They jumped from animals to humans, spread rapidly around the world. Both are pretty lethal. Fortunately, this is much less lethal than the 1918 pandemic. However, considerably more contagious than the 1918 pandemic. Virulence, itless will still kill a lot of people. Steve how did the country react . Of course, a different time in terms of news, and how his word spread about how to protect yourself from what at the time was called the spanish flu . John it was a completely different situation because we were at war. Woodrow wilson created an , designed to win the war, with a Propaganda Machine and the architect of that Propaganda Machine wrote and false are just terms, all that matters is what the impact is. That was one thing when you are trying to keep morel up during the war, it was another thing when you are fighting and infectious disease. And because of that infrastructure when the pandemic arrived, National Public Health Leaders or outright lying about it there was no tony fauci in 1918. One National Public Health Leader said, this is ordinary influenza by another name. It was called spanish influenza. Another one said, you have nothing to fear if ordinary precautions are taken. But people did have plenty to fear. So the information they were getting, that message was echoed pretty much in every place. Local Public Health leaders largely echoed the same messages. In fact, there was also a law that made it punishable by 20 years in prison to print or disloyal or content by the United States for the even sent a congressman to jail under that law. When one newspaper in wisconsin try to print the truth about the pandemic, they were axially prosecuted actually prosecuted. Although that was dropped as the pandemic continued. There was no decent source of information, which left people completely in the dark to face what and often times was horrific symptoms and tremendous amounts of death and in an incredibly short period of time. Steve what about those on the front lines . Most notably the doctors, the nurses, the red cross trying to treat those patients. We are continuing to hear about the lack of protected protective gear. What kind of equipment did they have . John they really didnt have anything. Surgical masks was about it. Effective,t very surgical masks, in protecting against aerosol, airborne diseases like influenza and coronavirus. We know influenza definitely is airborne, perhaps more so than coronavirus. Theirus is also number of doctors and nurses that died in that were quite large. You read the journal of American Medical Association see page after page of obituaries of doctors who died. There was some real heroism back then, just as there is today. Last 15 yearsthe or so, i have been involved in the effort to prepare for pandemics, given a lot of talks, and i have often said one of the questions that remains ifnswered was whether today medical professionals would even treat Something Like this. In 1918, if you were a doctor or a nurse, you knew that you would face infectious disease. That is one of the risks you would take. But today, very few people die of infectious diseases. Medical personnel have stood up and behaved with , especiallyeroism when they know that theres equipment that will protect them, and yet they dont have, and nonetheless they still go forward and treat patients. Course, the cdc is advising those who go outside. We are seeing it here in washington and around the country, to go out with face masks. It was the same in 1918. John it was, but those masks were not very effective. For example, in san francisco, they passed a law requiring butle to wear face masks, they did not do much good. San francisco had the fourth or fifth highest mortality in the United States despite that law and despite closing schools and so forth. Steve it was called the spanish flu, but it did not originate from spain, correct . John absolutely. We dont really know where it began. We do know it did begin in spain. There are probably four leading hypotheses. , there was a note of it not too far from the texas line in kansas. I thought i had pretty good evidence, but there has been a lot of work done in the last 16 years since it came out, that hypothesis still might survive, barely. My own feeling is probably more likely in china. However, it could have been vietnam. It could have been france. A lot of people think it was france. There is even a slight possibility it was new york city. Spain, however, was not at war. The Spanish Press, when the first waves dropped, the first wave was actually quite mild. The Spanish Press was writing about it at length. The king of spain got sick, which generated more publicity. Notwarring countries were writing anything about anything , so itght depress morale picked up the name spanish flu. Steve the book is titled the great influenza the story of the deadliest pandemic in history and our guest is joining us from new orleans. Survey confirmed the obvious. People who live in the most Credit Conditions suffered more than those in more space. The poor died in larger numbers than the rich. Lets get to your phone calls. Pat is joining us from new jersey. Hello. How much weight would you give to the fact that we were just i . Ing out of world war how many people died who would not have died were it not the fact that we were suffering the ravages of war, and compare that ,o 1957, the hong kong flu killed 115,000 americans. First, the first outbreaks were spring of 1918. Wave, as i said earlier. The second wave, which was legal, began in switzerland, the first place to have a really deadly outbreak. That was in july. By midseptember, it was in the United States in lethal form and almost simultaneously, everywhere in the world. That lethal second wave lasted 14 or 15 weeks during which period probably two thirds of , it occurred in that timeframe. I dont think the war played a major role. It certainly didnt start because of the war. I think there is good evidence that american soldiers in the spring carried it to europe in large numbers, but it was already in the civilian ,opulations in new york city for example, so it would have gotten there anyway. 