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The Great Influenza: The Story of the Deadliest Pandemic in History

By John M. Barry

What you’ll learn

Until recently, the idea of a pandemic took most people’s imagination to Hollywood thrillers and the Black Plague that ravaged medieval Europe. But the most devastating plague to ever strike the human race took place a century ago, during the First World War. This story contains many lessons for how—and how not—to handle a pandemic. Barry’s tie-ins to our own day (most recent edition published in 2018) have an eerily prophetic ring to them in light of the corona virus that has recently swept the globe.

Read on for key insights from The Great Influenza: The Story of the Deadliest Pandemic in History.

1. The 1918 influenza virus targeted young adults, and killed far more than the Black Plague or AIDS.

It was in the fall of 1918 that a group of sailors from the United States began presenting never-before seen symptoms that baffled clinicians. The presenting symptoms were bleeding in the nose and ears, pounding headaches, painful body aches, deep coughs (sometimes deep enough to tear abdominal musculature), and, finally, skin turning blue.

The medical professionals called in Paul Lewis, a lieutenant commander and a medical doctor who was more familiar with death in all its varieties than just about anyone alive at the time. He was also brilliant. More than a few colleagues—accomplished scientists in their own rights—called Lewis the most brilliant man they’d ever met.

Lewis was highly accomplished and still young. When polio had ravaged New York, he was part of the group that proved a virus was the culprit. And then he developed a vaccine that proved 100 percent effective in animal trials. He’d also founded a research institute in affiliation with University of Pennsylvania. Though Lewis was an accomplished man of science and familiar with death and all its friends, he was still baffled by the bodies of dying, blue-skinned sailors. He’d seen something similar among British soldiers weeks earlier, something influenza-like, but he wasn’t sure.

Whatever it was that the sailors who came through Boston to Philadelphia had brought with them that fall, it spread. Despite the best attempts of medical personnel to contain the unknown disease, it spread from the 19 soldiers to 87, and then to 600 within just a few days. Hospitals ran out of beds quickly and had to involve other medical facilities to care for the sick sailors and the civilians with whom they’d come in contact. Simultaneously, the same symptoms began showing up all over the world. This wasn’t a passing rash of influenza going around as doctors in the United States and Europe had thought. It was actually the second wave of a mild influenza that had appeared months earlier in America’s heartland. It was not nearly as devastating then, in symptoms or spread. The second, far more pernicious infection was spreading like wildfire in the fall of 1918, affecting not just sailors in New England, but also soldiers in the British Raj in India, and everywhere in between.

And so, as the Great War continued to rage, another war had begun. It wasn’t just a fight of nation against nation, but also of nation against some unknown disease. It began in a small town in the United States in the spring of 1918, but had laid dormant. But between the fall of 1918 and 1920, millions died. Of those who contracted influenza and succumbed, their deaths were swift and painful.

Earlier estimates put the death toll at 21 million, but this is now considered a low ball. More widely accepted estimates from epidemiologists are between 50 and 100 million. The majority of these deaths took place within a half-year window, during the fall and winter of 1918. The disease killed more people in a year than ever died in the medieval Black Plague or from AIDS.

What made this pandemic even more tragic was that it was the young (people in their 20s and 30s) who were especially vulnerable to the pathogen. If the higher estimates are accurate, that means the 1918 influenza took out about 10 percent of young adults on the planet.

The 1918 outbreak marked a milestone in human history. It was the first time that modern medicine and nature had challenged each other in such a robust way. The virus that led to the infamous Bubonic Plague 700 years earlier was a far milder strain, but it still decimated Europe because science and infrastructure couldn’t put up any real fight. This time, it was different, and it was the individuals who retained poise and calm in the midst of dire circumstances who stopped the bleeding and kept the catastrophe from being any more grim than it already was.

2. Only a few scientists saw the world’s vulnerability to epidemics and began planning accordingly.

Around the time of the pandemic, there were a number of remarkable people who had helped bring medical practices and research to the cutting edge. There are some areas of study where, even a century later, medical practitioners remain indebted to these forebears’ expertise and the skills they developed in a time of influenza. Paul Lewis was one of those geniuses. Another was William Henry Welch, who founded the first academic program devoted to public health in 1916 at Johns Hopkins University in Baltimore.

Still, it took tremendous time and dedication to make medicine a modern, scientific pursuit. Until the late-1800s, the field of medicine had changed very little since the days of Hippocrates in ancient Greece. Even until 1900, only one medical school in five required a high school diploma in the United States, and only one medical school required a college degree for admission. Many applicants without any serious training in the physical sciences were admitted, simply by proving that they could pay tuition. Degrees were doled out to men (women were not admitted) simply for passing all the classes—even if they had never touched a body or seen a patient.

