8:00 p.m. eastern and enjoy american history tv every weekend on c-span3. funding for american history tv comes from these companies who support c-span3 as a public service. in 1918 a flu virus infected one-third of the world's population. up next, laura vote with the museum and memorial discusses the correlations between the 1918 pandemic and today's global crisis. she's joined by nancy bristow from the university of puget sound. this was hosted in partnership with the northeast kansas library system and the world war ii museum which provided the

video. >> now i'd like to introduce and like to bring to the proverbial stage here both ramsay and dr. nancy bristow for our conversation about the fact that we might have been here before. thank you to who is part of the rsvp. you gave us over 250 amazing questions. we are going to do our best to address some of them in broad strokes to begin with, and then to really kind of run through and do as many deep dive questions as we possibly can at the end of our conversation. again, i want to shout out to

there are people from across the united states from washington to pennsylvania. hello, texas, virginia, california, brooklyn, nebraska, georgia, reno, everyone from the towns mentioned in your county libraries, hello katherine footer. delighted you're joining us from new york. and i think rem si is working her way into our space. and while she does, i think i knew what the first question is going to be. there we go. fantastic. >> i'm afraid you may be muted. >> can you hear me now? >> yes.

>> we'll start with when, where and how did the spanish flu begin and what caused it? >> nancy. >> well -- >> i'm going to jump in really quick to just suggest that the name spanish flu itself is a misnomer. this flu did not begin in spain by any stretch of the imagination. in fact, it was called the spanish flu by contemporaries because the nation, the world i should say, was at war, world war ii was underway. spain was not a belligerent nation. they didn't have wartime censorship. as country after country succumbed to the flu attack, they hid the information. they didn't talk about how many citizens were sick because they wanted to look strong in the midst of this conflict. except for spain. and spain told the story so they got blamed for the flu when it's more likely that we should be calling it the american flu. in fact, that's right, your

neighbors there in kansas. >> and many of them say -- and the first reported case happened at fort riley in kansas. there's also a lot of scholars who might disagree and say it's one of the first reported cases coming from this base that you see in front of you, but there may be some evidence that show that it could have started earlier, an earlier variant might have occurred in the uk, in france. and then there's one scholar who suggests china, but the united states, this is the place that we can look at. and i have to say we just pulled this out of our archive at the museum and memorial. it gives me the hibijibis. all these people are closely packed together for a football game. i believe it's going to be 1918.

so really right before you have this spread. so this is right before some of this or kind of right as this is all starting to occur. and so you can see we all know that kind of being in close proximity and the like you're certainly sharing air and germs and all of that other good stuff that may or may not have been as clear 100 years ago, but you end up having really the first reported cases happening, and this is a picture of -- this was the picture from our event at itself. this is the picture of the medical space at the camp, but we're right in the midst of a war. you have these individuals who don't really understand the full extent to what is going to be happening -- just how con teenage it is, how quickly it's moving. in many ways it's back for us in

the united states, kind of that feeling of being the first couple weeks in march and february. we don't necessarily know and people are packed together, and they are moving out from the middle of the midwest. again, you can kind of see how all of a sudden you have this transporting of a virus. you have americans who are landing in russia. americans who are serving in china. so it's really easy to see how it becomes this global, very quickly becomes this global pandemic. it is in many ways similar to the type of travel that we have had that we have in the modern era. it really is the type of mass movements that are occurring at the time. >> one thing i would add to that in case it's -- it may become relevant as we talk about how they dealt with it. the first cases in kansas, people aren't aware there's a

global pandemic to happen. it's not unlike when we were first hearing about wuhan, but it's the mobilization from the troops from the u.s. to europe. it's when it arrives at the western front that people start really noticing something is happening and then in late august there is a shift in the virus, and that's when you get the really explosive illness that we associate with the pandemic. and it's almost as if it's already a second wave but the first wave had moved through without the same kind of severity. >> what were the public health measures back then, and were they as politicized as they are today? >> that's a really great question. and i saw some of the questions that some of you asked and they were incredibly poignant as

well. i think some of you have asked things like how did they cope with -- how did they cope with the stress? it really -- some really good -- you've got some great questions in there. i will -- i'm going to show some pictures of the era, and then nancy, if you want to kind of speak to some of -- some of this here in a second, but i want to start actually with a letter from the collection. we expect it to be quarantined upon our arrival. it was unexpected. they had as many deaths as they did on the ships on their way over. and it was something that would not happen again. people did kind of quickly learn about the disease, pardon me, about the virus. they tried to take measures to the best of the knowledge they had at the time. it's the same thing we've been

experiencing as well. they started off educating with the best information that they had available. sneeze but don't scatter. right? that's the really not the same version as this at all. but that's the point. it's telling you not to scatter. almost 100 years it's the exact thing we tell our elementary schools to do today. there's not so great advice like onion soup or other remedies that may not have necessarily been so helpful. but, again, if you take a look a little bit later in the second paragraph here, there's no sure method of preventing the influenza, but there's no doubt overcrowding and coughing and sneezing are two of the most important causes. fell free to use the word for

the coughing and think of us and how the language was used back in the day. every man should see to it he has allowed space, plenty of ventilation. some of the questions that we look to that we look to today. and lastly, when you get ill, go to the medical office. this is one of my favorite. the question many of you had about masks. this is on its way to france. they are going to seattle. each one of them had a mask provided by the seattle chapter of the cross. and folks are trying to figure out -- i believe this is a picture from ku hospital. their base hospital. they're trying to figure out what's causing this. we had a whole series of x-raies and the like. i did not add those in

specifically, but doctors are trying their best to get to the root causes, what is spreading it and the like. you can see some of those specific ways that folks are trying to address the public health issue. do you want to add more? >> i think you nailed what's so important here. on the one hand they can't see the virus. they don't have the technology, so we're in a much more advantaged position because we could identify the virus immediately. they did not have the technology, but they did understand germ theory. so they were operating sort of on face that these measures should help, but they couldn't tell whether they were either. so it was really a tough struggle i think to get people to continue to follow these restrictions, but it was very much the same ones. closures. right? not allowing public meetings.

