Speaker 1: Hi, My name is Carrie. I live in Colorado and
Speaker 1: work as a hospice chaplain. In that role, I provide
Speaker 1: spiritual and emotional support to some of the most vulnerable
Speaker 1: among us, those who are diagnosed with the terminal illness
Speaker 1: and expected to die within six months or less. This
Speaker 1: season of COVID has had an extraordinary impact on those
Speaker 1: who are already facing excruciatingly difficult circumstances. For those who
Speaker 1: receive hospice care at home, many have not had a
Speaker 1: chance to spend cherished time with children, grandchildren, siblings, and
Speaker 1: friends who are unable to visit due to travel restrictions,
Speaker 1: border closures, and the risk of virus exposure. This also
Speaker 1: means that family members who would ordinarily jump in and
Speaker 1: lend a hand with the intensive responsibility of twenty four
Speaker 1: to seven care for a loved one who is dying,
Speaker 1: are less available to provide the kind of practical and
Speaker 1: emotional support families need. Many who are terminally ill also
Speaker 1: receive hospice care in nursing communities, and that has proven
Speaker 1: especially challenging As a result of state restrictions to protect
Speaker 1: this population from devastating outbreaks, family members and hospice support
Speaker 1: staff are rarely permitted to visit nursing community residents in
Speaker 1: person right now, although family members are occasionally able to
Speaker 1: schedule window or outdoor visits, these are typically limited to
Speaker 1: thirty minutes or so. They are dependent on whether and
Speaker 1: difficult or impossible to coordinate for those who are bedbound,
Speaker 1: and unfortunately, window and outdoor visits are incredibly confusing for
Speaker 1: people who have dementia and frustrating for those with hearing
Speaker 1: and visual deficits. Telephone and video visits are typically not
Speaker 1: optimal or possible for the same reasons. So imagine that
Speaker 1: you're living in a nursing community. Anticipation builds as you're
Speaker 1: willed to an outdoor visiting area where your wheelchair is
Speaker 1: locked in place six feet away from your son or
Speaker 1: sister or best friend you haven't seen in six months.
Speaker 1: You can't hear what they're saying because you're too far away.
Speaker 1: You can't watch their lips because they are wearing masks,
Speaker 1: can't hug them, and aren't allowed to sit with them
Speaker 1: and enjoy your favorite lunch they picked up on the
Speaker 1: way to visit someone inside inners in community during the
Speaker 1: pandemic in the state of Colorado. Your loved one must
Speaker 1: be actively dying to qualify for what we're calling compassion visits. Occasionally,
Speaker 1: hospice support team members are permitted to visit during this
Speaker 1: short window of time. When people are dying, their greatest
Speaker 1: need is almost always to spend time with those who
Speaker 1: are closest to them, reflecting on memories, verbalizing expressions of love,
Speaker 1: offering forgiveness, seeking reconciliation, and sharing hugs and kisses. There's
Speaker 1: usually some level of fear about the dying process, concern
Speaker 1: regarding a finish business, and a desire to address these issues.
Speaker 1: When family members, friends, and support staff can be present
Speaker 1: to offer reassurance, calm anxiety, answer questions, and respond to
Speaker 1: unmet emotional and spiritual needs, the dying process is more
Speaker 1: peaceful for the person who is dying and also for
Speaker 1: family members and other companions during the process. It's important
Speaker 1: to know that when we're actively dying, that period of
Speaker 1: time when in person compassion visits are allowed, we can
Speaker 1: generally hear what's going on around us, but are minimally
Speaker 1: responsive and don't have the energy to engage in conversation.
Speaker 1: During this especially tender time, I encourage family members and
Speaker 1: friends to keep talking to their loved one and watching
Speaker 1: for subtle signs of response, usually a facial movement or
Speaker 1: eyes opening briefly. The difficult part of limiting family visits
Speaker 1: to the last few days of life is that most
Speaker 1: of us want opportunities to interact, to have important conversations
Speaker 1: before our loved one is actively dying and becomes minimally responsive.
Speaker 1: This is often not possible with current guidelines. That's heartbreaking
Speaker 1: for family members and friends, and also difficult for healthcare
Speaker 1: staff to witness. In fact, it compounds and complicates screeting process,
Speaker 1: not only now, but likely for years to come.
Speaker 2: My name is Clint and I'm a high school special
Speaker 2: education teacher in northeast Kansas. For most of the twenty
Speaker 2: twenty twenty twenty one school year, our district was going
Speaker 2: back and forth from fully remote to a hybrid schedule,
Speaker 2: with half of the students coming in the morning and
Speaker 2: half coming.
Speaker 3: In the afternoon.
Speaker 2: It was rough on all the teachers, but those of
Speaker 2: us in special education had a really tough time meeting
Speaker 2: our legally mandated service minutes for our students. Even when
Speaker 2: we were able to to connect with the kids on
Speaker 2: our caseload, it was often over zoom, which is a
Speaker 2: pay a limitation of actual student contact. All year, I
Speaker 2: been getting calls and emails from parents worried about their
Speaker 2: kids falling behind and expressing frustration at turning into their
Speaker 2: own kids de facto case managers and service providers. Each
Speaker 2: kid enrolled in special education services gets an Individualized Education
Speaker 2: Plan or IEP written for them every year. This year
Speaker 2: we had to amend every IP with a remote Learning
Speaker 2: contingency plan within the first month of school. During that time,
Speaker 2: the district changed their attendance plan and we had to
Speaker 2: adjust our servicemnts written on each IP as we rewrote
Speaker 2: our contingency plans. And the worst part for me and
Speaker 2: probably all of my colleagues as well, is that all
Speaker 2: this paperwork and bureaucracy comes at the expense of getting
Speaker 2: to actually spend time with our students. By far, the
Speaker 2: most important part of being a special education teacher is
Speaker 2: forming relationships with the students in our resource classes and
Speaker 2: our caseloads, but so much of our energy has been
Speaker 2: spent rewriting legal documents and organizing legally mandated meetings. I
Speaker 2: have some students I haven't even met all year, Even
Speaker 2: now that our district has gone back to full time
Speaker 2: in person. I actually had to hold an IPU eating
Speaker 2: last week for a student I haven't met at all. Fortunately,
Speaker 2: that student's guardian was very understanding and was able to
Speaker 2: be a strong advocate for them. Any teacher can tell
Speaker 2: you that it feels like very little actual teaching and
Speaker 2: learning has been happening since about March of twenty twenty,
Speaker 2: but in special education it's been particularly difficult. We're now
Speaker 2: back to school all day, every day with masks and
Speaker 2: social distancing, and it's becoming more and more clear just
Speaker 2: how much we lost being unprepared for a pandemic. All
Speaker 2: we can do now is try to make up as
Speaker 2: much lost ground as we can.
Speaker 4: Hi, my name's Millie. I'm twenty three years old. I
Speaker 4: graduated last year in twenty twenty and I live in
Speaker 4: Northern England in the UK. Like many people my age,
Speaker 4: I've found it really hard to get a job, at
Speaker 4: least a job that I want because of the pandemic.
Speaker 4: So I took a job in a COVID nineteen test center.
Speaker 4: We do the lateral flow test, which is a form
Speaker 4: of asymptomatic testing. We don't test people with symptoms that's
Speaker 4: the PCR test. The idea is to catch cases of
Speaker 4: COVID nineteen that wouldn't have been apparent, you know, because
Speaker 4: they don't show symptoms. And we work in a school,
Speaker 4: so we test teaching staff and all the pupils twice
Speaker 4: a week now, although the government guidance changes pretty much
Speaker 4: every week, so sometimes we're telling people to swab their
Speaker 4: tonsils four times, sometimes it's five, Sometimes it's just two
Speaker 4: on each tonsil, sometimes it's just upper nostril. We're really
Speaker 4: playing it by ear and it seems quite inconsistent the guidance.
