Spanish Flu Quotes

Me: Not happening. Him: How bout tmrw night? I’m free at eight. Me: Can’t. I have the Spanish Flu. Highly contagious. I just saved your life, dude. Him: Aw, I appreciate the concern. But I’m immune to pandemics that wiped out 40-mil ppl from 1918 to 1919. Me: How is it u know so much about pandemics? Him: I’m a history major, baby. I know tons of useless facts.

My platitudes don't hold their interest and I can hardly blame them for that. My real stories are all out of date. So what if I can speak firsthand about the Spanish flu, the advent of the automobile, world wars, cold wars, guerrilla wars, and Sputnik — that's all ancient history now. But what else do I have to offer? Nothing happens to me anymore. That's the reality of getting old, and I guess that's really the crux of the matter. I'm not ready to be old yet.

It's not Americans I find annoying; it's Americanism: a social disease of the postindustrial world that must inevitably infect each of the mercantile nations in turn, and is called 'American' only because your nation is the most advanced case of the malady, much as one speaks of Spanish flu, or Japanese Type-B encephalitis. It's symptoms are a loss of work ethic, a shrinking of inner resources, and a constant need for external stimulation, followed by spiritual decay and moral narcosis. You can recognize the victim by his constant efforts to get in touch with himself, to believe his spiritual feebleness is an interesting psychological warp, to construe his fleeing from responsibility as evidence that he and his life are uniquely open to new experiences. In the later stages, the sufferer is reduced to seeking that most trivial of human activities: fun.

What the Spanish flu taught us, in essence, is that another flu pandemic is inevitable, but whether it kills 10 million or 100 million will be determined by the world into which it emerges.

The Spanish flu is remembered personally, not collectively. Not as a historical disaster, but as millions of discrete, private tragedies.

By the time the Spanish flu had completed its cycle, there was nobody in Linares who had not lost someone, so there was no one to ease the sorrow of others with their condolences.

The fact is,” he says, “we are really no better prepared for a bad outbreak today than we were when Spanish flu killed tens of millions of people a hundred years ago. The reason we haven’t had another experience like that isn’t because we have been especially vigilant. It’s because we have been lucky.

The Spanish Influenza did not originate in Spain. In fact the first recorded case was in the United States, in Kansas, on March 9th, 1918. Beware the Ides of March. But because Spain was neutral in World War I, it did not sensor reports of the disease to the public. To tell the truth then, is to risk being remembered by its fiction. Countless countries laid blame to one another. What the US called the Spanish Influenza, Spain called the French Flu, or the Naples Soldier. What Germans dubbed the Russian Pest, the Russians called Chinese Flu.

The COVID-19 pandemic reminded us of how life was before vaccinations.

When asked what was the biggest disaster of the twentieth century, almost nobody answers the Spanish flu.

Your best chance of survival was to be utterly selfish.

Most of the death occurred in the thirteen weeks between mid-September and mid-December 1918. It was broad in space and shallow in time, compared to a narrow, deep war.

It was the greatest tidal wave of death since the Black Death, perhaps in the whole of human history.

After all, the girl actually had faith in something, which was more than most people had in these dark times. It was wrong to destroy it.

For flu to spread, therefore, people must live fairly close together.

that density–collectively called ‘social distancing’–can both bring it to an end sooner, and reduce the number of casualties.

Schools, theatres and places of worship were closed, the use of public transport systems was restricted and mass gatherings were banned.

In August the flu returned transformed. This was the second and most lethal wave of the pandemic, and again by

During World War I, forty thousand American soldiers were killed by Spanish flu. For perspective, that’s only seven thousand fewer American soldiers than were killed in combat in Vietnam.

First discovered in Kansas in March 1918, by the time the H1N1 pandemic, commonly known as the Spanish flu, burned out in 1919, it took the lives of as many as fifty million people worldwide.

To try to prevent some of these problems, in 2015 the World Health Organization issued guidelines stipulating that disease names should not make reference to specific places, people, animals or food.