1600s, pandemic lines made it from europe to north america where it ravaged the native american populations, and for that matter, people in massachusetts and virginia. You didnt need modern travel. Pandemic,f this 1957 that was about 70,000 died, americans. Wasourse, the population just about half what it is today. So those numbers, you have to adjust for population and get a sense of scale. Steve danbury, connecticut. Good evening. Youer in your book, indicated wilson overrode his medicos in sending sick troops to europe and there was a high casualty rate on the ships. Is there a parallel to executive decision in the u. S. Now where cuomo overrode de blasio, the guy who wanted to shut new york down, but hindsight it was a bad decision . John im actually not sure about the precise relationship between cuomo and de blasio. I think de blasio wanted to keep schools open. Actually, there is a dispute among experts, whether schools are Significant Players in this pandemic. Of course, they are closed pretty much everywhere anyway. In influenza, schools definitely play a role. But this pandemic is different. There are differences between the viruses. Actually tough for experts. Steve i just want to show you a post from 1918 called influenza suspends all gatherings, cities meet and demand action by the eminent spread of the infection. Clearly, you write about this in the book. They. They knew about social distancing back then. John absolutely. One of the reasons i got involved in the preparedness effort is because i knew something about 1918. The cities that almost every city in the country, not all, but almost all did do much of what we are doing now. Early. Cities had acted before, there were a lot of deaths in the community, they had better results than the cities that acted later. The reason was by the time a lot of deaths had occurred, the virus was already widely disseminated in the community, so shutting things down will not help that much because it wont help. We are actually doing more than. As done in 1918 schools, bars, restaurants, sporting events, stanley cup finals were suspended. 1918,things were done in but they did not close businesses. However, fear tended to keep people away. The absenteeism for industry scores industries was astronomical. You can understand why. Although the case fatality rate in 1918 in the west was about 2 , it was much higher in the west developed world because less developed world because they had never seen influenza at all and they were more vulnerable to it. The 1918 virus killed people, and 50 yearsn 18 old. According to metropolitan life, people in that age group who were industrial workers, 3. 25 population died. The case fatality would have been 10 or 12 . This is happening in an incredibly short period of time. It would move through a community in six to 10 weeks. You can imagine that time occurring in a factory. Datas where we have good on absenteeism from work, starting in the shipyards, which were a war industry, workers were told that its important to have soldiers on the front line. They also had medical care at work, which was not available in the civilian community, and they also did not get paid if they didnt show up. There was no sick pay. Even so, you have ship shipyards with 60 absenteeism. When you get into industries people did not have an were not told they were being patriotic to go to work, and where there wasnt medical care had high absenteeism. So things were largely shut down but not by the government. Steve we go to john in san francisco. Caller hello. Thank you. Here in san francisco, i have been observing the rate of mask adoption. I myself adopted it about 10 days ago, i always wore a mask. I live in a predominantly 80 asian neighborhood, and i noticed 70 to 80 wear masks. For caucasian folks, i think its down around 20 . It seems like there is some kind of social stigma possibly about wearing a mask, and as i see it as being a crucial part of trying to squelch this thing as possible, it seems like if our leaders like nancy pelosi, when they were having their signing meeting and it turned out one of the congresswomen was covid are doingand they this six foot distancing, but to me the six foot is a bit of a joke, its better to be 10 or 20 if ouray, obviously, but leaders were to don a mask, do you think it might send a signal out to people that its ok to wear a mask in public . It seems against common sense, but i know a lot of people still, even cashiers and people in the public are not wearing a mask. Steve thank you. John well, i get upset if i deal with the cashier who is not wearing a mask. The masks are there to protect other people from you if you are carrying the virus and i think it would be very good if the Political Leadership did we are masks, so i am in absolute agreement. Whether it is trump at press conferences, everybody up there wearing a mask, i think it would send a signal. The same for congressional leadership. Steve you are also in one of the