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

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

3

Jun 29, 2017

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 wasnt the jolliest read, but heck, my friendly GR poppets, life is not all 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. ...more
1

Dec 21, 2017

Nerd addendum update (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, Nerd addendum update (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.

...more
3

Oct 22, 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 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. ...more
5

Apr 01, 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 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!

...more
4

Oct 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 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! ...more
5

Dec 09, 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 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. ...more
3

Oct 04, 2017

Fascinating subject made boring by ponderous writing and an extreme reliance on speculation and anecdote.
4

Mar 02, 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. Lovecrafts 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
“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. ...more
4

Sep 15, 2018

I dont 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 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. ...more
2

Oct 07, 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
5

Jun 15, 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 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. ...more
4

Mar 25, 2019

Trigger warnings: pandemic, lots and lots and lots of death, mentions of war.

I've been interested in this since it came out, so I was very excited to discover that my local library had a copy of it. Medical history is my jam and I'd never read anything about the Spanish Flu, so reading this was pretty freaking eye opening.

Let's be real here: the bulk of what we hear about the Spanish Flu and its death toll is about Europe and North America, yes? That's where we all assume the bulk of the Trigger warnings: pandemic, lots and lots and lots of death, mentions of war.

I've been interested in this since it came out, so I was very excited to discover that my local library had a copy of it. Medical history is my jam and I'd never read anything about the Spanish Flu, so reading this was pretty freaking eye opening.

Let's be real here: the bulk of what we hear about the Spanish Flu and its death toll is about Europe and North America, yes? That's where we all assume the bulk of the deaths happened. UH, WRONG. What I loved about this is that it looks at the Spanish Flu on a global scale and demonstrates that while the death toll in Europe and North America was certainly devastating, it pales in comparison to places like Iran or Samoa, where over 20% of the country's population died. In India alone, over 17 MILLION people died. I'm not saying that Britain's 250,000 deaths were insignificant. They're not. But literally dozens of languages became instantly extinct in Samoa as a result of Spanish Flu. Like........???????

In contrast, Australia had only 12,000 deaths (still a significant number, but nothing compared to the northern hemisphere) because after the initial outbreak, we went "Nah, mate. That's some bullshit right there" and imposed severe quarantine regulations. New Zealand didn't and was much harder hit.

In short, this was FASCINATING and I liked that Spinney included the ways in which scientists are conducting research even today to prevent a similar outbreak.
...more
3

Oct 02, 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.
4

Oct 03, 2018

The captains and lieutenants who died while serving with the British Army Vera Brittains 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 mothers womb in the autumn of 1918, may lay claim to it too, for different 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. ...more
3

Nov 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 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). ...more
3

Aug 14, 2019

Wide ranging exploration of the devastating, nearly-forgotten H1N1 flu pandemic that broke out at the end of WWI.

This was an advanced/intermediate-level work on the 1918 flu pandemic. Having advanced education and a general knowledge of early 20th Century history, particularly the history of the aftermath of World War I would be needed to really leverage its contents.

I have a keen interest in epidemiology. In pursuing that interest Ive read several books on the mis-named Spanish flu of 1918. Wide ranging exploration of the devastating, nearly-forgotten H1N1 flu pandemic that broke out at the end of WWI.

This was an advanced/intermediate-level work on the 1918 flu pandemic. Having advanced education and a general knowledge of early 20th Century history, particularly the history of the aftermath of World War I would be needed to really leverage its contents.

I have a keen interest in epidemiology. In pursuing that interest I’ve read several books on the mis-named Spanish flu of 1918. Spinney’s book is a short, wide ranging survey of the disaster. It covers the science, history and the effect of that plague on politics, religion, population and society. It takes a global view, which is uncommon. To the extent to which I’m familiar, all of the covered points and examples use the current best academic research. At points I was disappointed by the depth of the discussions. For example, I wished for a longer more detailed analysis of the effect of the pandemic on the Russian Civil War (another interest of mine). However, in retrospect I generally came to appreciate the breadth of the work. It exposed historical and geo-political relationships of the pandemic which I did not suspect. However, there were sections that were either of little interest to me, or I thought were a reach. For example, the section devoted to long-term effects of the pandemic on global mental illnesses and art and literature felt squishy in comparison to previous historical and technical sections.