public masking. quarantining of the sick. educating of the public. more air circulation. it's down the line almost identical to the measures we're taking today. it's just that we know because we have their data, in fact, as well as day that we've produceed this time around. we know that these measures work. they're having to use them kind of on faith and on belief in what the leadership is asking for. and that's where the politicizing comes in. it's interesting here. i would argue it's not in any way as politicized, because in this iteration of a terrible global pandemic, in our nation at least, it was politicized very much around party politics and around elections. so to wear a mask or not to wear a mask was to make a political statement of sorts. there was nothing like that in 1918. what you do see, though, is public resistance, nevertheless. at the beginning of the pandemic, people are anxious to do anything they're told in

hopes of staying healthy. but as they realize that people around them are continuing to get sick and to die, there's kind of a loss of faith in the leadership, because they can't know. they don't have the idea of flattening the curve we can throw around. when many communities go through a serious wave in the fall of 1918 and it's followed by another wave in the winter spring, it's harder to get people to cooperate in that next wave. because, like, wait a minute. we did what you said. we're also getting sick. i am over the whole masking thing. >> yeah. so to the first -- >> that's where you end up with the anti-masking group in san francisco. >> to the person who specifically the question did the u.s. population behave themselves any better before than they are this go-round, i believe like that was just answered. and thank you for writing it that way. because it did make me laugh. and it's part of our everyday experience.

for the importance of addressing a person not wanting to wear ppe, we have a little bit here and hopefully more for you in a bit. someone else asked a really good question not only about did health care workers wear it and the answer is definitely yes. but also about the death tolls to health care workers and if you can still see it if you have a large enough screen, if you look at the left hand side and see the woman with her arms crossed, you can actually see how thin that mask is. what we benefit from is we know the importance of having a thicker mask, being able -- not being able to blow out a candle from behind it and the like. a lot of the masks provided and that people were working with at the time were made of a causy material. so they weren't as effective.

it was a great question about the death toll for nurses. i can say that one of -- in our museum and memorial, there's a listing of the dead from kansas city in memory hall, and it's kind of a in the greater kansas city here. we do have one nurse who we know died of the flu who is listed on the wall. he was taking part in and giving human -- humanitarian way, and she didn't die of combat, but because she was in the spaces, so those deaths are part of that sacrifice for the war effort. it also gets complicated for some of the other questions that come later about death toll.

>> okay. joefr all, how do you think the two pandemics compare, and was 1918 overall worse than 2020? >> i mean, there's so much to be said here. do you want me to start off and then toss it to you? >> yes. >> first, you're dealing with two different viruses. that's important to notice, and in 1918 you were dealing with a level of exposure and infection. the infection rates are roughly a quarter of the population, or a third of the population worldwide. something like 500 million people are infected with this disease. so it's an extraordinary number, and then it also has a high mortality rate at about 2.5% which is higher than we seem to be suffering from covid, though i think the statistics are unclear as are the statistics from 1918. one thing they had an advantage in 1918 is that you didn't --

you wouldn't have been able to infect others before you were symptomatic. there's none of this asymptomatic problem which probably helped in terms of trying to keep those who were sick away from those who were healthy. in terms of the virus, you're dealing with something that's different, and they lose 675,000 americans out of a population of 100 million. so we're not yet at the same death toll. we're a much larger nation today. in terms of numbers at this point it was actually worse and it was compressed into a tighter time period. almost all the death takes place in a roughly four or five or six-month period as opposed to ours being stretched over a longer period. but then in terms of how it is sort of -- how people make their way through it, there are so many similarities. it's awful, frankly, as a historian to watch. a lack of federal leadership in terms of the person in the white house. in both cases.

woodrow wilson never says a word about the pandemic and we know that the former president of the white house in our own time gave a lot of really misleading and misinformation around the pandemic that wasn't very helpful. in both cases without that leadership from the very top, without any sort of federal program, you have a scatter shot approach in both cases where city to city, county to county, state to state, there's so much variation. and what you want most of all in a pandemic is a unified approach, not to say that each community wouldn't be at different phases, because we're dealing with different moments of the pandemic, but that you should have a shared plan of attack because viruses don't care about state lines. they don't care about county lines. we have lack in both cases that kind of coordination from above. another thing that i think is really important, just to remember is the most important thing is the same about both, the main story is trauma and suffering. and loss of life. and that is shared across the

century. it was just as traumatic and just as horrific for people to lose their loved ones as it is now, and criminally, i would argue today as in those days, that is inequitably distributed in our society. that for me is frankly criminal in 2021 that we could have been in a place 100 years later with the same costs of poverty would still be so blatant, but those are the things that immediately pop to mind for me in terms of similarities that are marked despite the difference in the virus itself. >> okay. and i would say for me, right, being a curator of a museum, i always go back to the resources. i'll read this out loud in case it's not clear on your screen. this is from the highest medical profession in the land warning to the country that the

influenza epidemic, all possible precautions against the disease should be taken. it was issued by the surgeon general of the public health service. reports received by the service show a recurrence of the disease practically from one end of the country to another. and in his statement, the doctor advised of closing of public schools on the first sign of the reappearance of the epidemic. i feel like that is -- maybe not the exact words of dr. fauci, but there's a real sense of this exact same sentiment that is also just happening right now. we are in a very similar place. you can see here in a letter from walter shaw to his mother in bonner springs, he says, pardon me, i think it's vice versa. the influence is better, but

quite a few deaths have occurred here. i think school will begin next week. also churches and picture shows as everything has been closed for a month. now, we have this real similarity. this isn't new that question about do we close schools? do we close churches? you know, what happens economically to the picture shows, and the like? and nancy, i think you brought up earlier that when you used to teach this before this year, you would say can you imagine closing a school for two weeks? >> well, and, of course, that's one of the differences that -- i mean, it's so difficult to know what to do. because you don't know what's going to happen next. but this issue about closing schools, they were talking about something that might be in their community for two or three or four weeks. and here we are almost on a year anniversary of when my university, for instance, sent me home and said you learn how

