A migrant resident of Castel Volturno ties himself to a lamp-post, reenacting the crucifixion of Jesus Christ, as a protest against the conditions endured by migrants in the area [Giovanni Izzo/Al Jazeera]

India lockdown has highlighted inequalities

The Out Of The Shadows documentary lifts the mask on how the mainstream media & Hollywood manipulate & control the masses by spreading propaganda  - CIA Involved in Hollywood deciding what film content people see
outofshadows.org The Out Of The Shadows documentary lifts the mask on how the mainstream media & Hollywood manipulate & control the masses by spreading propaganda throughout their content. Our goal is to wake up the general public by shedding light on how we all have been lied to & brainwashed by a hidden enemy with a sinister agenda. This project is the result of two years of blood, sweat, and tears by a team of woke professionals. making a donation at outofshadows.org Category: People & Blogs

  Agency Through Adaptation: Explaining The Rockefeller and Gates Foundation’s Influence in the Governance of Global Health and Agricultural Development 
by  Michael Stevenson

 A thesis presented to the University of Waterloo in fulfillment of the thesis requirement for the degree of Doctor of Philosophy in Global Governance 
  Waterloo, Ontario, Canada, 2014  
  AUTHOR'S DECLARATION I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis, including any required final revisions, as accepted by my examiners. I understand that my thesis may be made electronically available to the public.

  Abstract The central argument that I advance in this dissertation is that the influence of the Rockefeller Foundation (RF) and the Bill and Melinda Gates Foundation (BMGF) in the governance of global health and agricultural development has been derived from their ability to advance knowledge structures crafted to accommodate the preferences of the dominant states operating within the contexts where they have sought to catalyze change. Consequently, this dissertation provides a new way of conceptualizing knowledge power broadly conceived as well as private governance as it relates to the provision of public goods.  
  In the first half of the twentieth-century, RF funds drove scientific research that produced tangible solutions, such as vaccines and high-yielding seed varieties, to longstanding problems undermining the health and wealth of developing countries emerging from the clutches of colonialism. At the country-level, the Foundation provided advanced training to a generation of agricultural scientists and health practitioners, and RF expertise was also pivotal to the creation of specialized International Organizations (IOs) for health (e.g. the League of Nations Health Organization) and agriculture (e.g. the Consultative Group on International Agricultural Research) as well as many informal international networks of experts working to solve common problems. Finally in the neo-liberal era, RF effectively demonstrated how the public-private partnership paradigm could provide public goods in the face of externally imposed austerity constraining public sector capacity and the failure of the free-market to meet the needs of populations with limited purchasing power. 
Since its inception, the BMGF has demonstrated a similar commitment to underwriting innovation through science oriented towards reducing global health disparities and increasing agricultural productivity in poor countries, and has greatly expanded the application of the Public-Private Partnership (PPP) approach in both health and agriculture. Unlike its intellectual forebear, BMGF has been far more focused on end-points and silver bullets than investing directly in the training of human resources. Moreover whereas RF has for most of its history decentralized its staff, those of BMGF have been concentrated mainly at its headquarters in Seattle. With no operational programs of its own, BMGF has instead relied heavily on external consultants to inform its programs and remains dependent on intermediary organizations to implement its grants.   
  Despite these and other differences, both RF and BMGF have exhibited a common capacity to catalyse institutional innovation that has benefited historically marginalized populations in the absence of structural changes to the dominant global power structure. A preference for compromise over contestation, coupled with a capacity for enabling innovation in science and governance, has resulted in broad acceptance for RF and BMGF knowledge structures within both state and international policy arenas. This acceptance has translated into both Foundations having direct influence over 
(i) how major challenges related to disease and agriculture facing the global south are understood (i.e. the determinants and viable solutions);
 (ii) what types of knowledge matters for solving said problems (i.e. who leads); 
 (iii) how collective action focused on addressing these problems is structured (i.e. the institutional frameworks  
  Acknowledgements I would like to begin by thanking my supervisor Jennifer Clapp. Since assuming this role over five years ago, Jennifer has shown tremendous patience, kindness, commitment, and skill. She has provided me with a high degree of latitude so that I could explore new ideas and take on additional projects, emotional support in times of self-doubt, and guidance in the art of balancing work-family responsibilities and duel careers. I feel very privileged to have had such a wonderful mentor. I would also like to thank the other members of my committee, Andrew Cooper, Derek Hall, and Dan Gorman, whose expertise and editorial prowess were instrumental to ensuring that I had a defencible end product. At the University of Waterloo, I would like to thank April Wettig for the tremendous administrative and moral support she provided me with over the six years that I was a student in the Global Governance program. I would also like to thank Will Coleman for facilitating access to a much-needed work space at McMaster University in the spring of 2011, and Nancy Johnson for her efforts in ensuring that space available for as long it was. I would like to express my gratitude to my former colleagues at the Balsillie School of International Affairs, and in particular to Jason Thistlethwaite, Stefano Pagliari, Laura Reidel, and Michele-Lee Moore, whose great empathy and sense of humour made returning to graduate school the pleasurable experience it ultimately proved to be. I would also like to thank Michael Moran for helping maintain my interest in my research, and for making academic collaboration from half way around the world a lot of fun. Without a doubt my greatest debt is to my partner Lynne Serviss, whose commitment to me has remained steadfast. Lynne has endured many challenges borne of this PhD. Through them all she has maintained her optimism, wit, and compassion. I love her dearly for this, am extremely fortunate for her daily presence, and look forward to sharing a long life with her. Since initiating this project, Lynne and I have become the parents of two beautiful little boys whose love and affection have ensured that any research-related setbacks were always kept in proper perspective. Their curiosity, creativity, and physical energy are a constant source of inspiration, and we are incredibly lucky to have them in our life. I would like to express my deep gratitude to Tina Serviss for being such a wonderful Oma, and to David Serviss, Christine White and family for ensuring that holidays are always joyous. My mother Beverly Stevenson has been a bedrock of support and a wonderful Nana to her grandchildren, and I am extremely grateful for this. I would also like to thank the dedicated and caring staff at McMaster Children’s Centre, and our many wonderful Westdale friends. A very special thanks to Allison Henderson and Danny Priljeva, James and Danielle Warner, Andrea Soos, Chad and Heather Harvey, and the rest of the ‘book-club’ families. Finally, my love of reading and interest in world affairs were instilled at a very early age and nurtured by my parents. I am forever indebted to them for providing me with so many wonderful learning opportunities. My father would have been especially fascinated by the focus of my thesis research, and it is to his memory that this dissertation is dedicated. 
Table of Contents 
AUTHOR’S DECLARATION……………………………………………………….. ii