My book was a modest 350-pages. This did not feel like a lot considering the ground being covered. It had an original UK copyright of 2017. Generally, reading went quickly.

Laura Spinney is a British science journalist and writer of both fiction and non-fiction books.

Spinney’s writing is very good. Her experience as a scientific journalist shows through. In addition, her original publisher Jonathan Cape (Penguin) is renowned for the prowess of their editors and proofreaders. The prose is clear, concise and I could find no errors. The footnotes were particularly well done, although I would have liked a separate bibliography. The writing had a very British aspect to it. In addition, a sophisticated vocabulary, including medical and biological technical terms was used. Some readers may have difficulty with some sections.

The book made good use of illustrations and maps. The included pictures were excellent. They were artistic. The maps were more akin to info-graphics. They were professionally done.

The book was broken-up into eight (8) sections and a separate important Afterward. Each of the sections addressed an aspect of the pandemic. Sections were divided into between two (2) and six (6) chapters. Chapters included at least one detailed illustrative anecdote. A global perspective was taken to the pandemic. In addition, to the pandemic's history, present and future developments are addressed. Typically, my readings on it were restricted to the: historical effect on the English-speaking world, flu epidemiology, and flu virology (H1N1 vs. H5N1 flus). If I have a subjective objection to the book, it was the allocation of scarce pages to chapters. For example, Part Seven: The Post-Flu World addresses the attributable effects of the flu for up to 10-years after the pandemic. This section shares chapters on a speculation of how the Treaty of Versailles was affected by flu-suffering delegations and on the post-epidemic appearance of previously unobserved or rare mental illnesses. The former I found very interesting, while I took no interest in the later. I also thought the pandemic’s effect on Dashiell Hammett’s creation of the hard-boiled detective genre of literature to be quite speculative. However, the historical and technical chapters were very good. Some were brilliant. The present day and future efforts by the WHO to prevent or mitigate future flu pandemics was current.

The book assumes a historical background on the period and some knowledge of biology. It is not an introductory text. I've already read several books on the Spanish Flu. It is an asset for folks looking to increase their breadth of knowledge on the subject. For example, I knew quite a bit about effects of the pandemic on the Anglo-west. The book added to my understanding of it on: India, parts of Asia, South America and Africa. However, I was skeptical about some of the non-historical and biological sections. In summary, I found it a worthy but not easy read for those interested in broadening their understanding of the 1918 Flu Pandemic and potential flu epidemics.

Readers interested in an introduction to the Spanish flu pandemic might try America's Forgotten Pandemic: The Influenza of 1918 . Previously, this was the best book I’d read on the subject. ...more
3

Feb 20, 2018

Re-read 2019

While not my favorite book on the Spanish Flu epidemic, I do like that it looks at how the disease affected more than Europe. It dedicates a few chapters on the flu in Asia and Australia.


This book about the Spanish Flu tried to do what other books on the disease haven't done. It discusses the effect of the Flu on countries in Eastern Europe and Asia. Most books on the disease focus on Canada, The United States, and Western Europe. In adding Eastern Europe and Asia to the discussion Re-read 2019

While not my favorite book on the Spanish Flu epidemic, I do like that it looks at how the disease affected more than Europe. It dedicates a few chapters on the flu in Asia and Australia.


