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 🤔
I’d better get Raoism codified.
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Lots of dubious patent medicines flourished since there was no regulation. Dr. Kilmer’s swamp root was one. americanhistory.si.edu/collections/se
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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.
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A Jewish “black wedding” was held in a cemetery to ward off the flu. Between beggars. Apparently many such were held around the world
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Next chapter, titled “Good Samaritans” begins with observation that your best strategy was to to be selfish and isolate yourself and hoard food. This would starve the flu and it would die out. Then as now, people mostly didn’t do that.
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Generally adaptive strategy of “social resilience”
(coming closer together in a disaster) is maladaptive in a pandemic. Apparently there’s lots of theories why. Force of habit, fear of ostracization later for bring antisocial, all-in-this-togetherism, expanded sense of self...
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With few exceptions people generally pitch in to help each other. Notable exceptions were in colonial conditions (Africa, India) where the colonized had learned to distrust white behaviors in crisis and deserted.
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“At some point... group identity splinters and people revert to identifying as individuals. It may be at this point — once the worst is over, and life is returning to normal — that truly ‘bad’ behavior is most likely to emerge”
Ah shit. The assholery hasn’t even really started.
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Rio carnival in 1919 was more out of control than before and there was a spike in rapes it seems.
And reports of a related ‘sons of flu’ baby boom (“hard to confirm”).
Spinney cites Decameron for similar effects after Black Death.
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Long bleak account of ravages of flu among Yupik of Alaska. Already dwindling from other European diseases, the Spanish flu hit them hard, wiping out entire villages. Relief ships found dogs eating bodies in some. Weird subplot of Russian orthodox vs American Protestant missions.
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300 orphans were brought to town of Dillingham of population 200. Today most inhabitants claim descent from flu orphans.
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This was a messy story, hard to summarize. Weird mix of Russian-American-native history, transition to modernity, decidedly mixed role of relief ships that appear to have done some looting of dead villages, but helped others... there’s an Oscar-worthy movie in this episode.
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Next chapter, “hunt for patient zero”. We stop here tonight.
This is an oddly choppy book. Lots of jump cuts and impressionistic dabs. It’s not as enjoyable as Tuchman’s more classical renaissance-painting tale of 14th century but in some ways more effective and comprehensive.
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The origins of the Spanish flu are uncertain. We begin with the hypothesis that it emerged in Manchuria in 1910 when China was weak and sick. The mandarins appointed the first western educated Chinese doctor, Wu Lien-Teh, to try and do something
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That appears to have been pneumonic plague and looked similar to the another in 1917 that Wu thought was also plague but is contested. Hard to do autopsies due to tradition.
300k men from this region served as a labor force in the European theater the following year.
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This region = northern provinces hit by the thing that might have been either plague or flu in 1917.
This is the modern Chinese origin hypothesis, not the speculation during the Spanish flu itself, which was more yellow peril mindset than a hypothesis.
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So Hypothedys A is Chineze laborers. brought the flu to WWI.
Hypothesis B is that it broke out on the western front of WWI (and infected the Chinese labor contingent after it arrived)
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Case for both is circumstantial, since there were not tests for the virus and records are poor. So it’s a case of a time-space jigsaw puzzle of outbreaks in 1917 that presented vaguely like the pandemic proper a year later.
Hypothesis C is similar — it cane from Kansas.
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These 3 are the most likely hypotheses. Apparently the one thing that’s nearly certain is that Spain is not a candidate.
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Next chapter on death toll. Already in the 1920s the best estimate 21.6m, 20x the Russian 1890s epidemic of 1 million. Revised up to 30m by 1990d, but likely still an underestimate especially for Russia and China.
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We circle back to Odessa, this time with an epidemiological lens, to cross check the Russian estimate of 450k/0.2%. Odessa data as a better documented Russian refugee zone suggests 1.2% and 2.7m instead of 450k.
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China was similarly undercounted. Probably 4-9m, though an estimate via different method landed on just 1m. India was likely 18m.
So modern estimates are between 50-100m. 2.5-5x initial estimates.
This is all extraordinarily shaky. Literally data as plural of anecdotes.
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Next: story of how multiple people converged on conclusion that it was not a bacterium but a virus. One of the first to publish, Rene Dujarric, had himself injected with filtered blood of a patient (thereby eliminating bacterial causes) and getting sick.
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His conclusion was flawed because influenza cannot be transmitted via blood apparently. Right answer, wrong method. Other research pair, Nicole and Lebailley, got it right. FUD of pandemic+war.
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So to peek ahead, modern theory is that Spanish Flu was a member of what is known as the H1N1 virus today (Though I did hear alt theory that it was actually a coronavirus)
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So methods were generally sloppy then, so people believed what they wanted to. Richard Pfeiffer, of the incorrect bacterial theory of influenza, stuck to his theory. Others tried and failed to replicate the filterable infectiousness result.
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Antibacterial methods seemed to work (likely because they addressed secondary infections). All in all, general confusion like today, leading to strong opinions.
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Took till 1930s to confirm viral theory and connect to swine flu. 1950s to figure out origins in species crossover, via a ferret sneezing on a British researcher named Wison Smith.
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So of the 3 kinds of influenza A, B, and C, only A causes pandemics apparently. There’s also a 4th kind added recently.
It was hard to prove because viruses can’t be cultured like bacteria, in a Petri dish. Only inside living cells.
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In 1931 Alice Woodruff and Ernest Goodpasture (solid names) figured out how to grow viral cultures in fertilized chicken eggs. I guess that’s why flu shots are grown in eggs and also why we get flus via birds. Very enlightening factoid.
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Russian dude Smorodintsev created first attenuated flu vaccine in 1936. Many eggs were needed. influenza.spb.ru/en/about_insti
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Aside: as a baby I had a bad reaction to a Russian-made smallpox vaccine (I’m old enough to have received that) that parents say almost killed me. So I have an extra large badass vaccine scar. As a teenager I used to tell other kids I got it in a knife fight. Some bought it 😎
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