hotspots. New orleans. Many attributing mardi gras to why louisiana is seeing a spike in cases. What is it like in the French Quarter . John well in the French Quarter, it is deserted. There are fulltime residents here. I walked through Jackson Square and there was nobody. I mean literally no one in Jackson Square. To a coffee to walk shop with my wife every day. Incidentally, it is our 25th anniversary, so i was happy to celebrate that with my wife. Anyway, we go to this coffee shop. We take the same walk now. We see practically nobody on the street. You can hear a bagpipe playing, which is a haunting sound, obviously. There are other parts of the city that are more active. I drove uptown to take a walk at obon park and it almost seemed normal on the street. People are keeping their distance and many of them are masked, but they are out. The weather down here has been incredible. Degrees and low humidity. Its sunny, which is actually pretty unusual for new orleans, normally you get a lot more humidity and more heat. Arry, john berry b thank you for joining us here on cspan. Congrats to you and your wife on your anniversary. We go to tim in milwaukee. Caller hello. I called on the medical line even though im not a medical provider, because back in 2006, i was developing some of the instruments. We have come along way in testing. You might comment there was probably no testing back in 1917 or 1918. Now it is called molecular imaging. I dont know if you are aware of that, but because we are able to get the dna faster of the getcule, people are able to it and thats why we have this problem. John of course, not only did they not have testing, they did not know what a virus was. They called basically all infectious pathogens viruses, and they knew that there is a really small virus that was so small, it would pass through the tiniest filters they had, but they did not know if it was a different type of organism or just small bacteria. The 1918 pandemic led to a lot of definitions. Virus did not come about until 1925. Is angh the coronavirus rna virus as is influenza, but the discovery that dna carried the code, you could even trace it back to Scientific Research that began because of aunt during the influenza pandemic. ,n terms of the testing today obviously the biggest failing of the United States response, it is almost incomprehensible. The testing failure. Behindl are far, far many other countries. We need to catch up if we have a real chance to get ahead of this virus. Steve how many people died in the u. S. And around the world from this pandemic 100 years ago . About 600 75,000 in the United States, out of a population of about 108 million. So you can basically triple that. It would be about the equivalent of 2 million today. Million toit was 50 100 million, which would be up to 220 Million People today. It was more lethal particularly in less developed parts of the world because they had never seen any influenza virus before severalest where influenza viruses had passed through and circulated regularly. They had seasonal influence as we do today. There was some natural cross protection that the immune system provided from other influenza viruses to this influenza virus, which was not available to a lot of people in more remote parts of the world. Steve and on the issue of viruses in the book, you write the fiery following quote. If a virus performs only one task, they are not simple, nor are they primitive. Highly evolved, elegant in their focus and more efficient than any other living being, they have become nearly perfect infectious organisms. The book looks back at what happened in 1918. Davis on the phone from tulsa, oklahoma. Caller good evening. My question is, i have a great deal of respect for dr. Fauci and dr. Birx. Did president wilson play an active role in dealing with the influenza pandemic . Did he have advisors such as dealingt trump has in with the pandemic . Where there any medications that were experimental medications encouraged by president wilson . Steve thank you. John wilson never made a Public Statement of any kind on the pandemic. Earlier, some National Public Health Leaders lied about it, they called it ordinary influenza by another name. We did have a Public Health and the Surgeon General wasnt much good. People and the Public Health service, it wasnt a lot. It was a laboratory and a few quarantine stations, they did try. Most of the effort came out of the military. Desertionsortion of in the United States were incorporated into the military, including what is now Rockefeller University and the theitute of research, entire entity became an army laboratory. Became researchers captains and majors and so forth. The dean of Johns Hopkins medical school became a colonel. Dean of university of Michigan Medical School became a colonel, and so on. The scientific community, most of them were in the army. They were extremely active. Research that they again, they didnt know what caused it and didnt know whether it was a virus. There was at least one hypothesis that it was a bacteria, which still has influenza in its name. That was not the cause, but it is did cause bacterial pneumonia. They developed a pneumonia vaccine. If you get the vaccine today, its a Straight Line descendent of what they worked on back then. That works against bacteria, but it did not get widely distributed. They did things like use convalescent serum, taking it from people who had recovered. We are trying that now. Everything that they could think of, they tried. There were no drugs, but pretty much everything was tried. The