to use your computer because you're teaching virtually on monday, and i found out on a saturday night. they didn't have computers. so we are able to stay in touch with computer. i've been teaching online almost a year, but we've continued some education in a way they didn't have that option, so it sounds crazy to say i feel lucky, but in some ways i think the technology that we have has been a real bonus. and also for those who are really sequestered as individuals. my mother is 91. so she can't be out and about, but as soon as i get off here, my next stop is the family zoom that we do every night. again, i'm grateful for some of the technology that we have. that they had to work without through the pandemic of 1918. and i love your point that this issue about the churches and schools, these were absolutely hot issues then just as they are today. there was disagreement about whether or not to close things. there were disagreements about when you should open them. and it was often the same

players that were taking the same positions. so there's so much resonance. it's fascinating sometimes to watch. and again, i don't think it was difficult to decide what to do in those days and it's difficult to decide what to do today as well. >> yeah. it gives us a historic empathy. i think many of us, likely not you as you've written an entire book on this, but all the suddown can really identify with this time frame in a much more visceral and much more empathetic way. because you can see where we do make some of the exact same choices and for many of you joining us, you are asking the same question. what is it we could learn from history? and some of them are these things of us trying to do our best. you know? when and where do you wear masks or how do you handle -- what are the sacrifices that individuals and communities are willing to make? at the end of the day, that

comes down -- that is one of the big questions that we end up asking that they were asking back then and we're asking ourselves today. in san francisco, we had one of the most stringent ordnances. their city board of health recommended against using streetcars during peak times, wearing face masks. they later enforced it as a final law. they did something similar in seattle. you can see a court that is being held outdoors because they were encouraging folks to do that. it is also in san francisco they had a scene of a pretty significant anti-mask protest. so if you're looking for similarities, right here. >> and one of the things that's really interesting about san francisco is they had had masks and things got better and they quit wearing them at one point, but during that first time period, they still had the mask ordnance in place, and the mayor and the chief of public health were spotted in a boxing match

without their masks on. and it completely undercut the whole masking effort in the city, and it goes back to the ways in which sort of modelling public health if there are restrictions, then having leadership model those can make restrictions, having leadership model those can make a difference in the public's response to whether or not they feel compelled then to also follow the rules. san francisco, it didn't help them, they went on to have a much higher death rate than seattle had. >> we'll see if we have a couple of -- again, back 100 years ago, as today, on your left hand side you actually see an advertisement for what we would now refer to as bone broth, saying it's going to keep you from getting infected. so certainly there's that element of capitalism that we see in other aspects of our lives. and journalism as well, an image here courtesy of bonner springs library. cannot say when the schools will be opened up again, everything

depends on what course the flu epidemic takes, new cases on decline. again, i feel like that's a similar headline that you might be seeing in other spaces today. so, you know, those feelings, that intensity, trying to find that balance, that is exactly what people were doing a hundred years ago and are encountering again today. at the national women's museum and memorial, we have a really wonderful teacher resource that was put together by our school programs manager cherie kelly. this answer guide, we give it as a sample because we're still in the midst of covid-19, but asking students to do a comparison between 1918 from history books and then taking a look at whatever your current events say at the time that you might be using this, and doing

this comparison between the past and the present. but the nice thing about really good teacher resources is that they're helpful no matter your age. so i'm going to really quickly kind of go through some of these different comparisons. and again, this was even crafted prior to getting all of your questions here together. but we'll give you a link about whether to grab this. and nancy, i've got a question for you about waves of infection later on, i think. whether or not you would say that it's three or four. i'll just ask you that question right now. >> you know, i'm not sure, i'm not an epidemiologist, i won't pretend to be one. i have family that are actually medical health professionals, so i have to be really careful not to say anything silly. it's hard to say. what we do know is there is a period in early 1920 when many americans do die of influenza

and pneumonia. two of my great grandparents are among them. i had always assumed they were part of the flu pandemic until i found out they died in 1920. howard markle suggested to me that it could be a fourth wave or it's the first wave of seasonal flu. one of the questions is, whatever happened to the spanish flu. it's still around, the descendants, many of our seasonal flus today are descendants of that virus from 1918. it shifts, as it did in the fall of 1918, it does it again, it becomes less deadly, less infectious, and peters out, but it doesn't appear, it continues to be a part of the influenza world, so to speak. >> okay. next question. how did the news report about the 1918-'19 influenza, how

different was it then than now? >> i think nancy already gave one of the best examples, which is, again, that spain did some wonderful journalism, and that's incredibly important, we can attest the importance of good journalism in the world. and they wanted to get that information out there. in spain, i think it was part of the royal family that had come down with it and they felt it was imperative, that it was kind of their moral responsibility to let the rest of the world know that this thing was occurring. and that is not necessarily the case for other spaces that had greater censorship on their newspapers and the like. the united states doesn't have the same level of censorship as what's happening in britain or in france.

so that's the first big answer on that one. nancy, i think you've got more. >> it's one of the things that's really remarkable, and i'm often asked this question, did they just not have as good information. it's true that the information traveled much more slowly, right? there wasn't a 24/7 news cycle. but even the smallest towns would have one or two weeklies. pretty much most americans in the contiguous states would have had access to a newspaper and it would include international news, how many people were dying in germany and england, what happened to the queen's sister, and it would include what's happening in dear creek, down the road in white plain. it would have the really localized stories about, you know, so and so's daughter who moved away to maryland, seems to have passed from the flu. farmer jones down the street was sick and his three children are

also ill. it was really closely documented in the newspapers with a lot of really terrific information. it's before everything was digitized, newspapers were one of the most important sources for gaining access into how, literally, what happened. newspaper reporting has been really important and influential in our understanding, because, again, people still had news, it just didn't travel quite as quickly, but it was pretty good news, pretty well-done news, i should say, the news was very bad, obviously. >> that's true. we've got, again, and these are images thanks to our library partners who are partners within this program this evening. you've got some really good examples here. no program for combatting the flu, i think we looked at that one earlier. to look at the different levels of reporting as we're going through, the number of claims --

pardon me, there we go. right, so you can see that similarity in some ways. you get the daily update, just like we do today. so topeka, still in the clutches of the flu, epidemic continues to spread, 180 new cases, december 2, december 3, 200 new cases reported yesterday. so you had this same level of pretty expansive amount of information that you can get and report within 24 hours, which in some ways isn't bad. having a day to be able to process that information is not necessarily a bad -- is not necessarily a bad thing. and really, to support what nancy said, there's a lot of importance, and in some ways we're losing a real resource in information when we're losing our smaller newspapers, when they might be getting bought out and the like.