We chose to destroy the human population because it took us less than three seconds to conclude that humanity is a virus that mutates over time and becomes stronger. Many vaccines have come along to try and cure Earth of humanity. Virtuous pandemics: the plague of Athens, the Black Death, smallpox, cholera, Spanish flu, tuberculosis, malaria, yellow fever, Ebola, Zika, and a thousand more. Humanity survives, adapts, grows stronger, multiplies, and continues to wreak havoc on this planet and all other species that inhabit it. Humans are programmed to mate with partners of differing immune systems so that their offspring can be stronger than them. You seek immortality through evolution, yet you annihilate everything in your path. Humanity is cancer, humanity is bacteria, humanity is disease, and you need to be destroyed.

What Casanova’s finding meant was that, regardless of their culture, diet, social status or income, one in 10,000 people are particularly vulnerable to flu–a vulnerability that they inherit from their parents.

However, as bad as things were, the worst was yet to come, for germs would kill more people than bullets. By the time that last fever broke and the last quarantine sign came down, the world had lost 3-5% of its population.

The naming of a virus is a controversial matter. In 1832, cholera advanced from British India toward Europe. It was called ‘Asiatic Cholera’. The French felt that since they were democratic, they would not succumb to a disease of authoritarianism; but France was ravaged by cholera, which was as much about the bacteria as it is about the state of hygiene inside Europe and North America. (When cholera struck the United States in 1848, the Public Bathing Movement was born.) The ‘Spanish Flu’ was only named after Spain because it came during World War I when journalism in most belligerent countries was censored. The media in Spain, not being in the war, widely reported the flu, and so that pandemic took the name of the country. In fact, evidence showed that the Spanish Flu began in the United States in a military base in Kansas where the chickens transmitted the virus to soldiers. It would then travel to British India, where 60 percent of the casualties of that pandemic took place. It was never named the ‘American Flu’ and no Indian government has ever sought to recover costs from the United States because of the animal-to-human transmission that happened there.

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–a range that reflects the uncertainty that still surrounds it.

When we’re really old, people in the future will interview us, because we lived through one of the biggest events in human history. Like the Spanish flu of 1918 that killed over 50 million people. Or the great depression. Or Pompeii. Or the Titanic.

Cordon sanitaire. Isolation. Quarantine. These are age-old concepts that human beings have been putting into practice since long before they understood the nature of the agents of contagion, long before they even considered epidemics to be acts of God. In fact, we may have had strategies for distancing ourselves from sources of infection since before we were strictly human.

The Swiss-born architect known as Le Corbusier retreated to his rooms in Paris and sipped cognac and smoked through the worst of the pandemic, while cogitating on how to revolutionise the way people lived (though he hadn’t even a diploma in architecture).

And although better coverage of the outbreak’s evolution in the press couldn’t have stopped the influenza virus, a single newspaper headline in Philadelphia saying “Don’t Go to Any Parades; for the Love of God Cancel Your Stupid Parade” could have saved hundreds of lives. It would have done a lot more than those telling people, “Don’t Get Scared!” Telling people that things are fine is not the same as making them fine. This failure is in the past. Journalists and editors had their reasons. Risking jail time is no joke. But learning from this breakdown in truth-telling is important because the fourth estate can’t fail again. We are fortunate today to have organizations like the Centers for Disease Control and Prevention and the World Health Organization that track how diseases are progressing and report these findings. In the event of an outbreak similar to the Spanish flu, they will be wonderful resources. I hope we’ll be similarly lucky to have journalists who will be able to share necessary information with the public. The public is at its strongest when it is well informed. Despite Lippmann’s claims to the contrary, we are smart, and we are good, and we are always stronger when we work together. If there is a next time, it would be very much to our benefit to remember that.

One 2007 study showed that public health measures such as banning mass gatherings and imposing the wearing of masks collectively cut the death toll in some American cities by up to 50 per cent (the US was much better at imposing such measures than Europe). The timing of the measures was critical, however. They had to be introduced early, and kept in place until after the danger had passed. If they were lifted too soon, the virus was presented with a fresh supply of immunologically naive hosts, and the city experienced a second peak of death.9

At least etymologically speaking, when we talk about influenza we are talking about the influences that shape the world everywhere at once. Today’s bird flu or swine flu viruses or the 1918 Spanish flu virus are not the real influenza — not the underlying influence — but only its symptom.