convalescence serum made it work a little bit. They had supportive care, which is what you have now, but they had no ventilators. They didnt even give oxygen in the way they do now. So things were pretty primitive. Steve anthony in marco island, florida. Caller hello. Good evening. Steve go ahead. You are on the air. Caller isnt it true that back in the 1918, the influenza epidemic, but a lot of help support authorities were saying just dont spit on the sidewalk and how it was all bs, right . John that was one of the things tuberculosis was a big problem back then. City hadly every antispitting ordinances and things like that designed against tuberculosis. It certainly didnt hurt anything to do that. It didnt do a heck of a lot of good. Streetcar posters saying keep your windows open. That actually would do some good. To the last question, reminded me that they were doing scientific studies of things when you coughed or sneezed, how far the pathogen might actually travel. They knew that in 1918, they had done experiments that if you put a mask on someone who is sick, you can protect people around that person. Thorough,quite specifically when i started, i got distracted for a second i was going to say even opening windows, they were doing studies of ventilation to figure out how much that helped. They concluded that her ventilation doesnt mitigate the disease, which we know for a fact today does mitigate the disease, which we know from a fact today. Caller i have heard that those who worked in factories that processed oregano and cinnamon were largely immune from the 1918 influenza pandemic. Is that true . John not to my knowledge, no. Steve i want to go back to something you said about president woodrow wilson, which is really stunning that he did not issue any Public Statement, and yet you had well over 600,000 americans who were dying. Man, wilson was a strange very, very focused on what he chose to focus on. The war was it. That was everything to him. He was not to be distracted. We did have an earlier question, i dont think i gave a really good answer to, asking about troops going across to europe. By medical staff not to send troops. Those ships became floating coffins. You can imagine how tightly packed you are on a troopship. That this is a war and if you go to the front line in combat, you have a chance of dying. Sending troops on these ships to europe, exactly the same way they were fighting the war, they were running a risk. He was actually advised that if you are going to do that anyway, troops fromake camps where the pandemic had already passed through because they did have significant Natural Immunity it against it, but he would not even rearrange any scheduling or order the army general staff to rearrange the scheduling of how they were shipping troops. There was actually a significant generaleen the army staff running the war and the Army Medical Staff which was very scientific and really knew what they were doing. William vargas was the army Surgeon General who had largely to bed the panama canal built by controlling yellow fever. Of the giants one of american science, arguably the most important scientist in , the mostistory influential, his discoveries were not that great, but he was Hopkins Medical School and welch had a desk. The army general staff simply ignored him, and in fact he turned 65 late in the war. It was september or october and they forced his retirement on age to get rid of him because he gave them a hard time on how to save soldiers steve lives. Steve steve if you are listening on cspan radio or tuning in, this is a primetime addition of washington journal during the coronavirus pandemic. We want to give you a chance to weigh in with questions, comments, and calls with leading experts. Our guest tonight joining us via barry, andhn berry his book is the great influenza the story of the. Adliest pandemic in history robert is joining us from california. Good evening. Caller thank you. One thing, there are vaccines at work, for the visa spirit vaccines, things like that, they work. These are scientists, and people get together and they work altogether and it turns like a symphony, a beautiful blue works. It and people are saying lives are safe. Now we have a hysteria of both the president and the media and neither side is helping each other. Caught in the middle is the medical profession. They are working art, but its hard when you have to steer from both sides. In your opinion, if both sides could Work Together and say, you know what . We want to help each other along with this president , no matter what politics are involved, in the president says i want to work you guys, and lets see if we could not come up with a polio herat moment. There are things that you will never cure. Like diabetes. Blindness, you can treat it before it happens. That is where i am at. I am blind. I would like to know what your opinion is, everyone, if we all work in one way together, what do you think . Steve john thank you, robert from california. Right,umber one, you are we are all in this together. Most disaster situations, communities come together. I live in new orleans. After katrina, everybody was helping each other as much as they possibly could. Earlier i was talking about walking down the street in the French Quarter couple blocks away. People i dont really know, they volunteer, is there anything they can do for me . Im over 70. Of course, i dont look at right . [laughter] so i am vulnerable. I have friends going to the market for me who are younger. My nextdoor neighbor is a dentist. Of