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January 9 - January 31, 2021
Influenza did visit the peace conference. Influenza did strike Wilson. Influenza did weaken him physically, and—precisely at the most crucial point of negotiations—influenza did at the least drain from him stamina and the ability to concentrate.
Historians with virtual unanimity agree that the harshness toward Germany of the Paris peace treaty helped create the economic hardship, nationalistic reaction, and political chaos that fostered the rise of Adolf Hitler.
By February 7, 1920, influenza had returned with enough ferocity that the Red Cross declared, “Owing to the rapid spread of influenza, the safety of the country demands, as a patriotic duty, that all available nurses or anyone with experience in nursing, communicate with the nearest Red Cross chapters or special local epidemic committees, offering their services.”
The year 1920 would see either (sources differ) the second or third most deaths from influenza and pneumonia in the twentieth century. And it continued to strike cities sporadically.
Only in the next few years did it finally fade away in both the United States and the world. It did not disappear. It continued to attack, but with far less virulence, partly because the virus mutated further toward its mean, toward the behavior of most influenza viruses, partly because people’s immune systems adjusted.
“the influenza epidemic not only caused the deaths of some six hundred thousand people, but it also left a trail of lowered vitality . . . nervous breakdown, and other sequella [sic] which now threaten thousands of people. It left widows and orphans and dependent old people. It has reduced many of these families to poverty and acute distress. This havoc is wide spread, reaching all parts of the United States and all classes of people.”
The disease has survived in memory more than in any literature. Nearly
The writers of the 1920s had little to say about it.
People write about war. They write about the Holocaust. They write about horrors that people inflict on people. Apparently they forget the horrors that nature inflicts on people, the horrors that make humans least significant.
those with power blamed the poor for their own suffering, and sometimes tried to stigmatize and isolate them.
Those in power, historians have observed, often sought security in imposing order, which gave them some feeling of control, some feeling that the world still made sense.
despite such occasional harshness, the 1918 influenza pandemic did not in general demonstrate a pattern of race or class antagonism. In epidemiological terms there was a correlation between population density and hence class and deaths, but
The disease was too universal, too obviously not tied to race or class.
It is impossible to quantify how many young men died because the army refused to follow the advice of its own surgeon general.
while those in authority were reassuring people that this was influenza, only influenza, nothing different from ordinary “la grippe,” at least some people must have believed them, at least some people must have exposed themselves to the virus in ways they would not have otherwise, and at least some of these people must have died who would otherwise have lived. And fear really did kill people. It killed them because those who feared would not care for many of those who needed but could not find care, those who needed only hydration, food, and rest to survive.
impossible to state with any accuracy the death toll.
The few places in the world that then kept reliable vital statistics under normal circumstances could not keep pace with the disease.
Record keeping had low priority, and even in the aftermath little effort was made to compile accurate numbers.
The first significant attempt to quantify the death toll came in 1927. An American Medical Association–sponsored study estimated that 21 million died. When today’s media refers to a death toll of “more than 20 million” in stories on the 1918 pandemic, the source is this study. But every revision of the deaths since 1927 has been upward.
in 2002 an epidemiological study reviewed the data and concluded that the death toll was “in the order of 50 million, . . . [but] even this vast figure may be substantially lower than the real toll.” In fact, like Burnet, it suggested that as many as 100 million died.
in excess of 5 percent of the people in the world died.
In a normal influenza epidemic, 10 percent or fewer of the deaths fall among those aged between sixteen and forty. In 1918 that age group, the men and women with most vitality, most to live for, most of a future, accounted for more than half the death toll,
Around the world, authorities made plans for international cooperation on health,
led to restructuring public health efforts throughout the United States.
emergency hospitals were transformed into permanent ones.
the disease left its chief legacy in the laboratory.
They also recognized their failures. They had lost their illusions. They had entered the first decades of the twentieth century confident that science, even if its victories remained limited, would triumph. Now Victor Vaughan told a colleague, “Never again allow me to say that medical science is on the verge of conquering disease.”
But they had not quit. Now this scientific brotherhood was beginning its hunt. It would take longer than they knew.
So far each laboratory had been working in isolation, barely communicating with the others.
On October 30, 1918, with the epidemic on the East Coast fading to manageable proportions, Hermann Biggs organized an influenza commission of leading scientists.
They knew so little. So little. They knew only that isolation worked.
they ended with agreement. They agreed on lines of approach, on the work that needed to be done. Only on that—in effect on how little they knew—they could agree.
They intended to proceed down two paths: one exploring the epidemiology of the disease, the other tracing clues in the laboratory.
Gorgas had had one goal: to make this war the first one in American history in which battle killed more troops than disease. Even with one out of every sixty-seven soldiers in the army dying of influenza, and although his superiors largely ignored his advice, he just barely succeeded—although when navy casualties and influenza deaths were added to the totals, deaths from disease did exceed combat deaths.
Now two million men were returning from Europe. After other wars, even in the late nineteenth century, returning troops had carried diseases home.
One of Gorgas’s last acts was to set in motion plans to prevent any such happenings this time. Soldiers were kept isolated for seven days before they boarded ships home, and were deloused before embarking. Soldiers would be bringing no disease home.
Slowly, over a period of months, a body of knowledge began to form.
The elderly, normally the group most susceptible to influenza, not only survived attacks of the disease but were attacked far less often. This resistance of the elderly was a worldwide phenomenon. The most likely explanation is that an earlier pandemic (later analysis of antibodies proved it was not the 1889–90 one), so mild as to not attract attention, resembled the 1918 virus closely enough that it provided protection.
In the laboratory, however, the fog remained dense. The pathogen remained unknown. Enormous resources were being poured into this research everywhere.
THE GREATEST QUESTIONS remained the simplest ones: What caused influenza? What was the pathogen? Was Pfeiffer right when he identified a cause and named it Bacillus influenzae? And if he was not right, then what did cause it? What was the killer?
reports created increasing doubt about the Pfeiffer’s influenza bacillus. Scientists did not doubt the word of those who found it. They did not doubt that the bacillus could cause disease and kill. But they began to doubt what finding it proved.
For a decade scientists had tried to make vaccine and antiserum for Pfeiffer’s influenza bacillus. Flexner himself had tried soon after Lewis left the institute. No one had succeeded.
As they explored Pfeiffer’s further, they became more and more convinced that B. influenzae similarly included dozens of strains, each different enough that an immune serum that worked against one would not work against the others. In fact, Williams found “ten different strains in ten different cases.”
The influenza bacillus, they now said, did not cause influenza.
since this particular organism is by no means always present it seems that the evidence is very weak. Indeed, it appears probable that some other form of living virus not recognizable by our microscopic methods of staining, and not to be isolated or cultivated by methods currently in use, must be the cause of the epidemic.”
He extracted from the mold the substance that stopped the bacteria and called it “penicillin.” Fleming found that penicillin killed staphylococcus, hemolytic streptococcus, pneumococcus, gonococcus, diphtheria bacilli, and other bacteria, but it did no harm to the influenza bacillus. He did not try to develop penicillin into a medicine.
findings and in April informed the institute’s Board of Scientific Directors. His findings would revolutionize all biology,
Avery had found that the substance that transformed a pneumococcus from one without a capsule to one with a capsule was DNA. Once the pneumococcus changed, its progeny inherited the change. He had demonstrated that DNA carried genetic information, that genes lay within DNA.
Avery’s experiments strongly suggested that future experiments would show that all genes were composed of DNA.
“Avery gave us the first text of a new language, or rather he showed us where to look for it. I resolved to search for this text.”
