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

Pale Rider: The Spanish Flu of 1918 and How It Changed the World (2017) Laura Spinney

This one took me a bit to get through, but mostly because I completely stopped reading non-fiction for awhile last year.

This is another story about the Spanish Influenza, this time focusing upon the changes the diseases wrought upon the world (hence the title) but it did delve a little bit into other subjects.

It opens on a note that–when the book was written–would have been shocking.

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

Sadly, the current death toll for COVID, 5,890,730, seems to have inured people to the death tolls in the millions.

But this line, also from the start of the book, still rings true.

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

The first chapters look at the history of flu–and infections diseases in general.

Flu is transmitted from one person to another in tiny infected droplets of mucus that are flung through the air by coughs and sneezes. Snot is a fairly effective missile– it should be, it was designed in a wind tunnel– but it can’t fly further than a few metres. For flu to spread, therefore, people must live fairly close together.

How these infectious diseases could not really develop and spread until humanity developed collectives and communities.

They needed a pool of thousands or even tens of thousands of potential victims to sustain them– hence the name, ‘crowd disease’. They would not have survived prior to the farming revolution, but after it, their evolutionary success was index-linked to the growth of human populations.

As well as the how disease affects not just humanity, but how a pandemic could have global changes, ie: pandemics causing widespread death, which lead to farms being abandoned, which lead to a greater sequestering of CO2 when forests regrew.

She also talks about health in general, and how lack of a public health system (a way of stopping curable or preventable diseases, could have been one reason why the many reasons the flu was so devastating; as COVID has shown us, those who suffered from or were weakened by chronic diseases, can be more susceptible ti infections diseases.

But what truly stood out to me, reading this book published in 2017, were the parallels we have seen for the past two years.

(T)he satirical magazine Careta (Grimace) expressed a fear that the authorities would exaggerate the danger posed by this mere limpa-velhos– killer of old people– to justify imposing a ‘scientific dictatorship’ and violating people’s civil rights.

(T)he difference between an overwhelmed public health infrastructure, where patients can’t get treated, doctors and nurses are pushed beyond exhaustion and dead bodies accumulate in morgues, and a functioning system that, though stretched to its limit, is still managing the flux of the sick.

(H)istorian Alfred Crosby, who told the story of the flu in America, argued that democracy was unhelpful in a pandemic. The demands of national security, a thriving economy and public health are rarely aligned,

As time went on, fatigue set in even among those who had complied to begin with.
…
People drifted back to their churches, sought distraction in illicit race meetings, and left their masks at home.

when the flu invaded an army clinic for venereal disease, all the patients succumbed except the syphilitics, and they wondered if it was these patients’ daily mercury injections that protected them. A Viennese doctor went so far as to conduct a small trial. Since none of his twenty-one flu patients died following mercury treatment, he concluded that it was an effective therapy for flu. 5 Unfortunately, as many syphilitic patients discovered, mercury is also toxic.

Having read widely but shallowly about the 1918 flu, I’ve been horrified by so much of what I’ve seen as lessons we should have learned a century ago, but being repeated–despite everything.

I’m also worried about what we’re going to see in the coming decade, as the disease changes from pandemic to endemic.

There is good evidence, for example, that the Spanish flu was itself a chronic disease, and that it had a negative impact on some people’s health for months or even years after the initial flu-like symptoms had subsided.
…
(S)ome patients found themselves plunged into a lingering state of lassitude and despair. How much of this wave of ‘melancholia’ was due to the flu, and how much to the war?

All-in-all, a good look at how the 1918 pandemic changes the world–and read now, a reminder of how little humanity has changed.

Publisher: PublicAffairs
Rating: 8.5/10

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