and I don't think (?) there was anything at all on its effect on labor markets.

Not the riveting read I was expecting, but very thorough if you're into public health issues. 2.5 stars
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