The Never Ending Story of the 1918 Pandemic

Transcript

• 00:00Welcome everybody for coming up.
• 00:03As so often happens in webinars,
• 00:06we have been having technical difficulties,
• 00:10but I'm really pleased to be able
• 00:14to turn things over to Joanna,
• 00:17who's going to introduce us to
• 00:21the never ending story of the
• 00:241918 pandemic? Thank you Naomi and
• 00:27thank you to everybody that is sign on.
• 00:30I also wanna give Naomi Um a special shout
• 00:34out for her musical stylings that was
• 00:38excellent improvisation and I want to.
• 00:41I guess I asked to say a
• 00:43little bit more about who I am,
• 00:46so you have some understanding of all
• 00:49of you out there wherever you are,
• 00:52what you're about to hear.
• 00:54I am associate professor at Yale in
• 00:56the section for history of Medicine.
• 00:59Naomi Rogers and John Warner,
• 01:01who you'll hear from after my
• 01:03talk are my colleagues there,
• 01:05and we formed the section
• 01:07of the history of Medicine,
• 01:09which is really wonderful place.
• 01:12Do not just think about what has
• 01:14happened in the past, but to try to
• 01:18bring new dimensions of meaning. Uhm,
• 01:20from a range of methodological resources,
• 01:22but predominantly historical to
• 01:24things that are happening now.
• 01:26So I want to thank mark for inviting
• 01:29me to share my perspectives on the
• 01:32history of the 1918 influenza pandemic.
• 01:35It'll come as a surprise to none of you
• 01:38since you're all here that this pandemic has.
• 01:42Kind of emerged as a dominant
• 01:44historical analog for the moment
• 01:45that we find ourselves in today.
• 01:48So I'm going to speak about that.
• 01:50I also want to thank Karen Cold,
• 01:52who you had a chance to see.
• 01:55I'm Sam Ann Todd Sanderson for helping
• 01:58to figure out what it means to do a
• 02:01web and R or to make a gathering at a
• 02:04time like this when it's so hard to be
• 02:07together before I dive into my lecture,
• 02:10I do want to say that it's difficult to know.
• 02:13How to connect with you when
• 02:16I cannot see you um,
• 02:18especially in this moment when so many uhm?
• 02:21Americans and people around the world
• 02:23are engaged in struggles for survival
• 02:26not only in the face of the novel
• 02:28coronavirus that emerge late last year,
• 02:31but the systemic racism that
• 02:33has raged for centuries.
• 02:35And what I'd like you to know before I begin.
• 02:41Is that I'm grieving
• 02:42right now? Um, for my black and from friends,
• 02:46colleagues, students,
• 02:46and fellow citizens, I'm grieving
• 02:48for healthcare and essential workers.
• 02:50I'm grieving for all of those whose
• 02:52lives and dreams have been upended by
• 02:55the failures of our leaders to provide
• 02:57adequate protection, let alone care.
• 03:00And I just want to confess that I'm not
• 03:03confident that what I have to tell you
• 03:06is what most needs to be said right now,
• 03:10or that I'm the voice you most need
• 03:12to hear today on a day when people are
• 03:15protesting and have been protesting.
• 03:17But I am confident that bioethicists and
• 03:20those of you who are here listening have
• 03:23an important role to play in ensuring
• 03:25that medicine fulfills its best potentials.
• 03:28And so ioffer the following
• 03:30remarks that in a spirit,
• 03:32both of humility and solidarity.
• 03:35And as we dive into the past,
• 03:38I want to ask you to consider questions
• 03:40that are at once both ethical in terms of
• 03:43what should we do and epistemological.
• 03:46How do we know what we know?
• 03:49How do we even know what counts is
• 03:52a question?
• 03:53What does it mean to equate addressing
• 03:55a global pandemic solely with defining
• 03:57and eradicating a nonhuman virus?
• 03:59This is a thread I'm going to focus on.
• 04:03What aspects, then,
• 04:04has of Health and illness has
• 04:06COVID-19 exposed that won't?
• 04:08Be able to be addressed by a vaccine
• 04:11or even a mutation of the viral
• 04:14agent to a less deadly form.
• 04:17Moreover,
• 04:17what kinds of research practices in
• 04:20relationships have been celebrated
• 04:21in the effort to understand pandemics
• 04:24solely in biological terms?
• 04:26This is to say,
• 04:27when we imagine that COVID-19 is.
• 04:30The pandemic that the virus is the pandemic.
• 04:33What other kinds of factors are we not
• 04:35including the equation and how does
• 04:37that change the way we think about
• 04:40what a bioethical conversation can be?
• 04:42And so intimately related to this
• 04:44is the question of who defines what.
• 04:47Questions are prioritized.
• 04:48We've heard a lot of talk,
• 04:50and I've heard a lot of my colleagues
• 04:53and bioethics on news and the
• 04:55radio being asked to a pine,
• 04:57not just when might we have a vaccine, but.
• 05:00You know what are the kinds of
• 05:03ethical questions involved with
• 05:04human trials and so forth,
• 05:06and those are important
• 05:08and crucial questions,
• 05:09but my contention is that they don't
• 05:12go nearly far enough to encompass
• 05:14the issues that bioethicists are
• 05:16in a position to reckon with,
• 05:19so I hope that what I'm going
• 05:21to say will inspire that,
• 05:23and I want to be clear that I
• 05:26wholeheartedly support efforts to
• 05:28understand and alleviate the kind of.
• 05:31Biroll virology,
• 05:31uhm of Cobit but I also want to
• 05:34emphasize as the charter of the World
• 05:37Health Organization makes clear that
• 05:39health is a state of complete physical,
• 05:42mental and social well being and not
• 05:45merely the absence of disease or infirmity.
• 05:48So I want you to think about that
• 05:51and perhaps consider the ways
• 05:52in which that mandate is not in
• 05:55alignment with the United States policy
• 05:58and probably can help to explain Why.
• 06:01President Trump no longer wishes for
• 06:03the United States to be a member.
• 06:05OK, last kind of comment before I dive in
• 06:08is to say um acknowledge the his the work
• 06:11of other um historians and journalists
• 06:14that I'm building on in this lecture.
• 06:17In particular, I'm drawing
• 06:19on two really dynamic works.
• 06:22John berries, the great influenza,
• 06:25which is just harrowing and gripping,
• 06:28especially right now and also Gina colada,
• 06:31a really renowned Reporter and science
• 06:35journalist whose stories about the kind of
• 06:39hunt for the virus are going to animate.
• 06:42A lot of what I'm talking about today.
• 06:48When historians think about the past,
• 06:50uhm, you know,
• 06:51we look for change overtime to see what
• 06:53is the difference between then and now,
• 06:56and the lecture that I'm giving you is
• 06:58one that I have often version of it.
• 07:01I've often given to Undergrads and
• 07:03yell college as part of a class
• 07:05on history of global health.
• 07:07And when I give that when I've
• 07:09given that lecture,
• 07:10they had no framework for understanding what
• 07:12it meant to live through a global pandemic.
• 07:15And when I was preparing for this webinar.
• 07:18I was going back to my materials and I was
• 07:22shocked at how much continuity there is.
• 07:25I was surprised to feel the ways in which,
• 07:29even though it's a different agent
• 07:31and we're in different times,
• 07:34many of the kind of social dimensions
• 07:36of the pandemic are similar,
• 07:39so that's what I'm going to explore.
• 07:42There are a lot of places I could
• 07:46begin this story,
• 07:47but I'm going to start in a little
• 07:50town called Brevig Mission in Alaska.
• 07:53This is an Inuit village that in
• 07:561918 had about 80 adults, 50 kids.
• 08:00It was 90 miles by dog sled from Gnome,
• 08:04which was the nearest town and
• 08:06on the last Saturday.
• 08:08in November of 1918,
• 08:10two visitors from Gnome attended
• 08:12a crowded church service.
• 08:14In a tiny Chapel run by missionaries.
• 08:17The visitors were treated
• 08:19with traditional hospitality,
• 08:20a feast for the entire village.
• 08:23In return, they spread flu.
• 08:25Two days later, the first villagers fell ill.
• 08:28by Tuesday,
• 08:29the 1st person died and within three weeks,
• 08:3271 more.
• 08:33Remember,
• 08:34this is an Inuit village of 80 adults
• 08:37and 50 kids.
• 08:38In one igloo,
• 08:3925 bodies were found frozen in the
• 08:41Arctic cold and by the time the
• 08:43fluid run its course in brevetted
• 08:45killed 90% of the town's population.
• 08:47The few able bodied men that
• 08:49could be found in nearby villages
• 08:51were left to Bury the dead.
• 08:53The villages were so far North and
• 08:55this is going to be crucial that
• 08:57the ground was permanently frozen.
• 08:59In order to dig into the rock hard ground,
• 09:01miners had to pump steam into the
• 09:04permafrost so they could dig a trench.
• 09:06There were so many corpses that they
• 09:08had to be buried in a mass grave.
• 09:10A pit 2 meters deep and then
• 09:13recovered with permafrost.
• 09:14Among the dead was a woman who's frozen body
• 09:18lay 6 feet underground in the mass graves,
• 09:21where remain for 70 years until.
• 09:26Emboldened by access to
• 09:27new genetic technology,
• 09:29is scientists decided to dig it up to
• 09:32see if the 1918 flu was still there?
• 09:36Now before we jump into that recent,
• 09:38more recent past, let's try to get
• 09:41a better idea of what people knew
• 09:43about the flu during the outbreak,
• 09:45what it was like to live during that time.
• 09:49And although the first cases were actually
• 09:52registered in the Continental USA and the
• 09:55rest of Europe long before getting to Spain,
• 09:57the 1918 pandemic received
• 09:59its moniker Spanish blue.
• 10:01Because Spain a neutral country during
• 10:03World War One had no censorship of news
• 10:06regarding the disease and its consequences.
• 10:08the Spanish King Alfonso,
• 10:10the eight became gravely ill,
• 10:12and he was the highest profile patient
• 10:14about whom there was coverage.
• 10:16Hence the widest and most reliable
• 10:18news coverage came from Spain.
• 10:20Thus, giving the false impression that
• 10:23Spain was most affected think about
• 10:25the effort to try to label COVID-19,
• 10:27the Chinese virus.
• 10:28We can see the kind of geopolitical
• 10:31tensions there.
• 10:32OK, basic knowledge that maybe many
• 10:34of you know already the virus circled
• 10:37the globe three times.
• 10:38I won't kind of read through these waves,
• 10:41but it's it's sort of remarkable to
• 10:44imagine the swiftness of that travel.
• 10:47But to also think about what that's
• 10:49going to mean,
• 10:51or what that kind of circularity means
• 10:53in our even more intensely connected day.
• 10:56I won't make too much more of a
• 10:59comment on this, but just to say that.
• 11:02This went on for some time and you may
• 11:07have heard the statistics that the.
• 11:11Pandemic um lead to more deaths
• 11:14than uhm were lost in World War One.
• 11:17Though estimates vary.
• 11:18The flu 1918 flu killed about
• 11:2150 million people.
• 11:22Although I've seen estimates
• 11:24as high as 100 million,
• 11:26but let's say conservatively,
• 11:2850 million people,
• 11:29including 675 thousand in the US,
• 11:32up to 40% of the world population was
• 11:35thought to have been stricken at one point.
