March 20, 2020
Hello ,
I am well. I hope that you are, too.
Welcome new subscriber, Marilynne Keyser. Thank you for joining us!
To be perfectly honest, I am reading too much news, not getting enough exercise, not writing as much as I wish, and I'm scared about what's going to happen.
But I'm also trusting in the goodness of people, and as always, I'm looking to the past, hoping history will offer wisdom for today.
Scroll to the bottom for: What we can learn from the 1918 Flu Pandemic
But first, take a look at how scientists went to the ends of the earth doggedly pursuing evidence to understand the virus that caused The Mother of all Pandemics.
It took 90-years and a delicate excavation into Alaska's permafrost before scientists broke the code.
Nobody knows for sure how the 1918 flu virus arrived at the small Inupiaq village of Brevig Mission, Alaska.
But the ravages of the disease could be counted by the number of wooden crosses marking a mass grave at the edge of the village.
Site of the mass grave in Brevig Mission, Alaska, Photo courtesy Angie Busch Alston.
Even today, Brevig Mission remains an isolated dot on the map at the western edge of Alaska's Seward Peninsula, 65-miles northwest of Nome. In 1918, the deadly virus was likely carried to the village via dog-sled traveling traders or someone delivering the
mail.
In one five-day stretch, November 15-20, the flu killed 72 of the village's 80 adults and an unknown number of children. Alaska’s territorial government hired gold miners from Nome to use their steam equipment to drive through the frozen ground and dig a grave to bury the bodies. It would be 1997 before the permafrost gave up it's evidence.
Alaska was not the only place where grave-digging proved a challenge that winter. It's estimated the 1918 flu killed at least 50 million people worldwide, including roughly 675-thousand in the United States.
In some rural families, no adults survived to dig the graves. In cities, bodies piled up in churches, as is now happening parts of Italy where funerals are prohibited.
Men load a coffin struck in San Francisco, while in Alabama lumber yards work three shifts a day to produce wood for coffins.
Philadelphia became one of the hardest hit cities in the U.S., after a crowd of 200-thousand townspeople gathered for a parade despite public health warnings.
At the height of the flu in Philly, 759 people died on a single day. The deaths overwhelmed the city's undertakers, so Catholic Charities organized vehicles to collect bodies throughout the city. When the dead stacked three and four high at Philadelphia's only morgue, a brewery offered its cold storage plant to temporarily
house 500 bodies.
Men dig a mass grave in Philadelphia to bury victims of influenza
In 1918 scientists barely knew what a virus was and they did not have a microscope
strong enough to see until the1933.
As the years passed and scientists learned more about viruses, many were curious to solve the mysteries of the 1918 flu. One man made it his personal mission to locate a sample of what he called “the most lethal organism in the history of man.”
Photo shows Johan Hultin working in the laboratory in 1951. Note: using one’s mouth to draw virus into a pipette is not considered a safe laboratory practice today. Photo courtesy Johan Hultin.
Johan Hultin, a 25-year-old Swedish microbiology student in the U.S. believed he might find the virus preserved in the permafrost at the Brevig Mission grave.
Hultin hoped to discover why that particular flu virus was so deadly, and possibly why it most often killed healthy young people.
Village elders at Brevig Mission granted Hultin permission to launch a scientific excavation at the burial site. It was no easy endeavor. Hultin and his university colleagues had to thaw the earth with campfires in order to dig.
Below: Johan Hultin left) and fellow university colleagues at the excavation, Brevig Mission, 1951.
Two days into the excavation, the scientists discovered the frozen, well-preserved body of a little girl, wearing a blue dress and red ribbons in her hair.
They continued to dig and eventually collected lung tissue from four bodies at the site.
Hutlin restored the grave and returned to his lab in Iowa. Using all techniques available in 1951, including injecting the virus into a chicken age, Hultin tried unsuccessfully to revive the virus.
His mission had failed.
But science continued to progress, and scientists continued to be curious about the
1918 flu virus. Forty-six years later, in 1997, Hutlin came across news about a team of molecular pathologists investigating the genetic code of the 1918 flu virus.
Below: Dr. Jeffery Taubenberger and Dr. Ann Reid reviewing a genetic sequence from the 1918 virus. Photo courtesy National Museum of Health and Medicine Online Exhibit - MIS 377212.
American soldiers had been prime targets for the 1918 flu, with more men killed by the virus than in battle. Lung tissue had been saved from a 21-year-old soldier who died September 26, 1918 in the camp hospital at Fort Jackson, South Carolina.
Working with that tissue sample, Dr. Jeffery Taubenberger and Dr. Ann Reid had sequenced nine fragments of viral RNA from four of the virus’ eight gene segments. This was only a partial sequence of the 1918 virus’ genome, but it gave scientists some clues to the genetic structure of the deadly flu.
Johan Hultin immediately called Taubenberger. At age 72, he hoped for another chance at the virus. Taubenberger agreed he could use more tissue samples.
The Brevig Mission village council gave permission for another excavation. Hutlin hired local people to assist him, and once more dug into the permafrost. He personally funded the entire venture. Five days of digging lead to a momentous discovery.
Johan Hultin in his excavation at Brevig Mission burial ground in 1997. Photo Johan Hultin.
Seven feet deep, Hutlin discovered the preserved body of an Inuit woman he named "Lucy." Lucy likely died in her mid-20s from complications after contracting the 1918 flu. Hutlin found Lucy's lungs perfectly preserved by the Alaska permafrost.