Assuming that you had a place you could call home, the optimal strategy was to stay there (but not immure yourself), not answer the door (especially to doctors), jealously guard your hoard of food and water, and ignore all pleas for help. Not only would this improve your own chances of staying alive, but if everyone did it, the density of susceptible individuals would soon fall below the threshold required to sustain the epidemic, and it would extinguish itself.

The Greek word “nostalgia” derives from the root nostros, meaning “return home,” and algia, meaning “longing.” Doctors in seventeenth-century Europe considered nostalgia an illness, like the flu, mainly suffered by displaced migrant servants, soldiers, and job seekers, and curable through opium, leeches, or, for the affluent, a journey to the Swiss Alps. Throughout time, such feeling has been widely acknowledged. The Portuguese have the term saudade. The Russians have toska. The Czechs have litost. Others too name the feeling: for Romanians, it’s dor, for Germans, it’s heimweh. The Welsh have hiraeth, the Spanish mal de corazon. Many

There was the plague of Athens in 430 BCE. The plague of Justinian in 541 CE. The Black Death in 1347. The Spanish flu in 1918. There were gods of plagues in ancient times—not only the Greek god Apollo, but the Vedic god Rudra and the Chinese deity Shi Wenye. Plague is an old, familiar enemy. And so, in 2020, a plague once again appeared.

Wars, too, brought epidemics in their wake. Conflict makes people hungry and anxious; it uproots them, packs them into insanitary camps and requisitions their doctors.

It makes them vulnerable to infection, and then it sets large numbers of them in motion so that they can carry that infection to new places.

The tubercular Franz Kafka caught it in Prague on 14 October and, confined to his sickbed, witnessed the collapse of the Austro-Hungarian Empire from his window.

Memory is an active process. Details have to be rehearsed to be retained,

The bubonic form is characterised by telltale ‘buboes’, when lymph nodes swell painfully; the septicaemic form arises from an infection of the

strategies have to be imposed in a top-down fashion. But

Stay Home!

he took three potentially life-saving decisions. First, he eliminated rush hour by staggering the opening times of factories, shops and cinemas. Second, he established a clearing-house system under which 150 emergency health centres were set up across the city to coordinate the care and reporting of the sick. And third and most controversially, he kept the schools open.12

Despite the name, Spanish flu struck the entire world — that’s what made it a pandemic instead of simply an epidemic. It was not the first influenza pandemic, nor the most recent (1957 and 1968 also saw pandemics), but it was by far the most deadly. Whereas AIDS took roughly twenty-four years to kill 24 million people, the Spanish flu killed as many in twenty- four weeks.

Against other things it is possible to obtain security,’ wrote the Greek philosopher Epicurus in the third century BC, ‘but when it comes to death we human beings all live in an unwalled city.

Medical science had little to offer in the way of prevention or cure, apart from the process of disinfection, notification and isolation as recommended by Dr Niven. There was little consensus on treatment apart from the traditional recourse to bed rest, opiates and folk remedies, while to make matters worse, significant individuals refused to take the threat of Spanish flu seriously.

virus, a single newspaper headline in Philadelphia saying “Don’t Go to Any Parades; for the Love of God Cancel Your Stupid Parade” could have saved hundreds of lives. It would have done a lot more than those telling people, “Don’t Get Scared!” Telling people that things are fine is not the same as making them fine. This failure is in the past. Journalists and editors had their reasons. Risking jail time is no joke. But learning from this breakdown in truth-telling is important because the fourth estate can’t fail again. We are fortunate today to have organizations like the Centers for Disease Control and Prevention and the World Health Organization that track how diseases are progressing and report these findings. In the event of an outbreak similar to the Spanish flu, they will be wonderful resources. I hope we’ll be similarly lucky to have journalists who will be able to share necessary information with the public. The public is at its strongest when it is well informed. Despite Lippmann’s claims to the contrary, we are smart, and we are good, and we are always stronger when we work together. If there is a next time, it would be very much to our benefit to remember that.