Table of Contents..………………………………………………………………………………v

List of Abbreviations.…………………………………………………………………………..vii

Chapter 1: Introduction………………………………………………………………………….1 1.1

Beginnings …………………………………………………………………………………...1 1.2

Contribution to the literature………………………………………………………………....5 1.3

The empirical evidence……………………………………………………………………...14 1.4

Methodology………………………………………………………………………………..17 1.5

Chapter synopses………………………………………………………………………….. 21

Chapter 2: Existing explanations for RF and BMGF agency in global governance……...

22 2.0 Introduction………………………………………………………………………………..

22 2.1 RF and BMGF as products of the American Polity………………………………………….

24 2.2 -Mainstream IR’s longstanding neglect of RF and initial disinterest in BMGF ………………

26 2.3 – RF historiography at a glance……………………………………………………………..

.28 2.4 The Small, But Growing Body of BMGF-focused Literature………………………………..

37 2.5 Conclusion…………………………………………………………………………………..42

Chapter 3: The relevance of existing theory to explain the agency of RF and BMGF……45

3.0 Introduction………………………………………………………………………………….45

3.1 Private Governance and Power………………………………………………………………46

3.2 Private power through the provision of public goods………………………………………...49

3.3 Knowledge Construction and Power…………………………………………………………53 3.4


Chapter 4: RF and The Progression To Global Health Governance……………………..66

4.0 Introduction………………………………………………………………………………….66

4.1 The Progressive/Immediate Post-Colonial Era……………………………………………....68

4.2 The Rise of Collective Consciousness………………………………………………………..84

4.3 The Neo-liberal World Order………………………………………………………………..95

4.4 Conclusion…………………………………………………………………………………109

Chapter 5: RF’s Global Influence over the Governance of Agricultural Development…111

5.0 Introduction………………………………………………………………………………..111

5.1 A Driver of state-backed agricultural modernization in the progressive era…………………113

5.2 Innovation in the IO era: The International Agricultural Research Centres…………………122

5.3 Adaptation in the Neo-Liberal Era: Innovating Around an Expanding Biotechnology Industry....130

5.4 Agency through adaptation in a neglected region: A focus on Sub-Saharan Africa …………140 5

.5 Conclusion………………………………………………………………………………….146 vi

Chapter 6: BMGF’s Influence over Global Health Governance………………………149

6.0 Introduction……………………………………………………………………………….149

6.1 The Perkin Years: Building on the PATH Approach…………………………………….....151

6.2 From General Contractor to Specialist Agency: Decision-making within BMGF…………..161

6.3 Three Criticisms of BMGF’s Influence in Global Health Governance……………………..169

6.4 The Future of BMGF’s Global Health Program……………………………………………184

6.5 Conclusion…………………………………………………………………………………186

Chapter 7: BMGF’s Global Influence over the Governance of Agricultural Development...191