Eventually, medical practice began to improve and become more empirically verified, first in Europe and then in the United States. United States medical science was the worst in the developed world before it became the best.

William Henry Welch was a forerunner who helped bring the massive and much-needed changes to the United States’ medical education. Welch was a capable scientist, physician, and professor, but his strength lay in his ability to inspire. He was a charming and charismatic individual. The students he taught at Johns Hopkins adored him and would become the most coveted in the United States. These Welch protégés formed an army of elites who would become more desperately needed than they knew in 1918. Welch was a man who convinced people that improvements in the American medical field were horribly overdue, and he provided a road map for how to get there, as well as a prestigious group of medical professionals to navigate it.

Welch’s influence revolutionized medicine in the United States, but another thing that  made Welch singular was that he saw what most everyone else had missed: humanity’s vulnerability to epidemics. He had noticed the trend that every time the United States went to war, disease killed far more combatants than the opposing armies. Moreover, war had a way of spreading illness. These facts led Welch to predict that, with the Great War on, it was just a matter of time before some kind of epidemic broke out.

Welch had pushed Johns Hopkins for a public health program since the 1880s, and he finally got his wish in 1916 when the Johns Hopkins School of Hygiene and Public Health was founded. This was just two years before the influenza began to emerge. He saw that robust public health (of which epidemiology, or the study of disease, is a central feature) was the best way to save lives. He was right, and his intuition holds true to this day.

3. The 1918 influenza began in Kansas, but it was quickly exported to the rest of the world, infecting hundreds of millions.

The influenza outbreak of 1918 most likely began in Haskell County, Kansas. There are other theories that it began in China or Vietnam or France, but the United States is the most probable starting point, and there’s no earlier record than from Haskell County. The virus drifted from Haskell to a nearby military base, when it was still tame in comparison to what was to come. Not much more was said about the outbreak than a forgettable health notice about “influenza of severe type” the Midwest. From there, the virus worked its way through the ranks of soldiers and was then exported to other U.S. bases and the various war theaters across Afro-Eurasia. It came roaring back to America in the fall of 1918, in the previously mentioned New England cities.

What makes influenza dangerous is that it’s caused by viruses—not bacteria (a discovery that one of William Henry Welch’s many protégés made). It’s not quite an organism, but it’s not as lifeless as a chemical compound either. Its mission is to replicate, but it cannot do so apart from a host. It needs an organism’s cells in order to make thousands or even hundreds of thousands of self-copies.

What makes influenza viruses unique is that they are extremely infectious and competitive. Influenza viruses set off all the body’s warning bells, and the immune system sets up defenses based on what the body has already encountered. But a new variation of the virus is unknown to the body, and attacks a compromised and blind immune system. The body beats down any other viruses that might be present, and then, once all other familiar viruses have been eliminated, the new influenza virus begins its work.

The United States was unprepared for the pandemic for a variety of reasons.

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by Rev. Dr. Peter Walker, Principal, United Theological College

Dietrich Bonhoeffer was executed on the order of Heinrich Himmler seventy-five years ago in a Nazi concentration camp in Flossenburg, only days before its liberation, in April 1945. Bonhoeffer had known from the age of sixteen that he wanted to study theology. He died having fully expended himself in that calling. And in so doing, he has become an inspiration to generations of Christians. As his gravestone reads: Dietrich Bonhoeffer, a Witness to Jesus Christ.

In 1935, Bonhoeffer accepted a call from the Confessing Church, an alliance of faithful resistance to Nazism, to lead an underground seminary for its pastors. There, in Finkenwalde, he wrote Life Together in 1938. Now a devotional classic, Life Together was first of all a guide to life in Christian community – a reflection for his underground seminarians. Within it, Bonhoeffer explores the joy and struggle of community lived in and through Jesus Christ; a spiritual and even divine reality, manifest in human fellowship, and marked by Bible reading, communal singing, sharing a table, prayers, and daily work.

Yet the central chapter of this beautiful book about being together is titled ‘The Day Alone’.

Hearing the voice of God

Bonhoeffer writes, ‘Let those who cannot be alone beware of community’. The noise and activity of life together may crowd out the voice we sometimes need to hear alone, the voice we might sometimes only hear alone – the voice of God.  Yet with a balancing wisdom, Bonhoeffer follows soon after with its opposite. “The reverse is also true”, he writes. “Let those who are not in community beware of being alone”. The voice which speaks out of the silence to our inner-most self, calls us into the community of Christ’s disciples.

