Quotes from John M. Barry

Seattle, like many other places, became a masked city. Red Cross volunteers made tens of thousands of masks. All police wore them. Soldiers marched through the city's downtown wearing them.

There are three different types of influenza viruses: A, B, and C. Type C rarely causes disease in humans. Type B does cause disease, but not epidemics. Only influenza A viruses cause epidemics or pandemics, an epidemic being a local or national outbreak, a pandemic a worldwide one.

WHILE SCIENCE was confronting nature, society began to confront the effects of nature. For this went beyond the ability of any individual or group of individuals to respond to. To have any chance in alleviating the devastation of the epidemic required organization, coordination, implementation. It required leadership and it required that institutions follow that leadership.

Throughout the wars in history more soldiers had often died of disease than in battle or of their wounds. And epidemic disease had routinely spread from armies to civilian populations.

In 1881 he became the first to isolate the pneumococcus, a few weeks before Pasteur and Koch. (None of the three recognized the bacteria's full importance.) Sternberg also first observed that white blood cells engulfed bacteria, a key to understanding the immune system.

the temperature at which various kinds of bacteria died and the power of different disinfectants to kill them. That information allowed the creation of antiseptic conditions in both laboratory and public health work.

Pandemics generally develop only when a radical change in the hemagglutinin, or the neuraminidase, or both, occurs. When an entirely new gene coding for one or both replaces the old one, the shape of the new antigen bears little resemblance to the old one. This is called "antigen shift.

Miner had seen influenza often. He diagnosed the disease as influenza. But he had never seen influenza like this. This was violent, rapid in its progress through the body, and sometimes lethal. This influenza killed. Soon dozens of his patients—the strongest, the healthiest, the most robust people in the county—were being struck down as suddenly as if they had been shot.

The preservation of morale itself became an aim. For if morale faltered, all else might as well. So free speech trembled.

More than that, many Puritans believed that if the battle with the Antichrist was commencing, they had to convert the Indians.

it can infect someone else for anywhere from an hour to a day after it is exhaled (the lower the humidity, the longer the virus survives). But they did know that it was "a crowd disease," spread most easily in crowds.

Influenza could not have been contained as SARS was—influenza is far more contagious.

Nature chose to rage in 1918, and it chose the form of the influenza virus in which to do it. This meant that nature first crept upon the world in familiar, almost comic, form. It came in masquerade. Then it pulled down its mask and showed its fleshleass bone.

Capps's article appeared in the August 10, 1918, issue of JAMA.

Henry James described the Hopkins as a place where, despite "the immensities of pain" one thought of "fine poetry . . . and the high beauty of applied science. . . . Grim human alignments became, in their cool vistas, delicate symphonies in white. . . . Doctors ruled, for me, so gently, the whole still concert.

Royal Copeland, head of the New York City health department, and the port health officer jointly stated there was "not the slightest danger of an epidemic" because the disease seldom attacks "a well-nourished people." (Even had he been right, a study by his own health department had just concluded that 20 percent of city schoolchildren were malnourished.) He took no action whatsoever to prevent the spread of infection.

The foundation of morality is to have done, once and for all, with lying." A brilliant scientist, later president of the Royal Society, he advised investigators, "Sit down before a fact as a little child, be prepared to give up every preconceived notion. Follow humbly wherever and to whatever abysses nature leads, or you shall learn nothing." He also believed that learning had purpose, stating, "The great end of life is not knowledge but action.

The question "why" is too deep for science. Science instead believes it can only learn "how" something occurs.

In fact, the virus can remain infectious on a hard surface for days.)

So the advances of science actually, and ironically, led to "therapeutic nihilism." Physicians became disenchanted with traditional treatments, but they had nothing with which to replace them.

San Antonio suffered one of the highest attack rates but lowest death rates in the country; the virus there infected 53.5 percent of the population, and 98 percent of all homes in the city had at least one person sick with influenza. But there the virus had mutated toward mildness; only 0.8 percent of those who got influenza died. (This death rate was still double that of normal influenza.)

To be useful, a result must be not only reproducible but . . . perhaps one should call it expandable. One must be able to enlarge it, explore it, learn more from it, use it as a foundation to build structures upon.

So the problems presented by a pandemic are, obviously, immense. But the biggest problem lies in the relationship between governments and the truth.

But the virus, even as it lost some of its virulence, was not yet finished. Only weeks after the disease seemed to have dissipated, when town after town had congratulated itself on surviving it—and in some places where people had had the hubris to believe they had defeated it—after health boards and emergency councils had canceled orders to close theaters, schools, and churches and to wear masks, a third wave broke over the earth.