This book about the Spanish Flu tried to do what other books on the disease haven't done. It discusses the effect of the Flu on countries in Eastern Europe and Asia. Most books on the disease focus on Canada, The United States, and Western Europe. In adding Eastern Europe and Asia to the discussion the author brings the possibility of the disease starting somewhere other than Kansas in the United States, a place where many researchers have believed it to have started. The problem with this book is that it tries to do too much in too few pages. If you haven't read anything about this epidemic prior to this book you may end up getting lost in the discussion. I have read a few other things on the Spanish Flu prior to this book, and I was left confused a few times on what was happening since the sections go from the beginning to the believed end of the Flu constantly when discussing how it affected each country. ...more
5

Jan 12, 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 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. ...more
4

Nov 26, 2018

Since I am an apocalypse monger, but a practical one, I do not worry about alien invasions or the reversal of Earths magnetic field, but I do worry about pandemics. This book, Laura Spinneys "Pale Rider," is a recent offering in the pandemic literature that has become popular in the past twenty years. It focuses on the only known pathogen likely to create a future pandemic, the influenza virus, through its greatest past outbreak, the Spanish Flu of 1918. I read books like these partially for Since I am an apocalypse monger, but a practical one, I do not worry about alien invasions or the reversal of Earth’s magnetic field, but I do worry about pandemics. This book, Laura Spinney’s "Pale Rider," is a recent offering in the pandemic literature that has become popular in the past twenty years. It focuses on the only known pathogen likely to create a future pandemic, the influenza virus, through its greatest past outbreak, the Spanish Flu of 1918. I read books like these partially for history knowledge and partially to understand what to do in a similar future situation, and "Pale Rider" is useful for both.

The title, though Spinney does not acknowledge it, comes from the Apostle John’s vision of the Fourth Horseman in Revelation 6:8. “And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him.” (True, the horse, not the rider, is the pale one. Spinney probably stole the elision from the 1985 Clint Eastwood movie of the same name. I guess "Pale Horse" doesn’t have the same eerie resonance.) The title is just an eyecatcher, not a signal of coming deep thoughts about humanity. In practice, Spinney plays it straight, alternating between the history of the pandemic, so far as it is known, and scientific discussion, both about the pandemic itself and about the current and future state of the influenza virus.

World War I plays a large part in the history. The war meant that large numbers of people, mostly men, were packed together in close proximity, and it also created a lot of movement that would not otherwise have happened, such as Chinese workers being shipped through the United States on their way to Europe. Still, while modern scholarship has figured out a lot, much of the history of the pandemic is guesswork, which Spinney freely admits. We don’t even know where the pandemic started—Spinney notes that the major candidates are China, France, and Kansas, which is a pretty broad spread. As a result, much of the book is anecdotes, rather than summaries of actual statistics of the time—but well-chosen anecdotes, from all around the globe, that give the reader a good flavor for the time and the events.

Though it seems close in time, 1918 is a foreign country to us. As Spinney says, “People regarded death very differently. It was a regular visitor; they were less afraid.” That’s not to downplay the emotional impact of the flu and the deaths it caused on the people of 1918, but they bucked up and got on with life more than I think we would. Parents regularly outlived their children. Many adults died early (my great-grandfather, a Budapest journalist, died in 1908 of tuberculosis, a young man), though it’s a myth that older people were rare in any past human society. It’s not for nothing that Psalm 90 says “The days of our years are threescore years and ten.” More generally, most people died of infectious diseases, “not the chronic, degenerative diseases that kill most of us today.” Leaving aside lifespan, I suspect the former is preferable—people live in fear of cancer, Alzheimer’s, ALS, and so forth, afraid of the long, slow, painful, decline. If you have to go, better to check out with a high fever and a few days of annoyance!

