Quotes from John M. Barry

All this together is called the "immune response," and once the immune system is mobilized, it is formidable indeed. But all this takes time. The delay can allow infections to gain a foothold in the body, even to advance in raging cadres that can kill.

execute, is that those who occupy positions of authority must lessen the panic that can alienate all within a society.

After it defeats an infection, specialized white cells (called "memory T cells") and antibodies that bind to the antigen remain in the body. If any invader carrying the same antigen attacks again, the immune system responds far more quickly than the first time. When the immune system can respond so quickly that a new infection will not even cause symptoms, people become immune to the disease.

NOTHING COULD HAVE STOPPED the sweep of influenza through either the United States or the rest of the world—but ruthless intervention and quarantines might have interrupted its progress and created occasional firebreaks.

positions of authority must lessen the panic that can alienate all within a society.

problems presented by a pandemic are, obviously, immense. But the biggest problem lies in the relationship between governments and the truth. • • • Part of that relationship requires political leaders to understand the truth—and to be able to handle the truth. If there's a lesson from the 2009 pandemic, it's that too many governments were incapable of doing so.

risk communication." I don't much care for the term. For if there is a single dominant lesson from 1918, it's that governments need to tell the truth in a crisis. Risk communication implies managing the truth. You don't manage the truth. You tell the truth.

But sometimes mutations change the shape of the hemagglutinin or neuraminidase enough that the immune system can't read them.

In 1918 the lies of officials and of the press never allowed the terror to condense into the concrete. The public could trust nothing and so they knew nothing. Society is, ultimately, based on trust; as trust broke down, people became alienated not only from those in authority, but from each other.

Even where fear closed down businesses, where both store owners and customers refused to stand face-to-face and left orders on sidewalks, there was still too much interaction to break the chain of infection. The virus was too efficient, too explosive, too good at what it did. In the end the virus did its will around the world.

Monument and Ignacio, Colorado, went further than banning all public gatherings. They banned customers from stores; the stores remained open, but customers shouted orders through doors, then waited outside for packages. Colorado Springs placarded homes with signs that read "Sickness.

In 1753 James Lind conducted a pioneering controlled experiment among British sailors and demonstrated that scurvy could be prevented by eating limes—ever since, the British have been called "limeys.

Between June 1 and August 1, 200,825 British soldiers in France, out of two million, were hit hard enough that they could not report for duty even in the midst of desperate combat. Then the disease was gone. On August 10, the British command declared the epidemic over. In Britain itself on August 20, a medical journal stated that the influenza epidemic "has completely disappeared.

The greatest challenge of science, its art, lies in asking an important question and framing it in a way that allows it to be broken into manageable pieces, into experiments that can be conducted that ultimately lead to answers.

Louis Sullivan, the first great modern architect, declared that form follows function. To understand viruses, or for that matter to understand biology, one must think as Sullivan did, in a language not of words, which simply name things, but in a language of three dimensions, a language of shape and form. For in biology, especially at the cellular and molecular levels, nearly all activity depends ultimately upon form, upon physical structure—upon what is called "stereochemistry.

Yet men could appear healthy while incubating influenza themselves, and they could also infect others before symptoms appeared.

But the virus can adapt to man. It can do so directly, with an entire animal virus jumping to humans and adapting with a simple mutation. It can also happen indirectly. For one final and unusual attribute of the influenza virus makes it particularly adept at moving from species to species.

The western world suffered the least, not because its medicine was so advanced but because urbanization had exposed its population to influenza viruses so immune systems were not naked to it.

If the Hong Kong chicken influenza had infected someone who was simultaneously infected with a human influenza virus, the two viruses might easily have reassorted their genes. They might have formed a new virus that could pass easily from person to person. And the lethal virus might have adapted to humans.

Man seeks to form for himself, in whatever manner is suitable for him, a simplified and lucid image of the world, and so to overcome the world of experience by striving to replace it to some extent by this image.

Risk communication implies managing the truth. You don't manage the truth. You tell the truth.

The revolution of modern science and especially medical science began as science not only focused on this answer to "What can I know?" but more important, changed its method of inquiry, changed its answer to "How can I know it?

And the way one goes about answering a question, one's methodology, matters as much as the question itself. For the method of inquiry underlies knowledge and often determines what one discovers: how one pursues a question often dictates, or at least limits, the answer.

As California senator Hiram Johnson said in 1917, "The first casualty when war comes is truth.