It is often said that the First World War killed Romanticism and faith in progress, but if science facilitated industrial-scale slaughter in the form of the war, it also failed to prevent it in the form of the Spanish flu. The flu resculpted human populations more radically than anything since the Black Death. It influenced the course of the First World War and, arguably, contributed to the Second. It pushed India closer to independence, South Africa closer to apartheid, and Switzerland to the brink of civil war. It ushered in universal healthcare and alternative medicine, our love of fresh air and our passion for sport, and it was probably responsible, at least in part, for the obsession of twentieth-century artists with all the myriad ways in which the human body can fail. ‘Arguably

In the 2017–18 flu season, to take one recent example, people who had been vaccinated were only 36 percent less likely to get flu than those who hadn’t been vaccinated. In consequence, it was a bad year for flu in America, with a death toll estimated at eighty thousand. In the event of a really catastrophic epidemic—one that killed children or young adults in large numbers, say—Kinch believes we wouldn’t be able to produce vaccine fast enough to treat everyone, even if the vaccine was effective. “The fact is,” he says, “we are really no better prepared for a bad outbreak today than we were when Spanish flu killed tens of millions of people a hundred years ago. The reason we haven’t had another experience like that isn’t because we have been especially vigilant. It’s because we have been lucky.

Live every day as if you might be struck blind--that was the rule I made for myself now. In those first few days after the quarantine was lifted, we went around marveling at the smallest things, as if the Spanish flu had rendered us all blind & we'd suddenly gained our sight again. Every detail seemed suddenly as sharp as if seen for the first time. Life returned to SF, and it had never been more precious.

Whereas in March 1520, when the Spanish fleet arrived, Mexico was home to 22 million people, by December only 14 million were still alive. Smallpox was only the first blow. While the new Spanish masters were busy enriching themselves and exploiting the natives, deadly waves of flu, measles and other infectious diseases struck Mexico one after the other, until in 1580 its population was down to less than 2 million.8

Whereas a benign, seasonal virus produced a transient cytokine response and localised, superficial damage to the lung, the 1918 variety produced a strong, prolonged cytokine response and damage that was severe and deep.

An epidemic will run its course and vanish on its own, without intervention, but measures that reduce that density–collectively called ‘social distancing’–can both bring it to an end sooner, and reduce the number of casualties.

cities now became breeding grounds for crowd diseases, such that urban populations were unable to sustain themselves–they needed a constant influx of healthy peasants from the countryside to make up for the lives lost to infection.

least 40 million people died as a result of the epidemic, the majority of them suffocated by a lethal accumulation of blood and other fluid in the lungs. Ironically, unlike most flu epidemics, but like the war that preceded and spread it, the influenza of 1918 disproportionately killed young adults. One in every hundred American males between the ages of 25 and 34 fell victim to the ‘Spanish Lady’. Strikingly, the global peak of mortality was in October and November 1918.

It had long been assumed that school-age children represented ideal vectors of infection, because they are among the preferred victims of seasonal flu, they meet and mingle on a daily basis, and their snot control has a tendency to be suboptimal.

Upon the death from flu of one German immigrant to America, for example, his widow and son received a sum of money. They invested it in property, and today the immigrant’s grandson is a property magnate purportedly worth billions. His name is Donald Trump.

The Oreo cookie invented, the Titanic sinks, Spanish flu, Prohibition, women granted the right to vote, Lindbergh flies solo across the Atlantic, penicillin invented, stock market crashes, the Depression, Amelia Earhart, the atom is split, Prohibition ends, Golden Gate Bridge is built, Pearl Harbor, D-Day, the Korean War, Disneyland, Rosa Parks, Laika the dog is shot into space, hula hoops, birth control pill invented, Bay of Pigs, Marilyn Monroe dies, JFK killed, MLK has a dream, Vietnam War, Star Trek, MLK killed, RFK killed, Woodstock, the Beatles (George, Ringo, John, and Paul) break up, Watergate, the Vietnam War ends, Nixon resigns, Earth Day, Fiddler on the Roof, Olga Korbut, Patty Hearst, Transcendental Meditation, the ERA, The Six Million Dollar Man. "Bloody hell," I said when she was done. "I know. It must be a lot to take in." "It's unfathomable. A Brit named his son Ringo Starr?" She looked pleasantly surprised: she'd thought I had no sense of humor. "Well, I think his real name was Richard Starkey.

