Laura Spinney: What Does The 1918 Flu Teach Us About Our Response To Pandemics?

Dec 18, 2020

Part 1 of the TED Radio Hour episode Making Sense of 2020

A century after the 1918 flu, we see similar patterns in the ways we've responded to COVID-19. Laura Spinney reflects on the Spanish flu and how societies learn to move forward after pandemics. A version of this segment was originally heard in the episode, Inoculation.

About Laura Spinney

Laura Spinney is a science journalist and the author of several books. Her latest non-fiction title is "Pale Rider: The Spanish Flu of 1918 and How It Changed the World." In the book, Spinney examines the enduring effects of this pandemic flu and society's response—how they altered global politics, race relations, family structures, and thinking across medicine, religion, and the arts.

As a journalist, she has written for National Geographic, The Economist, The Atlantic, Nature, and New Scientist among others. She holds a B.S. in Natural Sciences from Durham University, in the UK.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

MANOUSH ZOMORODI, HOST:

It's the TED Radio Hour from NPR. I'm Manoush Zomorodi. And we all know how tough this year has been. It's kind of a relief that 2020 is finally coming to an end. But looking back, we can also think of this year as a time of accelerated learning, the development of a vaccine in record time, of course. But even before that, we all had to wrap our heads around so many new concepts. And we needed the right people to help us make sense of it all - experts on chapters in history that we've never paid much attention to, researchers whose scientific side stories suddenly had huge relevance and artists whose not-so-obvious ideas put our strange year into context. And so that's what we're sharing today, the stories and interviews from this past year that brought us clarity - a little 2020 hindsight on the year 2020, starting with some time travel and historic parallels.

In the spring, we all learned about the previous century's pandemic, the 1918 Spanish flu. But did we pay enough attention to the details in this cautionary tale? You be the judge.

LAURA SPINNEY: Yeah So, I mean, just to give you a tiny bit of perspective, around 18 million people are thought to have died in the First World War. And the numbers we work with today, though they are uncertain, are between 50 and 100 million dead for the Spanish flu, which means that the Spanish flu probably killed more than either World War and possibly more than both of them put together.

ZOMORODI: This is Laura Spinney.

SPINNEY: I am a science journalist, also a novelist and a writer. And I wrote a book called "Pale Rider: The Spanish Flu Of 1918 And How It Changed The World."

ZOMORODI: And just like today with COVID-19, New York City was hit hard by the Spanish flu.

What was New York like in 1918?

SPINNEY: So New York in 1918 was quite a modern city. It was quite atomized. It's the peak of the pandemic. People are dying left, right and center.

ZOMORODI: And the city is papered with advice on how to prevent and treat influenza, things like...

SPINNEY: Handwashing...

ZOMORODI: ...Masks...

SPINNEY: ...Quarantine...

ZOMORODI: ...And self-isolation.

SPINNEY: What we call social distancing - you know, the collective term for all those measures that keep the sick and the healthy apart and so slow the spread of the disease.

ZOMORODI: Public gatherings were discouraged. Some were restricted. Sounds familiar, right? But that didn't always stop people from going out, like on October 20, 1918, when Charlie Chaplin's new film was released. For some New Yorkers, the opening night ticket was too hot to resist.

SPINNEY: Oh, Charlie Chaplin was so hot. And he made this film called "Shoulder Arms," in which a tramp kidnaps the Kaiser - good stirring stuff for wartime. And it premiered at the peak of the pandemic in New York City.

ZOMORODI: A bunch of people crowded together in a movie theater during a pandemic, not the best idea. And yet...

SPINNEY: Harold Edel, who was the manager of that cinema, I think he wrote in a newsletter, something like - he just congratulated people for turning out in such impressive numbers to watch the film.

UNIDENTIFIED ACTOR: (As Harold Edel) We think it a most wonderful appreciation of "Shoulder Arms" that people should veritably take their lives in their hands to see it.

ZOMORODI: So crowds of people came out to see the film. And Harold, the cinema manager...

SPINNEY: By the time his words were published, he himself had died of the Spanish flu.

ZOMORODI: Wait a minute. So despite the fact that the flu was ravaging New York City at the time, people thought, you know what? Those of us who are healthy, we want to go see Charlie Chaplin. He's the hottest thing out there. Let's get on with our lives and go to the movies.

SPINNEY: Yeah, I think so. And, you know, maybe you were seeing a little bit of the mentality we're seeing today where people are finding it hard to tolerate self-isolation over time. Maybe it's OK at the beginning, but sustaining it gets hard. I mean, to be fair, the places of entertainment had not actually been closed. There were restrictions on attendance at them. For example...

ZOMORODI: Oh, there were?

SPINNEY: Yeah. Children weren't allowed to go. And I think smoking was banned. But, you know, the general tone was don't gather in crowds. It was a bit like the British attitude at the moment. You know, we advise you not to.

ZOMORODI: I mean, it's so interesting to think of how people responded in 1918, how people are responding now. I mean, it depends on what country you live in, what state you live in here in the United States. But I guess I wonder, like, how do you look at this year, this moment, and put it into context with how pandemics have played out in the past?

SPINNEY: I mean, I think this is the thing - right? - that we find ourselves - I mean, this is a different world. This is a different germ. This is a different disease. But now while I'm living through it, what I'm feeling is something very ancient about this. There's something ancient about the way we react, about the way we behave well, behaved badly. It doesn't feel like it's changed since Greek times, since the Greeks described hysteria in these kinds of situation and good behavior in these kinds of situations. It all feels very ancient.

