The Great Influenza Of 1918: Learning Lessons As We Confront Epidemics

Magisterial in its breadth of perspective and depth of research, The Great Influenza by John M. Barry provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. As  Barry concludes, “The final lesson of 1918, a simple one yet one most difficult to execute, is 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. A leader must make whatever horror exists concrete. Only then will people be able to break it apart.”

At the height of World War I, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease.

Here are the excerpts from “The Great Influenza”:

“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.

The lowest estimate of the pandemic’s worldwide death toll is
twentyone million, in a world with a population less than one-third today’s.
That estimate comes from a contemporary study of the disease and
newspapers have often cited it since, but it is almost certainly wrong.
Epidemiologists today estimate that influenza likely caused at least
fifty million deaths worldwide, and possibly as many as one hundred million.

Yet even that number understates the horror of the disease, a horror
contained in other data. Normally influenza chiefly kills the elderly and
infants, but in the 1918 pandemic roughly half of those who died were
young men and women in the prime of their life, in their twenties and
thirties. Harvey Cushing, then a brilliant young surgeon who would go
on to great fame—and who himself fell desperately ill with influenza and
never fully recovered from what was likely a complication—would call
these victims “doubly dead in that they died so young.”
One cannot know with certainty, but if the upper estimate of the
death toll is true as many as 8 to 10 percent of all young adults then living may
have been killed by the virus.

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 1918. 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.
The influenza pandemic resembled both of those scourges in other
ways also. Like AIDS, it killed those with the most to live for. And as
priests had done in the bubonic plague, in 1918, even in Philadelphia, as
modern a city as existed in the world, priests would drive horse-drawn
wagons down the streets, calling upon those behind doors shut tight in
terror to bring out their dead.

Yet the story of the 1918 influenza virus is not simply one of havoc, death,
and desolation, of a society fighting a war against nature superimposed
on a war against another human society.

It is also a story of science, of discovery, of how one thinks, and of how
one changes the way one thinks, of how amidst near-utter chaos a few
men sought the coolness of contemplation, the utter calm that precedes
not philosophizing but grim, determined action.

For the influenza pandemic that erupted in 1918 was the first great
collision between nature and modern science. 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.”

(The book ‘The Great Influenza” by John M  Barry is available at all major online platforms including


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