The name “Spanish Flu,” as with the names of many diseases, is a misnomer, since it didn’t start in Spain at all. All disease naming, even today, carries a propaganda element. Perfectly reasonably, nobody wants to be tagged with responsibility or even be associated with the origin of a disease. For example, Spinney notes that some Chinese were unhappy a decade ago with the name SARS, an acronym for “severe acute respiratory syndrome,” because Hong Kong, one of the regions affected, has the acronym SAR, for “special administrative region,” in its official name. And AIDS was originally more accurately called GRID, for “gay related immune deficiency,” until the propagandists of both Left and Right decided to pretend it was a threat to America as a whole, a pretense that continues even today, though only halfheartedly. Nowadays, the preferred mechanism is to name diseases mechanically, based on effects and other relevant qualifiers, which is probably a better, if less colorful, solution. Making it worse for the Spanish, it’s not even clear whether some outbreaks of the time were the Spanish Flu at all. Spinney mentions confusion with several other diseases, including typhus, noting that disease, spread by fleas, “has long been regarded as the disease of social collapse.” It’s therefore indicative that, according to CNN a few weeks ago, typhus has reached “epidemic levels” in Los Angeles and Pasadena, as the derelict homeless population is allowed to expand in those areas, though kept well away from the gleaming castles of the Lords of Tech. If we’re lucky, though, such collapse will hasten California’s breakdown and the resulting implementation of my plan to enable the underclass to flourish.

Anyway, various interesting facts pop up throughout Pale Rider. For example, recently the estimated death toll for the 1918 pandemic has been substantially revised upwards. It might have been as many as 80 million people. I think it’s generally known nowadays that the Spanish Flu tended to kill healthy young adults to a greater degree than most flu viruses, or, for that matter, most illnesses. This has long been attributed to a “cytokine storm,” where a robust immune system over-responds, in this case drowning the victim from within. But the Spanish Flu did not kill teenagers at any higher rate than normal, and their immune systems are just as robust as an adult’s. Spinney acknowledges this, and the mystery, then drops it; I would have liked to know the current state of thinking on that disparity. Moreover, while it’s true that relative to normal flu, healthy adults died more, it’s also true that the Spanish Flu killed the very young and very old just like a normal flu, creating a “W-shaped mortality curve.” And it killed pregnant women most of all, in perhaps the saddest effect of the epidemic. Still, it wasn’t like pandemics in the movies, or the Black Death, where bodies stacked up in the streets. The death rate for those infected was 2.5% (with substantial geographic variation); most people who got the Spanish Flu experienced nothing different from a normal flu.

Deep down, most of us think that while today a new pandemic might kill quite a few people, we would soon enough, by throwing money and scientists at it, find a cure and get back to normalcy. That confidence is misplaced, I think—one has only to see the enormous resources thrown at AIDS over the past thirty years, where a cure appears no closer, to realize that it’s not that simple. There’s no guarantee of an effective treatment in any quick timeframe, much less a cure. Another misapprehension, I think, is that today’s bloated government would be helpful. At best, government is a mixed blessing in such situations. True, sometimes the government, especially local government, is effective at organizing a response. Spinney talks about the city’s efforts in New York to contain and treat the flu, which were reasonably successful. But Spinney also relates how the crew of a Coast Guard vessel was sent to remote Alaskan villages, where the local Eskimo people died at high rates. Instead of helping, the government workers mostly held dances on board and stole valuable church goods (the locals were Russian Orthodox, from the earlier Russian presence in Alaska).

Along these same lines, our thought about a pandemic today tends to be distorted by narratives of past pandemics that took place in vastly different situations. Thus, in 1918, treatment options were extremely limited, but follow-on effects, especially food shortages due to supply chain failure, were rare. As to treatment, in 1918 there were no antiviral drugs and there were no ventilators or other sophisticated equipment that might help those with lung failure. Those who ended up in the hospital were little better off than those at home. Today, in any similar pandemic, or one worse, demand for any available effective drugs and for sophisticated medical care, as well as simple hospital beds, would far outstrip supply, resulting in the need to triage such medical offerings. As to food, even cities in 1918 had a lot more food available; they did not have food trucked in just-in-time from across the country, like we do today. That means store shelves would be bare within a few days, and for most of us our food would run out, if the trucks stopped running, something the victims of the Spanish Flu generally did not have to face.