Speaker 4: So we're just learning to try and be as accurate
Speaker 4: as we can under the changing circumstances. And we're all
Speaker 4: absolute beginners. My own degree was in French. I have
Speaker 4: no medical background. The only people that are test center
Speaker 4: with a medical or scientific background are our labtape technicians,
Speaker 4: and they taught us to be really meticulous and careful
Speaker 4: when we process the samples. We've seen some hilarious things.
Speaker 4: Some of the kids have asked what the tonsils are.
Speaker 4: Some of them swab the outside of their neck or
Speaker 4: we handed them the swab. The kids are very resilient
Speaker 4: and they're adapting remarkably well to this situation. I think
Speaker 4: it's other people who are having a hard time here
Speaker 4: in the UK. The public sector is a big support
Speaker 4: network for people, especially in poorer communities. We need places
Speaker 4: like schools, ordinary state schools and libraries health centers to
Speaker 4: stay open, but it's difficult because of the pandemic and
Speaker 4: we have to turn people away who are actually quite
Speaker 4: lonely without those services. And in terms of our rollout
Speaker 4: of mass testing, it's focused on key workers, for example,
Speaker 4: those who work in factories for food production, supermarkets, healthcare
Speaker 4: and education. But it's mostly run by volunteers and redeployed
Speaker 4: council workers. So sometimes we worry that we're not really
Speaker 4: qualified to be conducting tests and giving people these very
Speaker 4: crucial test results. And recently, the most striking thing that
Speaker 4: I've found is that older people who I work with
Speaker 4: in the test center, who guide our students through the
Speaker 4: swabbing process, have been comparing the effort we're all making
Speaker 4: collectively against COVID nineteen as a war effort. And you
Speaker 4: know that these are the people who they can remember
Speaker 4: their parents being involved in, you know, the war effort
Speaker 4: of the Second World War, and they're right you know,
Speaker 4: much like how women during war time moved to working
Speaker 4: in factories elements they never worked in before. Those of
Speaker 4: us who work in the public sector in the UK,
Speaker 4: who are employed by the local councils have been sent
Speaker 4: to deal with this crisis. We test people, We try
Speaker 4: and pick up on asymptomatic cases of COVID nineteen. We
Speaker 4: have jobs now where we're responsible for maintaining health and safety,
Speaker 4: avoiding cross contamination, and so much like a war effort,
Speaker 4: what I've seen here in the UK, especially among teachers
Speaker 4: and ordinary low level government workers, the wonderful ways in
Speaker 4: which ordinary working people can really pull together in times
Speaker 4: of crisis. And it's been amazing to see how it's
Speaker 4: brought people together, even though of course there's a lot
Speaker 4: of hardship. Ultimately, just like with a war effort, everybody
Speaker 4: has pushed their limits and found something to do. I
Speaker 4: love working in the test center. It's actually really good
Speaker 4: fun and it makes me feel like a scientist.
Speaker 5: Thank you so much to everyone who has shared a
Speaker 5: first hand account with us for this series, for this episode,
Speaker 5: for just filling out the Google everything.
Speaker 6: We really appreciate it.
Speaker 7: Yeah, thank you so much. Hi, I'm Erin Welsh and
Speaker 7: I'm Aaron Allman Updike and.
Speaker 5: This is this podcast will Kill You.
Speaker 7: Welcome everyone to episode twenty twenty twenty episodes in our
Speaker 7: Anatomy of a Pandemic series covering the COVID nineteen pandemic.
Speaker 5: It's been a lot, it's been a lot, very much.
Speaker 7: This is tentatively our final episode in this series. We
Speaker 7: have come a very long way since our first episode
Speaker 7: of this series, and we've covered.
Speaker 5: So much ground, so much ground. When we started this
Speaker 5: COVID nineteen series back in early twenty twenty, I don't
Speaker 5: think that we had any idea how many episodes of
Speaker 5: this we were gonna do and how many different lenses
Speaker 5: we would use to like examine the impacts of the pandemic.
Speaker 7: No, you, it was supposed to be one episode, Eric
Speaker 7: at first, and then.
Speaker 5: I talked you into six, give me six.
Speaker 7: And then it was like, well we should probably do
Speaker 7: some more. Well we should revisit okay.
Speaker 5: I mean, I've loved putting this series together. I think
Speaker 5: it's been really interesting and really has like allowed us
Speaker 5: to kind of feel out just how many ways there
Speaker 5: are to look at like this massive, massive thing of
Speaker 5: course that's impacting all of us.
Speaker 6: Yeah, and there.
Speaker 5: Are still so many unasked and unanswered questions. There are
Speaker 5: still many lenses that we haven't explored, and lots of
Speaker 5: ground that we still have left to cover. And I
Speaker 5: think that, you know, like I said, that's just part
Speaker 5: of the nature of a global pandemic, one that I'm
Speaker 5: sure will inspire or already has probably inspired a field
Speaker 5: of study all of its own.
Speaker 7: So we're not entirely ruling out the possibility of picking
Speaker 7: up the series sometime in the future to kind of
Speaker 7: cover some more of that uncovered ground, but for now
Speaker 7: we are putting a pin in it. We are tentatively
Speaker 7: concluding the series with an episode imagining what the future
Speaker 7: might hold for us by looking back in time to
Speaker 7: what is possibly the closest comparison to what we've experienced
Speaker 7: with COVID nineteen of course, the nineteen eighteen influenza pandemic.
Speaker 5: Yes, but before we get to that, we have some
Speaker 5: business to take care of.
Speaker 6: We sure do.
Speaker 7: What time is it?
Speaker 6: It's quarantiney time eronre Is.
Speaker 7: It always is on this podcast.
Speaker 5: It always is. We thought that for this last episode
Speaker 5: in the series, and especially for the topic that we're
Speaker 5: covering that the Corpse Reviver number one would be a
Speaker 5: good choice, an appropriate choice.
Speaker 7: I absolutely love it. So if anyone doesn't remember or
Speaker 7: hasn't listened, our very first quarantinie of all quarantinies, that is,
Speaker 7: from our very first episode, was Corpse Survivor number two,
Speaker 7: which we called the H one Drink one yep, from
Speaker 7: our first episode on the influenza pandemic. I love erin.
Speaker 7: When I saw that you suggested the corp Survivor number one,
Speaker 7: I was like, that's phenomenal.
Speaker 5: I mean, I was like, what was popular during nineteen eighteen?
Speaker 5: And then I was like, duh, there's Corpse Survivor number two,
Speaker 5: which implies there must be a number one, So let's
Speaker 5: do that one. It's going to be interesting to do
Speaker 5: a non alcoholic version, but that's okay.
Speaker 7: So what is in this quarantini?
Speaker 5: Ah, yes, so it is. I've just found this recipe
Speaker 5: on the internet. It is one ounce Kognak, one ounce Calvados,
Speaker 5: and half an ounce of sweet vermouth. But if you
Speaker 5: don't remember that or write that down, don't worry. We
Speaker 5: will post the full recipe on our website. This podcas
Speaker 5: will kill you dot Com and all of our social
Speaker 5: media channels, and that's also where we will post the
Speaker 5: non alcoholic version, whatever that will look like.
Speaker 7: If you go to our website, what you'll also find
Speaker 7: is so much other stuff, like a link to our
Speaker 7: merch and our Goodreads list, and our bookshop dot org
Speaker 7: affiliate account, our Patreon. You can find transcripts. You can
Speaker 7: find a list that Aaron Welsh put together of all
Speaker 7: the promo codes that we say on this podcast, so
Speaker 7: you can save some money if you're buying things. So
Speaker 7: many things, check it out. This podcast will kill you
Speaker 7: dot com.
