What is the main message of The Great Influenza?

The main message of The Great Influenza is the devastating impact and lessons learned from the 1918 influenza pandemic.

How long does it take to read The Great Influenza?

The reading time for The Great Influenza varies depending on the reader. However, the Blinkist summary can be read in just 15 minutes.

Is The Great Influenza a good book? Is it worth reading?

The Great Influenza is worth reading for its comprehensive exploration of the pandemic, its historical context, and the lessons it offers about preparedness.

Who is the author of The Great Influenza?

The author of The Great Influenza is John M. Barry.

The Great Influenza Summary of Key Ideas and Review

Name: The Great Influenza
Rating: 4.6 (139 reviews)
Author: John M. Barry

Introduction

What’s in it for me? An unflinching look at the human catastrophe wrought by the 1918 influenza pandemic.

The 1918 influenza pandemic was the worst outbreak of disease in human history. It claimed more human lives in a year than the Black Death did in a century; it killed more people in 24 weeks than AIDS killed in 24 years. The disease was an especially virulent strain of the flu, but it wasn’t just the illness that killed people. Government distraction, and then inaction, was also a death sentence for people all over the world.

These statistics are alarming, but they don’t tell the true story of the pandemic. These blinks paint the full picture of the 1918 influenza pandemic, delving into the nature of the influenza virus, the reason behind its deadliness, and why even the world’s best scientists working together were ultimately unable to prevent catastrophic loss of life.

In these blinks, you’ll learn

why Harvard was actually a pretty awful medical school before the twentieth century;
why the rural farm county of Haskell, Kansas, is infamous in the medical community; and
how influenza might have contributed to the rise of Adolf Hitler in Germany.

Key idea 1 of 10

By the onset of World War I, American medical science had improved tremendously and was approaching world class status.

“First, do no harm.” You might recognize those words from the Hippocratic oath – the oath doctors take before they can start practicing. It’s named after the ancient Greek physician Hippocrates, who lived in the fourth century BCE.

Hippocrates had ideas about medical therapy too. He prescribed bloodletting and leeching as therapies for many ailments because they could restore harmony to a sick body’s unbalanced humors. Until the nineteenth century, doctors still used these methods to treat various maladies. Even in 1800, over two millennia after Hippocrates, medicine remained what one historian called “the withered arm of science.”

By contrast, nineteenth century Europe was a revolutionary place for medicine. A wave of increasingly revolutionary discoveries culminated in 1883, when German physician Robert Koch proved that germs can cause disease. It was the first modern breakthrough in the study of disease.

Medicine in the US, however, lagged far behind. That was soon to change.

The key message here is: By the onset of World War I, American medical science had improved tremendously and was approaching world class status.

In 1873, business tycoon and philanthropist Johns Hopkins died, leaving $3.5 million to found a university and hospital in Baltimore. His trustees aimed to make the institution a beacon of American medicine.

There wasn’t much competition. American medical schools at the time paid their faculty and earned profits from student fees, incentivizing them to admit large classes of students irrespective of academic talent. Even the best schools operated this way: in 1870, you could get an MD from Harvard having failed four out of nine classes.

Johns Hopkins University changed all that. By recruiting graduates from the finest German medical universities, it gained instant credibility. One of these professors was William Welch, a charismatic young instructor who would head up Hopkins medical research arm. Welch presided over a close-knit group of brilliant, curious researchers.

Hopkins’s new approach to medicine attracted attention. Looking after his own legacy, business magnate John D. Rockefeller founded the Rockefeller Institute in 1901. As with Johns Hopkins, money bought excellence; Rockefeller’s institute quickly became influential.

Together, the Hopkins and Rockefeller institutes raised the bar for American medical schools. In fact, by the outbreak of World War I, American doctors were becoming as good – if not better – than their European counterparts.

The feather in Welch’s cap would be a school for public health aimed at disease prevention, which he inaugurated at Hopkins on October 1, 1918. Welch was sick that day with a cough and a violent headache. He’d recently traveled to Boston to investigate a new epidemic engulfing the Northeast. He suspected it was a new strain of influenza.

Key idea 2 of 10

Influenza is a highly efficient virus, constantly mutating to evade our immune system.

When Welch started feeling under the weather on the train back to Baltimore from Boston, the virus had already been in his body for days, silently multiplying. Welch’s every sneeze and cough carried virus molecules looking for a new host. Presumably, his long career in public health would have made him extra careful. But the train journey must have given the virus an opportunity to spread with chilling efficiency to other travelers.

