The Never Ending Story of the 1918 Pandemic

July 23, 2020

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Joanna Radin, PhD

June 2, 2020

ID5414

To CiteDCA Citation Guide

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.