Speaker 5: Yes, okay, Now let's get to the actual meat of
Speaker 5: this episode. Over one hundred years ago, the world experienced
Speaker 5: one of the deadliest, if not the deadliest pandemics in history. Yeah,
Speaker 5: a highly virulent strain of the influenza virus rapidly spread
Speaker 5: around the globe, killing an estimated fifty to one hundred
Speaker 5: million people. And if you've heard of the nineteen eighteen influenza,
Speaker 5: there's a good chance that it was in the context
Speaker 5: of the current COVID nineteen pandemic. With so many articles
Speaker 5: and podcasts and books and news programs and so on
Speaker 5: making comparisons between what's happening today and how things transpired
Speaker 5: in nineteen eighteen, and many of these comparisons are apt
Speaker 5: in some ways. What happened in nineteen eighteen is eerily
Speaker 5: reflected in the events of twenty twenty and twenty twenty one,
Speaker 5: and neither of us has gotten up the nerve to
Speaker 5: re listen to The very first episode of this podcast,
Speaker 5: and We Never Will Never Will I was released in
Speaker 5: twenty seventeen on the nineteen eighteen influenza So pre COVID,
Speaker 5: and several listeners who have listened to it have pointed
Speaker 5: out just how spooky it is to hear in light
Speaker 5: of this current pandemic.
Speaker 7: Oh, I'm sure, especially because at the end we talk
Speaker 7: about what could come next, and so it was us
Speaker 7: thinking about the nineteen eighteen influenza that inspired the topic
Speaker 7: of this episode. We have, over the course of the
Speaker 7: last year and a half or so, learned so much
Speaker 7: about the virus that causes COVID nineteen and the widespread
Speaker 7: impacts of the pandemic. But one of the biggest questions
Speaker 7: that remains unanswered is well, what happens now right, And
Speaker 7: of course we can't actually answer that question, and we're
Speaker 7: not really going to, but we can do the best
Speaker 7: that we can by looking at what happened in the
Speaker 7: nineteen eighteen influenza pandemic. Granted, the world was a very
Speaker 7: different place back then compared to today, but there are
Speaker 7: key lessons that we learned from the nineteen eighteen pandemic.
Speaker 7: So how well did we apply them to this current
Speaker 7: COVID nineteen pandemic. And if we use the aftermath of
Speaker 7: the nineteen eighteen influenza pandemic as like a rough roadmap
Speaker 7: for a post COVID future, what are the limitations in
Speaker 7: those kind of comparisons? And what can we learn from
Speaker 7: the similarities between these two pandemics and from their differences.
Speaker 5: Yeah, and to help us wrap up this Anatomy of
Speaker 5: a Pandemic series by answering these questions and many more.
Speaker 5: As always, we are extremely excited to be joined by
Speaker 5: John Berry, Award winning author of several acclaimed historical books,
Speaker 5: including The Great Influenza, The Story of the deadliest pandemic
Speaker 5: in History, which is just an absolutely fascinating read on
Speaker 5: the nineteen eighteen influenza pandemic. And I talk with John
Speaker 5: on May twenty fifth of this year, and we will
Speaker 5: let him introduce himself right after this break.
Speaker 3: I'm John Barry. Consider myself a writer before anything else,
Speaker 3: but a couple of my books have ended up involving,
Speaker 3: I mean policy. I got involved in pandemic preparedness planning
Speaker 3: with the Bush administration, actually the very first meeting from
Speaker 3: which the plans on non pharmaceutical interventions and pis so
Speaker 3: called in other words, what are you doing you don't
Speaker 3: have any drugs? Then worked a little bit with the
Speaker 3: Obama administration during the two thousand and nine pandemic and
Speaker 3: so forth. So I stayed involved in the area, you know,
Speaker 3: pretty regularly. I was on a federal government's Infectious Disease
Speaker 3: Board of Experts as the only non scientist on EDAM,
Speaker 3: and currently I have a title of Distinguished Scholar at
Speaker 3: the Tulane University School of Public Health and Tropical Medicine.
Speaker 5: Wonderful, Well, thank you so very much for taking the
Speaker 5: time to chat with me today. I'm very excited to
Speaker 5: hear your thoughts on sort of COVID nineteen versus the
Speaker 5: nineteen eighteen influenza. So we'll just dive in. So over
Speaker 5: the past year and a half, as I'm sure you're
Speaker 5: very familiar, there have been many comparisons made between the
Speaker 5: COVID nineteen pandemic and the nineteen eighteen influenza pandemic. But
Speaker 5: these are two very different pandemics caused by two very
Speaker 5: different diseases. So can you remind us of some of
Speaker 5: these similarities as well as some of the differences, things like,
Speaker 5: you know, the groups affected, the backdrop of World War
Speaker 5: One and what influence that had, case fatality rate, duration,
Speaker 5: et cetera.
Speaker 3: No. Number One, they're both, you know, viruses jump from
Speaker 3: animals to humans. Number two. The mode of transmission is
Speaker 3: absolutely identical, respiratory droplets and airborne. There may be there
Speaker 3: is very little foamite transmission for COVID. There's probably a
Speaker 3: little bit more of that from influenza. They bind two
Speaker 3: different binding sites, once a cialic acid for influenza and
Speaker 3: so called these two for Sarus kobe two. Both viruses
Speaker 3: could bind to cells deep in the lung, which is
Speaker 3: unusual for influenza and doesn't happen with the common cold
Speaker 3: the other coronaviruses that we're familiar with. It. So you
Speaker 3: can start off with a very serious condition if you
Speaker 3: have a heavy load of virus deep in the lung.
Speaker 3: Both viruses buying to cells in the upper respiratory tract,
Speaker 3: which is why they are easily transmissible stars. COVID two
Speaker 3: is much more transmissible than influenza. Ordinary seasonal flu is
Speaker 3: going to a reproductive number about one point two eight.
Speaker 3: The nineteen eighteen pandemic was about one point eight. COVID
Speaker 3: nineteen is about two point five to three, And in fact,
Speaker 3: the variants that have developed or higher than that, or
Speaker 3: would be if you didn't do anything to stop transmission.
Speaker 3: The target audience you might say, or target victims. In
Speaker 3: nineteen eighteen, probably two thirds of the dead were people
Speaker 3: aged eighteen to fifty. Obviously, COVID nineteen is primarily people
Speaker 3: over sixty five. The difference in age groups it has
Speaker 3: certainly had tremendous impact in terms of the public response
Speaker 3: and the politicization of the disease. If most of the
Speaker 3: deaths two thirds of the deaths were people eighteen to fifty,
Speaker 3: you wouldn't hear anybody talking about let's try herd immunity,
Speaker 3: heard immunity I wouldn't work anyway for a variety of reasons.
Speaker 3: But I'm getting off the subjects. So let's say, uh,
Speaker 3: both viruses in terms of similarity. Both of them, in fact,
Speaker 3: affect virtually every organ, quite literally from the testes to
Speaker 3: the brain. If anything, in nineteen eighteen there was even
Speaker 3: more neurological complications. And we're seeing today the two biggest
Speaker 3: differences other than the one I already mentioned, virulence, The
Speaker 3: nineteen eighteen pandemic was much much, much more virulent. People
Speaker 3: could die in less than twelve hours. They could die
Speaker 3: with horrific symptoms. Now, most of the deaths were secondary
Speaker 3: bacterial pneumonia infections, which antibiotics would help with today. But
Speaker 3: even today, the case fatality rate for bacteria in pneumonia
Speaker 3: following influenza is about center eight percent, So that's roughly
Speaker 3: a quarter of what it was back in nineteen eighteen.