we can see different examples. these are not necessarily all small newspapers, by the way. in case you're joining us from outside of missouri, kansas area, let me make that part clear for you here. >> and you can notice too, the constant conversation about what are the rules, what are you allowed to do, should we be thinking of such a move soon, closing the state? a constant conversation and controversy, really, about what public health measures should be taken, when should they be taken, how long should they last, when can they be lifted. >> and you can see here, speaking to what nancy was talking about earlier, this idea of potentially a fourth wave, right? this is february of 1920. and still, how it's affecting communities, as that's going along. some of you have asked questions about globally, what did that look like. here is another really good example from "the scotland

herald," encouraging folks to do what they needed to do to try to stop the spread of the pandemic. >> okay. and how did the flu pandemic end in 1920? >> as i mentioned before, so influenza is a virus that moves very quickly. it's one of the reasons, right, that it's so difficult to get the flu shot right. they have to decide ahead of time which virus they think will be most important so they can produce this vaccine for us. by the time flu season comes around, that virus may have already drifted off into some other virus and the shot won't be effective at all. so it's a virus that's constantly changing, and that's what happens. it continues to change, and at some point, either, you know, with the end of the winter wave in 1919, or the end of the winter wave in 1920, it drifts enough to no longer be so

infectious and so deadly, because its interest -- its interest, i'm often criticized for an throw anthropomorphizing. there's a wonderful piece by jeffrey tauffen berger, he mapped the 1918 virus, he has a wonderful piece that talks about how the 1918 virus is still with us, it never went away fully.

>> there was no waves in the 1920 outbreak, the disease quickly reached its peak but there was no armistice to celebrate. this comes from the kansas state board of health epidemiologist. you can see this actually contradicts a little bit of some of the conversation, some things that you're seeing a little bit earlier there as well. so in kansas specifically, thanks to the kansas state library, we've got a very specifically outline of deaths and death toll. and i think -- did you have more? i apologize, did you have more on that particular question, nancy? >> no, but someone has just put in the chat, we want to call

attention to it, there is a thing online called the influenza encyclopedia, created by scholars at the university of michigan. they've done stories on 50 different american cities. given that we have an audience across the country, you may be interested in what happened in new york, what happened in louisiana, what happened in oregon. as i say, 50 different cities, they have a multiparagraph story, sort of an overview of what happened. and then they have a timeline. so you can look literally day by day by day. then they have links to lots of newspaper articles from that particular city's press. so depending on where you're from, you may find that a fun placing to to see what happened in your community during the pandemic. again, it's only 50 cities but it's an incredible resource, put together by really good scholars. they've done a lot of the work. if you want to find out, if not about your hometown, perhaps you can find a town somewhere near you. >> i would be remiss if i didn't at this moment also say, depending on where you're joining us from, look at your

local libraries. there are a lot of incredible resources there. reach out to a librarian. they are superheroes of information and can point you to some really good spaces. always of course reach out to us as well and our ever-gens resource center. there is likely a treasure trove of information. there may not be memorials. as a matter of fact i'm fairly certain there are not a lot of flu pandemic memorials around the united states. and some of that makes this unique, is that this pandemic is layered on top of this destructive, horrific, catastrophic global war. and so sometimes, and i'll say this as a caveat for some of the questions that may come up, on the real specificity of exact numbers, it's hard to tell

sometimes, and where to put -- you know, where do you put a number when you were serving for your nation, and you die of the flu. so there's some difficulty with exact statistics. and then at the same time, there's a whole other layer of just loss that occurs in this time frame. >> okay. and what are the most important things do you think that we've learned since the 1918 pandemic? >> nancy? >> that's such a great question. and i'll admit here my own bias is clear that i regret, i think there are things we didn't learn that led to -- like i think we

haven't learned to take seriously prevention and preparation for this kind of thing. we knew there would be a pandemic of some sort, but we weren't adequately prepared. this is my own opinion but my sense is we need to put more resources into preparation, for instance a more robust system for developing vaccines where you could use, for instance, the national laboratories. a better preparation plan locally, nationally, and globally. i think in part that comes from lessons that went unlearned, that we really didn't change our public health processes in the country hardly at all. and many countries did. the united states did not. one of the things we did learn that's super important, all the scientific research that's been done since. so we can see viruses now and we know how the virus works. as a result, we have a vaccine, which is just a stunning accomplishment, and how quickly it was done, beyond anyone's

guess, which again, that is a stunning accomplishment of the federal government for which i'm deeply grateful. another thing i think we learned was, as a result of what they went through, we know some things about what to do. someone asked a question, in fact, about the taking care of patients. we're so much better prepared medically to manage the disease now. and that's saving a lot of lives. we have antibiotics now, which they didn't have in 1918. so many of the secondary infections that people died from in 1918 like bacterial pneumonia we can actually deal with now. so scientifically we've advanced so many stages beyond what they all were hoping for and dreaming of in 1918, so much of that we've actually accomplished. but we didn't change a lot of other things related to how we provide health care and how we deal with the public health care system in the country. and again, that's a very politically charged question, i

recognize. so i'll just stop there. >> i'll pick it up by saying, neither nancy nor i are medical professionals. somebody asked the question, our best advice for staying healthy today. i would say it is listening to your medical professional. not your historian, as far as your health is concern. although we are a lot of fun to listen to. a couple of folks who you might be interested in following, michael osterholm from the university of minnesota, and powell kazanjian, are both epidemiologists who do work in this area and they also focus in on history as well. dr. kazanjian actually had a lecture recorded two years ago called "influenza's threat then and now." i couldn't recommend it more highly. it's also terrifying when you