What would result today, from these changes in treatment and food supply, is that inequality would immediately rear its head in any really bad pandemic. That happened in some places during the Spanish Flu. For example, Spinney quotes the Brazilian writer Pedro Navo, who lived through the pandemic as a boy in Rio de Janeiro. “There was talk of . . . chicken-stuffed jackfruits put aside for the privileged—the upper classes and those in government—being transported under guard before the eyes of a drooling population.” But generally, the poor suffered more because they caught the flu at higher rates due to inferior housing conditions (children were kept in school to keep them out of their homes), not from getting worse treatment or no food. Today, we would struggle with equitable allocations of both treatment (palliative or curative) and food.

The very rich would certainly get treatment and food. Steve Jobs famously jumped the line to get a liver transplant by having a private jet ready to take him at an instant’s notice to get a new liver. (He needed one because he initially refused to have surgery to cure his pancreatic cancer, one of a small percentage of such cancers curable by early surgery, preferring to try herbs and meditation first. He chose poorly, and he doubly ripped off someone poorer than him.) The very rich could also hire private doctors, nurses and machines. And, of course, with enough money you can always get food. Everybody else would have to fight for a space in the ICU or for limited doses of whatever drugs might be effective, and wonder where their next meal was coming from.

It wouldn’t be anarchy—people won’t abide anarchy, and individuals are often less selfish in practice during disasters. But some mechanism of allocation of both treatment and food would arise. I suspect treatment would be allocated along two axes. The first would be through personal or class connections, just as under any non-free market system. When my aunt, not an English citizen but the widow of an Englishman, though she had not lived in England in decades, was diagnosed with cancer, she returned to England from Asia, was illegally entered into the NHS, then moved to the front of the line with the best oncologists—all because she knew the right people in the professional-managerial class. Communism had similar mechanisms of allocation: the nomenklatura got the good stuff, and the top echelon of the nomenklatura got medical treatment in the West (like Fidel Castro), since their medical systems were so terrible. (Spinney credulously takes at face value Lenin’s pronouncements that he was going to offer great medical care to all Russians; she probably believes that the Soviet Constitution meant what it said too.) Allocation through connections is not a great system, and would in practice benefit the professional-managerial elite that has already dragged down America, but it’s the kind of thing that characterizes every human society, as Francis Fukuyama has noted.

The second axis, the group that would really jump the line on treatment allocation, is far more pernicious. That’s government workers. The process would start with Congress, which would pass laws ensuring they and their families were prioritized—for the good of the country, you know. Naturally, Congressional staffers and their families would also have to be included. And, of course, executive and judicial branch workers. Then, logically, administrative agencies—how could the country survive if EPA and EEOC drones died, or had to see their families die, or even had their work hampered by having to worry about their health? So most, if not all, federal government employees would be deemed essential and jump in line before the general population. (A few government workers might not want to so benefit at the expense of the more deserving, but they would be kept silent, directly or by peer pressure, since to question this process might result in its crumbling.) Sometimes the country just has to make hard choices; if prioritizing bureaucrats in Imperial City means the average Joe in Iowa City has to die, that’s unfortunate, but what else can we do?

The same process would probably flow downwards to the state and local level, though for treatment allocation, that would not result in much additional allocation to such government workers, since the federal government would hog all available resources. On the local level, food would be the real problem, and I expect many local governments, if food was short and not obviously coming anytime soon, would attempt to steal food from any place they could find it—stores, farmers, and individuals—to “ensure equitable distribution,” and then give it to their friends. Another reason to make sure you have enough guns.

Maybe this is all too cynical. It’s possible that government workers (other than Congress, which is irredeemable) would not take advantage of their power. Spinney notes that, somewhat surprisingly, in the Spanish Flu most people did not just “shelter in place,” which would have maximized their chances. Instead, they tended to try hard to help each other. As I say, you see this same pattern in most disasters—average people tend to view others as more, rather than less, deserving of help, even at personal risk. Selfishness decreases, when you think it would increase. Spinney calls this “collective resilience,” and I have no doubt it’s the reality, even in today’s more atomized society where intermediary institutions that were the primary administrative mechanisms of such have disappeared. I just don’t think that in practice it applies to the federal government, whose workers are taught to feel themselves superior and who show themselves incompetent in most disasters—see, e.g., Hurricane Katrina (though there the local government was even worse). But, in fairness, maybe I’m wrong and in practice the government would be a help, rather than a selfish hindrance, in a fresh pandemic. Let’s hope we don’t find out. ...more
0

