John M. Barry, the author of The Great Influenza, discusses the three waves of the Spanish flu. He talks about the beginnings in the US:
Although some researchers argue that the 1918 pandemic began elsewhere, in France in 1916 or China and Vietnam in 1917, many other studies indicate a U.S. origin. The Australian immunologist and Nobel laureate Macfarlane Burnet, who spent most of his career studying influenza, concluded the evidence was “strongly suggestive” that the disease started in the United States and spread to France with “the arrival of American troops.” Camp Funston had long been considered as the site where the pandemic started until my historical research, published in 2004, pointed to an earlier outbreak in Haskell County.
The way the virus spread around the world:
Initially the 1918 pandemic set off few alarms, chiefly because in most places it rarely killed, despite the enormous numbers of people infected. Doctors in the British Grand Fleet, for example, admitted 10,313 sailors to sick bay in May and June, but only 4 died. It had hit both warring armies in France in April, but troops dismissed it as “three-day fever.” The only attention it got came when it swept through Spain, and sickened the king; the press in Spain, which was not at war, wrote at length about the disease, unlike the censored press in warring countries, including the United States. Hence it became known as “Spanish flu.” By June influenza reached from Algeria to New Zealand. Still, a 1927 study concluded, “In many parts of the world the first wave either was so faint as to be hardly perceptible or was altogether lacking…and was everywhere of a mild form.” Some experts argued that it was too mild to be influenza.
How the Spanish Flu infected both throat and lungs:
A pandemic occurs when an entirely new and virulent influenza virus, which the immune system has not previously seen, enters the population and spreads worldwide. Ordinary seasonal influenza viruses normally bind only to cells in the upper respiratory tract—the nose and throat—which is why they transmit easily. The 1918 pandemic virus infected cells in the upper respiratory tract, transmitting easily, but also deep in the lungs, damaging tissue and often leading to viral as well as bacterial pneumonias.
The three different waves:
After that third wave, the 1918 virus did not go away, but it did lose its extraordinary lethality, partly because many human immune systems now recognized it and partly because it lost the ability to easily invade the lungs. No longer a bloodthirsty murderer, it evolved into a seasonal influenza.
Scientists and other experts are still asking questions about the virus and the devastation it caused, including why the second wave was so much more lethal than the first. Researchers aren’t certain, and some argue that the first wave was caused by an ordinary seasonal influenza virus that was different from the pandemic virus; but the evidence seems overwhelming that the pandemic virus had both a mild and virulent form, causing mild as well as severe spring outbreaks, and then, for reasons that remain unclear, the virulent form of the virus became more common in the fall.
The way in which people reacted:
In New Haven, Connecticut, John Delano recalled, “Normally when someone was sick in those days [people] would bring food over to other families but…Nobody was coming in, nobody would bring food in, nobody came to visit.” In Perry County, Kentucky, the Red Cross chapter chairman begged for help, pleaded that there were “hundreds of cases…[of] people starving to death not from lack of food but because the well were panic stricken and would not go near the sick.”
Considering the current coronovirus outbreak, it was intriguing reading Barry’s predictions:
In recent years, two different bird influenza viruses have been infecting people directly: the H5N1 strain has struck in many nations, while H7N9 is still limited to China (see “The Birth of a Killer”). All told, these two avian influenza viruses had killed 1,032 out of the 2,439 people infected as of this past July—a staggering mortality rate. Scientists say that both virus strains, so far, bind only to cells deep in the lung and do not pass from person to person. If either one acquires the ability to infect the upper respiratory tract, through mutation or by swapping genes with an existing human virus, a deadly pandemic is possible.