• 11:39More deaths than the World
• 11:41War that immediately.
• 11:42Preceded it an indeed.
• 11:44When historians have tried to make
• 11:48sense of why the 1918 flu was so, um,
• 11:51very late, why it caused so much death,
• 11:55they've had a lot of different
• 11:58a lot of different hypothesis,
• 12:00but one that came to the fore was
• 12:03the idea that it had exploited
• 12:06vulnerabilities in nations ravaged by war.
• 12:10And so I've been thinking.
• 12:12A lot about this dimension of
• 12:14the 1918 pandemic, alot war.
• 12:15What would it mean?
• 12:17This is just a question I'm
• 12:18going to put out there.
• 12:20I'm not going to cash it
• 12:22out in the rest of the top,
• 12:24but we can discuss it later.
• 12:25I just want to ask like what would it mean
• 12:28for us to understand our own moment as one?
• 12:31That's the product of war
• 12:33since September 11th.
• 12:33the United States has been
• 12:35engaged in overseas warfare.
• 12:36Unlike World War One,
• 12:37many Americans aren't forced to confront
• 12:39the violence of these military engagements
• 12:41in a daily basis that sometimes.
• 12:43We forget even that were in it at
• 12:46war because it's gone on for so long.
• 12:49Ah, OK, this is just for you to see.
• 12:53Um, spitting was became the
• 12:55new sort of deadly weapon.
• 12:57Uhm, and, uh, we see people
• 12:59arrested for spitting on sidewalks.
• 13:02Uhm, don't spit influenza.
• 13:04Uhm, but you know.
• 13:07Our colleagues now,
• 13:08who treat veterans at the VA,
• 13:10are acutely aware of the forms of
• 13:13physical and psychological suffering
• 13:14that face those who have served,
• 13:16and we know that federal funding
• 13:19federal funding for defense spending
• 13:20has significantly outweighed
• 13:22support for health care and the
• 13:24kinds of social support that
• 13:26ensure improved health outcomes.
• 13:27Um, for instance,
• 13:29how might we differently understand the
• 13:31opioid epidemic that's rage during this time?
• 13:33If we consider it as a kind of collateral
• 13:36damage of a nation traumatized by
• 13:39decades of war that happen out of sight,
• 13:42and the slide that I'm showing you here
• 13:44is a kind of invitation for soldiers
• 13:47who are suffering from what was then
• 13:50the new condition of Shellshock.
• 13:52In many ways of precursor to Pete ESD to
• 13:55deal with these new kinds of injuries,
• 13:57injuries that were invisible.
• 13:59And it's not surprising that military
• 14:02metaphors then have come to define the
• 14:04response to COVID-19 with health care.
• 14:07Workers asked to risk their
• 14:08lives on the front lines.
• 14:10Do the critical shortages
• 14:12of PP and the virus itself.
• 14:14Cast is an invisible enemy terrorizing
• 14:16Americans, and which must be vanquished.
• 14:19OK, so you're seeing, um,
• 14:22some of these parallels?
• 14:24What maybe is less clear with all
• 14:28the focus on physicians, is that,
• 14:31UM, in 1918 the profession of
• 14:34nursing was relatively new.
• 14:36Nurses,
• 14:36particularly those connected
• 14:37with the venue Red Cross,
• 14:40became a new profession,
• 14:42and nurses were recruited from volunteers
• 14:45amongst the women whose husbands and
• 14:47sometimes sons had gone off to war.
• 14:50Here,
• 14:51even as the war reached its end, uhm,
• 14:54nurses were faced with caring for
• 14:56soldiers who contracted flu in army barracks.
• 14:59and I put this slide up to see
• 15:02the same masks.
• 15:03This sort of low tech technology
• 15:05that we are all relying on today.
• 15:08Here's a kind of early version of that.
• 15:11They also public spaces were
• 15:13converted into makeshift hospitals,
• 15:14and I know that many of you in
• 15:17the Yale community saw this image
• 15:20that was posted back in March.
• 15:22Hospital beds lined up to make a
• 15:26reserve field hospital in a in a
• 15:28in a in a gymnasium at Yale and
• 15:31I think many of us who had seen
• 15:34images like this one were really.
• 15:36This was a wake up call that
• 15:39wow this is going to be big.
• 15:41And just as we've heard terrifying
• 15:43stories of what it meant to have covid,
• 15:46this is an account from a nurse back in 1918.
• 15:49N Josie Brown,
• 15:50who served at the Naval Hospital
• 15:52in Great Lakes Illinois.
• 15:53Is, she remarked,
• 15:54we didn't have time to treat them.
• 15:57We didn't take temperatures,
• 15:58we didn't even have time
• 15:59to take blood pressure.
• 16:01You would give them a
• 16:03little hot whiskey toddy.
• 16:04That's about all we had time to do.
• 16:06They would have terrific nosebleeds with it,
• 16:09with cope with 1918 flu,
• 16:10sometimes the blood would
• 16:12just shoot across the room.
• 16:14To get out of the way or someone's
• 16:16nose bleed all over you.
• 16:18And many of those who died did so by
• 16:20drowning in their own bodily fluids,
• 16:22and I hesitated whether or not to share
• 16:25this passage because it is so gruesome.
• 16:27But I think that it's important
• 16:29for us to remember, you know,
• 16:30the violence of these deaths
• 16:32that are happening today.
• 16:33Similar kinds of deaths out of Sight.
• 16:35Without you know,
• 16:36our ability to really understand what's
• 16:38going on inside inside the words.
• 16:40If we're not physicians when I say we,
• 16:42I mean historians, not physicians like.
• 16:44My partner uhm?
• 16:46In cities across
• 16:47the nation, black people struck
• 16:49by flu were often left
• 16:52to fend for themselves.
• 16:54They receive substandard care and
• 16:56segregated hospitals where they could be
• 16:59relegated to close quarters in basements.
• 17:01Or they were only allowed
• 17:04admittance to black only hospitals.
• 17:07We've lost at least twenty 1750
• 17:09black lives to COVID-19 to date,
• 17:12and I you can see here that there's
• 17:14black people are dying at a rate nearly
• 17:17two times higher than their population share.
• 17:20If you're interested, I don't know.
• 17:22I think you can probably click on this link.
• 17:25I tried to make them accessible,
• 17:28but Jacoby tracking.com if you want
• 17:30to dive into some of this data.
• 17:33It wasn't just um, black people,
• 17:37but um, indigenous Americans, uhm.
• 17:42Are now and then dying incredibly high rates.
• 17:46This is from a Navajo Nation
• 17:48project and I think it was.
• 17:51Yeah I did this two days ago.
• 17:54Um, 5 hundred 5317 cases in
• 17:57the Navajo Nation alone.
• 17:58Some of you might have seen Nick Kristof op
• 18:02Ed a couple days ago in the New York Times,
• 18:07where he pointed out that American
• 18:09Indian reservations are the
• 18:11most intense covid hotspots.
• 18:13Um, so going back to 1918.
• 18:15Um, you see some of the circumstances
• 18:18that laid the groundwork for that.
• 18:21You have American Indian indigenous
• 18:23peoples living on reservations.
• 18:24Many of the young people were
• 18:27at boarding schools.
• 18:28Um, and we're not talking
• 18:30about boarding schools like um,
• 18:32Exeter,
• 18:32or Andover,
• 18:33and we're talking about schools
• 18:35that were designed to separate
• 18:37children from their families so that
• 18:40they could be forced to assimilate
• 18:42cultures that were punished for.
• 18:44Engaging in there.
• 18:46Um, indigenous language practices
• 18:47and traditional practices,
• 18:48and this was what you know.
• 18:50If a parent was lucky or family was lucky,
• 18:54they might get a telegram like
• 18:56this one that says Lucy Antone,
• 18:58ill with pneumonia following influenza.
• 19:00Seems serious.
• 19:01Please advise her mother,
• 19:02Catherine Antonick San Tan.
• 19:04Now these came via telegram,
• 19:07but there was a lot of anxiety even about
• 19:11communicating that lines would be hacked.
• 19:13And here I've transcribed this.
• 19:16This is a document that was produced
• 19:18by the US public health service,
• 19:22a telegraphic code for the use of the
• 19:24United States public health service
• 19:27so that there could be information
• 19:30communicated so that without inciting
• 19:32panics and without inciting fears.
• 19:35And I think this is interesting
• 19:37for a lot of reasons,
• 19:39but in particular because it pre
• 19:41sage is a way of the ways in
• 19:44which our communication systems
• 19:46are sometimes surveilled, or um,
• 19:48used to make data or obscured data,
• 19:51and I felt like there was a lot
• 19:54of darkness in this lecture,
• 19:56and at this midpoint I wanted to
• 19:59talk about some of the ways in
• 20:02which efforts more contemporary
• 20:04efforts to try to use our.
• 20:06Some sort of smart phones to track
• 20:09and make knowledge about epidemic
• 20:11fevers has failed back, uh,
• 20:14let's say I think it was in 2012.
• 20:18There was a really big push to
• 20:21try to use Twitter,
• 20:23which was then relatively new to
• 20:26identify where emerging outbreaks
• 20:28were happening, and so they started
• 20:30tracking keywords like fever.
• 20:32And in 2012 there was a big spike in fever.
• 20:37Which led to a lot of frenzy and flurry
• 20:41until it was revealed that it was actually,
• 20:45uhm, Bieber fever, Justin Bieber.
• 20:47Uhm, then younger, uh,
• 20:49more babyfaced popstar than
• 20:51he is now was, uhm, you know?
• 20:54Scrambling the scrambling the
• 20:56epidemiological signal, if you will,
• 20:58and if you're interested this an article
• 21:01that I posted here in the Atlantic,
• 21:04and there's actually been several
• 21:06data science papers published
• 21:08about the mathematical models
• 21:09of kind of social virality, so.
• 21:12Bieber fever. There you go.
• 21:16Um but.
• 21:19Here we see back in 1918 the ways at the
• 21:22question of preparedness and how people
• 21:25were actually dealing on the ground.
• 21:27We're not so different than they are today.
• 21:30This was in the newspaper.
• 21:31This one page actually has
• 21:33so much information on it,
• 21:35but I want you to direct your
• 21:37attention to the lead headline,
• 21:39which is give us beds.
• 21:41Bedding is the plea of flu hospital.
• 21:43You can see, you know I won't
• 21:46have to rehearse for you again.
• 21:48This shortage of of P PE.
• 21:50And here is an image of an
• 21:53emergency nurse on this.
• 21:55She's actually a Spanish nurse
• 21:57dressed in garbage bags and a loaned
• 22:00mask from a private company at an
• 22:03emergency entrance door of the
• 22:05UM San Jorge Hospital in Spain.
• 22:08I don't want to go back to that
• 22:10same image because you'll see
• 22:12there's a couple of interesting
• 22:14other like Subheads on the bottom
• 22:16actor stranded because of flu.
• 22:18Do we remember Tom Hanks?
• 22:20Uhm, the first sort of celebrity covid case,
• 22:23but here this idea of vaccine
• 22:25to go to camps first,
• 22:27this headline is a little bit misleading
• 22:29because no one ever succeeded in
• 22:32producing a successful vaccine.
