Diarmaid Ferriter: It would be a mistake not to reflect on trauma of pandemic

When the Covid pandemic first began to wreak havoc, historians understandably looked to the past for guidance. Would this contemporary crisis be akin to the influenza pandemic of 1918-1919? Would we endure, like then, three waves until it greatly weakened rather than disappeared, leaving us able to manage rather than defeat it? How did those afflicted in 1918-1919 deal with their crisis? One of the paintings widely used to depict that period is Norwegian artist Edvard Munch’s Self-Portrait after Spanish Influenza (1919) which reflects both trauma and survival through a vividly portrayed anguish: “Illness, insanity and death... kept watch over my cradle,” the tormented Munch declared, “and accompanied me all my life.”

Art historians would suggest such depictions were due to contemporary despair at the combination of the impact of the first World War, influenza and political upheaval. They created existential angst about a world in chaos. We have our modern equivalents, especially due to the combination of Covid and climate crisis, but Munch’s comments are a reminder of the limitations of comparison. Life expectancy then was much lower and dying of infectious diseases was not unusual, meaning what happened was not as striking to contemporaries as it seems to us.

But the internalisation of trauma does not belong to any one era, and we just do not know what long-term psychological impacts will result from what we are living through. In promoting his new book, A State of Emergency, journalist Richard Chambers noted that he could find little written on the 1918-1919 pandemic: “Why didn’t we reflect on that? Why didn’t we learn the lessons from that? In Ireland we have this difficulty in reflecting on and speaking about traumas.”

Ida Milne has pointed out even growing up in the 1960s, 'damage from infectious diseases was part of the landscape of our classrooms'

While there are excellent books on Ireland and the great flu, notably by historians Ida Milne and Caitríona Foley, it seems surprising it is not better documented. It was somewhat buried between the war and our own revolution and the reluctance to reflect was not just an Irish reticence. The medical profession was flummoxed and according to Guy Beiner, who has written on the memory of that pandemic, it “irreparably punctured positivist confidence in modern science”. Some 20,057 people in Ireland were officially reported as having died of influenza in 1918 and 1919, regarded as a conservative estimate, while the average annual rate of influenza deaths for the years just before the war stood at 1,179.

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What Beiner has termed “Forgetting the Great Flu” was partly because it was not “lodged in popular memory as a cause of terror”. There were so many potential diseases to contend with. Ida Milne has pointed out that even growing up in the 1960s, “damage from infectious diseases was part of the landscape of our classrooms”, evidenced in damaged hearts from rheumatic fever or those struggling to walk due to polio, and TB was far from a distant memory.

We had another version of a 'triumphant climate' last year, marvelling at the speed with which the vaccines appeared

Vaccines began to make a huge difference, but also generated complacency. Yale medical historian Frank Snowden argues that the “triumphant climate” of the 1960s and 1970s proved to be “spectacularly misplaced”. Snowden has been at pains to point out that “Epidemic diseases are not random events that afflict societies capriciously and without warning”. They are shaped by the actions of the societies they infect, especially when humans destroy their environment. Covid-19 was not a shock to many scientists; they had long predicted a “Disease X” and, according to Sarah Gilbert, one of the scientists instrumental in the development of the Oxford AstraZeneca vaccine, “we did see it coming but we had not been able to persuade anyone to spend the money that we needed to do what was required...We need to ensure that when disease Y arrives, we are more prepared for it than we were for X.”

We had another version of a “triumphant climate” last year, marvelling at the speed with which the vaccines appeared; they have made a profound difference, but are not a panacea. Once again, we are facing the spectre of a health system being, as we are constantly reminded, “overwhelmed”.

That too was a factor in 1918-1919, but should it be now? This time next year the State will be preparing to mark the centenary of its creation. How we have fared will make for an interesting debate, but the remarkable failure to provide a health system that can cope with crisis in what became a wealthy, stable state, keen to project a progressive and civilised image, should surely be one of the bigger questions. It will remain relevant well into the second century of the State’s existence, not just because of the damage caused by Covid itself, but because of the knock-on impact on other health issues, the postponement of so much other vital care and the psychological impacts of the societal scarring, which may, if history is a guide, be buried due to an updated version of amnesia.