watch online anytime at c-span.org/history. i'd like to introduce our guest speaker. who is christopher knight nichols of oregon state university. he is a frequent collaborator of ours a board member an organist historical society his youtube videos talking about comparing the pandemic to what happened in 1918 are some of our most popular online. he's very active in civics and citizenship and we are just thrilled to have him with us a full bio is on our website about further ado professor. thank you so much derek. thanks so much to derek olson and to tim derosch into a world, oregon and to the partners at the oregon historical society who have helped make this event possible and most importantly thanks to all of you the tremendous interest in this topic has been inspiring to me and i'm excited to talk about it with you walk us through some of the questions that we have about pandemic exhaustion and pandemic to endemic lessons from the 1918 flu pandemic, so i will now share my screen so you can see some of the amazing images from this era and as i do so, i'd like to first consider our contemporary moment our current moment. you know, it's the second year. we're about to turn into a third year of the pandemic. it's you know, the truth is we're all worn out these headlines help to suggest. just how worn out we are and how many questions we have today. the pandemic has challenged us. it's it's changed us fundamentally in ways. we're not sure we fully appreciate it's revealed the fractures and fissures within society that many of us knew were there we had some sense of them, but quite a few of us chose to avoid them or ignore them or not address them and most of all for thinking about the pandemic today. it's not over and that's a crucial insight that we have from those who were pursuing sort of wishful interests and thinking in 1918 and 1919 and as many of us have longed for an end to this pandemic through 2020-21 and now into 2022 this pandemic is all so reminded us virtually every one of us of the importance of history. i'd argue and of standing past pandemics in particular. i've been really inspired by how many people were have been interested in learning about the pandemic of 1918 from journalists and members of the media to politicians to business leaders to citizens to my amazing students and others comparisons abound historical quote unquote lessons have been the subject of lots of conversations and a spread almost as rapidly as the virus itself in particular. the 1918-19 pandemic has become a major subject of interest. it shouldn't surprise us. so i thought for a first few moments of this talk, i'd assess kind of where we stand today. what a historians perspective is on where we stand today. um, first of all, first and foremost, i think there's an optimistic element here something we all need to just take a moment and take on board, especially, you know in these troubling times where russia has attacked ukraine, and there's a lot of uncertainty in the world in world historical terms. we've arrived at an amazing moment. fastest successful global race to effective vaccines has happened in our lifetimes everybody who is allowed today has witnessed this in some way shape or form even those who aren't fully cognizant of that fact. increasing production distribution and vaccination by spring and into early summer 2021, you know made the resumption of some seemingly normal activities something that that a lot of us. hope for and in fact could pursue and then of course in came the omicron and delta variance first dealt the delta wave overlapping with omicron wave but again as those various combined with the presence of large blocks of our unvaccinated population. did this fundamentally alter the trajectory of the pandemic? is this the sort of thing we've seen in the past or is this something new? that's a question for us historians for public health scholars and others and i would just add. you know, i'm a historian and not an epidemiologist or an md. so, you know, we've got this here this quote that i'm suggesting up there. absolutely remarkable in world historical terms and then on the other hand, you know the world health organization and others noting that even though the omicron subariant is perhaps less deadly. it's certainly more infectious and it's racing around the globe coming to catastrophic numbers of total deaths in the us, you know in 1918, and there was a race by scientists and others to try to push forward vaccinations try to figure out a science of that people long for better treatments in 1918. they searched desperately for effective ways to deal with the the pandemic and they had not trans in facts for sprinted across the country with prototypes of vaccines to try to get them into people's arms into that into the arms of volunteers and i'll talk a little bit about that. but as you think about this moment that we're in now it's sort of a tale of two pandemics as i know. here what's astonishing when you look at these numbers just in broad perspective and not in sort of fine-grained analysis is how how badly us global covid deaths have been in comparison to the us's percentage of global influenza deaths in 1918 and 1919 to put that insight slightly better perspective with a population of roughly 105 million. there were on the order of 675,000 estimated us deaths in 1918 into 1919 and today with a population of roughly 330 million the us is around 940,000 reported estimated covid deaths and counting. so one piece of analysis here, is that obviously the pandemic isn't over yet in the sense of moving through omicron, but also in the sense of the devastation that it's leaving in its wake so one of the historical lessons we have learned and my great colleagues like nancy bristow. john berry and others have emphasized in their great work on the 1918 pandemic is that we need to put forward lessons and insights about suffering and trauma that the people who survive pandemics often have what we call contagion guilt guilt related to the contagion themselves coming through it. perhaps surviving perhaps not having too many effects and also guilt about perhaps conveying it to others to family members to loved ones to members of their community. so as we think about these big numbers, i would encourage us all to think about the smaller scale numbers and the trauma and personal and private sort of suffering and mourning that you go through and locking into this set of concepts then i'd suggest one of the first lessons that came out of the 1918 19 pandemic that was telegraphed and shouted from the rooftops by public health officials in that period and that has been something we've heard pretty consistently from 2020 through now 2022. is that a viral deadly pandemic? is much easier to prevent than to cure and in the case of preventative behaviors and measures things like masking and distancing and closures. those are the best mechanisms for that. but of course easier to prevent than cure now in our contemporary moment, unlike 1918 and 19 vaccines and treatment strategies things that we know to be effective through modern science have really changed the game of how we may think about being easier to prevent than to cure. you know another element of this that i want us to pull out here at the outside of this talk as we think about questions of what is the meaning of endemicity and how how should we think about lessons from 1918 and 19 for today? is that giving up on pandemic measures or downplaying the significance likely means playing a paying a significant price. so here's two examples one from denver one from birmingham, you know the truck in 1918 into 1919, but particularly in the late fall of 1918 after several months or weeks in some cases only of what we call non-pharmaceutical interventions npis like social distancing and closure policies after just a few weeks or months people were eager to get back to their lives. they didn't like doing those behaviors very much as we haven't in fact and so one challenge particularly in the middle of november 1918 at november 11. armistice day ending world war one was that people gathered? they got out. they gathered they partied they were excited about this moment for the us and for the world and therefore as we now would think about it. you had enormous super spreader types of events and gatherings and even so even as these things were feared many public health officials, you know, many politicians and business leaders who wanted to keep their businesses open clergy members churches. wanted to keep their places of worship open pushed back against the non-farmaceutical interventions and you wound up seeing in a number of places upticks of infections deaths and disease in some places as i'll talk about in a little while like the city of denver you saw a higher peak of deaths in fact coming later in the deadly second wave of the pandemic. so that's another key lesson here. it isn't that you can't move away from those behaviors, but that it's it critically important to take into account data and disease more kind of wishful thinking. so i'll leave us in to thinking about this a bit. this is a glorious declaration in the city of portland from the oregon daily journal that officials say the flu endemic is over masks not needed. this is the sort of thing that we have been hearing in a number of blue states in fact in recent months the state of oregon right now has has said some time ago that by march 31st masks wouldn't be needed and now has set that forward even to march 19th. these are the kinds of decisions that are either made led by data and disease or by public pressure and one of the things that we saw in the 1918 19 pandemic was that public pressure to ease off on these kinds of restrictions was virtually omnipresent. enormous in a lot of places it didn't necessarily map on to politics or partisanship, but people got tired of these