The great influenza of 1918 had social roots.
The global war of 1914-18 between the European powers brought suffering and destruction to populations in the farthest regions of the world. While the military destruction took place largely in Europe, where 9 million soldiers were killed, the conflict spread to Africa, the Middle East, Central Asia and to most of the oceans of the world. The greatest numbers of casualties, however, were not inflicted by shells, bullets and chemical weapons, but by the diseases and hunger that ensued, and by the 1918 flu pandemic that sprang directly from the war. Genetic material taken from victims of the 1918 virus has enabled the reconstruction of the virus, and it shows similarities to that found in some of the current outbreaks of bird flu. 220,000 Britons were killed by the 1918 flu pandemic.
Most histories of these events have drawn a line between the two, claiming that while the war showed man's inhumanity to man, the flu virus was a deadly and totally separate creation of nature. The core of this argument is that influenza viruses mutate by learning how to jump from birds or pigs and then to flit from human to human, learning how to conquer our immune systems in the process. The virus is anthropomorphised, with an intelligence and willpower that enables it to survive.
The truth is probably the opposite. The habitat of the 1918 virus was created by the war. The free-floating atmospherically conveyed influenza virus moves from human to human in proportion solely to the proximity and number of human contacts it lands on. It mutates when it comes into contact with changing human conditions. It is very short-lived, and is prolonged solely by the number of contacts it makes.
The First World War provided the most fertile ground for its development and survival. Over 60 million soldiers were mobilised in Europe and worldwide over four years of intense and mainly static warfare. In addition over 70 million migrant workers were mobilised directly to assist these armies, mainly in the supply lines. In every country at war more than half the industrial workforce was employed for long hours in direct and indirect labour-intensive munitions production. Factory populations were huge. The Putilov factory in Russia and similar munitions plants in Germany and Britain employed tens of thousands of workers. By 1918 war production brought huge aggregations of rural, migrant and destitute workers from the countries ruled by the belligerent empires of Russia, Turkey, Britain, France, Belgium and the US.
Almost all workers suffered extreme conditions of overcrowding - in trenches, ships, factories, city tenements, rural labour camps and plantations. Never before had so many human beings been brought into such intensive concentrations in such a relatively small field of war. A report to the British Medical Association in 1919 argued that the 'augmented infectivity of the [influenza] organism was induced by the herding together of young susceptibles'. The group most likely to suffer and die from the virus was 20 to 45 year olds - exactly those who were employed in the factories or on the battlefields.
The pandemic began in Europe at a low level in 1917. Following in two waves, deaths rose astronomically in late autumn 1918 and extended in 1919 after the demobilisation of some of the armies. It lingered through 1919-20 in regions like the Middle East, Russia and Germany, where the victorious Allies fought to put down revolutions and anti-colonial struggles by hunger blockade and military invasion.
The 1918 influenza virus proved more virulent in the speed of death that it caused and in the extent of human suffering that it inflicted than any previous or subsequent outbreak. The numbers of deaths, probably in excess of 40 million, were six times greater in the Third World countries of the colonial empires and in China than in Europe and the US.
German and British scientists have confirmed its origins lay in the morass of corpse-ridden lands soaked with gas shells and high explosive residues that polluted farms, waterways, villages and towns across the French and Belgian battlefields. By concentrating in conditions of extreme overcrowding, the virus spread into the enormous army camps and troop concentrations based in northern France.
A feature of all army camps was their proximity to large populations of live animals and birds herded together to maximise the army's food supplies. From similarly overcrowded camps in the US, where 550,000 people of all races died, the fertilisation of the virus and its transmission process were more far-reaching. From dozens of US army camps packed with young and healthy raw recruits upon many of whom gas weapons had been tried out in army practices, the virus was conveyed as far away as the US colony of the Philippines where 90,000 died, from there to Indonesia where 800,000 died, to the Pacific islands of Guam where 800 died, Western Samoa where one in five of the population died, and to many other parts of the Pacific region.
In advanced Japan, 260,000 died through contact with the personnel of European belligerent powers. Where living standards were lower and the populations larger, the death tolls were alarmingly higher. The Allied Powers Sanitary Conference of 1919 reported that 6 percent of British India's population died, around 17 million, with even higher death rates in Afghanistan, Baluchistan, Iran and Turkestan.
