Swine Flu

I did not have the great year 2000 flu when I began her book. I did not have it when I was finished. But shortly after I spoke with her (by phone), the flu struck. I don’t believe the book made me sick. But I now recall certain passages such as: “William Sproat thought little of the attack of diarrhea that struck him on Saturday, October 23, 1831. He recovered immediately and simply put it out of his mind.” By dinner time, it was another story. William Sproat was racked by “agonizing stomach cramps … Sproat doubled over in pain, and a watery, white-speckled diarrhea poured from his bowels, seemingly gallons of it. Each attack was heralded by violent intestinal spasms. He began vomiting. Sproat barely made it home, where he crawled into bed, shivering with fever, writhing in pain.” Five days later, Sproat was dead. Of cholera.

Thanks to Kolata’s book, I now know that the great year 2000 flu feels exactly like cholera. Many nights I lay awake at 3 a.m. — feverish, sweating, eyes hurting, hacking up phlegm and worse — realizing that not only do I feel like William Sproat, but I’m also the equal to one of those Eskimos buried in the permafrost since 1918. Kolata’s book made me see how a considerable percentage of mankind’s dead died of forms of the flu. The 2000 flu is the ultimate equalizer between the living and the dead.

Yet this realization only rubs my nose in a maddening paradox: The flu is the essence of life. Yes. A flu virus has no consciousness. No brains. No animal instincts. Yet it possesses a fiercer hunger for life than I do. Is this flu the essence of God or the devil?

I explored this notion with Gina Kolata in an interview. I invite you to read our talk with ironic detachment. Neither one of us guessed how sick I would soon be after the interview was finished.

Your book was really scary. Were you worried about catching the flu while you wrote it?

No. You know how some people are constitutionally gloomy? Well I’m constitutionally the other way. I’m obnoxious. I never get sick.

I’m that way. But when I first started the book I thought, I can’t read this. I’m going to get sick. [Ha! Little did I know ...]

This is how I rationalize things. I’m naturally immune to smallpox. They couldn’t vaccinate me. It never took. Maybe I’m naturally immune to the flu. Who knows?

Why does America have historical amnesia about the Spanish flu?

That’s a really good question. I have two ideas. One: That it was just part of the nightmare of World War I. And when it was over people badly wanted to forget it. Every time I talk about this book on radio shows, people call in, ‘My parents died.’ There are all these family tragedies. In a sense, the Spanish flu is a personal tragedy rather than a historical one. That brings me to my other hypothesis and that is the ‘great man of history’ theory. No great leader was killed by the Spanish flu. Every side died equally during World War I. It was sort of historically neutral. Historians tend to emphasize the big events like battles and leaders, while all across the world children were losing parents. Families were being decimated.

You could write the history of the planet as sickness.

That would be interesting, wouldn’t it.

A fact in your book amazed me — until this century every major city kept being depopulated by diseases.

That surprised me too. I didn’t realize that cities couldn’t even maintain their populations. All this stuff really surprised me. Why, when we study history, we don’t learn how public health measures make such a difference until something like the flu comes along and makes it all seem like a joke?

Did you get a flu shot?

I did this year — for the first time. Flu shots got a really bad name because in the ’60s and ’70s they weren’t good at guessing what the flu was going to be.

Then Gerald Ford’s swine flu fiasco [the epidemic that never materialized] in 1978 made everyone sick.

That’s when I first decided that I never wanted a flu shot. They were immunizing people against the flu that never came, and then there was the whole threat of nerve diseases from the shots. Why would I want that?

If some new fatal flu appears, the shots aren’t going to work are they?

That’s what’s so scary. They have to know six months in advance to make enough for everybody.

I wasn’t quite clear on this: Are the Spanish flu and the swine flu the same thing?

It’s hard to know. When the 1918 flu was killing everyone, all of a sudden there was a flu epidemic that was killing pigs everywhere in the Midwest. It’s not clear whether people gave the flu to pigs or pigs gave it to people. In the 1930s, when they looked at people who survived the 1918 flu they all seemed to have antibodies with the flu that had affected pigs. The thought was, whatever that flu was in 1918, it at least superficially resembled the flu that affected pigs.

We can get flu from pigs — wasn’t the Hong Kong flu from birds?

That’s why they had the horrible episode in Hong Kong a few years ago, they thought maybe something like the 1918 flu was coming back because young people were dying of the flu and it turned out to be transmitted from chickens, so they killed all the chickens, ducks and geese in Hong Kong.

In general we can’t get it directly from birds. They get the flu all the time and don’t get sick. They have an enzyme that we don’t have. So in order to get a bird flu something has to change in it. Pigs can get flu from birds and pigs can get flu from people. They can be sort of a mixing bowl. So the two flu viruses can mix and match — and have some bird flu characteristics and some human flu characteristics, which will allow it go get into people’s lungs. Actually there are all sorts of animals who can get infected with flu — that’s why we can never wipe flu out from the world.