• 22:33Doctors tried,
• 22:34but later admitted that they
• 22:36were essentially just mash ups
• 22:38of blood in sputum injected.
• 22:39And because people reported that their
• 22:41arms really hurt after the injection,
• 22:43they were thought to have some efficacy.
• 22:46So we start to think about the kinds
• 22:48of desperate measures that people
• 22:50turn to in the search for cures to
• 22:53manage a new kind of infectious agent
• 22:55that people are not sure what it is.
• 22:58and I haven't even pointed out yet that
• 23:00people didn't know what virus that did.
• 23:03They were not speaking in the
• 23:04language of viruses at 1918 there
• 23:06was something that was spreading.
• 23:08They knew that it was.
• 23:10Going from person to person,
• 23:12but there wasn't the same language or
• 23:15the different kind of language of viral
• 23:18precision that we are talking about.
• 23:20Today I wanted to put this up here.
• 23:24This is.
• 23:25Remember,
• 23:25um,
• 23:26the recommendation or the the suggestion
• 23:29that bleach consuming bleach might be
• 23:31used to help prevent infection with Covid?
• 23:35And this is an announcement that
• 23:38the World Health Organization had
• 23:41to put out to counter political
• 23:44information that lead people to
• 23:46take on these kinds of tours.
• 23:49An you know,
• 23:50we're all aware of multiple others
• 23:53that are perhaps. Uh, less uhm?
• 23:58Obviously dangerous, uhm,
• 24:00but we can see lots of different kinds of,
• 24:05um, false tours being being advertised so.
• 24:10I've talked a lot about the
• 24:12kind of health experience,
• 24:13but as we see today,
• 24:15the 1918 flu infected social life as well.
• 24:18This is a kind of like a jump rope song,
• 24:21like a little like Diddy that
• 24:23kids would play would sing if
• 24:25they were on the playgrounds,
• 24:27but they couldn't go to playgrounds and
• 24:30I don't know like what the melody was.
• 24:32Uhm,
• 24:33but you could imagine you know
• 24:35kids sort of
• 24:36jumping rope and we can think back
• 24:38to songs even like ring around.
• 24:40The Rosie pocket full of Posey Ashes Ashes.
• 24:44We all fall down as a saw as a sort
• 24:48of song from an earlier played time.
• 24:52It'll be interesting to see what
• 24:55kinds of youth phenomena emerged.
• 24:57Of course. Playgrounds, again,
• 24:59still closed, and we see these kinds of.
• 25:03Facets of the epidemic creeping in to
• 25:06children's lives and in ways that will leave
• 25:09marks that are really hard to reckon with.
• 25:12Adjusted my last point on the question
• 25:16of like the cultural practice,
• 25:18this is the kind of announcement that
• 25:22you would see, you know, go home,
• 25:25go to bed until you are, well, stay home.
• 25:29These are the kinds of signs
• 25:32that we see everywhere.
• 25:34If you if you go outside.
• 25:38And this was just an image of a theater.
• 25:41So like you know we allot
• 25:43and Broadway went dark.
• 25:45Uhm, that was uh,
• 25:46a really another kind of signal
• 25:48moment of what was happening.
• 25:50So.
• 25:52What I've been trying to show you
• 25:55then is that there are tremendous
• 25:57continuity's uhm between what we're
• 26:00living through now and what Americans
• 26:03lived through over 100 years ago.
• 26:05What was unusual was different.
• 26:07It seems about the 1918 flu.
• 26:10Is that those who appeared to have stronger
• 26:14immune systems were at greater risk.
• 26:16So people who were in the prime of
• 26:20their health and perhaps were seen as.
• 26:23Having every reason, uhm to be healthy.
• 26:26Uhm,
• 26:27were being struck down and scientist
• 26:29some have since posited or considered
• 26:32that this was because the disease
• 26:35triggered an overreaction by the
• 26:37immune system that could cause a young
• 26:40person's immune system against itself.
• 26:42What we call the cytokine storm,
• 26:45and we've heard some about that today.
• 26:48But as I pointed out there,
• 26:51we didn't have a language
• 26:53of viruses or virality in.
• 26:551918, and the idea of germ theory
• 26:58itself had only just taken hold,
• 27:01so there was a lot of contestation.
• 27:04what I think is really interesting is that,
• 27:08UM.
• 27:08When I've taught this lecture before,
• 27:11UM, covid, uhm,
• 27:12the students are very astounded there like,
• 27:14well, of course you know,
• 27:16like you know,
• 27:17now that we know that you know,
• 27:19we know about viruses and we have
• 27:22completely adopted the germ theory.
• 27:24You know this isn't this isn't an issue,
• 27:26but of course what we're seeing
• 27:29now during code.
• 27:30That is the way in which science and
• 27:32medical information is contested,
• 27:34and it might lead us to ask is the
• 27:37germ theory is accepted as we who are.
• 27:40Fluent in the Sciences might wish it were.
• 27:43What does it mean for a theory
• 27:46to be accepted if people in the
• 27:49public are not going to embrace it,
• 27:52especially when it comes to
• 27:54something like public health?
• 27:56So just to kind of bring a little more
• 28:00precision to what I'm trying to say in 1918,
• 28:03the agent couldn't be seen with
• 28:06the microscopes at the time.
• 28:08There were no electron microscopes,
• 28:10couldn't be studied by the culture method
• 28:13that have been effective for bacteria, right?
• 28:16Trying to grow it in culture and amplify
• 28:19it so that we could study it and could only
• 28:23could only be carefully studied through.
• 28:26Animal models, and with serological tests.
• 28:28And, you know, we're hearing.
• 28:30Also today, we still don't know if
• 28:32people had coded and didn't get a test.
• 28:35Are they immune? Are they not immune?
• 28:37You can see what's going on
• 28:39here as the epidemic waned.
• 28:41It was thought that the flu
• 28:43microorganism died out too.
• 28:44Gone from the face of the Earth,
• 28:47the biological mystery of the flu
• 28:49would be was beyond the powers of
• 28:51Science and medicine at the time,
• 28:53and it would take the emergence
• 28:55of a science of virology.
• 28:57And this is Richard Shoup, some of you.
• 29:00May be familiar with him, um,
• 29:02who determined that influenza
• 29:04was caused by a virus,
• 29:06but by the time he was working,
• 29:08you see he wasn't even he would.
• 29:11He lived through the 1918 flu,
• 29:13but it was already gone by the time
• 29:15he had the expertise to study it
• 29:18and he he began to think, you know,
• 29:21if the virus that caused it could
• 29:23somehow be recovered and studied,
• 29:25scientists might learn something about
• 29:27why it was so deadly and this became.
• 29:30A dominant preoccupation
• 29:32of biomedical research,
• 29:33researchers for the.
• 29:34Second half of the 20th century,
• 29:37right up to the present and after
• 29:39the Second World War,
• 29:41Johan Hult in a speech pathologist,
• 29:42was working as a postdoc at Indiana,
• 29:45where Shope had done his work.
• 29:47He was looking for a new project when a
• 29:49faculty member said to him over lunch.
• 29:52You know,
• 29:52we still don't know what caused the 1918 flu.
• 29:55The only thing that remains is for
• 29:57someone to go to the northern part
• 29:59of the world and find bodies in the
• 30:02permafrost that are well preserved and
• 30:04that might contain the original virus.
• 30:06And that's what Holton set out to do here.
• 30:09He is digging a trench trying to
• 30:11get into that mass grave brings
• 30:13us back to Brevik Mission,
• 30:15where in 1951 a team of scientists,
• 30:17including Holton wound up there.
• 30:19The village had since been re populated
• 30:21Anhalt and explain the purpose of the study.
• 30:23He was about to dig up a grave but realized
• 30:26he needed permission from the villagers.
• 30:28It's interesting that he did not
• 30:31realize that he needed permission
• 30:33to dig up a grave until he was
• 30:35already there about to do it.
• 30:37There were three survivors from 1918
• 30:39that were still alive in the village,
• 30:41and apparently he told them this.
• 30:43He said it is now possible to
• 30:45prevent this from happening again,
• 30:47but I need your help if you
• 30:49allow me to dig in the grave,
• 30:51I will do my best to find some
• 30:54specimens and once we have the virus
• 30:56we can produce the vaccine and the
• 30:58next time the disease comes you will
• 31:00be immunized and you will not die.
• 31:02This sounds like a pretty appealing prospect,
• 31:05but I I hope this is something that we
• 31:07can talk about more because there are.
• 31:10Many many, many ethical questions
• 31:11Laden in here about the research
• 31:14relationship that's being formed.
• 31:16The promises that are being made,
• 31:18the terms in which people agree
• 31:20to have their dad there ancestors
• 31:22exhumed for the purposes of science.
• 31:25The villagers agreed.
• 31:27So halting began digging.
• 31:28He lit a fire to begin
• 31:30melting the permafrost,
• 31:31and after four days of digging,
• 31:33he came upon a body of little
• 31:36girl with red ribbons in her hair.
• 31:38They then found more for more bodies,
• 31:40all adults.
• 31:41They cracked open four of the
• 31:43still frozen cadavers rib cages,
• 31:45scooped out chunks of their lungs,
• 31:47packed it on dry ice,
• 31:49and attempted to study the
• 31:51tissues in the lab.
• 31:53But they were unsuccessful in
• 31:56recovering the virus from the
• 31:58tissue and threw away the specimens.
• 32:02I should've told you earlier in this
• 32:04lecture that I have written entire
• 32:06book on the history of efforts to use
• 32:08old tissue samples for new things.
• 32:10Old frozen tissue samples for a new thing.
• 32:13So this is something that I know a lot about.
• 32:16We can talk about more,
• 32:18but what I've told you just now
• 32:20isn't the end of the story.
• 32:22Flash forward to the 1990s ayoung
• 32:24pathologist named Jeffrey Taubenberger,
• 32:25working at the Armed Forces
• 32:27Institute of pathology,
• 32:28which maintained an archive of
• 32:29hundreds of thousands of differently
• 32:31preserved tissue samples.
• 32:32Ranging from slides to bits of
• 32:35tissues and wax paraffin as well as
• 32:37more recent specimens and freezers,
• 32:40taubenberger realize that the
• 32:42collection included tissues from
• 32:44soldiers who died in 1918.
• 32:45If they could find the right samples,
• 32:48maybe they could find a bit of flu.
• 32:52In 1997,
• 32:53Taubenberger Anna brilliant
• 32:55technician name Dan Reed,
• 32:57succeeded in finding genetic
• 32:58material from Spanish flu in a
• 33:02formaldehyde soaked scrap of lung
• 33:04tissue from a 21 year old soldier
• 33:07who died during the 1918 epidemic.
• 33:10His name was Rosco.
• 33:12Ran here is a statue that's
• 33:14been erected in his memory.
• 33:16Johan Holton, still alive,
• 33:18learned of this research and was inspired
• 33:21to return to Brevig Mission once again.
• 33:24This is 50 years later,
• 33:27inspired by access to new
• 33:29diagnostic technologies,
• 33:30scientists dug up another
• 33:32victim from the same site.
• 33:34She was a mostly frozen woman,
• 33:37about 30 years old.
• 33:40Before he left with that issue,
• 33:42Holton made markers to match the ones
• 33:45that originally stood at the grave site.
• 33:47This time they were successful
• 33:50in extracting viral material.