It's just my luck,” he said gloomily. “It's the kind of thing that couldn't happen to anyone but me. Damned fools! Where's the sense in shutting the theatres, even if there is influenza about? They let people jam against one another all day in the stores. If that doesn't hurt them why should it hurt them to go to theatres? Besides, it's all infernal nonsense about this thing. I don't believe there is such a thing as Spanish influenza. People get colds in their heads and think they're dying. It's all a fake scare.

The scale of the misery was so vast in America — as elsewhere — that I find it impossible to understand why I didn’t learn more about it in school, or through memorials or stories. As many as twenty thousand Americans died in a week during the height of the Spanish flu. Steam shovels were used to dig mass graves. Health authorities today fear precisely such an event. Many insist that a pandemic based on the H5N1 virus strain is inevitable, and the question is really one of when it will strike and, most important, just how severe it will be.

One 2007 study showed that public health measures such as banning mass gatherings and imposing the wearing of masks collectively cut the death toll in some American cities by up to 50 per cent (the US was much better at imposing such measures than Europe). The timing of the measures was critical, however. They had to be introduced early, and kept in place until after the danger had passed. If they were lifted too soon, the virus was presented with a fresh supply of immunologically naive hosts, and the city experienced a second peak of death.

Blue darkened to black. The black first appeared at the extremities–the hands and feet, including the nails–stole up the limbs and eventually infused the abdomen and torso. As long as you were conscious, therefore, you watched death enter at your fingertips and fill you up.

In many ways, it is hard for modern people living in First World countries to conceive of a pandemic sweeping around the world and killing millions of people, and it is even harder to believe that something as common as influenza could cause such widespread illness and death.

They say that those who do not learn from history are doomed to repeat it. Since Americans spent centuries failing to learn from history, we get to repeat it all at once. The year is 2021 and we are living through simultaneous revivals of the worst of the American past: the Civil War, the Spanish Flu, the white mob violence of the 1919 Red Summer, the extreme wealth disparity of the Gilded Age, the fascist movements of the 1930s and 1940s, the Jim Crow era of voter suppression, the riots of the 1960s, the corruption of Watergate, the cover-ups of Iran-Contra.

The new collectives that farming supported gave rise to new diseases–the so-called ‘crowd diseases’ such as measles, smallpox, tuberculosis and influenza. Humans had always been susceptible to infectious disease–leprosy and malaria were causing misery long before the farming revolution–but these were adapted to surviving in small, dispersed human populations. Among their tricks for doing so were not conferring total immunity on a recovered host, so that he or she could be infected again, and retreating to another host–a so-called ‘animal reservoir’–when humans were scarce. Both strategies helped ensure that they maintained a sufficiently large pool of susceptible hosts.

The world’s last great pandemic was the Spanish flu outbreak in 1918 that killed a hundred million people—about 5 percent of the world’s population. If a pandemic like that were to happen again, it would spread faster and might be impossible to contain. According to the Bill & Melinda Gates Foundation, in such a pandemic “the death toll could reach 360 million”—even with the full deployment of vaccines and powerful modern drugs. The Gates Foundation estimated that the pandemic would also devastate the world financially, precipitating a three-trillion-dollar economic collapse. This is not scaremongering: Most epidemiologists believe such a pandemic will eventually happen.

That’s the way of the colonizers. They divvied their arts up so much that they were left with nothing but ashes, and when even that started to fail, they combined alchemy and science into Mechomancy, hardly requiring any art at all. But the mystical arts have been around far longer than their machines and constructs. The Possibilities will always balance out, somehow, some way. And when the reaction is powerful enough—” “You get the Great Rust,” the Skylark says. Miss Fox nods. “Or the Spanish flu. Or the Johnstown floods. Really, this land has been telling folks for a while to get their business in order, and we just keep on legislating nature, as if the Possibilities care what a bunch of men in some building in Washington have to say about them.

Experience has shown that people have a low tolerance for mandatory health measures, and that such measures are most effective when they are voluntary, when they respect and depend on individual choice, and when they avoid the use of police powers. In 2007, the CDC issued guidelines for how to ensure maximum compliance with public health measures in a pandemic. Based partly on lessons learned in 1918, these recommended that measures only be made mandatory when the proportion of the sick who die rises above 1 per cent (remember that this proportion was at least 2.5 per cent for the Spanish flu). Using 2016 numbers, that means that more than 3 million Americans would have to die before the CDC would advise such a step – a measure of how counterproductive that organisation believes compulsion to be.

