“The number of dead could have been as high as 100 million—a number so big and so round it seems to glide past any notion of human suffering without even snagging on it. It’s not possible to imagine the misery contained within that train of zeroes. All we can do is compare it to other trains of zeroes—notably the death tolls of the First and Second World Wars—and by reducing the problem to one of maths, conclude that it might have been the greatest demographic disaster of the twentieth century, possibly of any century.”
The influenza epidemic that began in 1918—which became known as the Spanish Flu—has drawn a lot of interest in recent months as comparisons are made to the current situation with COVID-19. Pale Rider by Laura Spinney was published in 2017, shortly ahead of the flu pandemic’s centenary year. As such, it is quite current, but of course does not directly address our present circumstances. Spinney tracks the influenza’s two year path around the globe, while also providing historical context, history of medicine, and a significant look at recovery and collective memory as it relates to the pandemic. By the numbers, the contemporary estimate of deaths was 20 million, but over the years that has risen to 50-100 million as more records and evidence come to light. Probably about one in three of the then 1.8 billion living people would have become infected, and while most recovered, up to five percent of the sick may have perished.
I selected this title from among a few popular books about the 1918 pandemic as it is noted for its attempt to take a more global approach to understanding the outbreak. Other previous titles have a more North American and European focus, despite the fact that these areas were not the hardest hit. According to Spinney, that dubious honour likely goes to India, though the numbers for China are murky. In addition to addressing the first recorded case, at Camp Funston military base in Kansas, and covering the impact on the Western Front as well as the acquisition of the “Spanish Flu” nomenclature, Spinney goes further afield to dig into the available numbers for places as various as China, Persia, India, Australia, Iceland, and more, resulting in a more complete picture of the global impact.
The structure of the book is circular, and somewhat repetitive. Rather than following a chronological timeline, Spinney takes a locale-by-locale approach that covers the same chronology multiple times in different places. Despite the repetition, this is an effective structure for sinking into each location and getting a full sense of their experience of the pandemic, which had huge regional variations. Australia, for example, experience only the third wave, having effectively kept out the deadly second wave with a maritime blockade. Spinney also covers three major theories about where the flu may have emerged before it surfaced and was recorded in Kansas, but with a careful eye to the contemporary prejudices that may have been shaping these hypotheses, particularly with regard to China. Within the United States, she addresses the tenements of New York, as well as the remote villages of Alaska, and highlights how differences in responses between cities led to vastly different death rates.
In addition to tracking the pandemic, Pale Rider provides and explains historical context about where the development of medical understanding and technology stood when the pandemic began. Notably, the electron microscope was not invented until the 1930s, meaning that while bacteria could be seen on an optical microscope, viruses—which are about twenty times smaller—were still invisible. Spinney briefly traces the evolution of Western medicine in relation to contagious diseases, and in specific locales such as Indian, China, and Persia, she also addresses how this knowledge was interacting with local medical traditions like Ayurveda. In the West, she also briefly chronicles the backlash against traditional doctors for their failure to prevent the outbreak in the first place.
A notable cautionary note that emerges from Pale Rider is the danger of mass gatherings for any purpose. Influenza does not distinguish between a church service and an armistice parade, a wedding or a funeral. Particularly chilling is Spinney’s account of the Spanish city of Zamora, which was among the hardest hit in that country. Zamoran congregations actually swelled as the pandemic raged, and the populace sought solace and prayed for relief. The city had a zealous new bishop who encouraged religious gatherings, called novenas, promoted the adoration of relics, and continued to distribute communion, all activities that send a shiver down the spine of anyone with a current understanding of the germ theory of disease.
In the latter part of the book, Spinney dives into the difficulty of trying to tease apart the inextricable impacts of the one-two punch that was the Great War with a pandemic following close on its heels. Although more people died in the pandemic, the war remains much better remembered, though Spinney suggests that the centenary is changing that, and no doubt the current situation will also contribute to the revival of interest. For those wondering whether they would be up to reading this book at the moment, I found the author’s approach thorough, but largely not grisly, though there are some dark spots. Spinney leans more towards statistics rather than graphic descriptions of the physical suffering of the flu victims.