Improved preserving methods and transportation allowed Hutlin to ship the precious sample quickly and safely to Taubenberger's lab at the Armed Forces Institute of Pathology. Ten days later, scientists confirmed they had retrieved 1918 virus genetic material from Lucy’s lung tissue.
Hutlin's work and Lucy's tissue allowed scientists to fully sequence the genome of the 1918 virus. They determined that it originated from swine, rather than birds. And they documented its continued survival in one form or another to the present day.
By constructing a "family tree" for the 1918 virus, scientists know it's descendants have been the cause of almost every seasonal influenza A infection worldwide over the past century. That's why it's been nicknamed “The Mother of all Pandemics.”
Americans experienced the first important health ramifications stemming from the sequencing of the 1918 virus in 2009, when Swine Flu hit the world.
This recent swine flu killed roughly 203,000 people
worldwide, similar to a normal flu season. Knowledge gained from its 1918 ancestor saved many lives.
Health officials were able to predict that healthy, young adults would be most at risk of dying from the virus. When vaccines were in short supply, they young adults were given priority over other age groups who had some natural degree of protection.
In addition, scientists the types of secondary bacterial co-infections had caused complications in the 1918 pandemic, so the medical community could be aware and prepare for these threats.
What help does this provide us today when under the onslaught of COVID-19, a virus that originated in bats? The science of the virus can tell us some about how pandemics spread. More importantly, looking at human actions during the 1918 flu, we can see what works and what mistakes to avoid.
Social Distancing works to flatten the curve
Analysis of historical data show that in cities where public officials intervened early and closed schools, canceled public gatherings, and isolated and quarantined this sick, fewer people died.
Voluntary Compliance can be a problem
As today, the need for early intervention was well-known in 1918. The first U.S. cases were army soldiers. The Army surgeon general barred civilians from all 120 army camps in the states, and order all soldiers entering them be quarantine. Soldiers showing symptoms were to be isolated and whole units quarantines if several soldiers became sick.
Unfortunately, only 99 or 120 camps followed the directives, and of those only a tiny number of camps rigidly enforced the rules over time. If in wartime, the army failed to sustain compliance to social distancing, isolating and quarantine, it's clear it will be enormously difficult for us in peacetime.
We can hope that social media might give us an advantage over history.
An emergency hospital at Camp Funston, Kansas, 1918. “Of the 12 men who slept in my squad room, 7 were ill at one time,” a soldier recalled. (New Contributed Photographs Collection / otis historical Archives / National Museum of Health and Medicine)
Getting facts to people quickly saves lives and promotes trust
The facts of flu outbreaks in 1918 were suppressed due to the federal sedition act that made it a crime to say anything that could reflect negatively on our ability to fight the "Great War" in Europe.
The flu pandemic got it's nickname the Spanish Flu because Spain was the first county to publish news that the outbreak was fast-spreading and deadly. Spain's neutrality in the war allowed them to share the news first. Americans believed the flu originated there.
It was more difficult to get the facts out in the U.S. and even then people did not want to believe them, as evidenced by the city of Philadelphia holding its parade. When the city closed school. saloons and theaters, one newspaper wrote: “This is not a public health measure. There is no cause for alarm.”
As the infection blazed out of control, people didn't know who or what to believe. According to John M. Barry author of “The Great Influenza: The Story of the Deadliest Pandemic in History” Citizens lost trust in one another.
"They became alienated, isolated. Intimacy was destroyed. 'You had no school life, you had no church life, you had nothing,' a survivor recalled. 'People were afraid to kiss one another, people were afraid to eat with one another.' Some people actually starved to death because no one would deliver food to them.
"Society began fraying — so much that the scientist who was in charge of the armed forces’ division of communicable disease worried that if the pandemic continued its accelerating for a few more weeks, 'civilization could easily disappear from the face of the earth.'”
Walter Reed Hospital in D.C. during the great influenza pandemic of 1918–19. Harris & Ewing/Library of Congress
Everyday people make a profound difference
In 1918, people praised the doctors and nurses who worked incredibly long hours and risked their own lives. Communities came together and average everyday citizens stepped up to help their neighbors. Teachers out of the classroom volunteered to drive ambulances, deliver food and filled in for critical workers who got sick. People cared for orphaned children and cared for bodies.
In Bremerton, Washington, the virus the Puget Sound Navy Yard, and then spread to the community. When the naval hospital overflowed with patients, a nurse volunteer to care for patients at the First Methodist Church. Angie Webber Harrison and her husband helped open the city's first non-military hospital in Bremerton and later bequeathed their estate to keep it operating.
Harrison Hospital became Kitsap County's first permanent civilian hospital after treating flu patients in 1918. Today, Harrison's nurses, doctors and personnel are once again serving as Kitsap's critical hospital for a pandemic.
Some decades ago between pandemics, nurses in the Harrison Hospital maternity ward welcomed a young mother about to deliver her second daughter. It became the birthplace of a certain writer you know. 😉
Here are some great articles from my news reading this week.
Library closed? Need books?
Pema Chödrön describes a liberating way to relate to our fears: not as something to try to get rid of or cast out, but as something we became very intimate with. In so doing, she explains, we come to find that the journey of knowing fear is in fact the journey of courage. From this wisdom, we learn to embrace the fullness of our experience in life. Check out her video here... Fear and Fearlessness
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