kinds of behaviors fairly rapidly much like we've seen in the last few years. now one of the ways that this was manifested by public health officials, just eight days earlier before that pronouncement was and i think this is really salient to us. it will resonate with a lot of you i bet was this kind of accusation of individuals being careless that the apathy of the public is the hardest thing officials have to fight or the carelessness is the greatest cause of spread this dr. ea sumner director of consolidated public health in portland, you know made this argument that only until recently in february 1919. so in some accounts in some ways of thinking this would be in the midst of a third wave or in the in the case of portland really there was a long duration second wave of the influenza pandemic. he was arguing that finally people were changing their behavior, but the reality of this moment is that the city was rescinding some of these orders and mixed messages because of push back as well. but this argument here is that it's about public responsibility and personal responsibility and one thing that i think is worth noting as we think about later stages of pandemics like the one we're in today is the ways in which individuals are the burden is placed on individuals not always the collective in other words this accusation here this set of comments is about people not wearing their masks essentially or gathering too much that sort of thing. it isn't so much about what the city or the state owes to those individuals. so if you think about questions of who and what counts as an essential worker, or the kinds of inequality that are exposed when a pandemic affects people who are say in businesses where they have to interact with a lot of individuals or in larger numbers, at least then you can think about how this argument for personal responsibility may have some limitations right? it's not as if people want to go into workplaces if they're forced to and interact in groups with those who may be carrying infectious diseases now things have changed for us again with vac. science and boosters, but even today less than 50% of adults who've gotten their first or second vaccine have pursued a booster shot in the us which we know to be the best preventative measure. so here's some headlines from the new york times selected out from 1918 and 19 and the new york times. i would highly recommend to you would be great to search they cover the national and the local pretty well in thinking about the 1918-19 flu pandemic and it gives you some sense of the kinds of mixed messages that that individuals and groups were getting from public health officials and from politicians the kind of wishful thinking of politicians and public health officials at different times the sorts of special interests interests that were invested in staying open or reopening. they you also find in some of these cases a real fears about a return of the of the pandemic in late 1919 into 1920 and one of the key things before i walk us through the whole pandemic very briefly and get us to the endemic stage is to note that there's four ways really most historians track the first three through the summer of 1919, but in the winter of 2020 that fourth wave what's being worried about in some of these notes some of these headlines in the middle to late 1919 that fourth wave was worse than the first and the third so, you know one of the true-isms about pandemics is that in fact, they sort of operate on three year time scales. this doesn't necessarily hold for all pandemics. it may not hold for ours today. it doesn't exactly fit for 1918 and 19, but there's some truth to that and i've done a roundtable article with some scholars of this that will be out in april that talks about some of the kinds of time horizons that you can expect based on past experience. so, let me walk you through a little bit of the overall ways in which the in which the pandemic preceded so that we can get a sense of how it developed and then where what we can think about in the later stages that it might be lessons for us today. so i think it's incumbent on us to think very much about the human suffering as i noted and about how that affected risk assessment. so one of the things that scholars often note when they talk 19 18 19 pandemic is the importance of historical memory and we've been puzzling for years over the fact that in the 1920s into the 1930s. there are lots of small bits kernels if you will of evidence about how the pandemic affected people there was something called law a long flu. there was a sort of brain encephalitis condition there were psychological psychological ramifications. in fact, there was something like a seven times increase in hospitalizations do to psychological issues and diseases coming out of the pandemic very much akin to long covid and subsequent medical knowledge has suggested that virus is often increase the the ways in which many individuals and groups have heightened risk of other kinds of diseases. so, but i want us to think as we move through this as historians emphasize the suffering the personal suffering the private traum, often inform public behavior and one of the best examples of this is the doctor victor von. he was dean of the university of michigan medical school a former president of the american medical association founding editor of the journal of lab and clinical medicine and he was serving as a colonel in the army when he led its division of communicable diseases when the influenza outbreak again, and you can see in his memoirs you can see in his writings at the time and later that he's as he travels to camp devins in in, massachusetts outside boston in september 1918 with a team of those appointed by the army surgeon general to look into the outbreak of the spanish flu, then so called the influenza pandemic. he he was pretty shocked. he said he would say i might say that i thought my eyes would never see such horror as i saw there. i went through the spanish-american war i saw and thousands of cases of typhoid fever, but i never had anything so depressed me as the conditions that existed at camp devins and as i have up there from his memoirs, he even though he says in the introduction of his memoirs, he won't talk about his experience of the 1918 flu he does in fact very much at the end of it talk a lot about it poignantly. they're placed on the continents until every bed is full and yet others crowd in the face is soon where i bluish cast the distressed and cough brings up this bloodstain sputum and in the morning, the dead bodies are stacked about the more glycorwood, you know, one of the things that's so essential to understand about that pandemic unlike hours today is that it disproportionately affected the most healthy amongst us it affected the sort of age bracket of 18 to 45 such that roughly half of all deaths of the 1918 19 flu pandemic came in that age range. so it disproportionately affected the young and the healthy led to extreme nursing shortages and medical. caregiver shortages it took people out of the workplaces. it killed numerous parents and transformed the lives of the orphans in all sorts of ways that historians have documented and can only imagine so let me walk you through a bit more how the pandemic began and what that signified. well, there are a number of origin stories about how the pandemic began or where it began epidemiologists are still tracing this one origin story is that it developed in vietnam. another is that it came from china yet another tracks it to an outbreak in 1916 in near the french lines in the imm world war one, but as we track it over its global spread in late winter 1918, it looks to most scholars like it moves along the transmission lines of the us military moving from camp funston in kansas in february and march 1918 and incubated in this sort of perfect petri dish of large camps of young healthy men moving together training together in very close proximity as john berry historian writes a soldier recall that of the 12 slept in my squad room seven were ill at one time within not long within just a few months. you find that that or within under a month of march 24 of the 36 largest us camps are overwhelmed by flu cases, and this is all in the context of world war one and one of the challenges for us in trying to figure out the lessons of that pandemic and how it transformed to be endemic. is that the devastation of world war one and the transmission lines and the global connections of world war one. i've really overwhelmed how we can understand and disaggregate the flu story of world war 1 so estimates are that perhaps as many as 50 million people around the globe in a global population of about 1.5 billion died of the 1918-19 flu pandemic in some populations. it was as much as five or 10% of the of the population in others. it was on the order of one to two percent. and it meant it matched with the sort of lost generation kinds of concepts that fit how observers in the 1920s and 1930s thought about the devastation of the war effectively. the world was globalized in 1918 and so as the flu spread in march and april from kansas across the atlantic it crossed to port facilities where us troops and material were headed in breast in france moves around the world such that but it's in algeria by june and only australia is able to keep it out until the end of the year by a very strict quarantine policy and then eventually sick troops on troop transports bring it in at the end of 1918 and early 19 19. so just like in 2020 the virus traveled around the world through the conditions of the great war and as you see here us training forces there in an induction camp in syracuse, new york and french forces near the western front are near ideal kinds of conf. patients of human beings to help spread and to help enhance mutation of viruses and if you think about this