Deadly arrogance

My article called “Links in a Mysterious Chain” in this issue refers to three worthwhile books on epidemics, and here are three more from the past decade: Alfred Bollet’s Plagues & Poxes (2004), Irwin Sherman’s The Power of Plagues (2006), and John Aberth’s Plagues in World History (2011). But the best I’ve read recently describes the worst: John Barry’s The Great Influenza (2004) tells of the virulent flu epidemic of 1918 that killed 50 million to 100 million humans out of a world population that was then 1.8 billion.

The downside of Barry’s book is that it’s almost entirely about the United States: That’s harrowing enough, since at least half a million died here, but the virus also killed 17 million residents of India and perhaps 7 percent of Russians and Iranians. Steamships brought the virus to Guam, where 10 percent of the population died; to Western Samoa, where 22 percent died; to the Fiji Islands, where one out of seven died in just two weeks. (In American Samoa, though, where authorities imposed a rigid quarantine, not a single person died of influenza.)

One upside of the book is that it shows how governmental arrogance certainly increased the U.S. toll. The epidemic spread as men drafted for World War I crowded into training camps. Doctors pleaded with officials not to send possibly infected men to other camps, or to Europe on troop ships, but the trains and ships departed anyway and became traveling caskets. Doctors urged President Woodrow Wilson to decree delays until the epidemic was under control, but he decided on Oct. 7 to keep the pressure on Germany, which was already sending out peace feelers (and would give up on Nov. 11).

The result: One nurse at the Great Lakes Naval Training Station saw bodies “stacked in the morgue from floor to ceiling like cord wood.” Dying increased after Col. Charles Hagadorn, commander of Camp Grant in Illinois, overruled doctors and put more trainees into the barracks, stating, “There must as a military necessity be a crowding of troops.” On Oct. 8 Hagadorn pulled out his pistol, shot himself, and died.

Many local civilian authorities, concerned about panic, acted like Philadelphia public health director Wilmer Krusen: As death spread through his city, Krusen told reporters of “a few cases in the civilian population” and insisted that health inspectors would “nip the epidemic in the bud.” He approved a Sept. 28, 1918, parade designed to sell millions of dollars of war bonds: Several hundred thousand persons, assured there was no danger, crowded together along the parade route. Three days later, 117 flu-stricken persons died, and five days after that, 289. Health officials said the epidemic had peaked, but three days later 428 died, and soon the daily death toll was double that.

Doctors helplessly watched patients “struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth.” The epidemic spread down the East Coast.

A Washington, D.C., resident remembered, “You were constantly afraid … you were surrounded by death. … It wiped out entire families from the time that the day began in the morning to bedtime.” One resident of Goldsboro, N.C., recalled, “People were actually afraid to talk to one another. … Don’t look at me and breathe in my face.” Then the epidemic hit the West and Midwest. It started to diminish only as cities closed down. One Philadelphia doctor drove home 12 miles from the hospital and saw no other cars on the road. As Barry put it, “The virus burned through available fuel.”

Amid this reign of error, one official was sensible: On Sept. 26 Enoch Crowder, in charge of military recruitment, canceled the next draft, which would have sent 142,000 more young men into the flu-ridden camps. And there’s a lesson for us: When a new or more virulent plague comes, tell the truth. Take emergency action. Anticipate worst case scenarios, and if the worst does not come, rejoice and thank God.