Patients coughed up blood riddled with parasitic bacteria, spraying it across hospital rooms. Dying bodies inflated with the air seeping out of their punctured lungs. Huge numbers of otherwise healthy young people died within hours when their powerful immune systems turned on them. Worldwide, between 50 million and 100 million people perished. Among remote populations that lacked immunity, the mortality rate often exceeded 90 percent. Cities threw the dead in mass graves—unless, as in Philadelphia, too few workers remained to bury them all. Scientists and governments were powerless to stop it. This is no horror-movie vision of Ebola or the Black Death. These are stories from the Spanish flu pandemic a century ago, which claimed five times as many victims as World War I. More scientifically rigorous accounts exist, but Arnold, a popular historian, has assembled the most terrifying eyewitness testimony. The lessons are obvious. A pandemic today might well spread even more quickly and kill even more people. General multipurpose vaccines—even genetically engineered ones—are often power-less to combat diseases that mutate rapidly. Only a permanent global system that can quickly diagnose and treat people could blunt the spread of such a scourge, yet governments still underfund such programs.
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