moment another key element to understand about that pandemic and in some of the ways that we have dealt with it in the us and around the world is to think of it in terms of patriotism and in terms of nationalism or other kinds of calls for bringing people together for communal or collective effort. and so you saw in the world war one context first a real attempt through organizations like here through the red cross to manifest and operationalize a kind of patriotism to turn that against the virus as the war was ending as that deadly second wave was coming across and crashing across the us and red cross volunteers and others making god's masks. we're in the songs so called fight against the virus as you see there this this line if i fail does is a direct translation between there's a direct translation between the war effort if i fail he dies in terms of caregiving and in terms of mask making in other activities, there's another element of this and i'll just mention it briefly which is that wartime censorship played a big role in the information that people could have and so one of the lessons learned of that moment for future public health and you saw this in public health preparedness documents from the cdc and other organizations has been honest clear transparent communication is essential in messaging public health behaviors and risk assessments related to an infectious disease in this case. here's the defense of the realm act in 1914 in the uk in this case. you see the 1917 and 1918 espionage sedation acts in the us which made it a crime for journalists to publish stories that might undermine the war effort ostensibly and of course this was about the war and preventing people from undermin war and as such it also caught up in the undertow journalists who for instance would have reported about those induction camps and barracks that were overwhelmed with cases of flu, even when as in the first way it was a much less lethal and and less infectious disease. so, you know there was this effort to minimize the flu the three-day fever as the us public health service noted and the surgeon general rupert blue. that was the assessment in early 1918. and so there was relatively little reporting on it. these the censorship was also part of why it got the name spanish flu because the spanish country was a neutral in the war effort spain was neutral and therefore it's journalists were able to report when the king of spain got the flu and a number of elites and aristocrats came down with the flu and there was a widespread disease and then it was weaponized so very often into anglo-american press you would hear spanish flu used derisively to talk about a place and people who are much more prone to getting this disease now, of course if you look at any of these documents you you find that in fact, a american doctors and british doctors and no very well that the flu did not originate in spain but minimizing the risks minimizing. the flu itself was widespread even as the second deadly wave was spreading across the country as you see these invocations here like no occasion for panic and this is exactly the sort of thing that we saw for many officials across many countries, but certainly in the us in spring of 2020 and it's something that we've heard in certain in terms of wishful thinking before there was more data for instance on the delta variant on or omicron wishful thinking that perhaps the virus was mutating and developing to be less infectious or less deadly and there's no there's no reason to think one way or the other. there's no teleology or wishful intent of a virus except to self-replicate. so as we think this through we talk through the whole the whole of the pandemic the second wave the second deadly wave really occurred in late summer and fall 1918, and you know when you when you look to what was happening around the world in the world seen in this minimizing in the midst of the war, you know, you need look no further than what us and british intelligence officers were saying as they saw a more infectious and far more deadly variant arrive. they said things in secret and confidential documents like the disease now epidemic throughout switzerland is what is commonly known as the black plague, although it's being designated as spanish sickness and grip and what they warned they're waving a red flag of warning is that this is going to seriously affect the war effort that this may undermine the anglo-american war effort and they were challenging in particular the wilson administration to do something about it or at least to try to keep troops combat effective in some fundamental way. of course the problem in this moment is also the war effort not wanting to undermine the war effort. and moving forward with things like liberty loan parades to help support and pay for the war. and so one of the things you see in september 1918, which i bet a lot of you smart folks in the audience have been thinking and have heard about is that there was this super spreader event in in philadelphia in september 1918 local public health officials had been minimizing the risks of the flu. they said that it could be contained in the in the naval docs and in the military facilities, and it would not affect the civilians and then as it began to encroach into the civilian population, they said we can still contain it with modern nursing methods and even though there were warnings against holding a parade like this at this point. it was the largest in the history of philadelphia nevertheless. it did move forward and then it's worst in the wake of the super spreader event you had as many as 700 people dying a day. city of philadelphia as i often say it's and if you look at the social history if you look at the letters, it's heart-rending and it's it's just so devastating, you know, you can look at some of these animals examples here that in some families. there are none left to take care of bearing they're dead and others are unable to bury them or cannot get undertakers, you know husband and infant dead in a few hours woman dying as i noted before by the later stages of the deadly second way of you know, a state like pennsylvania had 45,000 orphans, and this was also in an era when if the or if the if the child lost just a mother father is very often didn't weren't sort of culturally conditioned and permitted by their communities to take care of those kids. and so those kids were sent to orphanages anyway, and so the devastation is massive in this moment, and if you look at letters and correspondence even a generation later you often find people talking about the private devastation having been sent off to live with relatives because of the deaths of parents the ways in that the ways in which that affected educational attainment or career opportunities or the regions that people lived in or grew up there. so there are lots and lots of these kinds of elements that i think are worth just flagging for a moment in thinking about the movement of people and the private trauma and devastation of code. and i think that will be with us for quite a while. so as we're thinking about the move across the us the that first wave, you know went out from kansas across the atlantic the second way of comes back it comes in to boston. it comes down to eastern seaboard as you can see here and then it moves across the country one of the things that you can see when you track through the very good records that we have about the kinds of interventions that worked and didn't work in this era the places they were put on and when the subsequent infections and spread and death and case fatality rates one of the things that you see is that across the us with the time lag. there's a development of different types of interventions. so you wind up having more masking for instance on the west coast southwest because people have had a little bit more time to figure out that that might be effective or at least that as a behavior that goes that travels with other behaviors like keeping more distance abiding by a policies that it's the sort of thing. it may be useful and so you see this spread across the country and as it goes you see the effects of social distancing as well. i'm sure lots of us are familiar with this. i won't belabor this point either, but it's very clear from the data and one lesson. we learned and new to apply immediately in 2020 was the effects of social distancing and the city of philadelphia with that super spreader event is a great example. it's the best example in the city of saint louis where it's chief public health officer was the son of a union army surgeon who have been obsessed with and deeply interested in infectious diseases and spread and control. he was armed with more capacity by the mayor to put on social distancing policies early and keep them on for longer now, it's not like there wasn't infection and death and spread, but if you look at saint louis versus philadelphia you see a much lower peak. and you see a more effective overall total? strategy, so that's a pretty clear lesson to learn another lesson that we learned then and something that we've even seen with omicron is the healthcare infrastructure can be easily overwhelmed now, of course in 1918 and 19 the public health infrastructure was much smaller. and another thing to keep in mind. is that citizens then regular people living in communities really had far fewer possibilities or opportunities to go to doctors to go to medical facilities, and they didn't have the same expectations of them that we have today. so for instance one thing that i've been thinking a lot about i don't fully formed ideas about this yet is that there's a sort of double kind of privilege that we think of today for instance. there are people who think that it's perfectly fine to not be vaccinated or not be boosted to not wear a mask and then should they get very ill they also