coursehis office anddonated all his gloves masks to a local hospital and volunteered to do medical procedures which puts his life at risk. There are things to take the burden off healthcare workers. We are all in this together. I a lot more of that than anything else. I see a lot more of that than anything else. It would be great if we could Work Together. I dont want to point fingers, because it would not be conducive to the message. As far as the vaccine, i dont think political dispute has any impact whatsoever on the scientific effort to develop a vaccine. Difficult it is scientifically fickle. A virusinfluenza is that is very hard to get a vaccine for because it mutates so rapidly. Reasons and optimism to get a vaccine for this virus, but it will still take time. Steve among the other works by our guest, john barry has written about the great mississippi flood and is also a tropical medicine at tulane university. Liz is on the phone in tampa. Caller yes. As a medical professional, i am a registered nurse, and i have nurse friends in louisiana, mississippi, alabama and florida. I am in tampa now paired we see a lot of patients here are actually not the majority is not over 65. We are seeing a lot of nations coming in patients coming in with no preexisting illnesses ranking from 35 to 45. The average age here is 42 to 44. Is that because elderly people took heed to the warnings and were in fear earlier . I dont know, but as far as preexisting illnesses, you hear so many issues, especially on onses connecting lines , but we arec. Seeing a lot of deaths of younger adults with no comorbidities. Steve thank you. John im glad you said that, because it will help get younger people to take this disease seriously. Anyone steve . Just because people over 70 are , and theerable incidences of obesity does burden the body, and does seem to be comorbidity, but otherwise, perfectly Healthy People can get very seriously ill and die. Difference between and 1918, the, young people were the target. The peak age of death was 28. Over 90 of excess mortality came in people under 65 years old. Steve i want to follow up on this. That is surprising in the book. You would have thought it was the opposite. Why was that . John the elderly were apparently protected, there is only one rational explanation. That is a virus very similar to the 1918 virus passed through their lives at some prior date and gave them significant immunity. In terms of the young people guess the918, i leading hypothesis is that their immune systems are stronger than the elderly. Their immune system changes over time. It is strongest when you are young. Virus, unlike seasonal influenza viruses that verily bind to thever, cells in the long, the 1918 virus was binding to the cells in the long. The coronavirus also does as well. It transmits easily because it affects the upper respiratory tract, and is dangerous because it affects the lungs also. So young peoples immune systems in 1918 were throwing every ,eapon it had at the virus creating whats called a cytokine storm. The battlefield was the lungs. It is destroying the lungs in effect in an attempt to kill the virus. Most people did die probably of bacterial pneumonia, but the virus meanwhile had stripped the immune system of many of its defenses, allowing bacteria that would normally not be able to do bacteria. Ct and kill you would get people who would ,ie in five or six days or less including less than 24 hours sometimes. That would be directly the virus , attributable to the virus. You would get some people more than a week, 10 days, two weeks, that is bacterial pneumonia. Erica,from california, you are next. Caller good evening. Thank you for taking my call and my question. I am super excited to speak with you as i read your book last november. I believe because i read it, i took early mitigation efforts for my family. Starting in january, around new years, i started shopping in off hours and limiting outdoor excursions. I had multiple conversations with friends and acquaintances in january and told them to read your book because it was so insightful. I followed the news and so many of the things you mentioned in the book were so insightful. One of the problems was sharing it with people and a lot of people were giving me the eye roll, like, whatever. It was hard for me as i started to see more things coming on the news. Impactedring how that as you start thinking about the sharing of information moving forward. What are your thoughts that and how it could inspire people to move earlier . Also i had watched about your Pandemic Response show in 2017 and you discussed nonpharmaceutical interventions including medication. You mentioned earlier about fresh air. I was wondering what other things would you recommend that are nonpharmaceutical . Besides medication but other things like fresh air, hot , other things you discovered during your research . Just another question. I work for a company that always talks about this. Theys funny that mentioned it a couple months ago and i read your book. They have talked about it for years. Thank you so much again for your insight and being available. John thank you for that. You are hearing pretty much everything that is recommended. Social distancing is crucial. You lock someone inside a room who is infected, they will not infect anybody else. If you lock yourself inside your room, you will not get infected. Those are two extremes that will not happen. You have to treat the person infected and you cant simply live in your room, but the more social distancing, the better chance you have of avoiding the virus. Cough etiquette, cough into your elbow, good handwashing, all those things are important. Even washing your nostrils out because can be helpful it possible, when you sleep, most people sort of aspirate. If there is virus in the nostril and they end up in your lungs, even just washing your nostrils, that is not one that you hear much, but there is a pulmonologist whom i regard highly and i am taking his advice on that. Steve in alexandria, virginia. Greg, good evening. Caller good evening. I have a question about testing. Today in the president s speech, he spoke that the United States had given 1. 