Conditions right for the perfect pandemic: virulent flu, anti-science culture and politics

The woman who would have been my grandmother died in the devastating Spanish influenza epidemic. But it wasn’t just the disease that killed her. A rigid field that changed little since the time of the Greeks, combined with a populist rejection of the use of science in medicine, helped create the perfect pandemic, which took more lives than any disease in human history.

This isn’t some anti-religion screed. If you spoke with pastors from that era, you might find they faced some of the same criticism as doctors of the day, or scientists, or even lawyers. That’s because we can think of that 19th century in America as an interesting mix of traditionalism and populism. It was a time when a new way of thinking was hotly resisted because it clashed with the way things were always done. And populism was always there to provide a more simplistic source of blame and a solution that may well be worse than the problem itself.

Believe it or not, the field of medicine had changed little since the time of Hippocrates. While other fields began to adopt a more scientific approach to study problems, medical colleges stubbornly resisted such an approach. You didn’t need to take biology, chemistry, physics, or any other science before going to most medical schools. You didn’t even have to pass all of your exams, or interact with patients, or even visit a hospital. As long as you passed a slim majority of exams and could afford medical school, you could become a doctor.

While the Europeans slowly began to develop laboratories and medical universities, and conduct research in the 1800s, the American medical establishment stubbornly resisted such advances. One historian documents how a prominent faculty member at a prestigious college objected to the new university president pushing for written exams, as many of the would-be doctors were illiterate.

Scientists of the 1800s were able to find fault with traditional medical practices. But before they had a chance to demonstrate how science could produce cures and vaccines, they were shoved aside by populists, who might blame just about anyone for the spread of a disease. This is the era of the Klan and Know-Nothings, and others who needed little provocation to grab a pitchfork, and light the torch. Immoral hucksters might prescribe morphine and quinine for anything, or any elixir they could concoct that appeared to provide some relief.

As a result of this, Americans began to (often understandably) reject anything related to medicine. It was an era when people saw themselves as the center of the universe, when real education, experience and rigorous study were scorned in favor of homespun advice and remedies. Often, the response to disease was “do nothing” and let nature take its course.

As you can see, this had tragic results when the Spanish influenza struck America and the world with a vengeful furry, killing more in 24 weeks than AIDS killed in 24 years. Unlike most diseases, this one took most victims in their 20s and 30s (one young character from the hit PBS series “Downton Abbey” also tragically perishes). A handful of doctors, a few women and men, some from academia and others from the military, were only able to stem the tide with the application of the best scientific principles that could be mustered. Thanks to what we learned, America amazingly surpassed even the Europeans in medical discoveries and knowledge, when the scientific approach was finally embraced.

What might happen today? Certainly, we’ve come a long way, but with the presence of anti-vaxxers, public mistrust of scientist driven by politics, and some degree of traditionalism that pervades some medical practices, who knows? But today’s shocking influenza outbreak, and a potential Asian flu pandemic, will test us as the Spanish flu of the 1918-1920 did.

This story was originally published January 26, 2018 at 1:13 PM with the headline "Conditions right for the perfect pandemic: virulent flu, anti-science culture and politics."