believe that it's perfectly fine and appropriate to take advantage of to use all the tools that they're disposal within the modern medical public health infrastructure in 1918 and 19. certainly, there were people who pushed back against behaviors and strictures and restrictions like masks and closures, but there wasn't the widespread sense that a hospital would be available for you or a modern medical treatment would necessarily cure you or solve your problems in the way that it is today now, we'll deepen that thought to just suggest that in 1918 and 19 with the rise of modern and professional medicine a kind of gendering of the profession where where women were nurses and women were making a case to be more professionalized nurses with training and and there were more men a gendered male medical doctor md there were lots of promises made that modern medicine could help cure or deal with these kinds of infectious diseases and other other concerns and one of the lessons that came out of the 1918 19 pandemic and one of the reasons that i started with that victor von quote is that at first doctors are very, you know, you see this in speeches you see this in their memoirs and letters doctors are very sangu. honest about the fact that the medical professions couldn't deal with the flu that the flu caught them by surprise and they did not have the tools that they're disposal the knowledge to grapple with it that the best they could do was palliative care essentially and this was sort of what we were dealing within 2020 before there were treatment strategies before there was much known about covid but by the late 1920s, and this is a lesson that i think we should consider the late 1920s one of the lessons that those same doctors and medical professionals were putting forward was that this was a triumph of modern nursing that modern nurses were able to deal with this overwhelming of the healthcare infrastructure that that these now newly trained professional women nurses were doing a very good job and if anything the main lessons and arguments to come out of the flawed strategies and medical treatments of 1918 and 19 was that we needed more essentially. so the argument they made was we need more money for science and research we need more money for vaccines and see lots of studies in the early to mid-1920s, especially of trying to figure this out. um, there was of course some pushback but one of the things that's worth noting when you saw the non-pharmaceutical interventions come into play was that most accepted and that is arguably the same case and story that we've seen throughout the course of this pandemic even as there's been an ebb and flow of fatigue and exhaustion from the pandemic even if there's been pushed back and misinformation the vast majority of people seem to have agreed to and supported and accepted the closure policies whether they were schools or churches or businesses or limits on gatherings limits on the number of people who could come into businesses like grocery stores and that sort of thing, you know, and this is one good example where you see in washington dc churches and protestant ministers and at a meeting vote unanimously to a seed to the request of the district commissioners, the churches be closed in the city. so when you saw, you know some time ago these these battles over whether or not religious groups should have a special exemption to gather based in their faith, one of the interesting things that you saw in 1918. um was that religious groups generally agreed? and in fact, you see lots of innovative ways in which they attempted to do their preaching and do their teaching for instance by correspondence courses and have people coming and picking up letters and sermons and sending them back that sort of thing. um, then like now there's been bad information and incoherent messaging the one that i that i tend to think about most isn't the us surgeon general right there, although it's remarkable the number of times that he said there wasn't much cause for alarm as that deadly second wave was spreading but rather one of the things that i think is most interesting in this moment, that's a direct comparison between ours and and theirs is that woodrow wilson never wants spoke publicly about the flu pandemic. he was far more concerned with world war one and barely see references to the flu pandemic in his private correspondence, even though it seems very likely that in the paris peace negotiations to end the war in 1919. he in fact did come down with the flu and that flu case even if it wasn't so bad did seem to affect his personality and even if you want to argue against that element, it's very clear that it may have had effects on his vascular degeneration that led to a stroke that later in 1919 which undermined his ability to negotiate not just about the peace, but about the us joining the league of nations. so there are lots of repercussions in this moment wilson didn't mention this. there was lots of misinformation questions about vicks vapor rub gargling you see there by troops you see on the there are also volunteers getting a vaccine. and then a number of other places, you know as they ease on and off as they relax quarantine procedures predictably places like billings montana. they saw on the order of a third to a half of the county come down with the flu in the fall of 1919. so it continued on throughout this period because of because of the flow of the disease and because of the ways in which people's and groups work through the pushback against them. i noted this race for vaccines and i wanted to suggest how just important how important that was and also how much mixed messaging was there as we think about our race for effective vaccines and how important that's been in world historical terms the race for vaccines in 1918 and 19 really was a was a challenge for public health officials at the local level. they didn't want to over promise and under deliver and worried about possible side effects. and as they see these these first anti-grip vaccines this influenza vaccine, they're hopeful but actually they find that they don't work particularly well and and the us military and navy. are the volunteers for quite a few of these studies as our convex, which is another part of a lot of these stories that comes up to the present whether or not people are volunteering for these for testing and for medical testing and skepticism about the effectiveness of treatment strategies as things move forward in the fall of 1918. there's a there's a ongoing push and pull and messaging is a real problem when will things lift how will they lift? we're seeing that right now in 2022, so it's a promises about health commissioners and governors and mayor saying that things will change and be altered and yet, you know in some cases following death and disease and spread and other cases following a push of special interests, so of the lessons. we also know about this moment one of the things that we should all think about whether we're business leaders or politicians or individuals in other kinds of institutions. is that phase reopenings are what tend to work that is you reopen slowly you keep on kinds of behaviors like masking or distancing and then you have to be prepared to slam the door shut. so one of the ways in which the sort of turn to endemicity can be described and thought of isn't that it's over or that there's a new normal but rather there's a sort of phased opening back towards a new normal and there may not be a new normal for quite a while, but it can permit kinds of new normal activities or old activities that you want and you see this again and again in city after city across the us. but there are some cautionary tales. so, you know one of the key elements at work here is the case of denver and i highlighted this before as we began, you know in denver in late november. there was something that i tend to think of or that scholars called the amusement lobby the business businesses and leaders who were invested in keeping theaters movie houses pool halls and other venues open, they successfully pressured the mayor and public health officials to rescind and then revise a closure order and this in turn generated with the rocky mountain news called quote almost indescribable confusion followed by widespread public defiance of mask and other public health prescriptions add into that the fact that in november and i foreshadow this with that early warning about gatherings in by the middle of november you have armistice day and people gathering to end world war one you suddenly have a second and much higher peak. of deaths in the city of denver so, you know one of the ways to think about that is to think about how these flu mask issues that came up to places like in utah in salt lake the board of health when they were being pressured by local interest and if you think about how this is preceded at other local levels for instance mask battles at the at the school board level, you can imagine the kinds of pressure being exerted on individuals and groups. so he in the case of the city of denver. it's on the mayor and the public health board, but in other places it's you know on the board of public health or on commissioners of schools and in san francisco where resistance was generally less successful than in denver there was significant buy in for a second round of masking today to first round of masking in the fall of 19 18 and then a second round of public health and mandates and masking in early 1919 during a new surge and this is what led to what lots of you i'm sure know something about the one really organized. at all large-scale push back organization in the us on masks the anti-maskically against san francisco. they claimed a number of four to five thousand total individuals within the group. it's always good to be skeptical skeptical about what numbers or group