STEVE INSKEEP, host:

Health officials had much less practice when a brutal version of the flu virus swept the world in 1918.

Mr. JOHN BARRY (Author, "The Great Influenza"): Probably the most horrific symptom, people could bleed not only from their nose and mouth but from their eyes and ears. Sometimes people would die in less than 24 hours after the first symptoms.

INSKEEP: John M. Barry wrote "The Great Influenza" about the so-called Spanish flu. Starting near the end of World War I, the virus killed tens of millions of people worldwide. That virus seems far more lethal than what we've seen today. Yet there may be lessons in the world's response back in 1918. Barry says authorities were worried about interrupting the war efforts, so they pretended nothing was wrong in cities like Philadelphia.

Mr. BARRY: Hundreds of people a day in Philadelphia were dying and they finally closed all schools, banned all public gatherings. The public health director in one of the newspapers actually said this is not a public health measure.

INSKEEP: What did they say it was?

Mr. BARRY: They didn't explain that, but…

INSKEEP: We think public gatherings have grown rather dull, and we'd just like to stop them for a while.

Mr. BARRY: Yeah, but it's not public health. You have nothing to worry about as long as proper precautions are taken.

INSKEEP: Why were authorities lying and lying and lying?

Mr. BARRY: Primarily because it was the war and their whole goal was to keep morale up. But of course once people discovered that they were being lied to, they couldn't trust anything that they were being told, and personally I think society is based on trust. Trust broke down, and frankly in some parts of the country society began to disintegrate.

INSKEEP: Well, did this lousy response in 1918 actually make the pandemic worse?

Mr. BARRY: The real impact was that it did cause people to lose any faith they had in any position of authority and they felt completely alienated, every person for himself or herself. That in a lot of ways was the most terrifying part of the situation, to the extent that people who were trying to organize volunteers and get - just to carry food to people who were sick, they couldn't get volunteers, or a volunteer would show up for a single shift and never be seen again; to the extent that people were actually starving to death because their neighbors and in some cases even their families were afraid to come and bring them food.

And I noted that occurrence in some big cities and I was kind of curious whether that kind of alienation was limited to the cities. So I looked in some very rural areas where neighbor and family really was everything, and I was -somewhat to my surprise - found the same thing there: people starving to death because others were afraid to bring them food. And I think that was a direct result of the government lying about how bad things were.

INSKEEP: (Unintelligible)

Mr. BARRY: In a very few places, such as San Francisco, where they told the truth, where the government and the unions and the business leaders all signed a joint statement, huge type in the newspaper said wear a mask and save your life, even though the mask didn't do any good, that's a very different message than saying this is an ordinary influenza by another name.

And San Francisco functioned. Nobody starved to death in San Francisco 'cause others were afraid to bring them food. You know, they had a pretty well organized system there to carry people to hospitals and things like that, much better than other places where people were lied to.

It got so bad that Victor Vaughn, who was a very serious, sober scientist who at the time was in the war effort as the head of the Division of Communicable Diseases, he said that if this continues its current rate of acceleration for a few more weeks, civilization could easily disappear from the face of the Earth. And he wasn't really referring to the illness itself. He was referring to the way society was beginning to disintegrate.

INSKEEP: John M. Barry is telling us about "The Great Influenza" which is the title of his book about the flu pandemic of 1918 and 1919. And Mr. Barry, the government today seems to face the same dilemma, the same balancing act, because you want to inform people without unduly alarming them.

We had a very compelling example, I thought, last week when Vice President Biden said that he would not recommend to his own family that they get on an airplane right now because the virus can go all the way through. And of course his advice had to be very quickly rephrased.

It seems obvious that if a sick person were to get on a crowded airplane, that it could be a bad situation where they're more likely to spread the virus. But of course what Vice President Biden was talking about was whether a healthy person should go into a crowded airplane. What do the data show about that?

Mr. BARRY: The question is at what point it becomes appropriate to take a certain measure. There probably would be a time where it would make sense to avoid getting on a subway car. But fortunately we're not at that point now.

INSKEEP: What shows that we're not at that point now?

Mr. BARRY: Well, this virus is not now behaving in ordinary influenza fashion, much less in pandemic fashion. It is not an explosive virus yet. You know, it's an organism that's been moved into a new environment. It's got to adapt to that environment or die. If it adapts to that environment, then it will have an explosive spread and cause a pandemic, no doubt. It's possible - frankly I think it's unlikely - that it could simply die out.

INSKEEP: John M. Barry wrote "The Great Influenza." Thanks very much.

Mr. BARRY: You're very welcome. Thank you.

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