3 million tests, and that was more than any other abbott hadd developed a fiveminute test, which is better than a 15 minute test, increasingly better and more accurate than other countries. Earlier in the broadcast, you mentioned we are actually behind other countries in virus attention and the serum tests for surveillance aspects of it. Im just wondering how you could say we are behind. If you could elaborate on that and help me understand, just explain to me. As a layperson, i just dont have any idea, but it seemed at odds. Thank you. John unfortunately, the president says a lot of things are available or done before they are actually available or done. One of the keys will be getting a very fast response. There are still people right now today that need to be tested that cant get tested. I know hospital workers who say if they are not showing symptoms, they cant get tested. Even people with symptoms cannot get tested. In terms of the quick response, which will be very important Going Forward trying to get us restarted as a country, those things have to be made available. They are not available yet. Im not sure when they will be available. The president said something the other day about people being , i assumen they get he meant having their temperature tested on and off airplanes, but thats not happening either. It would be helpful. The bush administration, which really took seriously pandemic planning. Steve didnt george w. Bush read your book and then alerted his staff and hhs to mobilize . John it was actually someone who has become a close friend of ise, stuart simonson, who right now with the world health organization. He read it and took it to his boss, secretary mike leavitt, who read it and took it seriously. He took it to the president , who read it and took it seriously. With bush behind it, the entire administration took it seriously. They passed legislation in the billions of dollars, which created the stockpile. It put money into Vaccine Technology development, vaccine manufacturing, and also developed preparedness plans. There was a federal plan, the federal government planned for every state. I participated in the early days in conceptualizing the plan. Not in the actual writing or the nittygritty of it. In those very early days when we were discussing the plan, and this gets back to somebody earlier who was saying, cant we all come together and depoliticize it, we were all discussing who a spokesman should be if we ran into a pandemic. We were unanimous that it should not be any politician, because no matter who the politician is, a significant portion of the public was going to dislike and possibly distrust that person. We thought it had to be a medical professional. You remember Ronald Reagans Surgeon General. We thought he would be good. But he was not available. Tony fauci is the guy. And it would be much preferable in my view and certainly nonpartisan, taking all the part of politics out of it, if instead of a polarizing figure got up there every day, that the white house kept itself in the background and just let tony fauci be the spokesperson. Improvemente a vast. People would trust the message. You wouldnt have half the public disagreeing with it, distrusting it. You wouldnt have the Fact Checking that news organizations ,elivered every day unfortunately, necessarily because i think we may or may not get into what i regard as a huge lesson from 1918 that you have to tell the truth at all times and be completely transparent. But that is the way to depoliticize it. Thats the way to get everybody in it together. Take the politics out of it. Let the medical, Public Health professionals be the spokesperson. And take charge of the response. Steve the book is titled the great influenza the story of the deadliest pandemic in history and our guest is john barry, joining us from his home in new cspans washington journal, live every day with news and policy issues that impact you. Coming up this morning, transport topics in your congressional reporter eugene bolero discusses the infrastructure bill is part of the u. S. Coronavirus response. Employment talking about federal assistance for those that lost their jobs amid the coronavirus pandemic. On changesresearcher several states have made to alcohol laws during the crisis. Watch cspans washington journal live at 7 00 eastern this morning. Join the discussion. The house and senate are expected to return from legislative business after the easter and passover holidays on monday, april 20. But that is subject to change due to the coronavirus pandemic. Watch live coverage of the house on cspan and the senate on cspan two. Up next on cspan, an update on how states are responding to the coronavirus pandemic, starting with michigan governor gretchen and later we hear from ron desantis and ned lamont. Governor whitmer hi. Well, welcome to this is my Capitol Office in the State Capitol building. It is monday, april 6th