claims are its membership, but in any case this wasn't organized lobby they did lobby hard. they argued that both liberty was at stake and also the utility or efficiency and functionality of masks was at stake. and of course they also argue to some extent against the kinds of penalties that were put in order to ensure that people would would wear their masks and would behave in those ways. and so you saw these these famous cases in that moment refuses to donna mask and shot by a mask, you know held on a charge of disturbing the peace most of these people who are find were men many of these were men who are from were recent immigrants or or second generation immigrants working men in many cases. so there's some reason to think that policing of anti-mask or people who were refusing to wear masks was also skewed by inequality and racism and so that's that's important for us to note as well as we think about this moment. as this pushback happened in a second round of mandates in 1919. and in the reason why the mask mandate was put back on as were other public health measures was because there was rising there were rising cases and deaths the anti-maskeleague, you know had formed public defiance became more pronounced and eventually anti-maskers and an improving epidemic situation combined and the mask so called masked cities second mandate one of the things i'm pulling out here is that january 17th is when they put back in that mandate and you can see some of the lower numbers of deaths there on a daily basis coming out of that. so for the mayor and other public health officials that meant success and that meant they could pull back so keeping us moving, you know as the flu burned through vulnerable populations, you know by late winter early spring 1919 death and infections dropped rapidly shifting towards an endemic moment and the but the flu would remain present and the other things that disrupted the country took the four and so you had a readjustment of the economy coming out of the war you had racial violence and massacres you had the largest strikes in us history the great steel strike and others you saw global tumult as well in the year 1919 the red scare you saw the ongoing civil war in russia, and so it shouldn't surprise us too much that at this moment in our pandemic. we are seeing global tumults as well and tom alton the us you might say as you think about the kinds of pushback we've seen from both the left and the right so as i bring us back around to a conclusion, here's courtesy of the us centers for disease control a very basic map very very basic chart thinking about that flu pandem. you have here that first wave much more modest you have into a second wave quite enormous significant numbers of death the month of october 1918 alone. you had almost 200,000 americans die in that third wave which is how we tend to just think about this pandemic you see another significant uptick right? it's not as if this is gone away, but what i want to emphasize is from another is from another more detailed chart by one of the the major statisticians working on these issues in this era cell when collins and look to 1920 this is that fourth way of that i mentioned this is what people when we tend to think of the 1918 pandemic as being quote unquote endemic when we tend to think of that you in fact find very high death rates in the late winter and spring in 2020 in 1920, excuse me, and so it's worth as we think about how catastrophic this was. just how important those later waves for in suffer. and death right in the human stakes and tolls and then i also wanted to note again if you're looking at thinking about that age range the age brackets of those being affected again, really salient and important thing that i wonder what we'll see in years to come is how many of this younger age bracket? so you see in the lower part the age range the 1918 pandemic is taking lots of younger people 1919 waves taking lots of younger people 1920 still taking lots of younger people and it's not until 1924 that the what we would think of as the seasonal flu is now more affecting the older age demographics one of the speculations that epidemiologists have and public health historians have is that this the older groups in 1918 had had exposure in in during a flu pandemic of 198 of 1889 to 90 and that their previous exposure to something that was perhaps somewhat similar had led them to have at least a partial immunity a little bit of kin to what we've been talking about a lot lately so that at least the worst outcomes. death didn't befall them. so as i wrap up to conclusion, i want to give you one political cartoon because i always love these and one set of overall takeaways. this is the chief objectors from the fort wayne sentinel december 9th, 1918. here are people going out doing their holiday shopping and one of the things i love about this is how it suggests that there were in fact objectors in society then right those anti-maskers type people those folks not following the rules and here giving you a sense of germ theory giving you a little bit of an insight even about injections and how people would be thinking about those you see here the chief objectors in this moment with with a group of people still close together but masked is that they're saying i thought this holiday shopping would be our chance, but them infernal masks spoil it all we can't get through and everybody safe. this is a sort of public health messaging through political cartoons that you saw on that era as one of many efforts, especially late in the period to try to get across the message. so here let me you a few pandemic to endemic insects for as long as there's a deadly infectious disease spreading at scale in a community or across nations. there's no such thing as business as usual or business as before. this is something that you see in the historical record people longing for and it's a good thing for us to just jettison as a concept or a term better to think that you can return to new normals or that you can develop different behaviors, but that in fact a return to businesses usual is just inappropriate frankly, right not when there are people who are immune compromised in our population not when there's a large population of unvaccinated people not when there are those who cannot be vaccinated at least according to the fda in terms of under under five or at risk individuals. so that's one piece of thinking about how this pushback and push and pull of 1918 into 19 provides an insight for the present another one as i noted, but is always worth worth keeping clear honest clear communication even a bad news and uncertainty is best. so, you know if you think about efforts by state governments recently to talk about ending math mandates, they've promised dates, but without a lot of information as to why so you would want to think if you're following this communications strategy that you should know why not just because people want to be on masks or have different behaviors indoors, but what is the evidence for that and you know, one of the arguments that we've seen for instance from the cdc last year and late 2021 about quarantines was that they thought that people could go back to work early and they wanted to keep businesses open one of the things you saw in 1918 and 19 and that we see today. is it kind of facile pitting against it's each other of the health of business or public health and reality one of the lessons of the pandemic to endemic stages is that you can have both but you can't have both as fully and there's some good studies by economic historians and economists in general that suggests that putting on or putting on later non-farmaceutical interventions to save people suffering and death actually has positive economic benefits. now another element is this is you think about 1918. so 19 and risk assessment is that we have to beware succumbing to fatigue, but also honor it that is if you look at the cities and states that we're doing pretty well into 1919. they were saying okay we need to get back to something some new normal. we can't just have all the same closure policies and this was before vaccines. of course, they didn't have them so honoring that but not so coming to it in other words not doing what denver did not reopening not having second peaks one other element that historians author offer a lot. is it the question of how private trauma and suffering get translated to the public is very hard when you're at numbers like 940,000 dead in the us there are impossible to grapple with but we all know some people who have suffered and many of us know people who have suffered tremendously including ourselves and so part of that is how to get that into the public narrative historical memory of the 1918 and 19 pandemic is very limited. it appears in art it appears in literature. sporadically, is that going to be the case of the suffering from this pandemic and my hope would be that it wouldn't be but if it if it is the case, then you're unlikely to see the kinds of substantive changes to public health that you might want. another element as i said at the outside, is that pandemics expose inequality and a question about inequality for all of us is how should public health move forward at an endemic stage if we also know that people are unequal in whether or not they're vulnerable to the disease and so part of that is thinking about the structures of government. that might make it possible for people to work from home or to have a better social safety net. and another element of that is thinking about how we can all in our own behaviors consider, you know grocery store workers and delivery workers as essential workers in that old sensibility of an essential worker for the war effort in that patriotic sensibility now as we've finally conclude thinking about this pandemics for sure, but they're all psychological