• 33:52And in 2005,
• 33:53a team of scientists were able to
• 33:56use old frozen tissue to sequence
• 33:59the full genome of the viral RNA.
• 34:02So on the one hand,
• 34:04this is a story of the power of a
• 34:07particular kind of biomedical research.
• 34:09There's something, uhm,
• 34:11that feels perhaps nothing short of
• 34:13miraculous of recovering a tissue or
• 34:15a virus thought to be disappeared.
• 34:18I see there's a hand brace I'm
• 34:20just going to wait until the end,
• 34:23if that's OK.
• 34:25Merin culas story of biomedical research.
• 34:27But it's also one that,
• 34:29as the memories of 1918 and the
• 34:32lived experience of the flu faded
• 34:34attention became focused more and more
• 34:36and more on characterizing the virus.
• 34:39In this narrative,
• 34:40we can characterize it if we can sequence it.
• 34:44If we can study it more precisely
• 34:46more precisely, we will have.
• 34:48A vaccine we will have a cure
• 34:51and no one will get sick um.
• 34:54In 2014, nature published well,
• 34:56actually I want to jump ahead the
• 34:59same ability to recreate to be able
• 35:02to sequence the full genome of viral
• 35:05RNA is also inspired scientists to
• 35:08reconstruct the virus at the CDC,
• 35:11which lead in 26,
• 35:12two and a major outcry about
• 35:15bioterror that what did it mean?
• 35:18What's the?
• 35:19What's the boundary between studying
• 35:21these kinds of agents in the bio
• 35:24technological methods to do so?
• 35:26And potentially exposing people
• 35:28to risk and you can see that it
• 35:31studies like this that start to
• 35:33creep into conspiracy theories
• 35:34like COVID-19 was created in a lab
• 35:37and these are all in a brew that
• 35:40are circulating around as we try
• 35:42to make sense of what's happening.
• 35:44So just to kind of show that what
• 35:47I meant when I said this study.
• 35:49The never ending story of 1918 flu.
• 35:52The biomedical story appears
• 35:53to never end in 2014.
• 35:55Nature published a study that
• 35:57provided still new evidence.
• 35:59Of the origins of the 1918 flu,
• 36:01this one done by a evolutionary
• 36:04biologist at University of Arizona
• 36:06who wanted to understand what the
• 36:08kind of nonhuman reservoir was.
• 36:11Did it come from birds, horses, pigs, backs?
• 36:14And he produced an evolutionary tree
• 36:17that showed that the jeans of the
• 36:191918 pandemic were of avian origin,
• 36:22but there have been conflicting
• 36:24stories about whether the jeans
• 36:26came from birds or from pigs, and.
• 36:29What I found really interesting
• 36:30when I read this study was that the
• 36:34author said what we really need is
• 36:36a sample of the virus preserved in
• 36:39a burial for the medical experts
• 36:41to uncover that would have the best
• 36:43chances of settling the debate.
• 36:45So we see this return.
• 36:47This returned to try to dig up the bodies,
• 36:50dig up the past,
• 36:52dig up particular kinds of the past
• 36:54in a way to understand the virus.
• 36:57I think that what I'd like to
• 36:59Emphasize in my argument is that
• 37:02our understanding living as we're
• 37:05living through covid right now,
• 37:07I think it's pretty clear that if
• 37:10we only understand the virology
• 37:12of the novel coronavirus,
• 37:15we will have missed a tremendous
• 37:18dimension of what?
• 37:20It means to live and seek health in 2020,
• 37:24so it brings us back to the present.
• 37:27UM, where specimen we see here?
• 37:30I just posted this.
• 37:32This is from you, know, Yale,
• 37:34where people can get tested.
• 37:36But I also want to kind of knowledge
• 37:39that getting tested is also a
• 37:42way of creating specimens.
• 37:44And in my book,
• 37:46which I'd be thrilled for you
• 37:48to read if you are so inclined.
• 37:51Talk about the ways in which public health
• 37:54offices that we're collecting materials
• 37:56testing for all kinds of conditions,
• 37:59including state mandated
• 38:00state mandated simplest tasks,
• 38:02wound up using those tissues for
• 38:04research purposes that public health
• 38:06officials and scientists said.
• 38:08Wait a minute.
• 38:09Why would we throw these materials away?
• 38:12They're really precious.
• 38:13I'm going to someone who works at Yale,
• 38:17Studies the use and reuse of old tissues,
• 38:20and the bio ethical considerations
• 38:22that they raise. And really.
• 38:24Interested in trying to understand
• 38:26what's going to happen to the
• 38:28specimens that are being collected?
• 38:30How will they be used?
• 38:31What does it mean to consent for reuse?
• 38:34You can imagine all these ethical
• 38:37issues that unfold. Hum so.
• 38:40I wanted to give the last word here,
• 38:43um to my colleague, actually, um,
• 38:45um Marcela, Doctor Marcella Noona Smith,
• 38:47who is the director of equity
• 38:50research and and it the equity
• 38:52research and Innovation Center
• 38:53at the Yale School of Medicine.
• 38:56And this is the link to the website
• 38:59and I've got the link down there.
• 39:01If you want to see what's going on,
• 39:04she recently told NPR.
• 39:06We know that racial ethnic
• 39:08disparities in Covid are the
• 39:10result of pre pandemic realities.
• 39:12It's a legacy of structural discrimination
• 39:14that has limited access to health
• 39:17and wealth for people of color.
• 39:19Now.
• 39:19I hope that will be able to
• 39:22find ways to come join forces.
• 39:25Um,
• 39:25those of us who work at places like Yale
• 39:28or those of us who work at medical,
• 39:31medical schools and other research
• 39:32universities to try to figure out
• 39:35what it means to ask bio ethical
• 39:37questions that are informed
• 39:38by those kinds of insights.
• 39:39and I want to just mention a project
• 39:41that my colleagues and I engaged
• 39:43with called COVID-19 history of the
• 39:46present which was at Yale School
• 39:48of Medicine involving medical
• 39:49students and nursing students wear.
• 39:51We began to build the archives that
• 39:53we hope that historians and other
• 39:55people in the future will be able
• 39:57to benefit from and getting a more
• 40:00robust understanding of what it has
• 40:02meant to live through this pandemic,
• 40:04but also to imagine that thinking about
• 40:06this sort of a femora that's around
• 40:09us right now is a way to construct
• 40:11meaning in a very difficult time.
• 40:14And on this day of of sort of
• 40:17reckoning on civil rights,
• 40:19the resurgence of civil rights in our
• 40:22country, I want to end on this slide.
• 40:26Really important organization called
• 40:28white coats for black lives which
• 40:31has been organizing justice for
• 40:33George Floyd but has been doing
• 40:36work for some years now to try to
• 40:39enhance understanding on activism and
• 40:41engagement amongst healthcare professionals.
• 40:43And so I hope that you will join me in.
• 40:47Learning more about what they are doing,
• 40:50so that's the end of my formal
• 40:53presentation and I'm happy to
• 40:55turn it over to John and Naomi.
• 40:57And then I think we will open it up for
• 41:01discussion. Yes, we will thank
• 41:03you very much. Doctor Raden
• 41:05this is Karen called Mark
• 41:07material will be joining us shortly.
• 41:09Naomi Rogers will go next
• 41:11to followed by John Warner,
• 41:13Naomi Rogers, a more doctor.
• 41:15Naomi Rogers is a professor of.
• 41:18History in the history of Medicine.
• 41:20In the section of the history of
• 41:22Medicine at Yale Medical School and
• 41:24the program in the history of Science
• 41:26and medicine at Yale University,
• 41:28where she teaches undergraduates,
• 41:29graduate students, an medical students.
• 41:31I'm her historical interest.
• 41:32Include health, activism,
• 41:33gender and health, disease,
• 41:35and public health disability,
• 41:36an alternate medicine and welcome mark.
• 41:37Will I just wanted to Joanna,
• 41:39could I ask you to do it
• 41:41again? Because I I missed it. I am so
• 41:44sorry. I would
• 41:45love to find some
• 41:46clever way to blame somebody else for this,
• 41:48but I had some serious zoom
• 41:50difficult habit on zoom meetings
• 41:52for the last two months off and on,
• 41:54but I think something with
• 41:55the upgrade didn't go right.
• 41:57I think I didn't do it.
• 41:58I was supposed to do so.
• 42:00This is on me.
• 42:01I'm so sorry, Joanna.
• 42:03Well, Fortunately it's been
• 42:04recorded excellence. I'll be
• 42:05able to see that I got to
• 42:07actually look at it real quick,
• 42:08but I'm moderate the session from here.
• 42:10If this works, will see if I can see
• 42:13the QA's and whatnot from this link.
• 42:15Hopefully it all works.
• 42:16Thank you so much, so I apologize and Karen.
• 42:18Thank you so much for pinch hitting.
• 42:20Everybody else is on this Good afternoon.
• 42:22My name is mark material on the director
• 42:24of the program for Biomedical Ethics.
• 42:26I am not the director of computer
• 42:28services at Yale University.
• 42:29Would be pleased to know,
• 42:31but I think we're up and running.
• 42:32And next is Naomi, right? Karen?
• 42:34did I just hear you introduce Naomi?
• 42:36Yeah, she did perfectly.
• 42:38Only would you please speak to us for a
• 42:41few minutes about this?
• 42:43Thank you so much.
• 42:44Can you let me let me start my video my.
• 42:48You're the host. I'm.
• 42:51Aw, thank you. OK.
• 42:55Thank you very much.
• 42:58So welcome everybody,
• 43:00I'm so glad that you can be here
• 43:05and I'm really delighted to be
• 43:09one of the two uhm commentators.
• 43:14Uh, where, uh, uh.
• 43:16Also in joann's Department,
• 43:17in the section of the history of
• 43:20Medicine at the medical school
• 43:22and in the program of the history
• 43:25of Science and medicine at Yale.
• 43:27So what I wanted to do is to talk a
• 43:31little bit and I guess is sort of an
• 43:35odd thing to say, but I'm this this.
• 43:38These are comments in which I want to
• 43:41reflect on thinking about their forgetting.
• 43:44Of the Spanish, a pandemic, and um,
• 43:48the reason I said that's kind of
• 43:51odd is that really until covid,
• 43:55uhm, the Spanish pandemic was
• 43:57considered kind of interesting.
• 43:59Sort of old-fashioned sort of thing
• 44:03that happened long ago and was,
• 44:06uh,
• 44:06the interest of only really a very
• 44:09small number of historians and journalists.
• 44:13There was a book in 1977.
• 44:16Hum by historian called
• 44:18America's forgotten pandemic,
• 44:19which I think tells you everything
• 44:22you need to know so that in in
• 44:25thinking about this I I want to
• 44:28reflect focused on what it means
• 44:30to have things be forgotten.
• 44:32And then I want to reflect a little
• 44:36bit on what it means to be to start
• 44:39to remember things like this pandemic.
• 44:42Now I'm thinking about forgetting
• 44:44is something that I've done in my.
• 44:46Earlier work um,
• 44:48and so I wanna drawn um a moment
• 44:52that I uhm investigated myself um
• 44:56around sister Elizabeth Kenny.
• 44:59Now sister Kenny was a celebrity nurse
• 45:03in 1940s America who died in 1952.