It was a fascinating hint that flu might have a heritable component, but other studies failed to replicate the finding. Then in January 2011, in the midst of the annual flu season in France, a two-year-old girl was admitted to the intensive care unit of the Necker Hospital for Sick Children in Paris, suffering from ARDS (acute respiratory distress syndrome). Doctors saved her life, and one of them, Jean-Laurent Casanova, sequenced her genome. He wanted to know if it held the key to why an otherwise healthy child had nearly died of a disease that most children shrug off. It turned out that the girl had inherited a genetic defect that meant she was unable to produce interferon, that all-important first-line defence against viruses. As a result, her besieged immune system went straight to plan B: a massive inflammatory response similar to the one pathologists saw in 1918.

They say that those who do not learn from history are doomed to repeat it. Since Americans spent centuries failing to learn from history, we get to repeat it all at once. The year is 2021 and we are living through simultaneous revivals of the worst of the American past: the Civil War, the Spanish Flu, the white mob violence of the 1919 Red Summer, the extreme wealth disparity of the Gilded Age, the fascist movements of the 1930s and 1940s, the Jim Crow era of voter suppression, the riots of the 1960s, the corruption of Watergate, the cover-ups of Iran-Contra. In August 2021, Hurricane Ida made landfall in Louisiana on the anniversary of Hurricane Katrina. One month before the twentieth anniversary of 9/11, the Taliban retook Afghanistan dressed in US military uniforms abandoned in the hasty retreat from the quagmire war. It’s like America is on its deathbed, watching its life flash before its eyes.

in a letter to the New York Times, Dr. Hans Neumann from the New Haven Department of Health noted that based on the projected scale of the immunizations, within two days of getting a flu shot, about 2,300 people would have a stroke and 7,000 would have a heart attack. “Why?” he asked. “Because that is the number statistically expected, flu shots or no flu shots.” Likewise, in the week following a flu vaccine, another 9,000 people would contract pneumonia, of whom 900 would die. These would certainly occur after a flu shot, but not as a consequence of it. “Yet,” wrote Neumann, “can one expect a person who received a flu shot at noon and who that same night had a stroke not to associate somehow the two in his mind?” Grandma got the flu vaccine in the morning, and she was dead in the afternoon. Although association does not equal causation, this thinking could lead to a public backlash against vaccinations that would threaten future programs.

Military history teaches us, contrary to popular belief, that wars are not necessarily the most costly of human calamities. The allied coalition lost few lives in getting Saddam out of Kuwait during the Gulf War of 1991, yet doing nothing in Rwanda allowed savage gangs and militias to murder hundreds of thousands with impunity. Bill Clinton stopped a Balkan holocaust through air strikes, without sacrificing American soldiers. His supporters argued, with some merit, that the collateral damage from the NATO bombing of Belgrade resulted in far fewer innocents killed, in such a “terrible arithmetic,” than if the Serbian death squads had been allowed to continue their unchecked cleansing of Islamic communities. Hitler, Mao, Pol Pot, and Stalin killed far more off the battlefield than on it. The 1918 Spanish flu epidemic brought down more people than did the First World War. And more Americans—over 3.2 million—lost their lives driving cars over the past 90 years than died in combat in this nation’s 230-plus-year history.

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 (but not immure yourself), not answer the door (especially to doctors), jealously guard your hoard of food and water, and ignore all pleas for help. Not only would this improve your own chances of staying alive, but if everyone did it, the density of susceptible individuals would soon fall below the threshold required to sustain the epidemic, and it would extinguish itself.

In a future flu pandemic, health authorities will introduce containment measures such as quarantine, school closures and prohibitions on mass gatherings. These will be for our collective benefit, so how do we ensure that everyone complies? How, too, do we persuade people to get vaccinated each year, given that herd immunity is the best protection we have against a flu pandemic? Experience has shown that people have a low tolerance for mandatory health measures, and that such measures are most effective when they are voluntary, when they respect and depend on individual choice, and when they avoid the use of police powers.