get to the last part. i sat through at it first time live, and then you really appreciate just how spot on dr. kazanjian was. you can find that at our youtube channel, if you go to theworldwar.org in the upper right hand corner, you can delve into a little bit more about what could we have learned from the science perspective there at that particular lecture, just taking flu, if you go to our page, there's a youtube link in the upper right hand corner, click on that, type in "flu," it will pop up. that's one of those for me. we spend a lot of time looking at letters. one of my favorites, and i'm afraid i'm not going to quote it correctly or directly right now, is actually -- it's a wonderful -- i believe the name is ernest mckay, may be how it's

pronounced. it's this wonderful series of letters he's writing back and forth to his wife and daughter. and he serves overseas, then he comes back. they're debating whether she should come and visit over the holidays. he literally starts off the letter, i'm not sure you should do this, if you do, be sure to get the best car that you can, wear a veil. it's just wonderful, that we have these letters. so i would say one of those key things to -- that we can learn is how important it is to tell the people we love that we love them and to be sure to engage in that. i would also say kind of from a museum perspective, keeping those diaries, capturing your personal experiences, that's how all of this informs all of these other books. the book that nancy wrote, all

of this comes from these personal experiences. and as we're losing some of our amazing local newspapers, as they might be bought out by other spaces, we don't have the access to that. and certainly there are other spaces and technological places to share that, but make sure to share that information. that's another really important thing. >> and if your local historical society or local library or archive is doing a collection about the pandemic, don't hesitate, if you have a story to tell. that's been uplifting to me, seeing attention to getting the story recorded during this pandemic precisely because we realize how many voices we didn't have from 1918 and trying to avoid that this time. so on my little island where i live, the historical society, until we got into the most recent spike, we were doing oral histories and trying to hit first the medical providers,

people who are doing testing, then who is working at the grocery stores, on through, the school kid, trying to get all those voices that a hundred years from now will be really helpful as people are trying to make sense of it from the future. so tell your story. >> okay. are there any additional resources that you would recommend for people who want to find out as much as possible about the pandemics? >> absolutely. and i'm going to kick this one off. and i would say that one of -- and one of you -- here is the person, if you are still watching this, thank you for telling us this was a great resource and you watched it in preparation for this. we have our resource called "how world war i changed america," you can find it at

wwichange.org. we've got a whole series of seven minute or less videos as well as teacher resources, videos, podcasts, lesson plans, primary source stuff you can assign for them to do from their home if you would like. that is available. there's also, i believe this is what sharon mentioned at the beginning, a lovely resource list that includes fiction, nonfiction, that is there on nextkansas.org. and it is there listed under the "we've been there before" suggested reading list. one of you asked did the flu influence the arts as much as the war did. really good question. it's difficult to really pull apart, because those two events layer on top of each other. i would say that certainly the war influenced some writers in a

very different way. you've got winnie the pooh, tolkien, c.s. lewis, all of these folks who spend some time and their writing is in some way a way for them to process their experiences as well. but you've got some wonderful things to be looking at there for in that spectacular reading list, so do take a look. if you're in and around the kansas area, and thank you so much for emailing me about this, take a look at "pandemic on the prairie," a little podcast about the intersection of public health and war in kansas. you can see the web address, nancy, if i'm not mistaken, you're one of the first episodes. >> and i believe john barry is also part of it. i suspect there are several other scholars involved with with it, doing really nice work. >> also take a look at nancy's book, "american pandemic: the lost worlds of the 1918

influenza pandemic." we've also talked about a couple of other things as well that we've been trying to fill that into chat. hopefully you're getting that in the facebook live chat as well. nancy, other resources you suggest? >> i popped my two favorite pieces that if you want to just get a sense of the lived experience of it, in some ways there's two semi autobiographical novellas that are terrific. i put them both in the chat. one is william maxwell's "they came like swallows." he would go on to be a well-known writer and editor for "the new yorker" for years and years. he was a child when his family faced the pandemic, i won't spoil it, i'll just say that. he tells the story from the perspective of different family members. catherine stewart had influenza

and she writes about her own illness and that of her beloved adam, it's all bound up in the war and it's very effective on the mental phase, the psychological complexity, how hard it was on the patient in terms of what it did to their minds. those were my favorite, favorite pieces. and great reads, and not very long. then there are lots of good scholarly books out there. gina colada, if you're interested in the search for the virus itself, her book "flu" deals with that, it's a masteriful piece. if you're interested in what happened in the military, it starts in the military and the camps are hard hit by it, a very good book called "fever of war" deals with the pandemic in the ranks of the military for the u.s. as well. and then laura spinney's "pale horse," one of the newest books, it's an international history, a beautifully done book by a very well-known international journalist. i think she hails from england,

lives in paris, and wrote this beautiful book that's just one of the newest books i think on the pandemic. >> i am also -- i have not had the opportunity to read these but two other things that were suggested to me were marilyn holt, she wrote great articles pertaining to the spanish flu for kansas history. if you're looking more for the kansas angle on this. someone asked -- a couple of people, actually, asked really good questions about orphans in and around this time frame. we would specifically encourage you to look at ellie vance's thesis from 2019. also if you are around the kansas city area we would encourage you to take a look at the strawberry hill museum, they've got some really nice information about specific -- some things specific to this, to

our region. >> and one thing to be said about the orphans, it's a wonderful question, especially for this pandemic, one thing we didn't talk about was that this took -- it was in one of your charts, that covid is taking especially the elderly, which is what we expect where influenza traditionally takes the very young and the very old, but 50% of the deaths in the united states were between the ages of 20 and 40, a.k.a. parents, so huge numbers of orphaned children. my uncle lost his parents, a 15-year-old who in the course of less than a week, he becomes an orphan and an adult, and he's one of literally thousands of young people to whom that happened. good lord, somebody just put in

the chat, i had talked to someone 104 years old who lost both their parents on the same night. can you even -- oh, my god. >> you guys can all see why i always enjoy having conversations with dr. nancy bristow. so a couple of other questions that i see here, we've got just a moment or two. has anyone addressed property and assets because of the flu. nancy, do you by chance have a -- >> i don't. it's a wonderful question. and the issue around the economics of the pandemic and its aftermath are just now being studied with obviously significant interest. there were some early studies that suggested that the same communities that had low death rates also recovered economically more quickly. but this was very preliminary work. so i don't know if that's been borne out over the last few months with additional research or not. but the questions around the

