Pinning down figures is difficult, but estimates of the final death toll reach as high as 100 million. In Britain and the US, losses amounted to only half a per cent of the population. Elsewhere the casualties easily outweighed those claimed by the First World War. In some Indian regions, six per cent of the population perished, in parts of South Africa this rose to ten per cent, and in Bristol Bay, Alaska, four out of ten people were lost.
Until fairly recently, historians paid the Spanish Flu surprisingly little attention: perhaps, Spinney suggests, because ‘pandemic memory’ takes a long time to mature. We now know much more and Spinney’s book provides a masterful account of the possible origins, spread, and cultural consequences of this modern-day plague.
Especially interesting are the context-providing sections on humanity’s millennia-old encounter with flu and on the frantic, flawed, attempts to understand the science behind the outbreak. Back in 1918, theories clashed about where the flu originated (almost certainly not Spain, for the record) and about how it was transmitted, but the medical establishment was largely limited to throwing ‘the medicine cabinet at the problem.’
We have moved on, but Spinney has no doubt that another pandemic is inevitable. Lessons, she says, can be learned from 1918 and there is some small comfort in the fact that many reacted with generosity. ‘Your best chance of survival was to be utterly selfish’ – to hide away and ignore cries for help. Many did the opposite and demonstrated noble, if foolish, ‘collective resilience.’