The sanitary brigades invaded poor homes and ordered the poor to strip, wash, and shave hair. In some places they burned down poor tenements and the homelessness probably caused flu to spread faster.
All societal ignorance reliably hurts the poor first.
Still true with Covid
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A chapter on how disgust-based distancing and burial practices are hygiene measures found beyond humans in nature and how these behaviors gave rise to distancing practices. Three big ones: cordon sanitaire, isolation, and quarantines. All 3 from times of ships and small towns.
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With the rise of big cities and other forms of travel besides sea, these measures became less popular. Takes a small town where everybody knows each other for this stuff to work without external top-down authoritah. Large cities = impersonal = defection behaviors.
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Huh interesting, disease surveillance became a governance thing after the Middle Ages and by 20th century most western countries had systems for tracking spread of key diseases. The problem is, in 1918, influenza was not on the list. Slipped under the surveillance radar.
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For modern disease control you need 3 top down things to work: detection, tracking of spread, and compliance with measures. In our case, testing, research on spread (droplets etc), and masking. Older control measures don’t scale to modern cities.
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This point about historically cities and villages administering their own measures, often really harsh, is surprising. Town in England cordoned itself off and half the people died before it was lifted. Makes sense. They had no good medicines. Containment had to do all the work.
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Flu snuck under radar everywhere except a few islands, Australia being the major one. They had enough warning and got quarantine right to skip first 2 waves. New Zealand didn’t. American Samoa escaped because they figured out spread. Western Samoa, under New Zealand, didn’t.
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Long discussion of epidemiology 101, social distancing, masks, vaccine controversies etc. All familiar now but would have read like science fiction when this book came out. It’s weird to read about this stuff covered with reference to 1918 with academic distance.
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Feeling of not deja vu exactly but something like it. As in “omg they already knew all this stuff 100y before Covid and we’re just learning it under live fire and relitigating 1918 arguments like they’re new?”
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Must be weird for authors like Spinney to suddenly see their obscure interests take over headlines. It’s like if 2x2s suddenly took over headlines and everybody started citing my 2x2 stuff.
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This part is a bit boring but would have been interesting in 2019. Authoritarianism vs democracy, role of newspapers, minorities and marginalized populations suspicious of health measures. All stuff we’ve been through live.
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One difference is that keeping schools open was a better bet then since kids otherwise lived in crowded tenements or ran around unsupervised.
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Extended description of New York’s relatively good performance despite early fumbles. It was full of particularly vulnerable Italian peasants at the time, living in slums and already disproportionately suffering from respiratory diseases like TB. Pandemic led to improvements.
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...Paired with similar extended description of events in Mashed, Persia, where things went much worse. At the time it was a medieval pilgrimage center and Persia was in a partial vacuum due to the collapse of Tsarist Russia and the Great Game.
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The British were filling the vacuum and doing their usual thing of simultaneously raiding the country (for troops) and trying to govern it. Two bad harvests and the people were already starving. It was set up to be a shitshow and it was.
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Weird time machine aspect here. 1918 was around the beginning of global synchronized time. Local stories ranging from nefyevsl to modern. Governance systems with similar range of vintages.
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Mashed appears to have been somewhere between Shanxi and South America in development terms. New York comes off most modern so far. As in Shanxi, Christian missionaries played a significant role. Targeting a Shiite holy spot for evangelism and being tolerated for medicine.
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We interrupt this thread to note that Trump and Melania apparently just tested positive. Well our own shitshow just got worse so I’m glad to read about even worse shitshow in Persia 102 years ago

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That Mashed vignette was interesting. A sense of modernity arriving alongside missionaries and medicine. Persia modernized shortly after in 1921 under Reza Khan. Seems like Spanish Flu triggered a lot of modernity arrivals. Covid might trigger a lot of anthropocene arrivals.
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We stop here tonight. Gotta check on what the Discourse is saying about Trump having Covid. This seems like an awful development to me. He might win on sympathy votes or die and trigger a civil war from the grave. Ugh. BoJo, Bolsanaro, and now Trump. Hmm.
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We return to 1918, and the next chapter, titled The Placebo Effect. Conventional medicine had just recently been privileged by law over alts like naturopathy and faith healing. There were no antibiotics or antivirals. Drugs were artisan. No double-blind or animal trials, no QA.
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Aspirin was the big deal and heavily overprescribed in unsafe doses, which may have caused some deaths. Quinine too which may have caused some of the reported loss of color vision as a side effect. Digitalis, strychnine... sounds like an Agatha Christie medicine cabinet.
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Arsenic, Epsom salts, castor oil... Some doctors fell back on older techniques. Bloodletting etc. Galenic “humors” medicine was still strong. Medicine was closer to astrology than astronomy in 1918.
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Temperance movement was big so alcohol was controversial as a treatment. Some thought cigarette smoke killed the virus.
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Le Corbusier “retreated to his rooms in Paris” drinking and smoking and reflecting on how to impose Modernist Authoritah on the world. Gee thanks Spanish Flu. Wonder what bad ideologies are taking shape in Covid domestic cozy retreat right now
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Lots of dubious patent medicines flourished since there was no regulation. Dr. Kilmer’s swamp root was one. https://americanhistory.si.edu/collections/search/object/nmah_714581 …pic.twitter.com/nNDWwOPDmh
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Traditional home remedies also thrived. Mustard poultices and stuff. This stuff is living memory even for me. When I was sick with coughs and colds and bronchitis as a kid in the early 80s (often), I was often administered Ayurvedic remedies like Starbucks turmeric lattes.
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So basically all treatments being tried were placebos at best (hence the chapter title). Many were nocebos it actually harmful. The only worthwhile advice was to stay hydrated.
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Section on fate of Odessa, which had been curiously unaffected by Bolshevik revolution and the only city to even detect the flu. Couldn’t do much with knowing because it kept changing hands through the war and revolution.
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The city was half Jewish and a prominent Jewish doctor/bacteriologist Yakov Bardakh led what efforts could be undertaken. The city was reeling under a flood of refugees from the revolution. It was apparently a famous cosmopolitan city of its time, known as Marseilles of Russia
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The Russian silent movie star Vera Kholodnaya retreated to Odessa and died of the flu there at age 25. https://en.m.wikipedia.org/wiki/Vera_Kholodnaya …
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