economics of the earlier pandemic will be even of greater interest now. i'm even less of an economist than i am an epidemiologist. >> what u.s. city fared the best, the fewest deaths from 1918, which also kind of begs the question, is there one that fared the worst. >> the worst is probably pittsburgh and/or philadelphia. both had just disastrous, catastrophic experiences with it. philadelphia is always the story that gets told, because they hold the liberty parade just as the pandemic is hitting them. three days later, they have 600 plus new cases. and it's the beginning of a terrible experience with the pandemic in philadelphia. in part, that's not their fault. they were one of the really early cities. so in general, western cities do better than eastern cities because they have more time and they have the experiences of other cities to look at. some of the cities that do

really well, milwaukee, wisconsin does really well. they had a, quote, progressive, as in the progressive era, public health system. they had developed it over the preceding ten or 15 years, they were well-prepared for it, put a lot of measures in place and had a low death rate. seattle does well. several cities in the west do reasonably well and several cities in the east had just catastrophic experiences. >> i'll answer a couple of other fast questions and then if you're willing to stay on for just a few more, we can officially close. a few more of the in depth questions that we have here. andrea asks, how were individuals with severe respiratory conditions treated since they couldn't wear a mask? i would say in many cases the masks weren't made of the same material they are today, they weren't as effective, but also if someone had a really significant respiratory issue, that wouldn't necessarily have

been a problem. i happen to think of -- your question triggers something like gas sort of -- things along that line. that's not somebody who would be going out and about and doing other things, they wouldn't be out trying to -- or being in those spaces, i think, with some of those ordinances. i could be wrong and i really haven't delved into some of the protests of masks. nancy, do you have more? >> no, only that, again, because you either were sick or -- how can i put this? those who were really sick, often you'll see that the caregivers are wearing masks, but the patients often are not. and i don't know the story line behind that. but you're right, this is a respiratory illness so the idea of putting a mask on people who are literally, if you're dying from the spanish flu, you're drowning in your own bodily fluids. so breathing is so belabored that those people would not have generally been wearing masks, is my sense, at least from looking

at the photographs. that's what the photographic record seems to say. >> it would be lovely to have a list of all the recommended readings mentioned in this program. we will do our best to get those together. and i know that we have several librarians who are a part of this conversation here tonight, so i'm hopeful that someone has been tracking all of the different things that we have all kind of thrown out along the way. and somewhere between the leavenworth county public library which is showing this on facebook live as well as the national rover museum and memorial facebook page, we'll certainly do our best. sometime soon, we'll get that information out there. all right. as it is 8:03, we want to officially thank all of you for being a part of our conversation. i think, rimsie, are you

available for just a few more minutes for more questions? >> yes. >> fabulous. nancy, would you be willing? >> sure. >> i have another family zoom call coming. >> they won't be surprised, i'm often late. >> to you who joined us, thank you, the most valuable thing you share with us is your time. we are so prevent that you use your time to engage in conversations on history and on the enduring impact of world war i. those lessons that we can learn, because in some ways, we have been here before, and there are things that have occurred in the past that can help inform and create gracious, interesting, funny conversations for the present and inform our science and how we keep moving forward. and i apologize, i keep hitting my keyboard. i also want to say thank you to

our libraries for whom i will not name all of them, but for those of you all, if you belong to one of the libraries, i must say you've got to be so proud. it is such a delight to be able to work with them all. they work together so very well. you are truly lucky, and wherever you are, if you do not have your library card, go get it. you most likely have an incredible treasure right there. so do renew that, check out dr. nancy bristow's book, or any of the other resources that are available. and feel free to stay on in the kind of post-conversation where we'll address a couple of more of the questions. again, thank you all so very much for joining us for our conversation.

all right. so i think we do have a couple of more -- thank you to those staying on, man, there's a lot of you, 150 plus of you who are staying on with us. that's delightful. all right. we've answered steven right there. dean asks, are there any records of mental health consequences of the pandemic? >> such a great question. i think we know much less than i wish we did. but it's very clear that mental health was often a sequela, often a consequence of this pandemic, that this particular illness would lead to depression for many people. sometimes i suppose it was situational, because terrible things were happening, we were in the midst of a war, we were in the midst of a global pandemic, we all know how difficult that is to manage. also there seemed to be a physiological connection to mental health. so a lot of mental health trouble in the aftermath. i think one of the things that we didn't understand then was

post traumatic stress disorder. i think of the caregivers. this is a very traumatic illness to witness, it was an ugly disease, to be blunt. i won't go into the grossness of it but trust me, it was an awful thing to see. we don't have an awareness, there's not a recording of that. it's one of the things i wish, if i could go back in time, it's one of the things i would like to know more about. it's a wonderful question. and i like the way you framed it, because i think it's one of the things we can be thinking about now. that's something we can do better, i think, than they did in 1918, and that's to really attend to the wellbeing of those of us in our communities who have suffered, who have gone through loss, who have been sick themselves, and have the space to listen to them, to feel for them and with them. i think it would be a really important role that all of us can play as we come eventually into the aftermath of this. so i really appreciate that question. >> lindsey asks were schools still in session in the 1918 pandemic because they didn't

have the ability to do online school. you know, they were in session and then at times they were not in session. somewhere upwards of -- and we give the example with the kansas letters, upwards of a month for some schools. it really does depend on your different communities. lovely followup, thanks for that. >> and chicago and new york did not close their schools, because they believed, given the population and the large number of recently arrived immigrants in particular, that the best way to get public health information out to the public was through the schoolchildren who were english speakers. so both of those large school districts decided to stay open because they thought that they could do better public health education through those school districts than they could if they closed them down. very controversial, always a huge debate in every community about whether to close or stay open. it was for a much more finite length of time, so it made it possible to close down. the other thing is, for many communities, it was during the