• 45:07She developed an innovative method
• 45:10of treating polio paralysis of polio
• 45:14patients who had paralysis and.
• 45:16Just to say that it was extraordinarily
• 45:20successful and really replaced
• 45:22much of what had been standard care
• 45:26up till that point in the 1940s.
• 45:29She was also a major media figure,
• 45:32very familiar to people living
• 45:35in the 1940s and 50s.
• 45:37Um, a large woman in a big Black Hat.
• 45:41She was even the subject
• 45:44of a Hollywood movie.
• 45:46Which starred Roslyn Russell and
• 45:48you just have to know that that
• 45:51was a big movie star at that time.
• 45:55But after the development of
• 45:57the polio vaccine in 1955,
• 45:59and the gradual disappearance
• 46:01of polio epidemics,
• 46:03she was quickly forgotten.
• 46:04Sister Kenny made a few appearances
• 46:07in children's books.
• 46:09This is after her death and after the
• 46:13vaccine lives to remember in 1958,
• 46:16for example,
• 46:16and in books about famous nurses.
• 46:196 great nurses.
• 46:21She was one of the six in 1962,
• 46:24but soon even from those kinds
• 46:27of collections she was gone and
• 46:30today's lists you can look up
• 46:32famous nurses up through Google.
• 46:35And what you find is Florence Nightingale,
• 46:39um Clara Barton,
• 46:40the founder of the American red costs,
• 46:44um Margaret Sanger,
• 46:46a man,
• 46:47Sujana Truth and assorted others.
• 46:50But absolutely Kenny has
• 46:52completely disappeared now.
• 46:54Why was she forgotten and what is it
• 46:58about the forgetting of things and
• 47:01events and people in part it was.
• 47:05There was deliberate erasure by
• 47:08leaders of the March of Dimes,
• 47:10which was America's largest disease
• 47:12organization and the largest
• 47:14polio charity in the world.
• 47:16And the leaders had long tangled with her,
• 47:20and actually,
• 47:20we're eager to have the public see
• 47:24polio edit as a disease that had been
• 47:27defeated in the lab with a vaccine
• 47:30rather than at the bedside in 1958.
• 47:33For example, the March of Dimes.
• 47:36Organized a polio Hall of Fame at Warm
• 47:40Springs featuring 17 polio heroes,
• 47:43mainly neurologists and other scientists
• 47:47funded by the March of Dimes.
• 47:50There were no orthopedists,
• 47:53no physical therapists,
• 47:55and no sister Kenny.
• 47:57Sister Kenny was also forgotten because
• 48:01the public sphere of polio began to fade.
• 48:06Polio.
• 48:06Became a disease signifying
• 48:08not modern science,
• 48:10but an unenlightened world before vaccines.
• 48:14There was a widespread sense of relief
• 48:18that polio paralysis was no longer
• 48:21a constant threat to communities,
• 48:24and there was a vague hope that the
• 48:28care of living polio survivors would
• 48:31somehow go on in institutions far away from.
• 48:36Mainstream society.
• 48:38Paralyzed children did not fit the emerging
• 48:43picture of happy suburban families.
• 48:46Boys playing baseball girls
• 48:49playing jump rope, braces,
• 48:51crutches and wheelchairs was
• 48:54symbols of the bad old days.
• 48:58Now forgetting sister Kenny also reflected
• 49:01a wider optimism among medical professionals.
• 49:05Any American public that the
• 49:08power of medical science.
• 49:11Was conquering not just polio,
• 49:13but all infectious diseases, one by one,
• 49:17by vaccines and modern drugs,
• 49:19health officials now said that
• 49:22the US had turned a corner,
• 49:25and that the new public health
• 49:27battles would be to confront,
• 49:30not contagious but chronic ills
• 49:33like cancer and heart disease.
• 49:36Now,
• 49:36many of these assumptions were
• 49:39disrupted by the emergence of aids,
• 49:43arguably allfirst modern pandemic in
• 49:46the 1980s. There was widespread panic.
• 49:50Fear that the deadly aids virus would
• 49:54kill not only already stigmatized gay men,
• 49:58but also so called innocent Americans.
• 50:02And this Hispanic was fueled by anger.
• 50:06That medical scientists were not
• 50:09able to swiftly develop a vaccine
• 50:12or some other kind of medical fix.
• 50:15And as we know,
• 50:17after 30 years there is still
• 50:20no vaccine for HIV aids.
• 50:23So now I want to turn talk a
• 50:27little bit about COVID-19 and the
• 50:30rediscovery of the Spanish pandemic.
• 50:33With this our modern,
• 50:35now second modern pandemic.
• 50:38Many have turned to history for
• 50:42explanations for lessons and perhaps also
• 50:45for a sense of calm or or maybe maybe hope.
• 50:50The Spanish pandemic has been rediscovered,
• 50:53in part reflecting the media search
• 50:57for some other large scale epidemic
• 51:00respiratory disease in a past one wear.
• 51:04Black and white photographs control
• 51:07people wearing masks must just like us,
• 51:10right?
• 51:11The and also detail the takeover of
• 51:15public spaces for hospital care,
• 51:17as Joanna has shown us.
• 51:21The Spanish flu.
• 51:22Was a disease like covid that was
• 51:26highly contagious and also deadly.
• 51:29It attacked young healthy people and
• 51:32appeared at a time when scientists appeared
• 51:36to have little to offer that pandemic.
• 51:41Involved a different version
• 51:43of our more familiar flu,
• 51:45which does now have a vaccine,
• 51:48but one that only works year to year.
• 51:52If the flu virus has not
• 51:55significantly mutated, right?
• 51:57This is why the CDC always reminds
• 52:00people to get your flu shot,
• 52:03by which they mean your knew flu shot.
• 52:07Now I'm not sure, and this is my concluding.
• 52:12A paragraph, I'm not sure that
• 52:14as a historian of disease, that.
• 52:17Thinking about this moment.
• 52:20Doesn't offer much wisdom from the past,
• 52:25but studying the 1918 pandemic along
• 52:28with other epidemics I think helps
• 52:32us to understand popular frustration.
• 52:36Both with strict public health rules
• 52:40and with erratic scientific progress,
• 52:43and it it gives us. Oh, a wider awareness.
• 52:50Maybe understanding for the
• 52:53desperate search that we see all
• 52:56around us to find an easy fix.
• 52:59Thank you very much.
• 53:03Thank you so much, Professor Rogers.
• 53:08Before we get to an open discussion
• 53:10in the QA, we have one more speaker,
• 53:12professor John Harley.
• 53:13Warner is the Avalon Professor and
• 53:15Sheriff history of medicine here at
• 53:17Yale at the School of Medicine also is a
• 53:20professor of history, American studies,
• 53:21and history of Science and medicine.
• 53:23He teaches graduate medical,
• 53:24an undergraduate students.
• 53:25His research focuses on science,
• 53:27medicine and the health cultures from
• 53:29the 18th century through the present.
• 53:31It was John who I initially reached out
• 53:33to with this idea, and I should say,
• 53:36and I apologize again for not being here.
• 53:38To introduce all of this, but this was.
• 53:41This idea was hatched is being cosponsored
• 53:43from our program as well as the
• 53:45Interdisciplinary Center for bioethics,
• 53:46our sister program on the main campus,
• 53:48and in speaking with my counterpart
• 53:49over there, Steve Latham.
• 53:50We thought this would be a great thing to do,
• 53:53and I said,
• 53:54let me reach out to my friend,
• 53:56John Warner,
• 53:56who is got a handle on all of this stuff,
• 53:59and John was kind enough to recommend
• 54:00Joanna as our speaker and Naomi,
• 54:02and he also was kind enough
• 54:04to volunteer as a panelist.
• 54:05So John thank you so much for helping
• 54:07organize and we look forward to your
• 54:09comments before we get to the Q&A.
• 54:11John
• 54:11Warner. Sure, well I I did that,
• 54:14knowing that both Joanna and Naomi
• 54:17know much more about this than I do.
• 54:20But Joanna rating bukins her book ends or
• 54:23talk with the attempts to recover the 1918
• 54:26flu virus from the Alaskan permafrost.
• 54:30And it's a reconstruction in a CDC
• 54:33laboratory which I have to say really
• 54:36strikes me as something that has the
• 54:39makings of a Michael Crichton novel.
• 54:41And I for one, would love to hear more
• 54:45about the kinds of ethical debate sparked
• 54:48by the idea of bringing this virus from
• 54:51the past back into into our present world.
• 54:55There are a host of tantalizing springboards.
• 54:59In the presentation ranging from vaccines
• 55:02and human experimentation during the
• 55:05pandemic to the place of the movie theater,
• 55:08the pandemic was actually a major
• 55:10event in the development of
• 55:12the Hollywood film industry.
• 55:14But here I'd like to just focus
• 55:17on 1st the germ consciousness of
• 55:20Americans at precisely this moment.
• 55:22That is, in 1918.
• 55:24And then on the way,
• 55:27is that epidemiological change and
• 55:29historiographic change the ways
• 55:31that historians go about their
• 55:33business so often go hand in hand?
• 55:35And what different segment that makes a,
• 55:38especially as we revisit the 1918
• 55:41pandemic during the current one?
• 55:43Expanding on Joanne's question of
• 55:46what did Americans think they knew no?
• 55:50In 1918?
• 55:51It does matter that Americans in
• 55:541918 had a kind of lived experience
• 55:58with epidemics,
• 55:59and before the sulfa drugs of the
• 56:031930s and antibiotics in the 1930s,
• 56:06uh,
• 56:07close familiarity with deaths from
• 56:09infectious diseases like typhoid pneumonia.
• 56:12And and tuberculosis that in some ways
• 56:17does distance our world from theirs.
• 56:22But I think it's also important
• 56:25to underscore the extent to which
• 56:28the 1918 pandemic occur in the
• 56:30very midst of an aggressive,
• 56:33intensive,
• 56:33often sensationalized campaign to
• 56:35convert Americans to what one historian
• 56:38is called the Gospel of germs to
• 56:41transform vernacular ideological
• 56:43beliefs and also everyday behavior.
• 56:45This campaign was extraordinarily
• 56:48prominent in the public mind at the
• 56:51time that influenza for struck.
• 56:54So in the first instance,
• 56:56conversion to the Gospel of germs targeted,
• 56:59making the home into a germ proof fortress,
• 57:03a burden that very much felt
• 57:06heaviest on women.
• 57:07But Americans with privilege
• 57:09couldn't simply shelter in place.
• 57:12The new belief that individual germs like
• 57:15the tubercle bacillus cause deadly diseases,
• 57:19restructured their daily lives
• 57:21as they ventured into the risky
• 57:24environments in the workplace,
• 57:26the streetcar church, hotel or restaurant.
• 57:29After all,
• 57:30people with who were infected with
• 57:33tuberculosis and in 1900 tuberculosis was
• 57:36responsible for one in 10 American deaths.
• 57:40Infected people could long remain
• 57:42unmarked by their disease and
• 57:45circulate rather freely in public.
• 57:47This was also true of the then new
• 57:51new concept of the asymptomatic,
• 57:54healthy carrier.
• 57:55Like the Irish Cook, Mary Mallon,
• 57:58demonized as typhoid Mary.
• 58:00And in 1950 inches,
• 58:02three years before the epidemic
• 58:05condemned to lifelong origin.