Speaker 3: It's still quite high for that disease. That aside, there
Speaker 3: were many many deaths that were directly caused by the
Speaker 3: virus so called long covid. That same phenomenon occurred in
Speaker 3: nineteen eighteen. You know, worldwide, nineteen eighteen probably killed fifty
Speaker 3: to one hundred million people. If you adjust for population,
Speaker 3: that's sequel to two hundred and twenty five to four
Speaker 3: hundred and fifty million people today. So even if we
Speaker 3: did nothing with COVID nineteen except just let it run loose.
Speaker 3: The projections would not come up with anything like that
Speaker 3: kind of death toll, thank god. And another very important
Speaker 3: difference is duration, which you mentioned. Influenza just moves much quicker,
Speaker 3: but much much faster in every area. Incubation period, how
Speaker 3: long you're sick, how long your shed virus, how long
Speaker 3: to recovery, all those things are much faster in nineteen
Speaker 3: and influenza, whether it's seasonal influenza or nineteen eighteen. In
Speaker 3: that sense, nineteen eighteen was just like ordinary infla, it's
Speaker 3: just much faster. So in nineteen eighteen, probably as much
Speaker 3: as two thirds of the dead died in a period
Speaker 3: of really weeks, maybe fourteen weeks or so in the
Speaker 3: fall of nineteen eighteen, And in any particular place it
Speaker 3: was faster than that, because influenza then would go through
Speaker 3: a community in six to ten weeks, it would peak,
Speaker 3: and when it was gone, it was essentially gone. So
Speaker 3: there were waves in nineteen eighteen, but they were very discreet. Obviously,
Speaker 3: COVID nineteen has been around for much much longer now.
Speaker 3: Certainly a lot of that is because we interfered and
Speaker 3: tried to stop transmission, which I certainly applaud and saved
Speaker 3: hundreds of thousands of lives in the United States alone,
Speaker 3: And that has stretched out the length of time we
Speaker 3: had to deal with the virus, no question. But even
Speaker 3: if we had not done anything but let the virus run,
Speaker 3: we would still be dealing with it. So that's pretty
Speaker 3: much a rundown of these similarities and differences.
Speaker 6: Yeah, that's fascinating.
Speaker 5: So one of the things you mentioned was this politicization
Speaker 5: of the COVID nineteen pandemic, and it's true that it
Speaker 5: has been very highly politicized, both in the US as
Speaker 5: well as in other countries. And you know, going back
Speaker 5: to nineteen eighteen, did we see a similar intersection of
Speaker 5: public health and politics, And if we did, how did
Speaker 5: that affect both the way that the pandemic played out
Speaker 5: as well as the aftermath And what can that teach
Speaker 5: us about this current pandemic.
Speaker 3: There was a very significant political context in nineteen eighteen,
Speaker 3: what is very different from today. We were a war
Speaker 3: and therefore the government, the federal government focused absolutely everything
Speaker 3: on the war effort. They wanted nothing to distract from
Speaker 3: it or detract from it. This included any bad news
Speaker 3: which they felt was bad from around and as a result,
Speaker 3: there was a lot of fake news in nineteen eighteen,
Speaker 3: but it all came from the government, and the government
Speaker 3: was saying things like, this is ordinary influenza by another name.
Speaker 3: What people knew was ordinary influenza by another name. If
Speaker 3: you know, someone's dying in less than a day after
Speaker 3: the first symptoms, sometimes in less than twelve hours, and
Speaker 3: people dying in such large numbers, you know, everybody knew
Speaker 3: it was an influenza by another name. Nonetheless, the government
Speaker 3: continued to insist upon that, and in almost every local
Speaker 3: community they echoed that refrain, although nobody believed it, but
Speaker 3: it was not. There was no partisanship the entire country,
Speaker 3: probably more so than at any other time in American history.
Speaker 3: There was an effort by the federal government to control
Speaker 3: the way people thought, and also probably more so than
Speaker 3: any other time in American history. They were successful, but
Speaker 3: it wasn't partisan this time around. Obviously, it became highly partisan.
Speaker 5: Right Comparing the involvement of politics in public health, what
Speaker 5: was the aftermath of that like in nineteen eighteen, or
Speaker 5: what can we learn from that about you know, and
Speaker 5: apply it to today? Are there any lessons to be
Speaker 5: learned about this involvement of politics and public health in
Speaker 5: terms of pandemics.
Speaker 3: Yeah, the two lessons from nineteen eighteen that are pretty clear.
Speaker 3: Number one, tell the truth and number two so called
Speaker 3: non pharmaceutical interventions. Again, what do you do when you
Speaker 3: don't have any drugs that they work? So those are
Speaker 3: the two lessons, and they're intertwined because if you don't
Speaker 3: tell the truth, you're not going to get public compliance
Speaker 3: with the recommendations on public health. If that's going to work,
Speaker 3: people have to believe what you're saying. They have to
Speaker 3: trust you, and without telling the truth, people are not
Speaker 3: going to trust you. You know, some countries around the
Speaker 3: world did tell the truth from the beginning and did
Speaker 3: implement NPIs with extraordinary effectiveness. Well, Australia has had a
Speaker 3: total of nine hundred and nine deaths, which if you
Speaker 3: adjust for population, would be equivalent to twelve thousand deaths
Speaker 3: in the United States, and we are as we're speaking
Speaker 3: at five hundred and seventy nine thousand deaths in the
Speaker 3: United States. It's the same virus, they have, the same tools,
Speaker 3: they have the equivalent of twelve thousand deaths. We have
Speaker 3: five hundred and seventy nine thousand deaths. The difference is leadership.
Speaker 5: Yeah, absolutely, And so going back to nineteen eighteen, what
Speaker 5: are some of the ways in which countries failed to
Speaker 5: tell the truth back then? And I wonder if you
Speaker 5: could expand a bit more on our own, you know,
Speaker 5: the US honesty during this present pandemic and sort of
Speaker 5: tracing back the impact that has had.
Speaker 3: Well again in the US, we were doing things like
Speaker 3: the line was that this is ordinary influenced by another
Speaker 3: name in Philadelphia City I wrote about at length in
Speaker 3: the book. At a time when you know they're they're
Speaker 3: digging mass graves with steam shovels, and priests are actually
Speaker 3: driving horse drawing carts down the street calling upon people
Speaker 3: to bring out their dead. They blatedly finally closed schools, churches, theaters, saloons,
Speaker 3: and so forth. And one of the newspapers that actually said,
Speaker 3: this is a direct quote, this is not a public
Speaker 3: health measure. You have no cause for panic or alarm.
Speaker 3: It's not a public health measure. I mean, how stupid
Speaker 3: did they think their readers were. All that did was
Speaker 3: tell people they couldn't believe anything that they were in
Speaker 3: the newspaper, which, of course back then was the source
Speaker 3: of information. You know, the result was it spread terror.
Speaker 3: If you can't believe what you're being told and you're
Speaker 3: facing this very dangerous, even you know, horrific threat, then
Speaker 3: you were thrown entirely upon your own devices. Can't trust anybody.
Speaker 3: Fear is everywhere, and it spread fear and panic. And
Speaker 3: you know, in Philadelphia again it's an example when they
Speaker 3: were heads of volunteer efforts were calling for volunteers repeatedly,
Speaker 3: nobody was showing up. I think that was a direct
Speaker 3: result of the loss of trust. You know, I think
Speaker 3: society essentially is based on trust, and if without trust,
Speaker 3: I think society begins to at best fray and at
Speaker 3: worst fall apart. And in Philadelphia, society certainly began to pray,
Speaker 3: and maybe even worse than that.