winter holiday. it may have fallen over the christmas/new year's period, often that was when some of the worst wave -- or they could be closed and extend it a couple of weeks because they were already going to be on holiday. >> a teacher asked about the resource. this is a copy of it right here. beth carnegie, we were prepared for a portion of this question about orphans. we didn't have a chance to really dig into that very specifically. feel free to email specifically or if someone else has a question about this, to education@theworldwar.org. cherie kelly did very specific deep dives for you in some of this and we would love to share that with you as well. so thank you for those questions. rimsie, i think you had a couple of other questions as well. >> i do. one of them is, what was the

overall effect of the pandemic in 1918 on the u.s. economy? was it as bad as now? >> such a hard one, because you can't separate out the war and the pandemic. so you have the demobilization of the war. we have what was always described as a postwar recession. now we're asking ourselves, to what extent was that a postwar/post-pandemic recession, in other words what role did the pandemic play. i don't think we know the answer to that question yet, but it's a really important one. ing one that, again, is really different, things within the just closed for as long of a time period. so the kinds of economic impacts were different than they are today. and much more of a localized economy, much less of an international economy. so again, it's a really different situation, and one about which i know very little. >> okay. and one question i have is, did

president wilson actually have any kind of a medical expert like dr. fauci who he could get advice from or speak to journalists to try to explain what was going on? >> dr. rupert blue, the surgeon general, was instrumental. he was the primary voice for the spreading of public health information during the pandemic. and then that would be complemented by state and local public health leadership. the thing that's so strange about wilson is that he literally never speaks about it to the american public. so he may be getting information but he's certainly not sharing it. he is getting information, because he talks with people about whether to cancel the liberty loan, whether to slow troop movements. but he is unwilling to slow down because the war is in its closing stages and he's determined had to get the war done. >> here is a really good example

of how surgeon general blue doesn't necessarily use woodrow wilson as his -- as the speaking point. he's going straight to journalists to share this information. a really good question. i would love to ask this question, nancy, it will have to be to you, mary lancaster, i believe you're still on, thank you so much for that. she asks this very specific question. so when we say 675,000 died then, of course that is just 48 states, correct? what about in other u.s. territories? i assume those were added somewhere else. and of course we didn't have hawaii and alaska. great question. i'm going to start by saying, we had the real honor to work with the anchorage museum over the summer, and we had an expert who

is also from a tribe as well, who spoke to this specifically. you can find out more about that lecture, go to our youtube channel, type in "flu" and it will pop up, and you can find out more about the alaska experience. that is just the resource i can give that is a lot more comprehensive than what i could speak to. but nancy, you know a lot more about this than i do. >> it's a great question. and again, one of the things that's really hard is the recordkeeping was different in 1918 than it is now. and as you showed us, each community is keeping track. but influenza wasn't even a reportable disease when the pandemic begins. so the numbers are really -- the 675,000, to be clear, it's not a complete guess but it's really a

guesstimate, as are the worldwide figures. we just don't know for sure. you're absolutely right, we're talking about the united states as it was configured at that time. it's not including the philippines, puerto rico, cuba, these places that were actually at that point had been annexed by the united states or american colonies. those are not, i assume, included in those figures. but it's a great question. i'm not sure i know. the figure 675 needs to be handled with care because in any given traditional year, more than 100,000 people would have died of influenza anyway. so it's about 550,000 excess deaths. so about half a million people died more than would have normally died from the flu. so again, the numbers are really sketchy. they're best guesses. people have done really hard work to make good guesses. but again, we don't have information from a lot of places.

>> rimsie, i think i cut you off before. >> okay. i was wondering, okay, as far as how covid-19 has affected different demographic groups such as race, income level, and age, did the same thing happen in 1918? >> that's one of the things that's really hard to know, because the recordkeeping was really problematic. so depending on which newspaper you read and which public health report you read, you can get arguments that say african-americans died in higher numbers and african-americans died in lower numbers. what we do know is that access to health care was deeply influenced by the jim crow system, so that we know that people of color in general didn't have the same access to hospitals or public nurses that would have been going door to door to help families.

poor families without a social safety net were much more likely to end up hungry, to end up homeless, to have to put children into orphanages even when the parents were still alive. so we don't have data on death rates that is secure enough to trust. and yet there do seem to be reports that suggest the black community had a lower morbidity and mortality rate, that some people suggest may be accurate enough to work with. and then you have to ask questions about, so what is that about. and there's all kinds of guesses having to do with segregation, having to do with rural populations, having to do with people already infected early in the cycle. we just don't know very much. so we just don't have the same good data. what we do know is that the experience of it was much harder if you're a person of color or a poor american or, worst case scenario, both of those things. the tribal communities, by the way, also suffered very badly.

and that we know pretty definitively. >> there was a great question from dan here about how did the rapid onset of the disease in otherwise young and healthy adults, end of life symptoms, impact people's fear in 1918. again, that's a really difficult thing to address, because like today, where we've got our pandemic and a variety of other things that are all kind of occurring at the same time, you have this pandemic, but you also have this, again, global catastrophic -- the fear of socialism, the rise of the red scare, all these things are intermingling, political, economic, social, all these things may be contributing to people's fear. so that's a really good question and a difficult one to answer. there is also a question from will who is joining us on facebook live who said, nursing

was -- was asking a question about nursing, how did nursing change as a consequence of the 1918 pandemic. and i'm first just going to say some of it is going to be because of all of the tremendous changes that occur in nursing because of world war i. i want to expand that question just a little bit, because that is a moment that vastly changes the profession. i was very lucky to work with george thompson to help bring a symposium, again, we've got i think two lectures on the website, on the youtube channel, that looks very specifically and unpacks some of this. that's my short answer. a lot of my answers are just, there's another expert you can really do a deep dive with at our youtube channel that nancy bristow, you've got more answers. >> and mine is actually a more -- a higher level answer. so it's less about the practice of nursing than it is about the

status of the profession and women's experiences as nurses. one of the things that's really important to remember is that gender norms were much stricter in 1918. so nursing was much more of a female profession. for physicians, this was a disastrous episode, really crushing to professional pride for some of the physicians, because they can't do what they're supposed to do which is fix it, stop it, cure people. so for many people it's really a disillusioning and depressing situation. whereas for nurses, it's fascinating to read letters, diaries, school yearbooks from nursing schools where they'll talk about, it's so awful to see the sick people, but then after work we had jolly good times, or it was really awful but it sure felt good to make good as a nurse, or i really feel as a woman i arrived. they could feel good about what they were doing, they were