• 58:08So early in the 20th century,
• 58:11the National Tuberculosis Association
• 58:13had launched the first Mass Health
• 58:16Education campaign in American history,
• 58:19appropriating very much appropriating
• 58:21the techniques and the visual culture of
• 58:25the newly emerging advertising industry.
• 58:27It's posters and billboards were
• 58:30heavy handed, but hard to miss,
• 58:33as were its traveling exhibits, plays,
• 58:36pageants and parades, including.
• 58:39And some of the parades elephants who were
• 58:42draped in the warning spit spreads death.
• 58:46It was ubiquitous.
• 58:47The Association joined with the American
• 58:50Red Cross in a Christmas Seal Campaign,
• 58:53which combined education, spectacle,
• 58:55and fundraising and also drew
• 58:58heavily from one other new medium
• 59:00for publicity and education,
• 59:02namely motion pictures.
• 59:04And in 1950s they began
• 59:07enlisting American children,
• 59:09over 7 million of them in a children's
• 59:13crusade against tuberculosis.
• 59:15So before 1918.
• 59:17Women were being counselled to wear
• 59:21washable gloves when they went shopping,
• 59:25as in a Good Housekeeping article from the
• 59:28time called a course in scientific shopping.
• 59:32Children were cautioned about the
• 59:34dangers of door knobs and paper money,
• 59:37and everyone was warned about this
• 59:40shared drinking Cup manufacturers
• 59:42and ad agencies promoted the germ
• 59:45theory by marketing consumer goods
• 59:47ranging from the germ proof pastor.
• 59:50Water filter,
• 59:51it had nothing to do with pastor
• 59:54to German sides like Listerine
• 59:57to the new Dixie Paper Cup.
• 60:00This was the moment went
• 01:00:02Protestant congregations rethought
• 01:00:03the shared Communion Cup,
• 01:00:05and when hotels first introduced
• 01:00:07new cakes of rap soap for each new
• 01:00:11guest at also extra long sheets that
• 01:00:14could be folded down on the blanket,
• 01:00:17the sheet was washed.
• 01:00:19The blanket you never knew,
• 01:00:21unchecked coughing and sneezing,
• 01:00:23and above all a spitting became
• 01:00:25Cardinal sins as fear of germs
• 01:00:28really fashioned a new kind of.
• 01:00:30Public health citizenship.
• 01:00:32Among African Americans at the time,
• 01:00:35tubercule death rates were as high
• 01:00:38as two to three times that of the
• 01:00:42native born affluent and white.
• 01:00:44But reassuring themselves that it's
• 01:00:47not about us was not a safe bet for
• 01:00:51those with privilege in the 19 teens,
• 01:00:55African American activist groups like
• 01:00:57the Anti Tuberculosis Association of
• 01:01:00Atlanta used a slogans like germs.
• 01:01:02No no color line,
• 01:01:04and the socialism of the micro to
• 01:01:07motivate white attention to the
• 01:01:10health needs of black neighborhoods
• 01:01:12with some success.
• 01:01:14Uh well in 1918 here in New Haven,
• 01:01:18middle class leaders of the
• 01:01:21largely segregated and impoverished
• 01:01:22Italian immigrant community,
• 01:01:24in which the influence adept sorry,
• 01:01:27the influenza death toll,
• 01:01:29was about twice that of
• 01:01:31the cities Anglo community.
• 01:01:34They successfully used influenza and its
• 01:01:37connection with more time patriotism
• 01:01:39to advance the simulation and to
• 01:01:42uplift the image of the immigrant community.
• 01:01:46Among outsiders For our students,
• 01:01:49many of them who are attracted
• 01:01:52to the history of Medicine.
• 01:01:54The first place by what they
• 01:01:56see as its activist,
• 01:01:58potential,
• 01:01:58and acutely mindful of the ways that
• 01:02:01COVID-19 has brought into sharp relief.
• 01:02:03Or I should say public relief
• 01:02:06because we knew this all the time.
• 01:02:08But the way that weighs the Covid has
• 01:02:11brought into sharp relief disparities
• 01:02:13rooted in structural racism,
• 01:02:15inadequate public health infrastructure,
• 01:02:17and for so many.
• 01:02:18Broken health care system for our students.
• 01:02:22Progressive Era examples like these
• 01:02:25are suggestive of how perhaps fear
• 01:02:28of germs today might possibly be
• 01:02:31placed in service of social justice.
• 01:02:34The other thing that I just point
• 01:02:37to hear sort of echoing Naomi
• 01:02:40on remembering and forgetting.
• 01:02:43Went to the way that disease in
• 01:02:46the present changes the ways that
• 01:02:48historians right about the task
• 01:02:51and relate that them both to the
• 01:02:53future and nowhere in my lifetime.
• 01:02:56More so than with the case of HIV aids.
• 01:03:00The early 1980s there was really a
• 01:03:03frenzied race among historians to find
• 01:03:07telling models in epidemics like plague,
• 01:03:11Cholera, and yellow fever.
• 01:03:13By the 1990s,
• 01:03:15these epidemic models were losing
• 01:03:18their purchase as HIV aids was being
• 01:03:22reconceptualized as a chronic disease.
• 01:03:25It all prompted one historian of aids
• 01:03:27to suggest to me at the time that just
• 01:03:31suggested that Satiana got it wrong.
• 01:03:34Got it wrong in saying those who cannot
• 01:03:37remember the past are condemned to repeat it.
• 01:03:40Instead,
• 01:03:40as he proposed to me,
• 01:03:42those who do remember the past are
• 01:03:45condemned to make the wrong comparisons.
• 01:03:49Still,
• 01:03:49aids did transform not only the
• 01:03:52writing but teaching of medical
• 01:03:54history and COVID-19 will do the same.
• 01:03:57Many of our students were not born yet.
• 01:04:01By the early years of HIV aids,
• 01:04:05but an here's sort of echo and Joanna on
• 01:04:09her course on the history of global health.
• 01:04:14Covid will be a formative
• 01:04:16experience in each of their lives.
• 01:04:20The anxieties that animated the
• 01:04:22crusade against tuberculosis before
• 01:04:25they packs antibiotic A and the masks.
• 01:04:28Handkerchiefs and social distancing of
• 01:04:301918 will be newly legible to them,
• 01:04:34and the questions that the
• 01:04:36present inspires about the past,
• 01:04:39I think, will change yet again,
• 01:04:41if the current pandemic fades,
• 01:04:44but endemic infection lingers.
• 01:04:46Uhm,
• 01:04:47I will start with that other than to
• 01:04:50say that this is one reason why I'm
• 01:04:53so looking forward to the discussion
• 01:04:55and to the kinds of questions that
• 01:04:58might help inform the new historical
• 01:05:01investigations that are sure to come.
• 01:05:03I'm especially eager to hear what
• 01:05:06residences and also dissonances
• 01:05:07reflecting your reflecting on 1918
• 01:05:09bring to mind about our present moment,
• 01:05:12and I will start with that.
• 01:05:15Thank you so much John.
• 01:05:17I'm I'd like to invite you now folks.
• 01:05:19Uh, if we have we got a hard stop
• 01:05:21at 6:30 so we have 20 minutes for
• 01:05:24conversation and the way that conversation
• 01:05:26will work please is with the Q&A.
• 01:05:29Nothing joann up as well.
• 01:05:31There we go and with the Q&A bar
• 01:05:33at the bottom of your screen.
• 01:05:36You can ask a question and I will
• 01:05:38relate that to the speakers so you can
• 01:05:40identify speaker you'd like to address
• 01:05:42it to or address it to to all of them,
• 01:05:44and then we'll see who wants to respond.
• 01:05:46And while we're waiting for that,
• 01:05:48I do have one thing that came to the chat,
• 01:05:50which I would share with the group
• 01:05:52was simply it was a question about how
• 01:05:54long did the quarantine in the 1918 flu
• 01:05:56last and where this was their parallel
• 01:05:58unrest to what we're seeing today.
• 01:06:02From what I can say is, uhm.
• 01:06:06The quarantine situation is somewhat
• 01:06:08different than what we're dealing with now,
• 01:06:11but there were some groups that,
• 01:06:14um anti anti masking group some like
• 01:06:17today of groups of people that were for
• 01:06:20the same reasons you know not interested
• 01:06:23in in wearing masks and Proton protested.
• 01:06:26I would be mindful of in this case drawing
• 01:06:29too strong of a parallel in terms of the
• 01:06:33political divides in which that breaks out.
• 01:06:36Today, um, but just to say that,
• 01:06:39um, to the points that were made
• 01:06:42about the way that a 1918 helps us
• 01:06:45understand different kinds of public
• 01:06:47health practices in ways that people
• 01:06:50were instructed by public health
• 01:06:53officials to protect themselves,
• 01:06:54that there were, you know, this.
• 01:06:58There was resistance and people
• 01:07:01were not content to follow those.
• 01:07:04Follow those guides Naomi you
• 01:07:06wanted to add anything.
• 01:07:09Uhm, no I I think it's right
• 01:07:13to Quarantine the porn.
• 01:07:16Teens were very much determined by local
• 01:07:19mayors and local public health officials.
• 01:07:23As far as I'm, I'm mostly aware uhm,
• 01:07:27and they varied usually come in terms of
• 01:07:30months that that was my understanding.
• 01:07:32There's been some interesting work recently
• 01:07:35to look at the rates of the pandemic.
• 01:07:38Depending on the numbers of months
• 01:07:41that individual communities had,
• 01:07:42but it seems to me that there are
• 01:07:46actually a lot of variables that go
• 01:07:48into that that may be over and above.
• 01:07:52Simply the actual number of days.
• 01:07:54So there's a lot more that
• 01:07:57we that we need to
• 01:07:59understand. There I would just the only
• 01:08:02thing I would add is the quarantine was
• 01:08:05so variable from one city to another
• 01:08:08city and also one of the problems with
• 01:08:11with Corentin and something that really
• 01:08:14different separate things from today is.
• 01:08:16There was no test for the flu and a
• 01:08:20repeated question was how do you go
• 01:08:23about distinguishing the common cold.
• 01:08:25From what something that is developing
• 01:08:29into the flu and how do you arbitrate
• 01:08:33Corentin Corentin with that?
• 01:08:36Just on the question of resistance.
• 01:08:39I think that they they, uh,
• 01:08:42example of San Francisco is,
• 01:08:45perhaps instructive here that at
• 01:08:47first people vary widely warm.
• 01:08:49Ask voluntarily.
• 01:08:50It was a recommendation from the
• 01:08:53health Department and people did it.
• 01:08:56They got tired of that.
• 01:08:58And so by the 2nd wave there was
• 01:09:01an Anti Mask League formed in San
• 01:09:05Francisco protesting against the
• 01:09:07pressures to continue with that.
• 01:09:11Joanna, in line with that
• 01:09:13or or perhaps interview.
• 01:09:14So I wonder, was there?
• 01:09:16I think there is now and
• 01:09:18I'm wondering about then.
• 01:09:19I think there are believers and nonbelievers,
• 01:09:21and I apologize if you
• 01:09:23touched on this before.
• 01:09:24I was able to join in terms in
• 01:09:26the basic science at stake here,
• 01:09:28so some people I would imagine
• 01:09:30there were far more people.