one of the things we need to think about when we think about this shift to the endemic. is that most public health policy is local and so is most endemic stage thinking it's local. it's the risk assessments that i have that you have that we have as a community and that for some endtimicity entails a disease with stability with constancy. it's always there but at a lower level for others, it means you know one that concentrates in specific geographies so that it will be located in a particular place and for others still it's more kind of technical definition is about a state in which over say a year or several years each person who catches the infection will on average transmit it to you know, say one other something like that but at the end in the end endemic diseases can be in innocuous or they can be severe and and just like in the case of seasonal flu. you can learn to live with them. right and so this 2020 moment. it's the 1920 moment that i want emphasize for us is really important to understand the long-term health consequences. so then in 1920 with all of those new deaths more than the first and the third waves, you know, one of the long-term health consequences was the long flu, but though you find references to it in a literature into the medical sciences in the arts of the 1920s. you see this in all sorts of walks of life. people did not fully grapple with that and you know as we think about the endemic insights and stages to come grappling with long covid and the longer term vulnerabilities of our populations around the globe places that haven't yet had full vaccination have not had access to vaccines virtually at all is a whole another part of thinking about a global public health policy. so one lesson here is that there's a very close relationship between the local and the global and that's one that i would want us to emphasize particularly for world, oregon, but also thinking about, you know, public health policies as they move in concentric circles from a local to global and and from individual choices about masking and other behaviors. to other practices and so a final way of thinking about this is to think that there is no such thing as sheer certain endemic stages the 1918 pandemic some scholars argue certainly should lead through 1920 and that fourth wave in some would say up into the mid-1920s others would say that after 1919 you really see an easing of restrictions and though localities are ready to throw back on restrictions. they pretty much go wide open. so in that sense, it's in the eye of the beholder when we move to an endemic stage, but these insights help us to map a kind of menu of options moving forward. so, thank you so much for being here. i hope we have some good time for some q&a to follow. great. thanks so much chris. this is tim derouche director programs for world, oregon. as always. it's a pleasure to hear you. just expound and throw down on such a fascinating topic. we've got a lot of good questions from folks in the audience. and i'm gonna jump straight in. certainly. this was news today the state department of ed and the oha announced. they're moving up the date to end masking in schools and indoor public spaces to march 19th. do you see an echo of the past in this decision? a caving to public pressure that in hindsight may have been hasty and is there an object lesson for us from history? that's a great example of precisely what i was trying to tease out in that brief anecdote from denver, colorado in november 1918, but as special interests as individuals lobby for particular public health outcomes that they want. you are more likely to see precipitous public health measures taken by localities or from every level now, you know again, they aren't necessarily wrong. this is a question of kind of trying to figure out an appropriate balance strike and equilibrium, you know when some of these measures it strikes me sort of as a as an observer and a scholar of this some of these measures really aren't that onerous. i simply don't think that masking though. i don't enjoy lecturing and spending, you know, four to 12 hours in a mask is pleasurable. i don't enjoy it. i don't think it's particularly onerous so that as a kind of particular issue for say school age kids who haven't been vaccinated or or are kinds of things is strikes me as less important of a battle and therefore one where you could draw a firmer line in the sand the sorts of things that that happened in denver for instance that do have a kind of resonance to this set of decisions. statewide is about opening indoor facilities, right or having maximum numbers of people inside and that does seem like it should be led by data and disease not by lobby groups or other folks trying to push for the particular outcomes that they want and i think the lessons from 1918 and 19 are pretty clear places that opened precipitously even when there was increasing or still significant transmission in their communities, they did worth they had higher peaks of deaths or longer a series of infections or they had a longer duration of total infections. that's another thing that happened in cities and states. so i absolutely hear those resonances there and i think the the insight for us in thinking about our role in this is that we all need to make our own assessments, but also, push for a collective vest interest and i think you know one of the things that gets lost when you look at this historical literature, is that pushback that i wanted us to start with early on by public health officials against individuals saying it's the apathy that's the real problem now that may be true in some ways. but if you look at the historical record, it's you could flip that around and say it's really about public health officials making a very tough decision, you know, really standing up to those special interests or school board members or others and you've seen that in a few places in this state in oregon newberg for instance where one of the people on our school board said, look i will resign if you yank off this mask mandate right away and and he was able to to get people to keep it on at least for a little while longer. so a couple questions about sort of lessons from that period or models from that period were there any innovations that arose during the 1918 to 1920 pandemic that helped enable society to continue to function similar to us being able to use zoom for instance? you know, it's fascinating when you read the the personal accounts of people then newsstands magazine subscriptions there people were ravenously reading and interested in all kinds of all kinds of literature. so you see a real expansion of purchasing of reading correspondence courses as i noted sermons by mail. we're part of what people did but of course in there was nothing like zoom. there was no ability to to work from home and in fact economic scholars have made us really strong case that the economy was so fundamentally different between then and now that it's a little hard for us to compare as an apples to apples what i mean is, you know, we live with a kind of service economy with certain kinds of expectations about the ability to get say food or deliveries of all kinds of essential items and the ability to use the internet and remote working possibilities for a lot of kinds of jobs in ways that were impossible then so you know, i think the short answer is it was an expansion of some of some of the practices of correspondence kinds of courses and reading but people were report being far more bored if you look at memoirs and diaries from the era one of the things that they were was scared and bored they stayed at home, you know people like john berry historian have emphasized that society is very fabric seem to be rending because people wouldn't even help their relatives and friends. they were so worried because so many healthy young people were just literally dropping dead within 24 hours. and so, you know, there aren't the opportunities for any kinds of gatherings. another thing that you see in a lot of the newspapers and advertisements of the era is people buying often on credit pianos player pianos other kinds of musical instruments learning instruments. so what things that we would call picking up pandemic hobbies with something that was pretty common back then. you know interestingly you talk about that. i mean there was there was a shift in terms of looking inwardly at homegrown talent looking at jazz and and and the culture that was being produced here. we're also coming out of world war one where there was a lot of i mean you mentioned inequality, but there was there was a lot of otherization going on during this period and there was certainly there was a lot of anti-german anti-italian you you hinted it things around the red scare and we saw a similar. thing of this with the early days of covid with very strong anti-asian sentiment and i just i don't know if there's a good question in here, but do we ever learn and do we learn is it is it a natural inclination in you as a historian? did we point fingers and we try and we try and otherize anything like this. i think that's a great question and observation, you know, the early stages of this pandemic saw for instance the trump administration, you know kind of weaponize the rhetoric of the china flu or the wuhan flu or even worse the kung flu, you know in very much, you know, nationalized and racist kinds of terminology and like i said, right you saw something similar from the anglo-american press suggesting that the spanish climate or hygiene you can google this in the in the newspapers of the era were the cause of the spanish flu and then you saw kind of othering and and weaponizing of this kind of national racialized language where you know, the the spanish think of it as the french flu and they worry that the french war workers were the ones who brought it into spain the