Jul 07, 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 its not coming out for next years centenary, instead mingling with all the books marking a century since the Russian
"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. ...more
4

Aug 15, 2017

The First World War looms large in our collective cultural memory, arguable even larger than the Second World War, though more people died in that conflict. This has been ascribed to a multitude of factors - the pointless, the waste, the static pace, the fact that the 'War to End All Wars' only served to give rise to another, the disappointed promises, the harsh peace. But regardless of the reasons, WW1, and its 'Lost Generation', stands as one of the colossal tragedies of the twentieth century, The First World War looms large in our collective cultural memory, arguable even larger than the Second World War, though more people died in that conflict. This has been ascribed to a multitude of factors - the pointless, the waste, the static pace, the fact that the 'War to End All Wars' only served to give rise to another, the disappointed promises, the harsh peace. But regardless of the reasons, WW1, and its 'Lost Generation', stands as one of the colossal tragedies of the twentieth century, remembered every year, mourned, vowed to never be forgotten.

What is curious, however, is that there was another colossal tragedy, another episode of futility and helplessness and waste, that killed many more people, ten times as many, and did more to decimate the young and fit and contribute to the 'Lost Generation' than the War did. And yet this event has been forgotten, or at least ascribed to the footnotes of history. Every schoolchild learns about the Great War; many schoolchildren learn about the Black Death. But many people know nothing at all about the Spanish Flu outbreak of 1918, that infected one in five people around the globe and killed somewhere between 50 and 100 million people, some 3-5% of the world's population. One would think that such a cataclysm, an event that may well have been the biggest disaster in human history, would embed itself in the world's memory just as deeply and painfully as a war, and yet...not.

In this engrossing and thoroughly interesting book Laura Spinney traces the course of the influenza epidemic across the globe, rather than focusing on any particular country. She explores the origins of its name, Spanish Flu; debates the three competing theories on where it originated; explains the epidemiology of the influenza virus itself and how it evolves and adapts; details that attempts by science and medicine to understand and treat the virus; and explores the accounts of those who experienced it firsthand, many painful and heartrending to read, of entire families, entire communities wiped out.

It is curious that an event that shaped the world as much as, perhaps arguably more, than the First World War, has been so neglected by history. I remember looking for a book on the Spanish Flu a few years ago, before this was published, and being surprised at how few titles were on the market. This is a welcome addition to a thin field, and serves as a fine overview to get anyone started. I'm on the hunt for more books on this topic now - so authors, get writing! ...more
4

Nov 17, 2017

This is a book about the Spanish Flu of 1918 to 1920. The author provides an international perspective on the great epidemic and its spread around the world, as well as an update on current research on this mother of all epidemics. It compares well with and complements John Barrys book on the Great Influenza (2004), although it lacks Barrys truly terrifying descriptions of the havoc caused by the disease as it spread through the US.

The Spanish Flu got its name because it was reported on openly This is a book about the Spanish Flu of 1918 to 1920. The author provides an international perspective on the great epidemic and its spread around the world, as well as an update on current research on this mother of all epidemics. It compares well with and complements John Barry’s book on the Great Influenza (2004), although it lacks Barry’s truly terrifying descriptions of the havoc caused by the disease as it spread through the US.

The Spanish Flu got its name because it was reported on openly in Spain, while everywhere else was under wartime censorship. Where did the epidemic originate? Good question - and Spinney notes at least three competing origin stories for this flu. The Spanish Flu is noteworthy because it was arguably the most destructive and lethal event in all of human history, affecting around one third of the world’s population and killing more people that World War 1 and World War 2 combined - and all in a 2-3 year time span. In spite of this, the Great Flu has received little attention by historians and commentators, even though, as Spinney shows towards the end of the book, this pandemic thoroughly influenced the course of 20th century history everywhere on earth.