• 01:09:32I mean, I'm thinking of relatives
• 01:09:34of mine from not that long ago.
• 01:09:36I think that there were people who weren't
• 01:09:38really buying into the germ theory.
• 01:09:40In general, I wonder.
• 01:09:41If that was a common phenomenon
• 01:09:43back then that that some
• 01:09:45of the folks who resisted,
• 01:09:46for example wearing masks or quarantine,
• 01:09:48simply didn't buy into the didn't,
• 01:09:50didn't buy into the science behind it,
• 01:09:52such as it was.
• 01:09:54Yes. The simple question I did I
• 01:09:58did I did address it, but you know,
• 01:10:01the germ theory was as I said,
• 01:10:04relatively knew back then an what
• 01:10:06I think is apropos of the comments
• 01:10:09that John and Naomi gave particularly
• 01:10:11Naomi's comments about forgetting.
• 01:10:14Until you know a few until this year,
• 01:10:17the 1918 flu was also known
• 01:10:19as the forgotten pandemic.
• 01:10:21And when you know I talked,
• 01:10:24I've taught it before the students.
• 01:10:26You know I have to thread a fine line
• 01:10:29because they start to say Oh well,
• 01:10:32you know they didn't understand virology,
• 01:10:34they just didn't embrace the germ theory.
• 01:10:36But we know better now and I think
• 01:10:38that we see that theory is that, UM,
• 01:10:41many of us are had may be taken for
• 01:10:44granted as being kind of accepted.
• 01:10:46The RR.
• 01:10:47There are a lot of reasons why we're
• 01:10:50kind of struggling to persuade,
• 01:10:53or um, were struggling with questions
• 01:10:55of belief as you put it,
• 01:10:57which is something that is
• 01:10:59very uncomfortable.
• 01:11:00For those of us who are participants
• 01:11:02in a techno scientific culture
• 01:11:05and medical culture,
• 01:11:06and I think this is something that
• 01:11:09should make us think differently about.
• 01:11:12How we imagine, um,
• 01:11:14our authority as UM medical
• 01:11:17professionals and allied professionals.
• 01:11:21And I think I would actually like
• 01:11:24to add to that that now when you
• 01:11:27see so often UM in social media,
• 01:11:30you see pictures from 1918 of people
• 01:11:33wearing masks and the idea is that
• 01:11:36that sure is supposed to make an
• 01:11:38old fashioned disease look familiar,
• 01:11:41even sort of modern, right?
• 01:11:43They did it net. Then we're doing it now.
• 01:11:47It's a standard public health response
• 01:11:49or whatever kind of sort of lesson
• 01:11:52were supposed to draw from that.
• 01:11:55I think that it it may potentially
• 01:11:58make it easier for us to say,
• 01:12:00let's think about what it is that
• 01:12:03people believed in the heads of those
• 01:12:06people who who are wearing those mess.
• 01:12:09So the heads of the people who were
• 01:12:12refusing to wear those masks in a way
• 01:12:16that is both very contemporary and
• 01:12:18historical and just to pick up one
• 01:12:21of the questions that also asks about
• 01:12:24the disparities during the pandemic,
• 01:12:26for example between.
• 01:12:28Italian immigrant communities and
• 01:12:31white communities in New Haven.
• 01:12:34For example.
• 01:12:35I think the pandemic in 1918,
• 01:12:39just like covid,
• 01:12:41absolutely highlighted profound
• 01:12:43disparities in health and living conditions
• 01:12:48that had existed long before 1918.
• 01:12:51Um,
• 01:12:52and certainly meant that there
• 01:12:55were people who were vulnerable.
• 01:12:59One of the things that is strikingly
• 01:13:02interesting from a star called point of
• 01:13:06view about 1918 is that even if you were.
• 01:13:10Really quite healthy.
• 01:13:12You still were at very significant
• 01:13:16risk of dying from the 1918 virus,
• 01:13:19so there's still some very
• 01:13:22interesting questions about that.
• 01:13:24Thank
• 01:13:25you. I have some questions from the audience.
• 01:13:29Put this out to whoever would like
• 01:13:32to respond question about animal
• 01:13:34origins and virus in humans.
• 01:13:36How should we think about pandemics
• 01:13:39and human susceptibility to social
• 01:13:41crises as connected to changing
• 01:13:43relations to uses to an uses of animals?
• 01:13:46Yeah, I'm happy to feel that one.
• 01:13:49I think that's a really interesting question.
• 01:13:52On the one hand, right we.
• 01:13:55There's some. A lot of, uh,
• 01:13:59interest in this process of Zoo Gnosis,
• 01:14:01right? Uhm agents,
• 01:14:03that kind of jump from non human to human
• 01:14:06or could certainly go the other way.
• 01:14:09and David Quammen has an excellent book on
• 01:14:12that subject on the question of Zoo Gnosis.
• 01:14:16But I do think you know it's hard to
• 01:14:19answer this in a comprehensive way.
• 01:14:22I'm a historian, not a scientist,
• 01:14:24but I certainly think that
• 01:14:26we need to understand.
• 01:14:28When we're talking about structural factors,
• 01:14:30not just the ways that you know
• 01:14:32this viral agent functions,
• 01:14:34you know in a Petri dish,
• 01:14:36but to think about, you know,
• 01:14:38are there conditions and ways in
• 01:14:40which we are as a human species.
• 01:14:43You know,
• 01:14:44shifting in our relations with
• 01:14:45animals in terms of urbanization,
• 01:14:47in terms of factory farming,
• 01:14:49which I think is kind of what you
• 01:14:52have in mind that are also mirrored,
• 01:14:55I think there's something interesting
• 01:14:57to an important to explore.
• 01:14:59About humans relationships with non humans.
• 01:15:01Also mirroring an being an entangled
• 01:15:03with different kinds of susceptibility.
• 01:15:05To these to these emerging agents
• 01:15:08you can put this in a kind of like
• 01:15:11evolutionary framework and I think we
• 01:15:14see it's not just you know nature,
• 01:15:16red in tooth and claw.
• 01:15:18We see humans making choices
• 01:15:20even if they don't realize their
• 01:15:23choices about how they want to live
• 01:15:26in relation to non humans.
• 01:15:27And there certainly consequences and.
• 01:15:29As I'm talking,
• 01:15:30I know this isn't exactly what you mean.
• 01:15:33Uhm Jennifer, but um,
• 01:15:35I'm thinking about the, UM,
• 01:15:36the outbreaks that have happened in meat
• 01:15:39processing plants in the United States.
• 01:15:41And you know,
• 01:15:42the ways in which the conditions,
• 01:15:44even in which we prepare animals to eat,
• 01:15:47which is different,
• 01:15:48perhaps than what you're talking about,
• 01:15:50but become really intense
• 01:15:52spaces of susceptibility,
• 01:15:53and it should make us think about, you know.
• 01:15:57Again, like our relations,
• 01:15:58not even just to each other as fellow humans,
• 01:16:02but our relations to the
• 01:16:04animals that we rely on.
• 01:16:06So I think that question, um,
• 01:16:08it's one that, you know, can't?
• 01:16:10I can't perhaps definitively answer,
• 01:16:12but I certainly think it's one that you know,
• 01:16:16bioethicists have.
• 01:16:17It's an exciting domain of place of places
• 01:16:20to investigate and think more about.
• 01:16:23That's something that that hopefully
• 01:16:25in the coming year we're going to
• 01:16:28get a chance to look into a bit
• 01:16:30as well as the ethics program for
• 01:16:32Biomedical Ethics will move on,
• 01:16:34hopefully in person, if not on the screen,
• 01:16:37and that's certainly a fertile
• 01:16:38area for discussion.
• 01:16:39Another question here, please,
• 01:16:41how do you understand the current
• 01:16:43racial unrest and the covid pandemic?
• 01:16:45What are the parallels with
• 01:16:46history in the 1918 flu?
• 01:16:48And what are Rd Maps forward for us?
• 01:16:56John, you look like you were inhaling to
• 01:17:00prepare to speak, oh.
• 01:17:02It's a broader morning, so no,
• 01:17:05maybe let me comment on 1918 and then we can.
• 01:17:10We can get to now a couple of
• 01:17:13things were seemed to have been odd
• 01:17:16about the 1918 epidemic pandemic.
• 01:17:19One is that the kind of nativist
• 01:17:22and racist scapegoating that as
• 01:17:25historians we so associate with
• 01:17:27certainly 19th and 20th century,
• 01:17:29and you can extend this now.
• 01:17:32The kind of blame that you find in
• 01:17:37epidemics was remarkably muted in 1918.
• 01:17:4211 explanation for this or the
• 01:17:46main explanation is a shared sense
• 01:17:50of purpose in the middle of war.
• 01:17:54The other odd thing that has been
• 01:17:57suggested about the 1918 epidemic,
• 01:18:00which really separates it from now,
• 01:18:04is that actually the death rate
• 01:18:07among African-American seems
• 01:18:09to have been lower than 4.
• 01:18:12And for the rest of the population,
• 01:18:15which is completely non intuitive to me,
• 01:18:18although I think now we could
• 01:18:21find similar patterns in.
• 01:18:22Classic inferential's in the 1916
• 01:18:25polio epidemic that just preceded this
• 01:18:29I don't know a good explanations,
• 01:18:32but certainly one suggestion that
• 01:18:34has been posited is that it was
• 01:18:38precisely the greater vulnerability
• 01:18:41of African Americans to infection
• 01:18:44that perhaps they were more infected
• 01:18:47in the mild first wave,
• 01:18:50and therefore had some resistance.
• 01:18:53Collectively, when the 2nd wave came.
• 01:18:56But I would love to.
• 01:18:59I would love to know more from
• 01:19:02people who know
• 01:19:03the biology there.
• 01:19:04I actually would want to add an
• 01:19:06interesting historical note,
• 01:19:08which is actually something
• 01:19:10that I think is strange.
• 01:19:12Have not really looked at,
• 01:19:14so there was very profound racial and
• 01:19:18ethnic tensions right after the First World
• 01:19:21War are in a lot of race riots in 1919.
• 01:19:24Uhm, and these certainly have
• 01:19:27been studied in some ways as.
• 01:19:29Perhaps um, response to labor policies or
• 01:19:33economic shifts during and after the war.
• 01:19:37But historians have not
• 01:19:40really thought about well,
• 01:19:42what did they have to do
• 01:19:46with the pandemic as well,
• 01:19:49like where there are interlocking factors
• 01:19:52there that raised certain additional
• 01:19:55tensions in particular African American and.
• 01:19:59Immigrant community,
• 01:20:00so we don't actually know
• 01:20:02the answer to that question,
• 01:20:05but I think that simply just
• 01:20:07thinking about this past week
• 01:20:10makes me also start to wonder.
• 01:20:12Had there been a number of other
• 01:20:15kinds of moments that historians have
• 01:20:18not sort of taken seriously enough?
• 01:20:22Uhm, I think that's a really great
• 01:20:24point and it gets at one of the things
• 01:20:27that John was trying to articulate
• 01:20:29in his comment about the way history
• 01:20:33historians attempt to make sense
• 01:20:34of the past is often divided up,
• 01:20:37and I think what I hope and outcome of
• 01:20:40the time we're living in now is that
• 01:20:43historians that they are working on
• 01:20:45civil rights or political history will
• 01:20:48recognize that medicine and pandemics
• 01:20:50in history of biology are actually.