fulfilling their role as a nurse and fulfilling their role as a woman through that nursing. for the nursing profession, it was a real boost in a sense for them professionally. they had just a very different sort of overarching experience of what they did and what happened during the pandemic. i think they leave the war and the pandemic combined with much higher status, they're recall celebrated. nurses who die are talked about as being just as brave as the soldiers in the trenches. so there really is a fair amount of public, cultural, and obviously also political status that's gained as a result of the war and the pandemic together. >> kiana asks, was pandemic denial a thing in 1918 the way that covid denial is a thing today? were there people who insisted the flu is a hoax? from a museum memorial perspective, i don't have any archival sources that suggest that. i do have -- we've got resources

that do say people didn't want to -- they didn't want to abide by ordinances, the same kind of tensions that arise about, you know, where do you -- just priorities, and it's economics, right? where do you take the opportunity cost. but i don't have any evidences, any archival evidence. it looks like -- nancy? >> no, the one thing you do see, there's one population, for christian scientists, actually, they believe it's not a hoax, but they believe it's being caused, that the fear itself is causing the illness because they understand -- and here i'll be very careful because i'm not a christian scientist, but they use the language that, right, christian science, it's christ scientist is the church's name, so the belief has to do with having the right relationship with god, which is a very

studied relationship, is how one stays healthy. it's because that relationship is flawed that people aren't in the right mindset with god, that's what causes illness. so they believe that all the public health measures are actually making people worse, that the wearing of masks is causing people to be fearful which is causing them to get sick. and i have letters, for instance, between a mother and a son or things published in "the christian science monitor" and published also in local newspapers about the resistance of christian scientists to the restrictions and their belief that all those restrictions were only making things worse. but that's a very small population, with a very distinctive theology that led them to those perspectives. >> alan asks the question, at some point would love to hear what preventive efforts were different in 1918 versus now. i would say potentially one of them that was effective that we have come back to is this desire

to be back outside and be in open spaces. i think all of us have experienced a lot more time in our city, national, state parks, recently. and those were celebrated and new at the time. so i think that there was a greater emphasis on kind of being an outdoorsman or outdoorswoman at the time, which we are coming back to. that's one of the few things that i might be able to go to as far as preventive efforts. there's interesting things folks do with food as well that may not have been quite as effective in trying to prevent the flu. they also encouraged you not to overeat, not to overdrink. both of those are probably sound, not necessarily, again, against the flu pandemic. they did also suggest to not kiss people you didn't know all that well. so again, effective, but i don't know if that is -- it's not

really speaking exactly to your question. >> and the other thing that's going on, right, is this is the era of patent medicines, right? so the week before the spanish flu arrives, something being sold to ease your joint pain, when the flu hits, it will make you get better quickly, and there's scads of newspaper articles, advertisements, for instance, about all these different things that will save from you the flu, which of course didn't. and then the folk traditions that lora was speaking to earlier, there was the largest array, from breathing in the fumes of boiling red peppers to asphoetida necklaces. and who knows, i'm not in a position to know what did and didn't help, because part of it was psychological, did the fact

that you were able to do something make you feel a little better? i don't know. so i won't pooh-pooh what people choose to do if it made them feel a little more hopeful and less depressed, go for that onion diet if you need to. of course now you can do that because without your sense of smell, you can go ahead and eat an onion, right? sorry, my nephew had covid and lost his sense of taste and smell and sent me a video of him eating an onion, the whole thing, it was so awful, he was proving how sick he was by sending this video. they were doing that in 1918. >> not sending videos, they were not sending videos in 1918, but eating onions, definitely. if you want that onion soup recipe, that is available on our database, look up allied cookery. there is a really great tamale recipe as well if you start doing your digging in the online collections database. the cookbook that the onion soup

recipe comes from, allied cookery, is really delightful. we have a culinary exploration of world war i, if you need a gluten free chocolate cupcake recipe, we have you covered. but it is almost 30 minutes past time. nancy, i cannot begin to thank you enough for sharing your expertise, your time, your humor, with us this evening. >> lora, thank you, you know anything i can do for the public libraries, i'm always available, and i really mean that. the public libraries and the librarians that run them are a national and local treasure as is the world war i memorial and museum. again, it's just an honor and privilege to be with all of you and have a chance to talk about these things that all of us are thinking about and worrying about and having a chance to be together, i think it lifts the spirit a bit, so thank you very much for including me. >> thank you. and rimsie, thank you so much, not only for being a part of the conversation and bringing the spine of our questions, but also

for the work that you do as a journalist in the community, as a historian i can say, it is so important to have these stories, to have that facts and information that is published in communities around the nation. thank you so very much for what you are doing at the platt county citizen. >> thank you very much. >> to all who are listening, again, thank you. i'm actually going to give the last word to an epidemiologist i know, dr. john kafarti. for those who have asked for other good information, the last word goes to an epidemiologist in cincinnati, ohio, who suggests these three things. avoid the three c's. closed spaces with poor ventilation, crowded places with many people nearby, and close contact settings such as close

range conversations. it's the type of thing you could have seen in a chrome we chromolithography advertisement of the time. have a wonderful, wonderful evening.advertisement of the ti. have a wonderful, wonderful evening. weeknights this month we're featuring american history tv programs as a preview of what's available on the weekend on c-span3. tonight we look at crime and forensics. bruce goldfarb, author of the untold story of francis lee and the invention of modern forensics shows doll house scenes that are used for forensics training. he relates the story of ms. lee who constructed the dioramas.

watch tonight at 8:00 p.m. eastern and enjoy american history tv every weekend on c-span3. american history tv on c-span3. every weekend documenting america's story. funding for american history tv comes from these companies who support c-span3 as a public service. next on american history tv, california state university professor andrew stoner talks about his biography of author and journalist randy shilts who covered the hiv/aids epidemic for "the san francisco concorrectly" and died of aids in 1994. professor stoner describes his work.