Think about that. The Spanish Flu was by far the most destructive event that most people have never heard of before.

While we know a lot more about this epidemic than we did in 1918, Spinney also shows how medical researchers still know very little about the virus and at the time could do virtually nothing to prevent the epidemic or cure those who became infected. While the Great Flu was an occasion for much research, it was not established medicine’s finest hour. The consequences of the epidemic were associated with the increased importance of public health programs and greater efforts towards providing broader popular access to health care.

The book is fairly easy to read, although some parts are easier than others. The author likely tries to do too much with the story sometimes. How does one really separate the effects of the flu from the effects of the wartime slaughter of WW1 or the displacement of millions following the war. Towards the end, the book seems a bit fragmented but that is offset by the rich updating on research and the effective global perspective. Overall, it is a very informative book and really scary about the consequences of the Spanish Flu pandemic. It is well worth the effort. ...more
5

Oct 06, 2017

Given the events of The Great War (WWI) that overshadowed the Spanish Flu pandemic of 1918 many people don't even know that it existed. I myself was unaware of this occurrence until it was brought to my attention by Downton Abbey. (RIP Lavenia, but not really because Matthew and Mary are OTP) So when I recently read a book on a dozen different epidemics that the world has seen I was intrigued when the Spanish Flu came up. As I went looking for books on it I was surprised to see there weren't Given the events of The Great War (WWI) that overshadowed the Spanish Flu pandemic of 1918 many people don't even know that it existed. I myself was unaware of this occurrence until it was brought to my attention by Downton Abbey. (RIP Lavenia, but not really because Matthew and Mary are OTP) So when I recently read a book on a dozen different epidemics that the world has seen I was intrigued when the Spanish Flu came up. As I went looking for books on it I was surprised to see there weren't many interesting looking options.

I really enjoyed Pale Rider because it focused on many aspects of the epidemic. It discussed the effect the flu had on countries across the globe, how countries handled it differently, the results of those efforts, and how historical events, like a giant world war, aided the spread of the disease. Furthermore it discussed the scientific and historical implications of the spread, what the medical community has learned since then, and the likelihood of future flu epidemics/pandemics. If you have any interest in the early 1900s, disease epidemics, or global catastrophe this is a great book. (Written from a NON-American perspective, which I found refreshing.) ...more
4

Oct 16, 2018

I am sure there is a name for my bias here. I am unable to separate my enthusiasm for disease and epidemiology and the flu particularly from my reading of this book.

As a good overall treatment of the Spanish flu, it is excellent. I also feel the vignettes of personal stories were well done.

I lost a lot of enthusiasm for the authors approach to the how it changed the world side of the story when she praised socialized medicine and castigated the US for being so far behind. I would argue that I am sure there is a name for my bias here. I am unable to separate my enthusiasm for disease and epidemiology and the flu particularly from my reading of this book.

As a good overall treatment of the Spanish flu, it is excellent. I also feel the vignettes of personal stories were well done.

I lost a lot of enthusiasm for the author’s approach to the “how it changed the world” side of the story when she praised socialized medicine and castigated the US for being so far behind. I would argue that the success of socialized medicine in a variety of examples she cited should not be taken on its own as very good unless the heath—not merely physical—of the society is also very good, something she failed to prove, while purporting socialized medicine as an uncategorically good outcome in response to the Spanish flu. The death toll in the US from the Spanish flu was relatively low, so they did ok without socialized medicine. Anyway, i digress, but the author did so first. Socialized medicine as one important change the flu likely brought about, yes.

Don’t let this stop you from reading this book. Disease is fascinating, and this book is mostly fascinating as well. ...more
5

Sep 30, 2017

The story of the Spanish flu expertly told from contrasting perspectives, which kept me captivated throughout. It gave me tons of new information and tiny tidbits to treasure.

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