Sakura of DOOM

Subtitle: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It

I should have written this up sooner, since now I have forgotten many of the details. While Kolata does summarize the 1918 influenza pandemic, most of the book is on the aftermath, from how scientists figured out that a virus was responsible to actually trying to find a sample of the virus and figuring out why it was so virulent.

My big question after finishing Barry's The Great Influenza was how scientists eventually figured out that the influenza was caused by a virus and not by a bacteria. Kolata goes a little into this, but I don't actually remember exactly how people came to the conclusion. I believe it was less a single moment and more lots and lots of experiments that gradually ended up ruling out a bacteria? I also found it kind of hilarious that Kolata gives Barry's favorite scientists one or two lines and then skips over them entirely.

Most of the book is spent on how two different teams of people went looking for samples of the 1918 virus. The U.S. Army had actually preserved several bits of lung sample, but the big discovery was finding the still-frozen body of an Inuit woman in Alaska. I found Kolata's write up of the team that didn't succeed a bit odd, particularly her description of the woman in charge, Kirsty Duncan. There are just a few weird mentions of how attractive Duncan was to the men on the team, and one of the team member's daughters basically accuses her father and Duncan of having an emotional affair.

Also, although the successful team did end up getting the full genetic sequence of the virus, the book makes it sound like everyone is still puzzled as to why the 1918 virus was so deadly. When I finished the book, I felt as though Kolata had written the book too early, although of course one doesn't know if a major scientific discovery is going to be made or not.

I did end up finding an article on the reconstruction of the 1918 virus at the CDC, which was apparently in 2005. They did several experiments, and it seems as though the combination of several things all worked together to make the virus so virulent. My main question is if Kolata had written the book prior to this, and then published it in 2011, and if so, why it wasn't updated. It seems like this would have been good information to have in the book!

- rachelmanija, Ch. 1-2
- rachelmanija, Ch. 3-6

The pandemic begins! In the late winter/early spring of 1918, influenza begins to make its way through various military camps. Mostly it seems that while the number of cases and the seriousness of the cases was abnormal, it was mostly written off as a particularly virulent and nasty flu season, with a few outbreaks later in the year (around May) being even worse, with deaths hitting younger people and occurring within 24-48 hours of the onset of pneumonia.

But by August, it had quieted down. Then the October wave came, and it was really bad. Barry gives several possibilities as to what happened but mostly concludes that the original virus from the spring mutated to become more lethal, and notes that often the virulence of pathogens follow a sort of bell curve. They grow worse for a bit, but then gradually become less lethal, since you can't really get transmitted if you kill all your hosts too quickly.

Barry's descriptions of the October onset of the virus are pretty terrifying. Not only was it hitting mostly younger people harder, it caused bleeding out of multiple body orifices, and people's blood would be so devoid of oxygen that they would look blue or even so dark blue they looked black. The piling up of bodies, the way hospitals were overwhelmed all sound like some headlines from today, as do stories of the federal government playing it down, for fear that it would interfere with the war effort. Some mayors or governors were very blase and didn't shut things down due to the potential economic effects, while others, who were being hit by the virus, were asking the federal government for help and being ignored. It sounds like Woodrow Wilson never mentioned the pandemic at all, in public or in private, which is mind-boggling. And meanwhile, the press, pressured by anti-sedition acts, kept printing that everything was fine even as people could see everyone dying.

It sounds like the Public Health Service and the Red Cross were pretty good at organizing, but eventually there were just not enough doctors, and especially not enough nurses. It's irritating that Barry emphasizes here how important nurses were, because even if there were no cure, they could make people more comfortable, and keep an eye out for things getting worse about two weeks in to the illness. Except he doesn't talk about any nurses much at all! Then we find out that not only has Welch done no lab work for decades, he also comes down with the flu at the beginning of the second wave and doesn't contribute anything. But he still gets a chapter!

The other annoying thing is that the much vaunted "warriors" of Part I are currently all going down the wrong path and mostly determining that the outbreak was caused by a bacteria. It sounds like a few speculated that it could be a virus, but that got discarded fairly early. Here's the thing: I feel like there should be more stories about scientists going down the wrong path and building on other scientists' work because that is how you figure things out, and otherwise the story is that of lone heroes making miraculous breakthroughs. So this would have been interesting except for the fact that all these scientists were being lauded as lone heroes, to the point which other people doing organizing and caretaking are not ever mentioned by name. Argh.

- rachelmanija's write up of Parts IV-VII

( On the naming of things )

I am not sure anyone else is interested, but Rachel and I are doing Pandemic Book Club! Come join if you are interested as well!

To give you a sense of my brain, I actually read 2/3 of The Great Influenza several months prior to the coronavirus and also listen to podcasts like This Podcast Will Kill You for fun.

Anyway! On to Part I: The Warriors!

I remembered that this book got off to a slow start, and I stand by that judgment. Barry opens with an attention-getting prologue, describing one scientist's encounter with people struck down by the 1918 influenza, particularly emphasizing how deadly it was in young people, and how people would be so short of breath that they would literally turn blue or even close to black due to lack of oxygen.

...and then he goes back to the founding of Johns Hopkins. And then to establish the importance of Johns Hopkins, he basically ends up retelling the history of Western medicine from Galen and the four humors. Which I kind of knew about? And it's a bit of a distraction from Johns Hopkins, as I feel you could establish its importance by just noting that it was the first medical research institution in the US at a time when American medical schools basically granted anyone who could pay a medical degree and germ theory was not the widely accepted consensus.

...and then he goes on to talk about several notable scientists, none of whose names I can remember, even though I have actually read 2/3 of the book. As Rachel notes, Barry has a giant crush on William Welch, one of the founders at Johns Hopkins, but mostly goes on to talk about the scientific accomplishments of Welch's students. I get that he is trying to establish Welch as the connecting factor, but given that Barry himself notes that Welch did not have the concentration to pursue significant scientific questions, it feels very disjointed.

I feel this section would have been much more interesting if I had some sense of who all the people were in terms of the 1918 pandemic. I think Barry establishes that a bit later on, but I did get to some of the book that discusses how the pandemic influenced medical science in America, and it's still hard drawing the connections with the people in this section of the book.

Anyway, the pandemic is next! That should be much more interesting.

- rachelmanija's review of Part I