Bonhoeffer wanted his seminarians to understand the connection between silence and our ability to hear the still small voice of God which animates our faith; to understand “the essential relationship of silence to the Word.” And, he wanted them to understand that time together and time alone are both essential to Christ’s community. Time with others enriches our time alone, and time alone enriches our time with others. “The day together will be unfruitful without the day alone”, Bonhoeffer writes. And conversely, “After a time of quiet, we meet others in a different and a fresh way”.

“Only in this fellowship do we learn to be rightly alone, and only in aloneness do we learn to live rightly in the fellowship. It is not as though the one preceded the other. Both begin at the same time, namely, with the call of Jesus Christ.”

COVID-19 and ‘the day alone

COVID-19 has brought a form of ‘the day alone’ upon us all. In reality, it will be much more than a day. We are beginning a time of relative solitude that will last for weeks and may hold for months.

Notwithstanding our heartbreak for those to whom this virus brings suffering, for whom we must do all we can in love, I suspect Dietrich Bonhoeffer would encourage us, as individuals and as the church, to embrace this time alone. Embrace it for meditation on the scriptures. Embrace it as an opportunity to be intentional in our listening for God. That will not be easy, and we will need to be patient. Yet we have time. What is God saying to you? What is God saying to this church?

Embrace this mandated time apart as a time for prayer.

For the rest of the post…

asian american

Pastor Ray Chang and Dr. Michelle Reyes have collaborated with leaders across the U.S. to combat the rising racism against Asian Americans during the coronavirus pandemic. Under the umbrella of the Asian American Christian Collaborative (AACC), these leaders have released the “Statement on Anti-Asian Racism in the Time of Covid-19.”

“We call for an immediate end to the xenophobic rhetoric, hate crimes, and violence against our people and communities,” write the authors. “We invite all Americans to join us in combating these contagions and work with us for the welfare of all.” The authors go on to say:

In the last two weeks of March 2020, Asian Americans have reported nearly 1,000 incidents of racism, and without mitigation, we expect that number to rise in the weeks ahead. Many of these were violent attacks against life and human dignity, and many more incidents have gone unreported.

The statement recalls previous incidents of racism against Asian Americans in the U.S. during World War II, as well as the racism Middle Eastern Americans experienced following the 9/11 terrorist attacks. Noting the two greatest commandments to love God and neighbor, the authors write,

We urge you to speak without ambiguity against racism of every kind. Faithful Christian witness requires anti-racist work, and silence only perpetuates the sins not addressed. This includes going beyond shallow acknowledgement of the most obvious incidents of racism to taking responsibility in confronting the longstanding tendencies of people to discount and dismiss the realities of racism. It also includes addressing the disbelief and disobedience of your constituents who continue to ignore members of the body of Christ who are in pain and under threat.

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by Chuck Cantoya

As I began to grasp the uncertainty of the global pandemic, a question popped into my head: How would I really like my life to play out? Gut reaction: I’d like things to happen according to (my) plan in a well-ordered, no surprise manner. Then it hit me – that’s a life that requires no faith whatsoever.

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Baptism Continues, Though Rome Church Services Canceled

Since Italy is a country that has experienced years of decreasing birth rates and is now considered an elderly country; the death rate in Italy is reflecting that reality. Currently travel is severely restricted, and stores and restaurants are all to remain closed until further notice. Only grocery stores and pharmacies are permitted to remain open, with some industries operating with restrictions. Going to a friend’s house for lunch or dinner is not allowed.

IMB church planter Reid Karr baptizes new believer, Akille De Chirico. The baptism took place in De Chirico’s home when the church was not able to meet due to the coronavirus outbreak. Church members watched the baptism online via a livestream.

These restrictions are of course having a significant impact on religious and church meetings of any kind. Churches have had to cancel services and find creative ways to meet and have community. Modern technology has been a huge blessing and help for many seeking corporate worship.

On Sunday, March 8 in Rome, Italy, the evangelical churches Breccia di Roma San Paolo and Breccia di Roma centro (downtown) were to meet together to celebrate the baptism of Akille De Chirico. Akille was adopted as a young boy from Ethiopia into an Italian family. His family has loved him unconditionally and walked with him through good times and difficult times. His father is a faithful pastor and his mother is a dedicated nurse.

Akille spent his childhood in a home where the gospel was taught and lived, and he followed his family to church where the gospel was faithfully preached. For Akille, however, Christianity was just one religion among many and had no claim to absolute truth. Akille began attending the church plant Breccia di Roma San Paolo in September 2018. The Lord built on the foundation of his many years of exposure to the gospel and opened his eyes to the exclusive truth claims of the good news of Jesus Christ. The Lord revealed to Akille that forgiveness of sins, redemption, salvation and eternal life are found in Christ alone. Akille made the decision to follow his profession of faith in Jesus with believer’s baptism.

