The main themes in Flu are pandemics and public memory, the labor of science, and obstacles to scientific progress.
- Pandemics and public memory: Scientists emphasize that it is crucial to remember and learn from past pandemics, despite their traumatic nature.
- The labor of science: Kolata’s explanations of scientists’ years of work and passion indicate the sheer amount of labor scientific discovery requires.
- Obstacles to scientific progress: Through description of events such as the 1976 US flu outbreak and vaccinations, Kolata shows how political, journalistic, and societal forces can hinder scientific understanding and public safety.
Pandemics and Public Memory
One of the most important themes of Flu is the role public memory and record-keeping have played in pandemics throughout history. Kolata notes that before coming across an article on the 1918 flu in the late 1990s, her own knowledge of the deadly influenza had been sketchy, despite her background in science and journalism.
It wasn’t a coincidence: the 1918 flu epidemic barely finds mention in science and history textbooks, despite the “grim swath” it cut across the world. It is a pandemic committed to public amnesia, though it was unparalleled in the last few centuries. The pandemic killed anywhere between twenty and one hundred million people worldwide in 1918. It devastated families and decimated populations of entire villages. Historian Alfred W. Crosby notes that world almanacs of the time show that the life expectancy of Americans fell from fifty-one years in 1917 to thirty-nine in 1919—a decline he attributes to the skewing effect of the flu.
Given the magnitude of its impact, it is perplexing why the 1918 influenza is so little discussed, especially given that its lessons may help in future pandemic preparedness. However, when Kolata researches “plagues” or pandemics through history, she finds a similar pattern around outbreaks. After such outbreaks as the 1831 cholera epidemic in England, which killed 140,000 people, those who survived may have simply wanted to forget.
One reason public memory allows such pandemics to slip away is perhaps to protect the psyche from post-traumatic stress. Dr. Victor C. Vaughan, a physician who witnessed the horrifying deaths of young, previously healthy soldiers in Massachusetts in 1918, wrote that his memories were “ghastly ones” that he wished to tear away from his brain, if only they weren’t “inscribed” upon it. Already brought to a breaking point by the experience of a pandemic, communities tend to put the event out of their memory in order to keep functioning.
According to Crosby, in the case of the 1918 pandemic, the horror of the disease was amplified in the minds of those who lived through it, particularly because it fused with the “nightmare” of World War I, the first war in history fought using modern technology and chemical warfare. Further, the 1918 pandemic punctured the bubble of well-being that had pervaded the prewar years: with diseases such as tuberculosis losing their bite, the West assumed that epidemics were a thing of the past. Collective memory was eager to return to that naive state and dismiss the 1918 flu as an aberration.
However, Kolata notes that remembering and recording pandemics is essential to better deal with the next deadly virus. At the time of Flu’s publication in 1999, the threat of a new strain of bird flu has already emerged in Hong Kong. The idea that human progress equates to a victory over viruses has long been dismissed. The question around the next pandemic, then, is not if but when. Research shows that every pandemic offers a lesson: for instance, the cholera pandemic of 1831 led to a slew of public health and hygiene measures that forever changed Western cities for the better. For the light it throws on the ever-mutating, elusive creatures called viruses, no pandemic should ever be forgotten.
The Labor of Science
Scientific discoveries and breakthroughs that seem “sudden” are often the result of years—if not decades—of arduous, painstaking labor by doctors, researchers, and technicians. Through the story of the search for the genetic code of the 1918 flu virus, Kolata illustrates this theme in lucid detail.
The quest for the virus takes scientists, the “only” group of people...
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who remain “haunted” by the 1918 pandemic, to strange places, such as an Eskimo village near Brevig, Alaska. In 1951, the pathologist Dr. Johan V. Hultin went to Alaska to excavate the bodies of 1918 flu victims buried in the permafrost; he hoped that the virus was preserved in their lung tissues. Since the ground at the Brevig cemetery was “rubbery” with ice, which makes digging graves arduous, Dr. Hultin had to constantly keep a fire burning to soften the soil. For days, he dug into a smoke- and ice-filled pit to obtain small cubes of tissue, without knowing if the tissues would actually yield the virus. As it turns out, they did not, dashing Dr. Hultin’s hopes. Yet he persisted with his dream of revisiting Brevig someday, convinced that the ice held an important clue to the mysteries of the 1918 virus.
The inclusion of Dr. Hultin’s story of failure in 1951 is important because it is an apt showcase of the mixture of wild hunch, repetitive work, and obsessive passion that guides most scientific discovery. The story of Ann Reid is another example of this process. Part of molecular pathologist Dr. Jeffery Taubenberger’s team, which was ultimately the first to find and copy the matrix gene from the 1918 flu virus, Reid was a technician, a position generally thought of as inferior to that of scientists. Yet her work was extremely painstaking and meticulous: shaving off thinner-than-paper samples from tissue preserved for over eighty years, cleaning it of all cellular debris, mixing it with a hooking primer, running the solution through a PCR machine, labeling the material with a radioactive probe, and then waiting for the tagged tissue to replicate and hopefully burn black marks into an X-ray film. Reid repeated the procedure again and again—for eighteen months—before getting a successful result.
Thus, Kolata shows that every advance in medicine and science is made possible by the unknown, often tedious, work of scientists. Often, this work proceeds without surety of success, which makes the labor of science all the more wondrous.
Obstacles to Scientific Progress
When a government official named J. S. Koen noted an outbreak of influenza among pigs in 1918, he could not ignore its possible link with the epidemic raging among humans. Koen proposed that “swine and human flu are the same,” a hypothesis which was immediately opposed, especially by the animal industry. If pigs were indeed a source of the virus, they worried, pork consumption and sales could be decimated. Thus, Koen’s findings were buried in the historical record of the time.
As it turns out, Koen’s hypothesis, made as early as in 1918, is indeed relevant, and later-day scientists confirmed a connection between swine and human influenza. Koen’s case highlights the conflict scientists often face with competing interests, such as those of business, bureaucracy, politics, media, and sometimes even other scientists and researchers.
The liability fiasco in the wake of the 1976 flu outbreak in Fort Dix, New Jersey, is another example of how competing interests can seize control of scientific progress and public perception. With many varying interests at play, pandemic preparedness becomes more about perception management than about actual healthcare measures.
In the case of the 1976 outbreak, suspected to be swine flu, the US government planned a mass vaccination of all citizens, a move criticized as unnecessary by many scientists. Some believed that the vaccination plan was a “political” move meant to bolster President Gerald Ford’s popularity. Vaccine manufacturers had concerns around liability insurance, which they said the federal government brushed away. Meanwhile, some doctors went on record in the media to say that the vaccine could cause an adverse reaction in as many as fifteen percent of those vaccinated. Though the vaccine program was launched in October, it had to be stopped in December because of reports of death and a nervous system syndrome called Guillain-Barré syndrome among vaccinated people. Liability suits totaling billions of dollars were filed by victims, though the government opposed these claims.
Ultimately, the fiasco divided the scientific community itself: some doctors believed that the vaccine had backfired, and epidemiologists blamed negative perceptions created around the vaccine. Rather than yield insights into the flu virus, the episode now reminds scientists and policymakers not to assume a pandemic until one is underway—a lesson that may be a mixed blessing at best.