The purpose of a virus is to replicate and find new hosts. It’s extremely good at it. In fact, each influenza molecule can create between 100,000 and a million new virus proteins.

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Key idea 3 of 10

America’s effort to fight World War I created the perfect conditions for the spread of a virus.

By 1918, the world was used to death. It was the last days of World War I, which had left much of Europe in ruins. Over 5 million soldiers had been killed, and the horrors of trench warfare had traumatized the continent.

The US got involved in the war late, but once President Woodrow Wilson committed, he committed totally. He forged the nation into a weapon by concentrating the efforts of every faction toward one singular goal: victory over Germany. A draft was instated, calling all healthy men from age 18 to 45 to serve in the Army.

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Key idea 4 of 10

When the virus first hit, it seemed like the normal flu, but the second wave made clear that this virus was far worse.

The winter of 1917-18 was the coldest on record in Haskell County, Kansas. Gale-force winds came off the prairie, hitting houses like a gunshot. Folks there were used to it, though. They were a hardy sort, sodbusters who fully expected a life of challenge and independence on the vast plains.

Haskell’s farmers probably wouldn’t have expected anything from their county to have worldwide impact. But it was there that the 1918 strain of influenza made the jump from birds to humans. From Haskell, someone carried it to Camp Funston in eastern Kansas, home to around 56,000 men. In April, soldiers from Camp Funston went to war in Europe, and the virus was off to the races.

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Key idea 5 of 10

In the fall of 1918, the virus hit with terrible ferocity, exacerbated by the bungled response by city and Army officials.

On September 7, 1918, 300 soldiers arrived in Philadelphia from Boston, bringing death with them. By September 15, the virus had made 600 soldiers sick enough to require hospitalization. More men were reporting ill every few minutes. The disease threatened to engulf the city, heaving as it was with overcrowded slums, factories, and tenement houses.

Philadelphia public health director Wilmer Krusen was aware of the crisis in his city, as well as burgeoning deaths at camps and cities around the country. But he took no action. Not only did he publicly deny that influenza threatened the city, he didn’t prepare emergency stockpiles or action plans. He thought that any action would lead to panic and interfere with the ongoing war effort.

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Key idea 6 of 10

The 1918 flu was quick, grisly, and more likely to come for the young and healthy.

The 1918 strain of influenza was a particularly nasty one, but it was still just the flu. As such, while it made hundreds of millions around the world ill, the vast majority got well again.

But for an unlucky minority, it was worse than any flu before – or since. This meant not only more pain and horror, but also more patients who developed pneumonia, which led directly to a higher death rate.

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Key idea 7 of 10

America’s best scientists set about understanding what caused the virus, but their research only led to more questions.

Unlike their political contemporaries, the leading scientists of the US fully realized the catastrophic potential of the pandemic and did everything they could to move more quickly.

Scientists could agree on precious little – but they had a starting point. First, they knew that the flu was spread by an airborne pathogen and that it spread easily in crowds. Second, they knew it could be caught not just through inhaling, but by hand-to-face contact.

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Key idea 8 of 10

The US government’s inaction contributed to catastrophic loss of life all over the world.

The 1918 strain of influenza was perhaps the most virulent of all time. Once it made the jump from animal to human, there was no way to stop the virus from spreading.

The US government had several chances to slow the progress of the virus and save lives. By slowing the virus, better healthcare would have been possible for those who did catch it. If hospitals weren’t packed with the sick and dying, patients wouldn’t be forced to convalesce at home and risk spreading the flu to their loved ones.

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Key idea 9 of 10

The pandemic slowly abated, but the true scope of its consequences is hard to fathom.

As suddenly as the virus came, it faded away. By October 26, a mere two weeks after the peak of the outbreak in Philadelphia, city officials lifted the order closing public places.

Once a virus becomes efficient in its ability to infect, two processes begin. One is immunity – once influenza passes through a population, people begin to develop some resistance to it. For the 1918 influenza, this cycle took 6 to 8 weeks, after which reports of new cases declined dramatically.

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Key idea 10 of 10

Long after the pandemic, scientists remained obsessed with finding a cure. For most, this quest ended in disappointment.

The 1918 pandemic shattered the illusion that science could solve any problem. Every lab in the world was focused on finding a solution, but by 1920 the pandemic burned itself out with no help from science. As one physician at the time put it, “Doctors know no more about this flu than fourteenth century Florentine doctors knew about the Black Death.”

The scientists who had worked through the pandemic had seen enough horror to haunt them for life. But none would be able to rest until they had an answer. It was a quest that would lead, in some cases, to tragedy.

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