Epidemics, Fear and Denial: How Every American Is Threatened.

• Date: 24 December 2018
• Author: Orient, Jane M.

* This is the one hundredth anniversary of the great influenza pandemic of 1918. In his book The Great Influenza, John M. Barry described it as the deadliest plague in history. It killed more people in a year than the Black Death of the Middle Ages killed in a century.

The lack of a vaccine did not cause the flu. All epidemics start with an index case--which may or may not be identified. The great influenza may have begun in a patient in Kansas. The significance of the case was reportedly recognized by a country doctor, who was ignored. As the nation mobilized for World War I, and draftees from across the country were thrown together, illness spread and became much more virulent. Transport ships became "floating caskets." Troop trains were "rolling coffins." But Woodrow Wilson denied the existence or severity of the epidemic, and effective public health efforts were thwarted.

Despite this history, and the expenditure of billions of dollars, the U.S. is not much better prepared than in 1918. There have been warnings, such as Ebola, severe acute respiratory distress syndrome (SARS), novel H1N1 flu, and the 2014 outbreak of enterovirus D68 in schoolchildren. But when...