• 01:20:52Really powerful lenses that they can
• 01:20:54also be paying attention to to recognize
• 01:20:57that various kinds of social history
• 01:20:59also have kind of biological material,
• 01:21:01embodied origins.
• 01:21:02and I wanted to add to those excellent
• 01:21:04comments, one that I think gets
• 01:21:07at some of the questions.
• 01:21:09A thread that I'm seeing happen in some
• 01:21:11of the questions that are appearing.
• 01:21:14Someone asked a question about,
• 01:21:15you know,
• 01:21:16are there parallels between things
• 01:21:18like hurricanes and stuff like that?
• 01:21:20and I think that's a really
• 01:21:22great question because.
• 01:21:23One thing we shouldn't do is
• 01:21:26fall into the trap.
• 01:21:27Uhm,
• 01:21:28I think John points out as well
• 01:21:30of imagine of the only parallel
• 01:21:33historical parallel for the current
• 01:21:35moment is a previous pandemic.
• 01:21:37There's enormous amounts to learn,
• 01:21:39but I'm thinking of the way in which
• 01:21:42some scholars talk about things.
• 01:21:44Um,
• 01:21:45events like Katrina as an unnatural
• 01:21:47disaster in the sense that just as the way
• 01:21:51that covid involves a virus that's not.
• 01:21:53Human origin it comes,
• 01:21:55it collides with all kinds of
• 01:21:58systemic and structural forces
• 01:22:00that have disproportionate effects.
• 01:22:03It's like, you know,
• 01:22:05disaster might unfold in a
• 01:22:08particular kind of way,
• 01:22:10but differently based on the circumstances,
• 01:22:13the vulnerabilities that access to resources,
• 01:22:16the forms of social cohesion or otherwise.
• 01:22:20and I think that there are
• 01:22:23a number of really.
• 01:22:25Important kinds of places
• 01:22:27we could be looking for.
• 01:22:29Historical perspective.
• 01:22:30Beyond the pandemic,
• 01:22:31I think about,
• 01:22:33you know,
• 01:22:33work by Scott Knowles who's done
• 01:22:36work on disasters on Eric Kleinman
• 01:22:39Klingenberg on the Chicago heat wave,
• 01:22:42and the ways in which he demonstrates it
• 01:22:45was really about social isolation that
• 01:22:48lead to more extreme forms of death.
• 01:22:51and I think we're certainly seeing
• 01:22:54that COVID-19 Isn't especially
• 01:22:55its impact in the United States
• 01:22:57is A is an unnatural disaster
• 01:22:59involving a biological agent,
• 01:23:01especially when you when you
• 01:23:03know when we see that the death
• 01:23:06rate in the US is so much higher
• 01:23:08so quickly we have the benefit,
• 01:23:11for better or worse of the world as
• 01:23:13a global lab to compare and see what
• 01:23:16other kinds of practices have been used,
• 01:23:19whether kinds of social configurations
• 01:23:21have been used and you know,
• 01:23:23of course, there's been a lot of.
• 01:23:25Politicization of these different techniques,
• 01:23:27but I certainly think that we
• 01:23:30will miss a tremendous amount if
• 01:23:32we only focus as the scientists
• 01:23:35that I was trying to talk about,
• 01:23:38that were uncovering the tissue
• 01:23:40from the from the permafrost that
• 01:23:43they imagine all the answers
• 01:23:45to the lethality of
• 01:23:47this thing we call covid can
• 01:23:49be found within a kind of piece
• 01:23:51of protein that is maybe not.
• 01:23:54You know, alive or an alive.
• 01:23:56Endows the virus with entirely
• 01:23:59too much agency an excuse is
• 01:24:02the culpability of a wide range
• 01:24:05of actors. If
• 01:24:06I can just jump in, this is a very
• 01:24:10quick comment tu and another question
• 01:24:13that sort of follows from that,
• 01:24:15which is what about the question
• 01:24:18international cooperation?
• 01:24:19So because the the influence of the Spanish
• 01:24:22pandemic arrived during the First World War,
• 01:24:25although it ended after the war had ended.
• 01:24:29There were many countries.
• 01:24:30That of course were indeed at war with
• 01:24:34each other, and so while there was some.
• 01:24:37Exchanged information there
• 01:24:38wasn't a great deal.
• 01:24:40Um, but um, after the war ended
• 01:24:44and a pandemic ended up buying
• 01:24:471920 by the end of 1920,
• 01:24:49there was a major effort by a
• 01:24:52public health officials around the
• 01:24:54Western World to come together
• 01:24:57as part of the League of Nations,
• 01:25:00and they found that the League
• 01:25:03of Nations Health Organization,
• 01:25:05which historians have really
• 01:25:07seen as a kind of sort of.
• 01:25:10Pre World Health Organization and the
• 01:25:12model was that every single country
• 01:25:15should have uh officials there who work
• 01:25:17with each other and help each other
• 01:25:20during any other kinds of outbreaks.
• 01:25:22So that was actually one of
• 01:25:25the results of the pandemic.
• 01:25:27And as I pointed out in
• 01:25:29the lecture, the US never joined well. We
• 01:25:32didn't join the League of
• 01:25:34Nations either. Yes, OK,
• 01:25:36a couple of quick things
• 01:25:38'cause our time is nearly up.
• 01:25:40I have a. A short question.
• 01:25:42Uhm and then a final question
• 01:25:44I think is interesting.
• 01:25:45So the short question is this.
• 01:25:47From someone in the audience which
• 01:25:49was did Woodrow Wilson wear a mask?
• 01:25:53I don't know,
• 01:25:54we don't know. You're muted near
• 01:25:59me. I don't know either,
• 01:26:02but I will say that by
• 01:26:05the time the pandemic it,
• 01:26:08um Woodrow Wilson, was pretty sick.
• 01:26:11And, um, he sort of largely
• 01:26:14disappeared from public view.
• 01:26:16And, uh, so it's possible that he
• 01:26:18really sort of wasn't interacting at
• 01:26:21all in any kind of public space at that
• 01:26:24time I see, and it would just to
• 01:26:27underscore John's point about mass media.
• 01:26:30You know, it's a relatively recent
• 01:26:33phenomenon that we would have such a.
• 01:26:36Telegenic you know political leader
• 01:26:38that you would be expected to, you know,
• 01:26:41sort of see them appear in this way.
• 01:26:44So it's an interesting question,
• 01:26:46but it perhaps wouldn't
• 01:26:47carry the same kind of.
• 01:26:51In food. Yeah, I
• 01:26:53see one last question.
• 01:26:55If I could please from Steve Latham,
• 01:26:58the director over the International
• 01:27:00Interdisciplinary Center for bioethics.
• 01:27:01Steve notes that we've seen some in quotes,
• 01:27:04a pandemic exceptionalism in covid,
• 01:27:06meaning permitting research to be
• 01:27:08conducted in unorthodox ways and
• 01:27:10permitting publication of research
• 01:27:12results before peer review.
• 01:27:13And we've already seen some
• 01:27:15disastrous results from this crisis
• 01:27:17driven loosening of standards.
• 01:27:19Did anything similar happen in 1918?
• 01:27:23Well,
• 01:27:23it's a really. It's a great
• 01:27:25question and it gets to the heart
• 01:27:26of a lot of the most important
• 01:27:28bio ethical issues that are happy.
• 01:27:32Now Joanna is frozen on my screen
• 01:27:35and she throws it on Yours, John.
• 01:27:38Yes, she is.
• 01:27:39There was a time when there were not.
• 01:27:42Frozen on my screen, that's
• 01:27:43not good. Now you're moving on ours.
• 01:27:45We can hear you you're good now
• 01:27:48if you could speak Joanna will
• 01:27:49if you could you give us a short
• 01:27:52answer to that. Be great, Nope.
• 01:27:56Are we back?
• 01:27:57Yeah, keep going,
• 01:27:58be quick for you, go again.
• 01:28:01Um, I'm gonna keep going.
• 01:28:02I don't know if you can hear.
• 01:28:05The whole thing is
• 01:28:07crashing, um, just to say it was a
• 01:28:09very different research culture that
• 01:28:11we didn't have the kind of informed
• 01:28:14consent there were not I Arby's.
• 01:28:16Even the concept of the scientific
• 01:28:18Journal was a different state
• 01:28:20of its emergence. So you know,
• 01:28:22it's a really hard question to ask,
• 01:28:25especially when we're thinking about.
• 01:28:26As I said before,
• 01:28:28that the germ theory was still,
• 01:28:30you know, coming into existence.
• 01:28:32It wasn't the dogma that it
• 01:28:34assumed that it was assumed.
• 01:28:36I am, you know,
• 01:28:37the Golden Age of Medicine when we
• 01:28:39give antibiotics and it was also
• 01:28:41a time when I think you have lots
• 01:28:44and lots of people peddling various
• 01:28:46kinds of you know false cures.
• 01:28:48So you see doctors sort of just saying,
• 01:28:51oh it will match up this vaccine
• 01:28:53and will try it.
• 01:28:54So I think that you know if
• 01:28:57you kind of scratched it,
• 01:28:58that's cab you're going to find
• 01:29:00lots and lots and lots and lots
• 01:29:02of examples of practice and
• 01:29:04handling of scientific expertise
• 01:29:05that would not pass muster.
• 01:29:08Even under the relaxed standards of today.
• 01:29:10But I also think that John's
• 01:29:12point about the aids epidemic.
• 01:29:15We have to remember the way that
• 01:29:17activists were really crucial in
• 01:29:19creating new kinds of pathways for
• 01:29:21research on vaccines in therapy.
• 01:29:24So push the establishment.
• 01:29:25I think it's a question that's
• 01:29:28really hard to answer in Toto,
• 01:29:30but I think it would be a great
• 01:29:33subject for a subsequent seminar
• 01:29:35and love to be apart of it.
• 01:29:38With that, I think the hours a promise.
• 01:29:40I certainly want to thank professor
• 01:29:42Joyner Aiden and they only Rogers and
• 01:29:44John Warner for a terrific evening.
• 01:29:45I want to thank everybody listening for
• 01:29:47joining in, and for your patience with
• 01:29:49our technical my technical difficulties.
• 01:29:51By the way, the ultimate cure
• 01:29:52for those of you who want to tip,
• 01:29:54which is what my wife was an engineer.
• 01:29:57She's not here with me now and tell me,
• 01:29:59is I turned it off and turn it back on again.
• 01:30:02And then it works.
• 01:30:03But there was more to it than that.
• 01:30:06Thanks to Sam Nitsch and others
• 01:30:07who helped me out.
• 01:30:08But listen, this is going to be our
• 01:30:10last session for the program for
• 01:30:12Biomedical Ethics for this academic year,
• 01:30:14but will be doing more starting in September,
• 01:30:16either online or hopefully we can all gather.
• 01:30:18I look forward to the time we can gather,
• 01:30:21and Joanna.
• 01:30:21Thank you so much for a really ending.
• 01:30:23A very difficult year.
• 01:30:25On a high note in terms of
• 01:30:27the quality of the work.
• 01:30:28Thank you so much.
• 01:30:30Alright, Yes,
• 01:30:31thank you Joanna.