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Summary
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
In 1918, Paul Lewis was a lieutenant commander in the navy in the Great War (later known as World War I), as well as a scientist. He was socially awkward but brave in battle. Despite his bravery, however, he had never seen anything like the deadly illness that was tearing through navy hospital wards. He’d been called in to solve the mystery of the illness.
The book opens by focusing on Paul Lewis—one of the scientists leading the battle against the 1918 influenza pandemic—highlighting both that the book will be about science but also that it will focus on individuals’ personal stories. The image of Paul Lewis in military gear helps draw a comparison between the literal war going on in 1918 (World War I) and the metaphorical war between science and nature that occurred during the 1918 influenza pandemic.
Themes
Before this, Lewis had worked as a mentor under the man who proved that a virus caused polio, and his reputation in science only continued to grow after that. This is why he was called to look at the sailors in the hospital wards, who were coughing up blood and delirious. One of the characteristic symptoms was skin turning unusual colors, sometimes to the point that it wasn’t possible to determine a sailor’s race.
Lewis got his education both through formal training and through other events that shaped his view of science. Lewis benefited greatly from a mentor, and this foreshadows the role that strong institutions, like universities, will play later in the book.
Themes
Lewis was confused by the sick men he saw and afraid of the disease’s potential for harm. Despite attempts to isolate the disease by quarantining sailors, it had been spreading rapidly. Lewis took blood, urine, and saliva samples from the sailors, hoping to find the pathogen causing the disease and eventually make a cure or vaccine for it. He remained unsure what the disease was, but he guessed it was influenza, albeit an influenza unlike any that came before.
The description of Lewis’s attempts to investigate the disease show how Lewis understands modern scientific principles while also highlighting how much less equipment and knowledge doctors had in the early 20th century compared to today. Techniques like quarantining and taking bodily fluid samples are still used today, even though many other aspects of medicine have changed dramatically.
Themes
In fact, Lewis was correct. The influenza virus that emerged in 1918 (likely in the U.S.) and began to fade in 1920 killed more people than any other outbreak of disease thus far. While the Black Death in the 1300s killed a much larger share of the population, in raw numbers the early 1900s influenza pandemic was deadlier. Low estimates put the pandemic’s death toll at 21 million, based on a study of the disease done at the time, but a more modern estimate suggests the death toll was at least 50 million, perhaps as many as 100 million.
Barry provides statistics to help emphasize the scale of the 1918 pandemic. These numbers only tell half the story, though, and the rest of the book will deal more with how people felt as they were living through the influenza pandemic. Both now and in 1918, the Black Death is one of the first things people think of when they think of deadly pandemics. The comparison in this passage makes it clear that although the 1918 influenza pandemic was far from the first disease outbreak to plague humanity, it was unique because of how contagious the virus was.
Themes
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Beyond the sheer death count, the notable thing about the influenza pandemic was that roughly half the people who died were in their twenties and thirties (as opposed to elderly and infants, who are more likely to be killed by normal variants of the flu). At the upper end of the death toll, this would mean that 8 to 10 percent of all young adults alive at the time were killed by the virus, with most of those deaths occurring in a 24-week period after September 1918.
Diseases rarely affect young adults as severely as they affect older people and infants, so the fact that people in their twenties and thirties were dying of influenza was one of the things that made this virus unique. Though it was not nearly as deadly as the Black Death to the people who caught it, it nevertheless took a serious toll on the world population because it affected so many people who might have otherwise lived long lives.
Themes
In spite of all the death and destruction, the story of the 1918 influenza virus is also a story of science and discovery. The science behind today’s medicine was in its early stages, and researchers were prepared for the pandemic, at least as much as anyone could be.
Though the first edition of this book was written well before the COVID-19 pandemic, one of the author’s goals was to show how leaders can rely on science to combat future pandemics, which is why there are hopeful anecdotes about progress interspersed with the book’s otherwise dark subject matter.
Themes
The story actually begins before 1918. Even today, medicine may never be “fully” a science, because of idiosyncrasies of individual patients and doctors. But in the decades leading up to World War I, there were major developments in medical science. As late as 1900, it was actually harder to get into an American college than an American medical school, with many medical schools accepting any man (not women) who could pay tuition and only 20 percent requiring a high school diploma.
Understanding the 1918 influenza pandemic is only possible if one understands the history up to that point. Both the successes and the failures of the U.S. response to the virus were often rooted in events that occurred long before World War I ever began. An example of this idea is that before the early 20th century, most American medical schools were woefully inadequate at preparing their students to become doctors.
Themes
Shortly before World War I began, however, a transformation came in American medicine. A new generation of scientists, like Paul Lewis and his peers, had been trained specifically to prepare for the next pandemic. Ultimately, the medical knowledge that came out of the influenza pandemic would point directly to medicine’s future, having relevance even today.
Again, Barry balances out a story of failure (the state of early American medical schools) by providing a more hopeful example. What distinguishes Lewis is not just his own intelligence but the fact that he was among the first to benefit from training and institutions that previous medical scientists, particularly in the U.S., never had.
Themes