ZOMORODI: The way you put it, it sounds like it's all eerily familiar to you. And just going back to 1918 and the Spanish flu, one of the things I found so fascinating was these multiple waves to the virus. Can you walk us through them?

SPINNEY: So the pandemic is generally considered to have struck in three waves. It kind of depended where you were in the world. But in general, there was a kind of initial mild wave in the early months of 1918, which wasn't that different from seasonal flu. That went away in the sort of late spring, early summer of 1918. And then the second wave kind of emerged in the last weeks of August of the same year. And that was by far the most vicious wave when most of the deaths took place - receded towards the end of 1918. And then there was what's usually considered a third wave in the early months of 1919 that was intermediate in severity between the other two.

ZOMORODI: I mean, hearing that is terrifying. We know it's a different time. We know it's a different virus right now. But the thought of going through multiple waves of this is just kind of awful.

SPINNEY: Yeah, absolutely.

ZOMORODI: And so right now, though, we are seeing that older people seem to be particularly at risk. Were there groups in 1918 who were more vulnerable than others?

SPINNEY: In most of the world, overall, the most vulnerable age group were adults aged 20 to 40, which is unusual for a flu. But it was one of the reasons why that pandemic was so devastating - because it basically purged communities of their breadwinners, of their pillars, their, you know, fathers and mothers at a time when there was no real safety net socially in terms of social welfare. And this to me is why it's so fascinating because it's - a pandemic is not just a biological thing. It's social, as well.

ZOMORODI: So how did societies pull themselves back together again after the Spanish flu finally died down in the summer of 1919?

SPINNEY: So, I mean, they were pretty devastated. Of course, they also had to rebuild after the war in many parts of the world. It was - you know, it was a humanity-wide trauma. But at the population level, what's really interesting is that humanity quickly bounces back. So you see there's a big dent in the demographic profile of the people who died at that time. But in the 1920s, there was a baby boom. And one of the reasons for that boom, we think, is that the Spanish flu basically purged the world of people who were already sick with other diseases, notably tuberculosis. And so what it left behind was a smaller but healthier population.

ZOMORODI: Wow - Darwinian.

SPINNEY: Yeah, totally. So humanity replenishes itself but at the cost of huge amounts of individual suffering, of course.

ZOMORODI: Can we talk about the people's mental health after the pandemic?

SPINNEY: Yeah.

ZOMORODI: I mean, you mentioned the trauma.

SPINNEY: Yeah.

ZOMORODI: This sense of uncertainty, long, like, slow-moving uncertainty is something that I have never experienced in my lifetime. And I can only imagine that sort of the way that society functioned after the 1918 pandemic with the flu - I mean, it must have changed the way people thought of being human in the world.

SPINNEY: So there's quite good evidence to suggest that there was a kind of wave of depression that went over the world after the pandemic. I think a lot of people and not just military civilians, as well, were left with a similar kind of post-traumatic stress disorder by this pandemic. I think there was also a sense of sort of survivor's guilt because it was so random. You know, some died. Some didn't. But at the same time, of course, people were just sort of in a state of shock after the war. I mean, it must have been an extremely strange time.

ZOMORODI: So in your book, you bring up this idea of collective memory, which refers to how we as a society remember our past and learn lessons from defining moments like the Spanish flu or now with COVID-19. And it sounds as though the 1918 flu was not much of a cautionary tale for the generations that followed. The memory of it has been very flimsy, in fact.

SPINNEY: Yeah.

ZOMORODI: Whereas I have heard people talk about World War II all the time. Like, we can't let that happen again. We have to protect ourselves. Never let it get to that point.

SPINNEY: Yeah, we do say that a lot. I mean, I tend to be quite cynical about that. I think that just remembering these things, unfortunately, doesn't stop us doing them again. So I was speaking the other day to Jonathan Quick, a public health expert who wrote a book called "The End Of Epidemics." And he says, well, when it comes to pandemics, we just are in this cycle of panic and complacency. We'll see if this one puts an end to that. I personally doubt it. But it remains to be seen. We panic when it happens. And then we forget as soon as it's gone and don't do all the things which, for example, the WHO has been telling us forever to do outside of pandemics in order to protect ourselves better against them.

ZOMORODI: Tell me if I'm being too Pollyannaish. But in times like this, is there something that can help us maintain a positive and hopeful outlook on life? I mean, I guess I'm looking for words of wisdom for our listeners. The ancient lesson, I guess, is sort of that we survive (laughter).

SPINNEY: We do survive. And we know the shape of a pandemic curve, an epidemic curve. We will definitely come out of this.

ZOMORODI: Yeah.

SPINNEY: We'll just be a different humanity. And, you know, lots of us who are here now may not be here then.

I mean, I think that pandemics bring out the very worst and the very best in human nature, both the extremes, you know? I mean, so virology was not a field of science before the 1918 pandemic. It took off in the 1920s. We had our first flu vaccines as a result from the 1930s. You know, good things come out. But a lot of people pay the price for it.

ZOMORODI: That's Laura Spinney. She's a science journalist and author. Her book is called "Pale Rider: The Spanish Flu Of 1918 And How It Changed the World." We spoke to her earlier this year.

On the show today, making sense of 2020. I'm Manoush Zomorodi. And you're listening to the TED Radio Hour from NPR. Transcript provided by NPR, Copyright NPR.