Speaker 6: Yeah.
Speaker 5: Absolutely, And so you touched on something that I think
Speaker 5: is really interesting, which is this source of information that
Speaker 5: people use to try to get public health information back
Speaker 5: in nineteen eighteen, And you know, you said it was
Speaker 5: primarily through newspapers, and that is certainly not the case
Speaker 5: today where we have the Internet, we have social media,
Speaker 5: and you know, this overall interconnectedness makes it very easy
Speaker 5: to spread both factual information as well as misinformation or
Speaker 5: even disinformation. And this makes it really challenging to determine
Speaker 5: what is the truth, you know, and what is fiction.
Speaker 6: And so when people sort.
Speaker 5: Of abandoned newspapers and said I can't rely on this anymore,
Speaker 5: where else did they go to find, you know, public
Speaker 5: health information?
Speaker 3: Well, that's exactly the problem. There really was no place.
Speaker 3: It wasn't really an alternative other than a personal physician.
Speaker 3: If someone had a personal physician and if in this
Speaker 3: incredible onslaught of demand on that physician's time, if he
Speaker 3: could respond, and of course they were essentially all male
Speaker 3: back then, you know, that was part of the problem. Today,
Speaker 3: very good information is very accessible. Some people actively choose
Speaker 3: to ignore it, but it's there if they want to
Speaker 3: find it. Again, that wasn't the case in nineteen eighteen.
Speaker 3: There were a couple of places, but they were pretty
Speaker 3: unusual where the public officials in that city were very truthful.
Speaker 3: San Francisco would be a primary example of that, but
Speaker 3: very unusual.
Speaker 6: Interesting.
Speaker 5: Yeah, So this current COVID name teen pandemic has put
Speaker 5: public health, which is often overlooked, in the forefront of
Speaker 5: both international and national conversation. And people are now engaging
Speaker 5: with public health measures and information in ways that we
Speaker 5: haven't seen in the US in quite some time. People
Speaker 5: are doing things like wearing masks, they're not traveling, not
Speaker 5: gathering in groups, social distancing, and so on. How did
Speaker 5: the nineteen eighteen influenza affect like public health infrastructure or
Speaker 5: the general perception of public health among the public.
Speaker 3: Well, you know, many cities had public health agencies. Some
Speaker 3: of them were really good. I mean New York City,
Speaker 3: for example, had one that was a major supplier of
Speaker 3: if theory anti toxin, did tremendous amounts of research. Was
Speaker 3: almost like an asshole institutes of health. But number one,
Speaker 3: this disease hit so fast in most places, the public
Speaker 3: health authorities were complicit with the rest of the government
Speaker 3: in terms of false reassurance. Because of the war, you know,
Speaker 3: there wasn't really a relationship with the so called public
Speaker 3: health infrastructure. You know, pretty much every city tried to organize,
Speaker 3: certainly the larger cities did, you know, and they would
Speaker 3: have break the city into districts and so forth, and
Speaker 3: put people in charge of the districts, and it all
Speaker 3: sounded very good on paper. But the actual service to
Speaker 3: those districts left a lot to be desired. You know,
Speaker 3: it was just so overwhelming, and they just didn't have
Speaker 3: the people for it. In terms of numbers of personnel,
Speaker 3: that huge percentage of the doctors and nurses were actually
Speaker 3: in the army. They had been drafted or volunteered. So
Speaker 3: the war really affected everything in terms of what happened
Speaker 3: inside the United States and how it was handled. In
Speaker 3: terms of the spread of the disease, I think the
Speaker 3: war was a very minor factor. You know, there are
Speaker 3: people who think it's spread around the world. I think
Speaker 3: they're not thinking through what they're saying. We've had influenza
Speaker 3: pandemics that managed to cross the ocean in the sixteen hundreds,
Speaker 3: when it took weeks to cross the ocean, so you
Speaker 3: don't need an airplane. And of course much of the world,
Speaker 3: I mean all the world in nineteen eighteen, you know, Africa,
Speaker 3: South America, they were not at war, and they suffered
Speaker 3: grievously from the pandemic. You know, I think the only
Speaker 3: impact the war had was it probably accelerated the spread
Speaker 3: in Western Europe a little bit, maybe more than a
Speaker 3: little bit, but we're still only talking about a few
Speaker 3: weeks difference.
Speaker 6: Hm, that's really interesting.
Speaker 5: Yeah, I hadn't I hadn't really thought of that before,
Speaker 5: but that does make a lot of sense. So how
Speaker 5: did the nineteen eighteen influenza affect the way people viewed
Speaker 5: the role of public health in their day to day lives?
Speaker 5: Like once the pandemic.
Speaker 3: Was over, well, I think we got back to normal
Speaker 3: quite rapidly. You know, for most of the cities implemented some
Speaker 3: kind of NPI. It was all city by city. In
Speaker 3: most cases, it wasn't even a state, and certainly the
Speaker 3: Peri government didn't play a role in it. But again,
Speaker 3: the duration is so critical. We're talking about, you know,
Speaker 3: several weeks that these rules restrictions would be in place.
Speaker 3: You know, almost nowhere was it longer than five weeks,
Speaker 3: and usually it was shorter period than that. And plus
Speaker 3: they were less intrusive than what we went through. You know,
Speaker 3: no businesses were affected unless they were or like a
Speaker 3: saloon or a theater, because essentially every business practically was
Speaker 3: regarded as you know, essential war and so forth. All
Speaker 3: the factories remained open, and you know, there was a
Speaker 3: tremendous amount of absenteeism. You know where we had data
Speaker 3: from war industries like shipbuilding, it was generally between forty
Speaker 3: percent and sixty percent of the workforce was absent, either
Speaker 3: sick or caring for somebody sick or just afraight, and
Speaker 3: you know minds. For example, according to Metropolitan Life Insurance,
Speaker 3: over six percent of all the miners aged eighteen to
Speaker 3: fifty died. And you're talking about dying in a matter
Speaker 3: of weeks again, But when it was over, it was over.
Speaker 3: So we you know, having gone through this horrific experience
Speaker 3: for a period of weeks, everybody and the disease then
Speaker 3: disappeared and people went back to normal very quickly at
Speaker 3: the same time, almost to the day practically, obviously it
Speaker 3: would be a little different from depending where you are
Speaker 3: geographically and where the pandemic hit. But the war ended
Speaker 3: on November eleventh, just about the time in a lot
Speaker 3: of cities, a lot of parts of the country, the
Speaker 3: second wave of the pandemic ended. So you had this
Speaker 3: tremendous exuberance at the end of the war. So things
Speaker 3: did return to normal quite rapidly. You don't build permanent
Speaker 3: new habits over a period of a few weeks.
Speaker 5: That's really fascinating to think about, especially in comparison with
Speaker 5: the COVID nineteen pandemic. And so, you know, this pandemic
Speaker 5: is not the first one to happen in our lifetimes,
Speaker 5: or at least not the first disease outbreak or large epidemic.
Speaker 5: But you know, we kind of often have a short
Speaker 5: attention span, and so, you know, you mentioned that the
Speaker 5: nineteen eighteen pandemic people wanted to move on with their lives.
Speaker 5: And given the difference between the nineteen eighteen influenza and
Speaker 5: the COVID nineteen pandemic, do you think that the duration,
Speaker 5: the longer duration of COVID nineteen, might make this pandemic
Speaker 5: live in our collective consciousness a bit more vividly for
Speaker 5: a bit.