Is the flu virus a real species or is it a linguistic thing, that is, a certain virus that gives you a lung disease is called a ‘flu’?

It’s a linguistic thing. They started calling it a flu before they actually learned there was such a thing as a virus.

Smallpox is caused by a virus, right?

Yes.

So in a way, can you call smallpox a flu?

No. You couldn’t. It’s like saying because salmonella poisoning is caused by bacteria and pneumonia can be caused by bacteria so they both can be called salmonella. It’s different viruses causing different things.

Flu can be transferred through the air, right?

Right. That’s why it’s so scary. With AIDS you can say, ‘There are ways of not getting AIDS.’ But if something is being transferred by the air, it’s very hard to avoid it.

How long is flu’s airborne life span?

Not very long. Less than an hour. Viruses are strange creations. They have to live inside a cell.

Does Michael Jackson have the right idea with his gauze mask?

They don’t work. Back in 1918 many cities passed laws that you couldn’t go out without gauze over your mouth. It was useless. The virus passed right through.

So we need space helmets?

We need to really barricade ourselves in our houses like survivalists or something.

There’s no way to predict when a new virus will break out, is there?

That’s really frightening. First of all, I think AIDS was really humbling for the 20th century. Around 1980, scientists were in this phase where they said, ‘Oh we’re conquering everything.’ And here’s a new virus breaking out. With flu there’s always new viruses breaking out. If it’s an old one then everybody already has antibodies to it, so the virus has to keep changing to find a new population to infect. There are so many animals and so many people that can have flu viruses mutating away in them, it’s inevitable that every year there are new flu viruses.

The medical establishment is always worried about new influenzas. Do they know enough? Are they prepared enough to really get going on this? They’re concerned about how long it takes to make vaccines. They’re also concerned that in 1976 when Ford started to do swine flu vaccine, scientists got a reputation for crying wolf. Scientists now worry if they say, ‘This flu could be deadly. You really should get vaccinated,’ people will just say, ‘Yeah. You told us this before.’ So there’s so much cynicism. There’s a whole anti-vaccine movement going on even with vaccines for children that most people think are crucial.

Were the scientists cautious when they were digging up the Spanish flu corpses?

Sort of. The woman, Kristy Duncan, who went to that island off Norway, was. She was very worried about starting another epidemic. Everyone wore space suits. They had a little tent over the grave site. Then of course it turned out that the ground the miners were buried in wasn’t even frozen, so they were totally decayed.

I remember reading about that in the newspaper at the time and thinking, Why do you want to preserve a virus?

To know what it looks like. This could help forecast when a bad flu is going to come. If they can answer why this flu killed so many people in 1918, then if they then see a virus somewhere with these same characteristics they can say this is the one that we have to worry about.

In your book you mention these places where they have bits of people’s bodies laying around for years and years.

It’s just amazing. I went into this warehouse in Washington, D.C., called the Library of Congress of the Dead, and it was just row after row of boxes. And in the boxes were pieces of people’s brains and hearts. They died of ordinary things. And they died of strange illness. And along with each person’s piece of tissue were slides of their cells and their medical records. It’s just amazing to think that it’s there.

There is also one of those places in England. It’s not as well organized. It’s in the basement of this old hospital. Everything is written out by hand — this spidery handwriting. Some things are mislabeled. But they actually have a repository, too.

It sounds like there could be a little jar of bubonic plague sitting around and a cleaning woman opens it up …

I think because the things are mainly preserved in formaldehyde that anything in them would be dead.

So let’s talk preventive stuff about the flu. Do you use pay phones?

Ha! I do. I have a cousin who always carried around Lysol and sprayed the phones. I always thought that was crazy. I guess you could get infected from a pay phone.

Can you wipe flu germs off of a pay phone?

You probably could. You can overdo your paranoia. You gotta have a life.

If your number’s up, your number’s up. [Pause.] Can viruses die?

Die?

They’re not eternal, right? They’re parasitic and live off the host?

Yes. If they haven’t spread on to somebody else and the host dies, the virus will die too.

Then viruses are alive, right?

Some people would say they are. Some people would say they aren’t. Because you normally think if something is alive it can live on its own and reproduce itself. But viruses have to go into a cell and take over the cell’s machinery to reproduce itself.

What drives them?

What drives them?

What drives them to stay alive? Is God in a virus?

You’re getting beyond where I think I can answer. I don’t even have a hypothesis. [Pause.] I always have a hypothesis, but not on this one.

Mankind didn’t come from a virus, did we?

I don’t think so. We couldn’t. Because a virus has to live in a cell.

Yes. Moving from person to person and animal to animal. You’ll be fighting it off, but you would spread it to somebody else and then it would blindly reproduce in the next person while they fight it off and it spread to somebody else.

This is basically “Invasion of the Body Snatchers.”

[She laughs.] Yes. I should have thought of that for my book.