Arnold (Globe: Life in Shakespeare's London, 2015, etc.) collects global eyewitness accounts of Spanish flu, clearly illustrating why it caused more deaths than World War I.
The virus began in early 1918 and wreaked havoc around the world until summer 1919. It was considered a bacterial infection, and few questioned it since other diseases—e.g., cholera and plague—were bacterial. The modern concept of the virus was unknown in 1918, and the world war helped to create a perfect storm of factors that fed the virus. A massive military base in northern France housed a port, railway yards, stores, prisons, training areas, stables, and piggeries as well as areas to house ducks, geese, and chickens to feed the army. Ducks were a reservoir for bird flu viruses, and their feces would be absorbed by the other animals that were kept for food. Nearby was a general hospital, and 100 trains per day brought wounded from the front to be treated by up to 10,000 medical staff. This was where the first case appeared. The wounded were repatriated or returned to the front, carrying the disease throughout Europe. In America, a case appeared on a Kansas farm, and then an overcrowded Army camp in Kansas witnessed outbreak. The first appearances were spotty; most patients recovered, and it vanished as quickly as it appeared. Not so the second wave in the summer, as the author amply shows, when it struck with a deadly virulence. Any large gathering was potentially deadly, including massive troop movements, bond drives, and victory parades not to mention troop ships, which became floating incubators. It was an unusual flu in that it arrived in summer rather than winter and struck the young and fit rather than the old and infirm. By the time it passed, it had killed one-third of the world’s population.
A wealth of stories of gruesome infection, lack of health care, and
further transmission. A well-researched but ugly history that may fatigue
readers by the end.