germans called the russian past the russians blame both the germans and the in this period so there's out of that. absolutely and i think one thing that's really troubled me and worried lots of other historians as i was alluding, you know in several ways there is that you saw that you see this global turmoil. you see this turn inward by a lot of nation states coming out of the war and the pandemic and you know the in 1919 and and the 1921 and then especially 1924 or the three of the most draconian immigration restriction laws in us history the national origins act in 1924 limits limits immigration to the us to virtually a trickle which doesn't change until 1965 you see in the 1920s the rise of the clan a very inward oriented set of policies. that's very much scapegoating of people's and groups that don't fit a kind of dominant paradigm in society and that sense, you know, white anglo-saxon protestant in the us, so that's that's an enormous challenge and problem and i think the kind of viral language scholars have talked about this elizabeth a scholar in a book called viral modernism talks about this this viral language. it is something that infects and infects our minds and how we think and then matches up with this kind of sentiment for scapegoating and it's a very worrisome thing to think about in this moment. i mean, we're seeing some war around the world we're seeing potential for recession. we're seeing you know, we have seen anti-asian hate crimes in the us go up and other kinds of conflicts, you know, and i wonder to what extent the pandemic is is a causal force in that we can't be sure. it's it's not probably a one-to-one thing, but it is a sort of crisis that leads people to potentially seek escape valves and and alienate others and and it's really i think you put your finger right on it. it's very troubling. it seems to be something that's been repeated in other eras, and it's certainly going on today. so many voices i mean your own included and many of the great op-eds you've done has said that the great danger is to false sense of security and complacency after living with the pandemic for nearly two years, but i do wonder are we too polarized to be able to find agreements on this and do you think as a country? a galvanized sense of unity or a wee is really possible coming out of this. you know, that is also a great observation thinking about the 1918 and 19 moment, you know, yes, there were political dimensions to it both the republicans and democrats in the midterm election of 1918. talk about the ways in which public health intervention policies suited one party or the other but what did not happen then was it did not map on to party politics or partisan politics there weren't there wasn't a party more in favor of proactive public health measures and non-farmerceutical interventions like closure policies. what is really striking 100 years later is how much that has mapped on all the way into whether or not people take a life-saving vaccine and boosters or even how much they care about fellow members of their community. i think there you're talking about something really fascinating. i wrote a piece on what sort of what has happened to sacrifice as a political rhetoric in the us and what has happened to sacrifice as a practice, you know, and i think that patriotic language that in 1918. there was this concept of a draft slacker. it was it was a weaponized term to say that americans who dodged the draft or draft slackers were not patriotic many of them were in jail. they were sought out at the state level and that turned to the mask slacker concept, which i think is a great way of understanding it in the fall of 1918 into the spring of 1919 saying hey, it's a patriotic act for your fellow members of society to where i'm asked just like it is to serve in it'd be drafted and serve in a time of war. we do not have that today. it is surprisingly absent for a fairly large but still minority percent of the population and i think that's a really important thing for us to note too on the optimistic side, right which is to say the vast majority of americans and the vast majority of those in countries that have put forward non-pharmaceutical interventions to stop spread and death and to help fellow members of their communities have done that. right, but the challenge is that there's two large of a percentage of people who aren't buying into it, right? and that's a real challenge for how to create that we is there we that could gather in some more of those folks. what kind of messaging strategy as i was talking about would help get us there. you know, how can you do that move that i was suggesting beware succumbing to fatigue, right? how can we do that? what and while honoring it while saying? okay you've done your best. maybe you don't need to do masking at this point. maybe the summer is a less risky time for infections really, you know, go within reason do the things that you want to do, but for the collective, we is there a way to message then being ready to clamp on those measures like i was saying and in the phase reopening strategies in late 1918 into 1919, is there that possibility i would add one other weed question and if i had i'll even longer to give this talk and have this q&a i would i would have brought this in in 1919. there was an effort in congress to put a whole lot of money into the us public health service five million dollars, they wind up almost none of it over time that gets whittled away and whittled away and whittled away and you know one of the challenges of coming through and out of a pandemic is thinking about how to stop the next one and how to be responsible and ready at in the endemic stages when a not if a worse mutation comes on the scene like omicron it was shocking to me how poorly prepared we were for a macron, right? we knew it was coming. we saw it with modern medical science sequencing this out of south africa and yet the us wasn't prepared with its modern public health infrastructure and potential for great public health capacity for it. that's the kind of thing that nation state like the us needs to be leading on and then also helping other countries with right that don't have the full capacity and i think that's what part of what the we should be also collective and global if possible. i don't know if we can get there. i'm not optimistic on that one, but one of the clear lessons of 1918 and 19 is that america's peculiar propensity for going loan prevented the us from joining the league of nations, you know operations against infectious disease. it was also a part of why the us barely got involved in the world health organization coming out of world war two. in fact, it was a soviet diplomat who got the us of seat at the world health organization to start with in the late 1940s. and so those are the kinds of lessons. i think the us needs to be learning as well and citizens can clamor for and say hey, why isn't the us leading not just on vaccine diplomacy, but really distribution as well as production, you know countries are halting vaccinations in some places because they're not not because they don't have vaccine now, but because they don't have the people to deliver it in the tools and techniques and if the us could help deliver those things. wow, you'd really be getting somewhere. so that's a move from the we in the us all the way to the global way and i think that's worth thinking about because there was no real global we after the 1918 19 pandemic so, you know in speaking of the wii you brought up at the end all those great points and all the things to consider. quality was the one that keeps coming to mind. we have seen an increase in wealth concentration at the top during this pandemic. and is there any equivalent that occurred during the 1918 1919 pandemic? yeah, so, you know, i i recently challenged my students actually last month to think about this the relationship in the 1918-19 pandemic and world war one with the inequality that rose in the 1920s that eventually you know was a part and parcel of the great depression and it strikes me that there isn't a direct connection and historians have tried to explore the ways in which the economy of the 1920s was related to the pandemic and one of the ways in which they talk about it is is simply that a significant part of the us and western populations of working age were cut down in their prime. and so there were were a lot of adjustment. problems for the economy, but that said that which isn't a direct reference there that i the exposure of inequality that i would point to in that in the moment, then which wasn't acted on which i would hope we could act on more is this question of essential workers. so in 1918 while the war was going on the language of an essential worker came from the military itself and the argument was they had to be involved in steel production ammunition production textile production and yet you see in fall 1918, you know, sometimes 50% of folks not showing up to work say in october and that deadly month not because they're sick, but because they're taking this risk calculus and saying i can't afford to get sick, you know to take care of my family and that sort of thing and i felt like that was a very similar strikingly eerily similar parallel to what we were seeing in 2020 and 2021 before the vaccine was was more widely distributed that is to say, you know, we saw people who are doing the essential operations to keep society open in some cases being forced to work and get infected and in other cases not show. for work because the society had not prioritized them had not sort of truly made those essential workers essential in the sense of higher pay higher steam capacity to stay out of work when they're sick, you know those sorts of things. so that's a piece of thinking about inequality another element in 1918 and 19. that's heart-rending. that's worth