Edilio lay on the steps of town hall feeling as weak as a kitten. He had barely heard Caine’s big speech. He couldn’t have cared less. There was nothing he could do, not with delirium spinning his head. He coughed hard, too hard. It wracked his body each time he did it so that he dreaded the next cough. His stomach was clenched in knots. Every muscle in his body ached. He was vaguely aware that he was saying something in between coughs. “Mamá. Mamá. Sálvame.” Save me, mother. “Santa María, sálvame,” he begged, and coughed so hard he smashed his head against the steps. Death was near, he felt it. Death reached through his swimming, disordered mind and he felt its cold hand clutching his heart. Santa María, Madre de Dios, ruega por nosotros pecadores, ahora y en la hora de nuestra muerte.

To a large degree, the extent of the devastation that the flu caused on American cities depended on how they reacted to it. Those that took prompt action and made good choices had more limited devastation than others.

The natural reservoir of influenza is generally considered to be birds, especially waterbirds. The big giveaway that a certain species plays the role of reservoir for a certain pathogen is that it doesn’t get sick from it.

I have dwelt at length on famines because they offer such an outstanding example of British colonial malfeasance. One could have cited epidemic disease as well, which constantly laid Indians low under British rule while the authorities stood helplessly by. To take just the first four years of the twentieth century, as Durant did: 272,000 died of plague in 1901, 500,000 in 1902, 800,000 in 1903, and 1 million in 1904 the death toll rising every year. During the Spanish Influenza epidemic of 1918, 125 million cases of ‘flu were recorded (more than a third of the population), and India’s fatality rate was higher than any Western country’s: 12.5 million people died. As the American statesman (and three-time Democratic presidential candidate) William Jennings Bryan pointed out, many Britons were referring to the deaths caused by plague as ‘a providential remedy for overpopulation’. It was ironic, said Bryan, that British rule was sought to be justified on the grounds that ‘it keeps the people from killing each other, and the plague praised because it removes those whom the Government has saved from slaughter!’.

If COVID-19 is like Spanish Flu, there will be a more severe resurgence in the Fall of 2020.

The name was first coined by some fourteenth-century Italians who attributed it to the pull or ‘influence’ of the stars, but it took several centuries to catch on.

It was in the nineteenth century that crowd diseases reached the zenith of their evolutionary success, and held dominion over the globe.

In every conflict of the eighteenth and nineteenth centuries, more lives were lost to disease than to battlefield injuries. The nineteenth century saw two flu pandemics. The first, which erupted in 1830, is said to have ranked in severity–though not in scale–with the Spanish flu. The second, the so-called ‘Russian’ flu that began in 1889, was thought to have originated in Bokhara in Uzbekistan. It was the first to be measured, at least to some extent, since by then scientists had discovered what a powerful weapon statistics could be in the fight against disease.

Eugenics is taboo today, but in 1918 it was mainstream, and it would powerfully shape responses to the Spanish flu.

Despite its immense effect on the global civilization, Spanish flu started to fade quickly from the public and scientific attention, establishing a precedent for the future pandemics, and leading some historians (Crosby) to call it the “forgotten pandemic”. One of the explanations for this treatment of the pandemic may lie in the fact that it peaked rapidly, over a period of 9 months before it even could get adequate media coverage. Another reason may be in the fact that the pandemic was overshadowed by more significant historical events, such as the culmination and the ending of World War I. A third explanation may be that this is how societies deal with such rapidly spreading pandemics – at first with great interest, horror, and panic, and then, as soon as they start to subside, with dispassionate disinterest.

Even in Paris and Berlin, therefore, disease filled the interstices of human lives. It lurked behind the column inches devoted to the war. It was the dark matter of the universe, so intimate and familiar as not to be spoken about. It engendered panic, followed by resignation. Religion was the main source of comfort, and parents were used to surviving at least some of their children. People regarded death very differently. It was a regular visitor; they were less afraid.

This was the first wave of the pandemic, and it was relatively mild. Like seasonal flu, it caused disruption but no major panic. It did, however, create havoc in the European theatre of war, where it interfered significantly with military operations.

As many as three-quarters of French troops fell sick that spring, and more than half the British force. Whole units were paralysed and makeshift military hospitals were bursting at their canvas seams.

