The Great Influenza: The story of the deadliest pandemic in history
by John M. Barry
| New York Times Op-Ed|
GLENN: You know, honestly I don't know what to think of this swine flu. You know, maybe most likely it's absolutely nothing but, you know, you've got to pay attention to these things because it has happened before and it has been nasty. Now, most people if you've been alive, 1968 we had another pandemic. I was 4 at the time, but do you even remember reading anything about it? The one that everybody fears is 1918, the great influenza. There is a great book out called The Great Influenza: The Epic Story of the Deadliest Plague In History. Imagine this scenario in America where we just had the former Health and Human Services secretary where he said all businesses need to just have in their head some sort of a plan. What are you going to do if a third of your workforce can't come in to work? That sounds crazy. I don't know how you how does anything survive if that's the way it is? John Barry is with us. He is the author of the Great Influenza: The Epic Story of the Deadliest Plague In History and fantastic book. John, set the scene a little bit on what was happening in America right as the plague hit. How did this manifest itself and what happened?
BARRY: Well, for us it hit right toward the end of World War I, although people did not realize it was, the end of the war was only weeks away. So because we were at war, the government was so concerned with, quote, morale, unquote, politicians didn't want to say anything bad is happening, but that compounded it. In addition they had a law on the books that made it punishable by 20 years in prison to criticize the government.
GLENN: Right. If I'm not mistaken, to even criticize the president. By the way, if you are a fan of this show, you can guess what president it was. It was Woodrow Wilson. And so this played into people being quiet about the flu? They couldn't speak out?
BARRY: Absolutely. In fact, when one newspaper started to tell the truth about the flu, the army started to prosecute, and they were serious about the war. They sent a United States congressman to jail for 15 years for criticizing the government. But that's the setting, and the reason it's important is because the whole approach of both local and national government almost everywhere was to say what they actually said, it was called Spanish flu. And they said, this is ordinary influenza by another name. You have nothing to worry about if proper precautions are taken. But people are hearing this message but in their homes they are seeing their neighbor or spouse dies 24 hours after the first symptoms with horrific symptoms. Probably the scariest would be bleeding from not just nose and mouth but the eyes and ears. And they very quickly know this is not ordinary influenza and they very quickly lose all trust in any authority. And personally I think society is based essentially on trust. That's the bond. And when trust broke down, society in some places started to disintegrate to the extent that people with influenza were dying of starvation because healthy people were afraid to bring them any food. And I think that was a direct result of what today we would call bad risk communication strategies, unquote. And worldwide i n a population only one third as big as today's, 50 million people probably died at least and possibly 100 million. And that number comes from a Nobel Prize winner. So that was a very scary pandemic. But I think let me make a couple of comments about today. First, this is not the swine flu of 1976. There is absolutely no question this is an extremely serious threat right now
GLENN: Wait, wait, wait. John, why do you say that? Why do you say that?
BARRY: Because of the nature of the virus. Because we have you know, it's in New Zealand and Nova Scotia. It clearly has human to human transmission. The 1976 event was limited to a single locality really under special circumstances. Everyone they were army recruits, they were already stressed, weakened immune systems, they were all together, barrack situation, so forth, and
GLENN: And it never left Fort Dix if I understand.
BARRY: That's the point, whereas this has already gotten all over the world and infected I don't know the case count in Mexico, nobody does. But I would guess it is at least ten times and it could easily be many more than ten times the number of cases that are reported.
GLENN: Well, how many what are they saying? There's 100 dead and I think they are saying there's 1600 cases. If so, that makes it extremely virulent, much more virulent than anything that we saw in 1976.
BARRY: That's true, I wouldn't get too concerned about that. I am dead certain
GLENN: That's what you are saying, there are many more cases out there that aren't dying.
BARRY: Exactly. You know, if you've got 100 dead and there are 100,000 cases, that is still something to be concerned about, but it's not the same and I don't know if there are 100,000 cases but I can guarantee you there are more than 10,000 cases.
GLENN: Well, if I'm not mistaken, and you would know, that in the great influenza, it was about 2% mortality rate.
BARRY: In the west. In the west, in the developed world. In the less developed world it got much higher. I mean, there were and the reason, and your readers may be interested, today's there's an op ed in today's New York Times that I wrote that covers background on the four pandemics that we really know something about in detail. There were isolated places in the world where they had probably, people had never seen any influenza virus whatsoever in their lives. So they were extremely vulnerable to it. Their immune systems couldn't protect them. And in those places it was not unusual to see 30% of the entire population dead, whereas in the developed world where ordinary everyday influenza was, you know, an annual occurrence, so they had some cross protection to this new virus, that's where the case mortality was around 2%. Now, interestingly Mexico was sort of in between the worst case and the developed world. You know, obviously Mexico City is a very different place today than it was in 1918, but it is perhaps worth noting that the mortality rate in Mexico was much higher than the United States.