1918 All Over Again?

November 9, 2005
By Gene C. Gerard

Last week President Bush put forward a program to prepare for the eventuality of a bird flu pandemic. In his comments Mr. Bush noted, "If history is our guide there's reason to be concerned." In fact, the influenza pandemic of 1918 is a model for what we are likely to face with the bird flu. And unless the Bush administration responds more boldly we will relive the 1918 pandemic, only this time it will be worse.

The pandemic of 1918 is believed to have killed 675,000 Americans, more than the American casualties of World War I, World War II, the Korean War, and the war in Vietnam combined. It's estimated that the current flu strain would kill millions of Americans. Dr. Michael Osterholm, an epidemiologist at the University of Minnesota, has called the bird flu pandemic "the single greatest risk to our world today." Considering the potential fatalities, the $7.1 billion that Mr. Bush has requested to combat a potential pandemic is woefully inadequate.

Over $300 billion has been funded to date to fight the war in Iraq. The Pentagon is spending more than $10 billion to research and develop a ballistic missile defense system that many experts have said will not even be effective. And the Pentagon spent $4.5 billion this year to study the possibility of designing a new tactical aircraft. It's clear that the budget priorities of the Bush administration are seriously askew.

The bird flu strain is believed to be nearly identical to the virus that caused the influenza pandemic of 1918. Typically, a flu virus destroys the cells lining the upper respiratory tract, resulting in its victims succumbing to pneumonia. However, the flu in 1918, which originated in birds on the Kansas plains, destroyed the tissue of the lungs. This prompted an immune response reaction in which the lungs filled up with secretions, drowning those infected. Virologists believe the bird flu strain operates in the same manner.

Of the $7.1 billion that Mr. Bush has proposed spending on pandemic preparedness, $1.2 billion has been slated to purchase enough vaccine to inoculate 20 million Americans. But this would only protect 14 percent of the nation. The administration proposes spending another $2.8 billion to develop a vaccine against the bird flu once it mutates into a virus capable of directly infecting humans.

The goal is to produce enough vaccine for every American within six months of a pandemic outbreak. Yet Dr. Margaret Chan, the director of pandemic flu preparedness for the World Health Organization, recently cautioned that there would only be at best three weeks to contain a local outbreak before it begins to spread globally. And Secretary of Health and Human Services Michael Levitt has admitted that it will not be feasible for the government to create a significant number of vaccinations until 2010.

The administration proposes spending $1 billion to stockpile anti-viral drugs. The administration believes these drugs might lessen the length and severity of a flu infection. But the Director of the Centers for Disease Control and Prevention, Julie Gerberding, contradicted this assertion, stating, "There is no evidence that it will make a difference if we are hit with a pandemic." It make's more sense to put this funding toward purchasing or developing vaccines.

A bird flu pandemic is a threat to the armed services and our national security. Since soldiers are serving an average of two tours of duty in Iraq they would almost certainly carry the bird flu to the Middle East. In 1918 it was soldiers serving in World War I who brought the virus to Europe. And because they lived in close quarters, as they do today, a disproportionate number of soldiers died in 1918 and 1919.

The influenza pandemic of 1918 first appeared at Fort Riley, Kansas when an Army cook reported to the infirmary with head and muscle aches, a sore throat, and fever. Later that same day over 100 soldiers were complaining of similar symptoms. Within a week over 500 soldiers at Fort Riley had come down with the flu.

In September 1918 Dr. Victor Vaughn, the Acting Surgeon General of the U.S. Army, visited an Army base near Boston to access the pandemic. He found "hundreds of young men in uniform coming into the wards of the hospital. A cough brought up the blood-stained sputum. In the morning, the dead bodies are stacked about the morgue like cordwood." Today, sick and weakened soldiers in Iraq would be much more vulnerable than they already are.

The program that President Bush put forward is inadequate at best. The budgetary priorities of the administration should be shifted such that significantly more funding is allocated to prepare for the coming pandemic. Richard Falkenrath, a former advisor to the Homeland Security Department, recently noted, "A flu pandemic is the most dangerous threat the United States faces today. It's a bigger threat than terrorism." The Bush administration must act accordingly.

Gene C. Gerard taught history, religion, and ethics for 14 years at several colleges in the Southwest, and is a contributing author to the forthcoming book Americans at War, by Greenwood Press. His previous articles have appeared in Intervention Magazine, The Free Press, Political Affairs Magazine, Alternative Press Review, Impact Magazine, and The Palestine Chronicle.