All these nations provided troops, workers and munitions carriers for the war, as did Vietnam, China, Malaysia and Africa. Where native peoples who carried the war on their backs or made its raw materials were housed in tenements and dormitories and came into contact with the flu virus brought in by servicemen or indentured and migrant war workers, mortality rates from flu were far higher than from other diseases.
Four percent of British servicemen hit by flu in the autumn of 1918 in India died, but this rose to 14 percent of Indian personnel.
Economic warfare and war reduced whole nations to poverty. Guatemala, Central America's largest producer of coffee for the Central European powers, found its trade halted by the Allied blockade. Forced into migrant labour, 43,000 Guatemalans died from flu. In Jamaica 7,000 sugar workers in conditions akin to slavery died in the increased production of a commodity which had become an ingredient of high explosives because of scarcity of other materials. The 225,000 German civilians who died in 1918 had been weakened by the British hunger blockade.
The generals and politicians of the advanced countries were the originators of the transmission belt of fatal disease. US president Woodrow Wilson promised his French and British allies that 4 million US troops would replace the millions of French, British and Russians slaughtered in the war and the many more who by early 1918 were simply refusing to fight any longer. The crisis of replacement became severe after spring 1918, when Germany's leaders threw all their last reserves into the final battle for victory, inflicting the highest casualty rates of the war. In response, US generals delivered 1.9 million troops to Europe between April and November 1918.
They were crammed into overflowing army camps and jammed into even more crowded troop ships, decks filled to capacity with men, many of whom had contracted the flu virus before embarking. No better way could be found of increasing the virulence of influenza than by passing their recruits through the army and navy camps, barracks and troop ships. Generals told Wilson that many soldiers would be dead before even reaching the battlefields. 'Every flu victim has just as surely played a part as his comrade who has died in France,' he was told.
Britain's Chief Medical Officer, Sir Arthur Newsholme, warned the government after a flu epidemic in spring 1918 that another more serious outbreak would come in autumn and winter. He drew up plans to minimise infection. Factory working hours were to be staggered, workmen's trains, trams and buses were to be regulated to reduce passenger numbers, and every measure was to be taken to reduce overcrowding in schools and other public places, with extra police powers to reduce overcrowding in lodgings and in any other location that might increase risk of infection. The measures promised are a blueprint for Tony Blair's government, should a pandemic recur.
Newsholme was asked to consider the effects of his plans on war production, and his schemes were not put into effect. Challenged by his colleagues a few weeks after the ceasefire, he said he knew that by withdrawing his plan more people would die from flu, but that war needs took priority.
The specific factor that created the uniquely mutating and destructive 1918 virus was, from scientific accounts, derived from its interaction with toxic and poisonous chemicals, mainly from the massive production of gas weapons of mass destruction that marked the build-up to the final battles scheduled for July 1919. 150,000 tons of gas were fired by all the armies at war. Over 100,000 tons of unused gas WMDs were manufactured ready for use when the German and Russian revolutions forced the warring powers into the armistice. US generals complained the war ended too soon. They had ordered 200,000 gas shells.
Military doctors in the battlefield noted that victims of the flu had identical lung symptoms to those who died from gas attacks. Two army doctors tending to 42 victims who died reported to the British Medical Journal in May 1919 that they were impressed by the close resemblances in the lungs, the blood symptoms and the areas of emphysema of those killed by the flu and those killed by mustard and phosgene gas. Similar reports from other doctors were sent to the British War Office but never acted upon, and they disappeared from public scrutiny.
The famous blood poisoning specialist JS Haldane made more detailed examinations and found identical characteristics in blood specimens taken from both groups of victims. He reported finding chemical poisoning in both victims of flu and of WMDs.
Recently a group of specialists at Queen Mary's Hospital in London have made the same connections. They confirm that with modern technology, flu viruses can be tested for their readiness to mutate when in contact with polluting chemicals and compounds. This suggests that the prevention of virulent strains of the flu virus is not impossible, as Sir Liam Donaldson, Britain's Chief Medical Officer, argues. Carrying out the necessary research on these lines has become an urgent necessity if 1918 is not to be repeated. Previous research in this field was delayed by the failure to identify any flu virus until 1933, and by the concentration of virologists and drug companies since then on tackling outbreaks with effective vaccines.
Such steps are necessary, but the finest antidote to pandemic influenza and the best prevention of a repeat of the great 1918 flu pandemic would be the elimination from our globe of wars of mass destruction, and of massive poverty.