Speaker 3: Longer this time around, you know, having lived with us
Speaker 3: for more than a year. Yeah, I think it will
Speaker 3: affect our habits and everything. From architecture. I think maybe
Speaker 3: we'll go back to having windows you can open when
Speaker 3: they build a new building. That would be nice. You know,
Speaker 3: obviously we're talking by zoom. I think zoom it was
Speaker 3: already here, but I think it's expanded. Use is certainly
Speaker 3: going to continue, and you know, are people going to
Speaker 3: go back to shaking hands. I think they probably will.
Speaker 3: But yeah, having gone through this for more than the
Speaker 3: year certainly will have impact on everybody who went through it,
Speaker 3: and I think we'll remember and write about it more
Speaker 3: so than in nineteen eighteen. I think there'll be a
Speaker 3: lot of novels coming out of it, and a lot
Speaker 3: of nonfiction books, more so than in nineteen eighteen. Again,
Speaker 3: what behaviors, How much our behaviors will change, That's not
Speaker 3: entirely clear, but I think it will change at least somewhat.
Speaker 5: Right, Yeah, definitely, so switching gears a little bit. One
Speaker 5: of the things that I wanted to talk about for
Speaker 5: this pandemic is how one of the few bright spots
Speaker 5: has been how the global scientific community has really come
Speaker 5: together in many ways collaborating and sharing data. There's been
Speaker 5: a lot of publishing of open access papers, people working
Speaker 5: across disciplines. How does this compare to the scientific information
Speaker 5: sharing during the nineteen eighteen pandemic.
Speaker 3: Well, Number one, of course, in the middle of the pandemic,
Speaker 3: the world was still at war, so the German scientific
Speaker 3: establishment was certainly not cooperating with the American scientific establishment.
Speaker 3: Perhaps even more importantly, the communication was entirely different. You
Speaker 3: couldn't communicate with somebody internationally very easily, and of course
Speaker 3: the whole scientific infrastructure was a tiny fraction of what
Speaker 3: it is today. At scale, you can't compare. However, in
Speaker 3: terms of actual work you can. Just as today. Basically
Speaker 3: every scientist that had anything to contribute turned his or
Speaker 3: in a few cases her attention to influenza, and again
Speaker 3: it moves so quickly. It was the first wave that
Speaker 3: was hit or missed entirely, missed a lot of places.
Speaker 3: Where it did hit, it was extremely mild, and also
Speaker 3: to a scientific assessment at the time, it had a
Speaker 3: tendency to Peter Robbin. You know, nobody started work on
Speaker 3: anything in the first wave. There was no reason to.
Speaker 3: The second wave shows up in the middle of September
Speaker 3: and it's gone by the middle of November, depending on
Speaker 3: where you are. Even today, with every tool we have
Speaker 3: available to us, we are scientists would not have been
Speaker 3: able to respond that quickly, and of course back then
Speaker 3: they didn't have the tools. Nonetheless, it was a tremendous
Speaker 3: amount of scientific progress made that was sparked by the pandemic.
Speaker 3: We didn't know what a virus was in nineteen eighteen,
Speaker 3: knew there were these tiny, tiny organisms, but didn't know
Speaker 3: if they were just like bacterias, a small bacteria, whether
Speaker 3: it's entirely different kind of organism. And easily the most
Speaker 3: important discovery that you can link to the pandemic is
Speaker 3: a discovery that DNA carried the genetic code, which launched
Speaker 3: the entire field of molecular of biology, and that actually
Speaker 3: didn't come until nineteen forty four. But there are other things.
Speaker 3: If you get a pneumonia shot today and bacteria and
Speaker 3: pneumonia vaccine, that is a straight line descendment of something
Speaker 3: that was developed in the middle of the pandemic. So
Speaker 3: and you know, there was a lot of other scientific
Speaker 3: work as well.
Speaker 5: Yeah, I want to go back a bit to talk
Speaker 5: a little bit about this lifestyle changes that you mentioned
Speaker 5: after the nineteen eighteen pandemic. And you know, we always
Speaker 5: think of this period as like the Roaring twenties, it's
Speaker 5: dramatic lifestyle change and economic growth. So can you talk
Speaker 5: a little bit more about what exactly that looked like
Speaker 5: and how much of it came as this reaction to
Speaker 5: the end of the nineteen eighteen influenza pandemic or just
Speaker 5: the end of World War One as well.
Speaker 3: I think the pandemic probably had some small piece of
Speaker 3: the sense of fatalism and anui. You know, the so
Speaker 3: called Lost Generation was part of the Roring Twenties too,
Speaker 3: but it was much more. The war, you know, the
Speaker 3: Roaring Twenties was worldwide, from Sydney, Australia, Berlin, Paris, London.
Speaker 3: In Europe. Twenty million people died in World War One,
Speaker 3: ten million soldiers. The United States lost fifty three thousand
Speaker 3: soldiers in combat. So it's the same age group, the
Speaker 3: same demographics, say uh, and you know, ten million civilians.
Speaker 3: And it was spid one of the stupidest wars ever
Speaker 3: fought without a doubt, with the worst generalship. Talk about waste.
Speaker 3: So I think that was an important part of the
Speaker 3: attitude of the Roaring twenties, the fatalism, the let's party,
Speaker 3: nothing else matters. Also, you added in the United States,
Speaker 3: in utter collapse of agricultural prices. You know, the US
Speaker 3: during the World War One had fed France, Germany, Britain
Speaker 3: and so forth. Because all their farmers were in the army.
Speaker 3: US farmers greatly expanded the physical acreage that they were farming,
Speaker 3: and they were tremendous overproduction. When the war ended and
Speaker 3: prices utterly collapse, the farm economies went into depression right
Speaker 3: after the war and stayed there. Then you had a
Speaker 3: serious recession in nineteen twenty in nineteen twenty one. Only
Speaker 3: after all that did you get to the Roaring twenties.
Speaker 3: So I think, you know, the pandemic had a little
Speaker 3: bit of impact on it, but it was much more
Speaker 3: the other things, particularly the war.
Speaker 6: Yeah, that makes sense.
Speaker 5: So based on that, do you think we can expect
Speaker 5: to see any sort of Roaring twenty twenties or not
Speaker 5: so much?
Speaker 6: Are the two even comparable?
Speaker 3: You know? I think number one, we've already gone through
Speaker 3: our recession, so we will, you know, hopefully have a
Speaker 3: very strong recovery. It looks like we will. I hope
Speaker 3: we will. I think we will. In terms of the economy,
Speaker 3: you know, people have been penned up for more than
Speaker 3: a year, so and there'll be some of that. It
Speaker 3: won't have the sense of desperation or fatalism or survivor
Speaker 3: guilt that existed in the nineteen twenties, So it'll just
Speaker 3: be fun, I hope for everybody. So psychologically, I think
Speaker 3: it'll be a lot different, but in terms of you know, activity,
Speaker 3: there'll probably be some similarity.
Speaker 5: Yeah, well, looking forward to that at least. So while
Speaker 5: we can look to the nineteen eighteen influenza pandemic for
Speaker 5: some clues as to what the future might hold for
Speaker 5: us US post COVID nineteen, there are also many limitations
Speaker 5: in using the past to try to understand the future,
Speaker 5: in part because our global society is so vastly different
Speaker 5: today than it was one hundred years ago. So can
Speaker 5: you talk a little bit about some of these limitations
Speaker 5: in applying lessons learned from the nineteen eighteen influenza pandemic
Speaker 5: to today's reality.
Speaker 3: Well, in terms of the lessons the public health lessons,
Speaker 3: I think they've been confirmed. Number one, tell the truth
Speaker 3: and number two non pharmaceutical interventions work social distancing. It's
Speaker 3: that works, I can tell you because I was part
Speaker 3: of the conceptualizing of the plan, not the actual writing
Speaker 3: of the plan for the federal government. That transparency is
Speaker 3: written into the very you know, it's like the highest
Speaker 3: priority in the federal plan, and every state plan it's
Speaker 3: pretty much modeled on the federal plan. So transparency has
Speaker 3: written high up their highest priority of every state pandemic plan.