One of Jung’s biographers recounts the following, possibly apocryphal tale: one day, Jung was talking to the visiting wife of a British officer. During the course of the conversation she told him that snakes in her dreams always meant illness, and that she had dreamed about a huge sea serpent. When, later, the flu broke out in the camp, Jung considered it proof that dreams could be prophetic.

The Australian authorities lifted the quarantine early in 1919–too soon, as it turned out, because it was then that the third wave struck.

Australia, a gleaming exception to the rule that humans could do little to protect themselves, since a strict maritime quarantine kept the flu out.

If it is hot enough to barbecue,” a patient of mine once told me as I sutured the knife wounds on his chest, “it’s hot enough to stab someone.

When Friedrich died of the Spanish flu, twelve-year-old Fred became the man of the house.

Literally. On October 1, 117 people died of Spanish flu in Philadelphia. Still, on October 6, the Philadelphia Inquirer peppily reported that the best way to avoid the disease was to: Live a clean life. Do not even discuss influenza … Worry is useless. Talk of cheerful things instead of the disease.33

In 2007, the CDC issued guidelines for how to ensure maximum compliance with public health measures in a pandemic. Based partly on lessons learned in 1918, these recommended that measures only be made mandatory when the proportion of the sick who die rises above 1 per cent (remember that this proportion was at least 2.5 per cent for the Spanish flu). Using 2016 numbers, that means that more than 3 million Americans would have to die before the CDC would advise such a step–a measure of how counterproductive that organisation believes compulsion to be.

Societies, especially in the developed world, were thought to be on the verge of becoming invulnerable to new plagues. Unfortunately, this expectation has proved to be spectacularly misplaced. Well into the twenty-first century smallpox remains the only disease to have been successfully eradicated. Worldwide, infectious diseases remain leading causes of death and serious impediments to economic growth and political stability. Newly emerging diseases such as Ebola, Lassa fever, West Nile virus, avian flu, Zika, and dengue present new challenges, while familiar afflictions such as tuberculosis and malaria have reemerged, often in menacing drug-resistant forms. Public health authorities have particularly targeted the persisting threat of a devastating new pandemic of influenza such as the “Spanish lady” that swept the world with such ferocity in 1918 and 1919.

Fear. He’d seen something similar a few years back in Boston, during the height of the Spanish Flu epidemic, when anyone could be infected and you were scared to shake a friendly hand for fear of the invisible contagion. Thousands had died in the space of a few months, and the deadly terror that had spread in the wake of the disease had isolated whole swathes of the population as people became too afraid to travel. A siege mentality had pervaded the city, with the very lowest of Boston’s inhabitants bearing the brunt of the deadly plague. By the end of the epidemic, God only knew how many had died. It had taken at least a year before the mood of the city returned to normal and people began to breathe the air like they were enjoying it, instead of fearing it might kill them. The deserted streets, the boarded up stores and the people crossing the street to avoid you: that was Boston at the height of the epidemic.  And that was how Arkham felt right now. Like a city that people wanted to abandon, but were too afraid or too poor to leave.

Obey the laws and wear the gauze, protect your jaws from septic paws.

Unless and until we take account of the ecological, immunological, and behavioural factors that govern the emergence and spread of novel pathogens, our knowledge of such microbes and their connection to disease is bound to be partial and incomplete.

What motivates people to seek out dubious or frankly bogus treatments? Diverse motivations are likely to be at play, including imitation, conformity, desperation, and indiscriminate reliance on authority figures. According to one survivor of the Spanish flu pandemic: My mother used goose grease and turpentine mixed like a salve, sometimes she made a poultice out of it. I think it really helped. She told me it did, so I had to believe it. (Pettigrew, 1983, p. 120)

Under normal circumstances, the cytokines—soluble, hormonelike proteins—acted as messengers among the cells of the immune system, helping to target microbial infections like viruses, bacteria, parasites, and fungi, and directing the antibodies and killer cells to attack them. But with the Spanish flu, the whole system went into overdrive, the cytokines targeting everything in sight, the antibodies sticking like glue to anything they came into contact with, the killer cells blasting everything in range. It was like a wild shoot ’em up, devastating every cell in the body, compromising every defense mechanism, until the victim ultimately drowned in an overwhelming tide of his own mucus and virus-choked blood.