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Reid Karr is a church planter in Europe. He lives in Rome, Italy, with his wife, Stephanie, and three daughters.

Reid Karr is a church planter with the IMB, serving in Italy

Yesterday, I “preached” my second sermon sitting at my desk at Converge Church. It is very strange not preaching during the Sunday Morning Worship Service. May the church be the church and may the followers of Jesus be salt and light in this world. Last week, I began a sermon series on the Gospel of Mark. Below is a link to today’s message:

Setting the Stage for the Arrival of Jesus

Based on Mark 1.1-8.

Bryan

 

 

Fighting Fear in Uncertain Times – Annie Holmquist

Recently a friend asked me, “What’s it like over there?”

“Pretty quiet,” I replied. “Rainy. Normal. Looking out the window, life seems fine.”

It’s when one looks away from the peaceful window scene and begins looking at headlines that the sky seems to be falling. Whether it’s the threat of viruses, the implosion of the stock market, a potential job loss, or even the next election, fear creeps in quickly.

How do we handle that fear? Do we dismiss it entirely and become flippant in our response to life’s challenges? Do we yield to it, hunkering down and putting the Y2K preppers of yore to shame?

It’s a delicate balancing act, particularly when we are facing the unknown. Yet we are not the first to wrestle with the reality of fear, nor will we be the last.

Take Dietrich Bonhoeffer. A German theologian and pastor in the 1930s, Bonhoeffer became famous for resisting the Nazi regime and for his role in an attempted assassination of Hitler, actions for which he paid the ultimate price.

The winds of change were beginning to roar in early 1933. Hitler’s rise to German Chancellor, the burning of the Reichstag, and the rise of the Third Reich were fast approaching. Bonhoeffer likely sensed the fear these changes caused and sought to comfort his congregation, describing the warning signs and dangers that fear brings:

1. Fear Destroys

Fear gnaws away at the inmost being of a person. “It hollows out their insides, until their resistance and strength are spent and they suddenly break down,” Bonhoeffer explained. It also destroys their connections to God and others that are vital in the face of need and danger.

2. Fear Mocks

When a person is in the grip of fear, “fear leers” at that person, blasting him with mocking words:

Here we are all by our­selves, you and I, now I’m showing you my true face. And anyone who has seen naked fear revealed, who has been its victim in terrifying loneliness— fear of an important decision; fear of a heavy stroke of fate, losing one’s job, an illness; fear of a vice that one can no longer resist, to which one is enslaved; fear of disgrace; fear of another person; fear of dying—that per­son knows that fear is only one of the faces of evil itself, one form by which the world, at enmity with God, grasps for someone.

3. Fear Weakens

“Fear takes away a person’s humanity,” Bonhoeffer explains, distorting him and taking away his dignity. “This is not what the creature made by God looks like—this per­son belongs to the devil, this enslaved, broken-down, sick creature.”

For the rest of the best…

be the church

Even though most church buildings are temporarily closed due to the COVID-19 coronavirus, many pastors and members are busier than ever. Church leaders and volunteers throughout America are stepping up to serve their communities during a fearful time of unprecedented disruptions and long-term lockdowns. These churches are showing the world what it means to be the church.

At the outset, many congregations are providing food to schoolchildren, assisting homeless people, and coordinating with local relief agencies. And they’re emphasizing safety at every step, following advice about social distancing and reducing exposure…

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Due to guidance from the CDC’s 15-day plan, as well as local and state orders and advisories, Genesis Health Clubs will temporarily close all health clubs, effective March 17th. We plan to reopen as soon as possible, following local, state, and national guidance. Members will receive a prorated credit to their accounts for the days we were closed and we hope to announce a reopening date for each market soon.

In the nearly 30 years of owning Genesis Health Clubs, I could never imagine having to send a message like this or even contemplate this happening – Exercise is such a major part of our lives that it is essential we keep moving! I am so sorry that this is inconveniencing your workouts. We will be launching a series of work out at home group exercise videos and blog content tomorrow in order to keep our members fit until they can rejoin us in the club.

We share a deep commitment to health and fitness, and we encourage any member who experiences a fever, dry cough or any other symptoms to follow CDC advice in seeking medical attention. We hope to see everyone happy and healthy and ready to workout in the club soon.

Yours in Health,

Rodney Steven II

April 2020
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