noting is how badly some indigenous communities were affected, you know in alaska for instance, there's accounts of several villages of indigenous folks where you had fatality rates of 80 or 90 percent and it wasn't because they all died of the flu but rather because there was no public health infrastructure left. no caregivers left to take care of those folks and they died of they died a famine and other kinds of diseases and they died partly of racism because of white sort of patriarchal views of not taking care of those populations and to some extent we've seen, you know, marginalized groups and indigenous populations, certainly disproportionately affected by death and disease in this in this, imac and and that has exposed kinds of ways in which society is structure to disproportionately push down risk on those groups and that has a direct correlation with with the upper end where people who can work from home as you're noting with higher with higher amounts of wealth are able to do that much more safely so that you know one takeaway here would be perhaps society's need those essential workers, but why don't societies value them more so i know all of our minds are on we've been i mean the title of this program is pandemic exhaustion. so we have been we have been both inspired. we have been exhausted. it's also hard to look away but right now and today in the last couple days you ukraine is on our minds so it is i think that it brings up a lot of different questions. we're seeing citizens in the ukraine cramming into subways to avoid shelling. we're looking at a region that is really not dealt. well with covid there's still very much a lot of uncontrolled response to to the virus going on. so with this being the case curious if you can talk about the correlation or the the parallels with the disruption that world war one. created and how that played a role and how the us and the world dealt with the pandemic and if we were to walk into something that was hopefully not the the extent of what world war one was for everyone the great war. what would what would that do and have you do have any thoughts on this as a historian? yeah, so, you know one of the things that got me interested in studying that pandemic of 1918-19 was the politics of the world war one and as i noted just in passing i've read these documents, you know, look through them closely american intelligence officers british intelligence officers are seeing in the summer of 1918 this more deadly more infectious mutation as we would now think about it and knocking out in post, you know, as many as 80% of combat effective now combat ineffective troops. not that they're dying at that rate the worst rates of troops dying those posts was like 5% but still that's catastrophic if they're out an unable to man their posts on front lines for a war effort and that's precisely because of the kinds of conditions you're describing whether you're gathering and subways or you're gathering and barracks or gathering entrenches, you know, it's very easy to transfer viruses back and forth and those individuals are also petri dishes in terms of generating new mutations, so that's another challenge there, you know in the in the late stages of the war one of the things that i often note is that you know, when us troop transports landed in france in places like breasts were lots of troops arrived. they would be met by ambulances and hearses because so many american troops were dying and needed to go immediately to hospitals from the virus. you know, i wonder in this moment when we're looking at, you know a roiling, you know, large-scale invasion and conflict and large dislocations of individuals so likely refugees likely that peacekeepers and humanitarian relief all those people mixing. they're mixing across borders. they're mixing in large numbers. they're mixing in close quarters. that is the perfect recipe for you know, generating a mutations generating widespread, you know disease and discomfort probably death, you know, lots of stuff right, but it's also it's also a way that that conflicts can change right and so it's there's some arguments that the mutinies in germany as german german late german and french mutinies german late offensives in 1918 get stopped eventually that part of what's stopping them is also the flu on top of everything else. the flu is really undermining morale if not full combat effectiveness. so to what extent will covid be part of that process and even if it doesn't undermine say the conflict or peacekeeping very much. it's in our minds at least for many of us who care about you know infection and death. it's also will likely be in the minds of those, you know, moving through spaces trying to go back to family members say, you know coming back for instance for for births or deaths or to see sick relatives. and so you have all the added complications of the ways in which human beings will be transferring diseases on the front lines of a conflict or in a refugee crisis situation with this deadly infectious disease, you know, and we're hearing reports now other mutations that are that are kicking around, you know, you can only imagine that another mutation might well appear in some of these places that have not had good vaccine distribution programs or uptake or have had worse frankly vaccines that are less effective trotted out there. so there's a lot of development here that i think some has bears some distant echoes of the past in terms of the war in terms of refugee crises and you know, and that is deeply worrisome, too. also in terms of the comment that you made before about the ways that this the power dynamics tend to flow downhill. and so this is more likely to affect the refugees and those at lower, you know of lower status lower socioeconomic status. there's likely to be, you know, potentially more racialized violence related to this certainly you saw this in kinds of ethnic cleansing during world war one and in terms of the public policies and proactive policies of immigration restriction after world war one and inward looking kinds of orientations of nationalism and racism of that era. so all of this is kind of you know, which is brew of terrible things with a pandemic on top of conflict on top of inequality dislocation of people in a globalized world where viruses can travel all the way around, you know even faster than 1918-19 and so, you know, it's it's deeply worrisome is we're thinking about the legacies for of endemicity. however, you know part of that is learning to live with the uncertainty of having seasonal mutations of a virus. right, and so it's simply impossible to imagine a constant cycle of significant closure policies. they did not envision that in 1918 and 19, but they prepared to be ready to have closure policies to have limits to have remasking all that kind of stuff those that's a direct lesson for us. i think i think you need we all need to jettison the idea of a new normal that's business as usual and rather think of new normals that involve being ready to throw on a mask being ready to limit possible indoor gatherings of large sizes, but the potential for travel just disruptions because of closures or because of of border questions and that kind of thing and to always be on the at i think. potentially there will be new generational behaviors developed to be on the lookout more for the next pandemic on the horizon, you know in many of us on this, you know watching this talking about this thinking about this we're you know know about mers and sars and avian flu, you know, we've had a lot of close scares in recent years, and we've been living with one of the longest rolling. i'm actually human history, which is the aids crisis. and so they're all there. you know, you just need to open your eyes to see those kinds of those dimensions of pandemics that are around us. i would add one more behavior question, you know in 1918 and 19 about the only behavior that gets thrown out definitively after that. there's something that they called the common cup that people would regularly in schools or businesses or restaurants share a cup. that's about the only behavior that entirely is gone in terms of western culture in the us masking doesn't stay on, you know limits. don't stay on you don't see when seasonal fluids get bad in the late 1920s. you don't see masking. you don't see significant limits so, you know my question to all everybody in the audience everybody listening to this and thinking about about this concept is you know, if there are pandemic to endemic lessons, what are the behaviors we want to actually embrace in keeping on for our own for own reasons personal reasons? immune compromised family members lessons learned from suffering and private trauma and for what what kinds of behaviors do we think are best to be kept on in other spheres of life in businesses in schools in public gatherings on planes on subways on trains on transport. so remember in 1918 and 19 in lots of cities there was a requirement that you had to wear a mask on public transport that gets thrown out the window in 1919 doesn't come back on in virtually any place in 1920 and by the late 20s, it's totally forgotten. so will we still be masking in public places in a decade? well, we would be prepared to do so. those are big questions for us and you know, they're again, like i said, they're in the eye of the beholder. they're psychological. they're not necessarily clear public health answers to that. there's not necessarily clear political answers to that. they're about how we feel our own personal risk assessments and you see this in the records of 1918 and 19 and then they're about how we interact with our community and that's you know, you're a great point about the weed the what behaviors are we going to continue to thousands more online at c-span.org/history. good evening buenas noches, and thank you for tunin