Speaker 3: The problem is, as you know, as every football coach
Speaker 3: will tell you, got to go out there and execute
Speaker 3: the United States and execute, you know, for political reasons. Unfortunately,
Speaker 3: other countries did execute. So I don't I think the
Speaker 3: lessons from nineteen eighteen are absolutely valid and been validated
Speaker 3: by the experiences both in the United States and other
Speaker 3: countries where they've done it.
Speaker 5: Right, Yeah, definitely, it does seem a bit frustrating that
Speaker 5: these lessons that we've known about for so long we
Speaker 5: still fail to actually, like, like you said, execute. So
Speaker 5: what are some things that you hope that we keep
Speaker 5: from this pandemic, either personally or as a society.
Speaker 3: Well, there will be a future of pandemics, there's no question.
Speaker 3: You know, we had anticipated influence a pandemic. That's why
Speaker 3: all the preparation was done. It turned out not to
Speaker 3: have been an influenza virus. I mean, the reality is
Speaker 3: you could argue we got lucky for a lot of reasons,
Speaker 3: which I mean obviously the nineteen eighteen virus infinitely more virulent,
Speaker 3: you know, if we've been hit by something like that,
Speaker 3: or even Sorrows one, which is ten percent case mortality.
Speaker 3: If the SAR is one virus had become easily transmissible
Speaker 3: between people, then we would be in a totally different
Speaker 3: place than we are now. So given the fact that
Speaker 3: there are going you know, and influenza viruses that are
Speaker 3: going to jump species from animals to humans, they're still
Speaker 3: out there. There are just a lot of There are
Speaker 3: viruses we've never heard of. There are other coronaviruses, you know,
Speaker 3: there are a lot of threats and the public health lesson.
Speaker 3: You know, hope the next time around people will have
Speaker 3: learned that telling the truth matters. You know. The only
Speaker 3: time in Trump's entire presidency that he cracked fifty percent
Speaker 3: in approval rating was a couple of days after he
Speaker 3: declared war on the virus in March at twenty points.
Speaker 3: The only time people you don't want to rally around
Speaker 3: a leader, you know, the irony is for political purposes.
Speaker 3: The best thing he could have done was take on
Speaker 3: the virus and deal with it. Might very well have
Speaker 3: been reelected instead. He said the federal government is a
Speaker 3: backup in a national crisis. When the head of the
Speaker 3: federal government says the federal government is a backup, I
Speaker 3: mean that is not leadership. That is the absence, the
Speaker 3: abdication of leadership. Even if you love Trump, you have
Speaker 3: to admit that we needed a national response, and I
Speaker 3: think even the most politicized response in the future may
Speaker 3: take that into account and next time around and realize
Speaker 3: that the public health lessons from nineteen eighteen, which is
Speaker 3: I've made pretty clear, I think have been confirmed this
Speaker 3: time around that they are not only the best thing
Speaker 3: in terms of the public health, but did the best
Speaker 3: thing politically.
Speaker 5: Thank you so much, John for taking the time to
Speaker 5: answer all of those questions. I had an absolute blast
Speaker 5: chatting with you.
Speaker 7: I loved getting to listen to it, and as always,
Speaker 7: I'm jealous that I couldn't be there, but you did
Speaker 7: a phenomenal job.
Speaker 6: So thank you.
Speaker 7: Let's do what we always do and go through the
Speaker 7: top five take home points from that phenomenal interview.
Speaker 5: Let's do it okay. Number one. The two biggest lessons
Speaker 5: that we learned from the nineteen eighteen influenza pandemic are
Speaker 5: to tell the truth and that non pharmaceutical interventions such
Speaker 5: as social distancing and face masks do indeed work. And
Speaker 5: these two things are interrelated controlling or slowing the spread
Speaker 5: of a widely distributed pathogen like SARS Kobe two is
Speaker 5: only possible through large scale cooperation, and in order to
Speaker 5: get that cooperation, political leaders need to be transparent. They
Speaker 5: need to be honest. They need to be truthful about
Speaker 5: what they know and what they don't know. This is
Speaker 5: the only way that they will earn the trust and
Speaker 5: respect of the public and get the public's cooperation to
Speaker 5: participate in these non pharmaceutical interventions which save lives. And
Speaker 5: if you don't tell the truth, then you lose the
Speaker 5: trust of the public along with their cooperation. The COVID
Speaker 5: nineteen pandemic has provided us with many examples of countries
Speaker 5: that told the truth and were able to successfully implement
Speaker 5: these broad public health measures that helped keep cases lower.
Speaker 5: But there are just as many, if not more, examples
Speaker 5: of countries that did not do a good job of
Speaker 5: telling the truth, Countries where leaders failed their people by
Speaker 5: downplaying the virus or using it for political gain, undermining
Speaker 5: the public health health efforts to control the COVID nineteen pandemic.
Speaker 7: Yeah number two. Speaking of politicization, Politics and public health
Speaker 7: were definitely intermingled during the nineteen eighteen influenza pandemic, but
Speaker 7: in a very different way than they have been during
Speaker 7: the COVID nineteen pandemic. Using the US as an example,
Speaker 7: involvement in World War One affected the way information spread
Speaker 7: to the public to a very great degree. Essentially, all
Speaker 7: of the information was tightly controlled and any bad news
Speaker 7: was restricted with the line that bad news was bad
Speaker 7: for morale.
Speaker 6: So you had the.
Speaker 7: US government telling their citizens that this was just an
Speaker 7: ordinary flu and there was no need to panic, and
Speaker 7: that not showing up at your crowded work site meant
Speaker 7: you weren't a patriot. So you had a lot of
Speaker 7: fake news going on in nineteen eighteen, but a it
Speaker 7: all came from the government, and b it wasn't partisan.
Speaker 7: Another interesting point along those same lines is that although
Speaker 7: there has been intense fake news and politicization of public
Speaker 7: health during the COVID nineteen pandemic, we also have the Internet,
Speaker 7: which makes it both easier and in some ways more
Speaker 7: difficult to find factual information. But it's at least out
Speaker 7: there if you're looking for it. That was not the
Speaker 7: case in nineteen eighteen, when if a newspaper printed that
Speaker 7: this is just ordinary influenza, you had nowhere else to
Speaker 7: turn to get information. But that doesn't mean that people
Speaker 7: in nineteen eighteen blindly believed what they read. They saw
Speaker 7: the devastation around them, and they knew that they couldn't
Speaker 7: rely on their government or their newspapers to tell the truth.
Speaker 7: They were on their own.
Speaker 6: Yeah.
Speaker 5: Number three, It was fascinating to hear about the many
Speaker 5: similarities and differences between the two viruses that caused these
Speaker 5: pandemics and how those have affected the course of the pandemics.
