Memorial Day During a Pandemic

Remembering: A précis of Chapter 7 in Bryn Barnard’s book Outbreak: Plagues That Changed History. New York: Alfred A. Knopf; originally published by Crown Publishers in NY. (2005)

PURPLE DEATH WATCH: How influenza influenced war (Barnard, pp. 34-39)

World War I (1914-1918), the world’s first industrial war, introduced most of humankind’s efficient mass-killing machines: tanks; long-range artillery; machine guns; aerial bombardments; submarines; and poison gas.

Poet Robert Graves called the war “The Sausage Machine,” saying “it was fed with live men, churned out corpses, and remained firmly screwed in place.” An estimated 15 million people died, nine million of them in combat.

The war also introduced a new killer, Spanish influenza, the largest epidemic of the 20th century. Of the 100,000 American soldiers who died in WWI, 43,000 died from the Spanish flu. An estimated 20 million people died in India alone, and in isolated aboriginal villages in the Pacific and in Alaska, nearly everyone died.

The so-called “Purple Death” overwhelmed the ability of even the best-prepared governments to care for the living and bury the dead. Influenza forced the creation of global surveillance systems that eventually led to annual flu shots and discovery of the first antibiotic.

An estimated five million people died from this influenza before it disappeared in 1928. Many believe peace negotiations following WWI were so vengeful against Germany they paved the way for Adolf Hitler’s rise to power and the establishment of his infamous Third Reich.

Spanish flu was not so named because it originated in Spain, but because it was first reported in Spanish newspapers. Spain had remained neutral during the war and operated a national press. Other nations, the U.S. included, suppressed news about the disease, fearing it could provide aid to enemies. Nevertheless, the label “Spanish Flu” persisted.

In August 1918, a second wave of the deadly influenza appeared among troops stationed in Sierra Leone, France, and Massachusetts. The U.S. unwittingly took actions that spread the epidemic. Tens of thousands of young men lined up to register for the draft. Soldiers were shuttled around the country from base to base. By September, every major city in the nation was infected by the epidemic that lasted about a month.

Officials in San Francisco and Philadelphia, not prepared for the second wave, were stacking bodies in morgue hallways and ordering extra coffins. Understaffed hospitals and city morgues were overwhelmed. When the war ended, a majority of celebrants in public places wore gauze facial masks and chanted the rhyming warning:

“Obey the laws

And wear the gauze

Protect your jaws

From Septic Paws”

After the Spanish flu subsided, a worldwide flu surveillance network was developed to try to head off future pandemics. Several flu epidemics have been controlled since 1957.

Beginning in 2001, the US Centers for Disease Control stepped up surveillance programs and with the cooperation of scientists around the world was instrumental in dealing with SARS, another pandemic involving a flu-like respiratory disease.

In 1928 the antibiotic penicillin was discovered and became a major weapon in controlling bacterial diseases during WW2, but only in 1933 did scientists understand that influenza was a virus rather than a bacteria. By 1945, the US was producing enough penicillin to treat a quarter million patients a month.

The age of antibiotics had begun.

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