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Chapter 20
Themes
Key
LitCharts assigns a color and icon to each theme in The Great Influenza, which you can use to track the themes throughout the work.
Leadership and Crisis
Truth, Free Press, and Propaganda
Science vs. Nature
Education, Research, and Institutions
Summary
Analysis
The 1918 influenza strain struck so suddenly that some victims remember the exact moment it hit, even fainting on the sidewalk or falling off a horse. Death also came quickly, sometimes within 12 hours.
Pathologists studying the disease were most interested in what happened in the lungs. The lungs of people who died within a couple days of their first symptoms were unusual, not typical of normal influenza or pneumonia. During autopsies, pathologists didn’t find evidence of the bacteria that usually attack lungs during pneumonia and related infections. Normally the lungs are well-protected from viruses and sterile, so when the 1918 influenza virus invaded, it triggered a massive immune response. Ultimately, it was the immune system response that was killing young people, not the virus itself.
The use of autopsies and other methods of direct observation demonstrate how medicine was firmly in its modern period by the time the pandemic struck. The processes the scientists followed were frequently based on good science, but the speed and complexity of the virus exposed the limits even of modern medical science, particularly in a crisis situation.
Themes
In the 1970s, researchers would eventually learn about acute respiratory distress syndrome (ARDS), which can be caused by drowning or toxic gas, and which was also the mechanism for the 1918 influenza strain. ARDS is basically like a burn to the lungs. It didn’t cause the majority of the influenza deaths of 1918 and 1919, but it explains why so many young people died. It’s impossible to find the actual rate of death by ARDS (since most samples were from the army, where a higher proportion were young men), but ARDS is still a bad sign for future pandemics, particularly with the recent rise of antibiotic-resistant bacteria in hospitals.
Barry has drawn parallels between the 1918 pandemic and the present in previous parts of the book, and this is one of the most direct passages about what modern officials can learn from the past. Even before the COVID-19 pandemic, Barry was warning about how new diseases could follow a similar path to the 1918 pandemic. Antibiotic-resistant bacteria represent a particularly new threat, since it is only comparatively recently that antibiotics became prevalent enough for resistant bacteria mutations to develop.
Themes