Speaker 5: In terms of the viruses, both the influenza virus of
Speaker 5: nineteen eighteen and SARS covi two are respiratory viruses that
Speaker 5: can infect deep in the lungs, and both can cause
Speaker 5: significant disease in virtually any organ of the body, but
Speaker 5: SARS covy two is much more transmissible and has an
Speaker 5: overall longer duration compared to influenza virus, which has a
Speaker 5: shorter incubation and transmissibility period. We also have seen big
Speaker 5: differences in the age groups affected, with primarily eighteen to
Speaker 5: fifty year olds affected in nineteen eighteen, and of course
Speaker 5: today COVID has hit people over sixty five much harder
Speaker 5: than other age groups, and these characteristics of the two
Speaker 5: different viruses have affected the outbreak and spreads that we
Speaker 5: have seen, as well as the public response. Since influenza
Speaker 5: had such a shorter duration, we saw it burn through
Speaker 5: towns and cities in a matter of weeks, leaving millions
Speaker 5: dead in its way, while the COVID nineteen pandemic has
Speaker 5: continued to rage for months, and the fact that older
Speaker 5: individuals are more likely to become severely ill and die
Speaker 5: from COVID compared to the eighteen to fifty year olds
Speaker 5: that were affected in nineteen eighteen, that certainly has contributed
Speaker 5: to the public response to the COVID nineteen pandemic, allowing
Speaker 5: some decision makers to write off the severity, which would
Speaker 5: likely never have happened if we had seen the same
Speaker 5: mortality rate in younger individuals. Overall, the nineteen eighteen pandemic
Speaker 5: killed between fifty to one hundred million people, which adjusted
Speaker 5: for today's population, would be around I think two twenty
Speaker 5: five to four hundred and fifty million, a death told
Speaker 5: that thankfully we haven't come close to during this pandemic.
Speaker 6: Yeah, thank goodness.
Speaker 7: Number four Scientific collaboration and accomplishments. These are in some
Speaker 7: ways kind of hard to compare. For a number of reasons.
Speaker 7: In nineteen eighteen, influenza swept through cities so rapidly, and
Speaker 7: long distance communication was so much more difficult that the
Speaker 7: ability of scientists to collaborate was significantly less compared to
Speaker 7: what we've seen in this pandemic. And on top of that,
Speaker 7: much of the world was at war during nineteen eighteen,
Speaker 7: which certainly didn't lend itself to free and open collaboration,
Speaker 7: But nonetheless, so many scientific advancements that we rely on
Speaker 7: today can be credited in some way to the nineteen
Speaker 7: eighteen influenza pandemic. Early last year, many individuals and laboratories
Speaker 7: pivoted to working on coronaviruses when it became clear that
Speaker 7: this current pandemic was very serious, and the same thing
Speaker 7: happened in nineteen eighteen. During and after the nineteen eighteen
Speaker 7: influenza pandemic, nearly anyone whose work was tangentially related began
Speaker 7: working on influenza, and the work sparked by that pandemic
Speaker 7: led to things like the pneumonia vaccine, or the entire
Speaker 7: field of molecular biology, and so many other scientific accomplishments. Today,
Speaker 7: we have seen both collaboration and innovation on a scale
Speaker 7: like never before. So who knows what kind of scientific
Speaker 7: achievements may come in the future as a result of
Speaker 7: the work that started during this pandemic.
Speaker 5: It's very cool to think about.
Speaker 7: It's kind of exciting.
Speaker 5: Yeah. Number five, So back to our original question, where
Speaker 5: do we go from here? What will life be like
Speaker 5: in a post COVID world. Yeah, honestly, we don't know.
Speaker 5: Can we look to the post nineteen eighteen influenza world
Speaker 5: to give us any clues? Maybe? Kind of, kind of.
Speaker 5: One of the most substantial differences between the nineteen eighteen
Speaker 5: influenza pandemic and the COVID nineteen pandemic is in their duration.
Speaker 5: The nineteen eighteen influenza, like I said, would burn through
Speaker 5: a city or town in a matter of weeks with
Speaker 5: this intense onslaught of cases and deaths, and then nothing.
Speaker 5: And this is why we see these discrete waves in
Speaker 5: the pandemic of nineteen eighteen. This rapid spread meant that
Speaker 5: compared to COVID nineteen, very few businesses were substantially affected
Speaker 5: or affected for very long. There were some shutdowns in
Speaker 5: nineteen eighteen, but they didn't last that long either. During
Speaker 5: the COVID nineteen pandemic, our day to day lives have changed,
Speaker 5: in many cases dramatically, and this change was not weeks
Speaker 5: long like it would have been in nineteen eighteen. We're
Speaker 5: going on over a year now. Of course, the longer
Speaker 5: duration of COVID nineteen has been due in part to
Speaker 5: these non pharmaceutical interventions drawing out the pandemic, but that's
Speaker 5: for a very good cause, reducing the number of cases
Speaker 5: and deaths. But what is undeniable is that for nearly
Speaker 5: a year and a half, the CODEVID nineteen pandemic has
Speaker 5: been sown into the fabric of our lives, in the
Speaker 5: way we talk to each other, in the way we
Speaker 5: view other people, in the way we think about our future,
Speaker 5: both in the mundane like meal planning for two weeks
Speaker 5: at a time, and in the more abstract like what's
Speaker 5: important to me about my job, my home, my life.
Speaker 5: We all probably have some muscle memory of what it's
Speaker 5: like to live in a non pandemic world, but I
Speaker 5: think it will take some getting used to. In the
Speaker 5: nineteen twenties, the world was coming out of a brutal,
Speaker 5: deadly war and a devastating pandemic, both of which targeted
Speaker 5: this younger generation. Most of all, The result was a
Speaker 5: combination of survivor's guilt and a readiness to get back
Speaker 5: to normal, not to forget what happened, but just a
Speaker 5: desire to live and experience new things, and that in
Speaker 5: part is what kind of led to the Roaring twenties.
Speaker 5: But I think that we may see some things similar
Speaker 5: in the years to come. But just as the people
Speaker 5: who lived through the nineteen eighteen pandemic never forgot its impact,
Speaker 5: I hope that we remember some of the lessons of
Speaker 5: the COVID nineteen pandemic and actually apply them to the future,
Speaker 5: because this won't be the last pandemic, maybe even likely
Speaker 5: even within our lifetimes.
Speaker 3: Yeah.
Speaker 7: We've said that before, and we'll just continue saying it.
Speaker 6: It will always be true.
Speaker 5: Yeah yeah, yeah.
Speaker 6: Wow.
Speaker 5: Well, I thought this was a very interesting one to
Speaker 5: end on. I think it's the first time we've interviewed
Speaker 5: someone who's historian like looking backwards to tell us what
Speaker 5: to expect.
Speaker 6: I love it.
Speaker 7: I mean, I think that's something that we kind of
Speaker 7: often do in our normal episodes, right as we look
Speaker 7: to the history of a disease or a pathogen to
Speaker 7: try and understand the impact that it's had. So I
Speaker 7: think it's kind of nice to wrap up this series
Speaker 7: for now by looking back to the most recent pandemic
Speaker 7: that we can compare to.
Speaker 6: Yeah.
Speaker 5: Absolutely, Well, on that note, thank you again so much,
Speaker 5: John for taking the time to chat and for sharing
Speaker 5: all of that information.
Speaker 6: It was just so fascinating.
Speaker 7: Yeah, and thank you again as well to everyone who
Speaker 7: has written in to share your story with us, whether
Speaker 7: we were able to share it on the podcast or
Speaker 7: whether we just read it in our Google doc. Thank
Speaker 7: you so much. We feel really grateful that we got
Speaker 7: to listen to and share so many of your stories. Yeah.
Speaker 5: Absolutely, Thank you to Bloodmobile for providing the music for
Speaker 5: this episode and all of our episodes.
Speaker 7: Thank you to the Exactly Right Network, of whom we're
Speaker 7: very proud to be a part.
Speaker 5: Thank you to you listeners. You've been with us for
Speaker 5: quite a long journey and we really appreciate you coming
Speaker 5: along for the ride.
Speaker 7: Yeah, and thank you also to all of our patrons.
Speaker 7: You guys are amazing, absolutely amazing.
Speaker 6: Well until next time.
Speaker 5: In one of our normal episodes, I guess
Speaker 7: Wash your hands, you filthy animals.