7.0 Introduction………………………………………………………………………………..191

7.1 BMGF Turns Its Attention to Agriculture: 2004 – 2009……………………………………194

7.2. Beyond AGRA: Comparing RF and BMGF Agricultural Programs………………………..209

7.3 BMGF and Political Advocacy in the Governance of Agricultural Development…………...219

7.4 BMGF and the CGIAR…………………………………………………………………….228

7.5 BMGF and FAO…………………………………………………………………………...232

7.6 The limits of BMGF influence in the Governance of Agricultural Development…………...234

7.7 The Future of BMGF’s Agricultural Program………………………………………………238

7.8 Conclusion………………………………………………………………………………….240

Chapter 8: Conclusion………………………………………………………………….244

8.1 Summary of the Main Arguments…………………………………………………………...244

8.2 Three implications of states embrace of PPPs in health and agriculture……………………..255

8.3 Final thoughts………………………………………………………………………………270 BIBLIOGRAPHY……………………………………………………………………...274  
  Chapter 1: Introduction 1.1 Knowledge Construction as a Gateway to Power in Global Governance 

  Historically and continuing today, private foundations have played key roles in attempts to fill gaps created by public and private sectors within the United States. This phenomenon is both a reflection of and an adaptation to the longstanding distrust of ‘‘big’’ government and commitment to free markets embedded in the American psyche.

While certainly not limited to the United States, private philanthropic foundations are very much a product of the American polity 
  Ideas advanced by two particular private American philanthropic foundations,

the Rockefeller Foundation (RF)


the Bill and Melinda Gates Foundation (BMGF)

have featured prominently in collective-action focused on improving health and reducing hunger across the global South. This chapter articulates why RF and BMGF are worthy of an indepth comparison and how their common willingness to accommodate state expressed preferences within geographic and temporal contexts where they have sought to catalyze change in pursuit of their larger goal of providing public goods to vulnerable populations is at the root of the influence in the governance of global public health and agricultural development. Their agency, I argue, provides a new way of conceptualizing both knowledge power and private governance as it relates to the production and provision of public goods. 
  While RF and BMGF are but two of the approximately 60,000 private-grant making foundations currently registered under section 501c(3) of the United States Internal Revenue Code, RF and BMGF distinguish themselves by the fact that the vast majority of private American foundations limit the focus of their efforts to domestic issues and draw from endowments of less than US$10 million. RF and BMGF in contrast are the only American foundations with endowments of over US$1 billion that work on both global health and agricultural development issues. 
  While established in very different temporal contexts, RF and BMGF were both born out of the vision of individual entrepreneurs and the culture of American capitalism, and both have devoted significant portions of their resources to strengthen public health and agricultural systems in developing countries. RF was the first American foundation that took its domestic role (and all the potential benefits and shortcomings that came with it), and applied it to areas of the world where its leadership felt there was a need. Yet RF, now a century old, has largely dismantled its once vast agricultural program and appears to be reducing the scope of its public health initiatives as well. BMGF in contrast was only established in 1994 but has since become the largest philanthropic organization in the world and the single largest private donor to global health and agricultural development initiatives. Since its inception, however, BMGF has sought to emulate RF, both in terms of the issues on which it has chosen to focus and the strategies it has relied

on to bring about change. 
  This dissertation provides an explanation of how RF and BMGF have achieved influence in domestic, international and global policy making arenas regarding how public health and agricultural challenges should be conceptualized and overcome over time. Consequently the dissertation examines the ability of the two foundations to shape the actions and means adopted by individual states, the inter-state system, and global to society as whole, to organize itself in collective action focused on agricultural development and the promotion and protection of population health, including the delivery of collective solutions in pursuit of common goals.2 Both foundations, I argue, have displayed an ability to create and advance knowledge structures for understanding and responding to public health and agricultural challenges that have served as roadmaps for collective action. The central argument that I advance in this dissertation is that the influence of RF and BMGF in the governance of global health and agricultural development has been derived from their ability to advance knowledge structures crafted to accommodate the preferences of the dominant states operating within the contexts where they have sought to catalyze change. 

  From the first decade of the twentieth-century to the present, Rockefeller money has been illuminating how science-enabled innovation can help overcome longstanding challenges  perceived to be jeopardizing health and food security and constraining economic development across the global South. In the context of the immediate post-colonial era, RF funds drove scientific research that produced tangible solutions, such as vaccines and highyielding seed varieties, to longstanding problems. Moreover, it also led the construction of new institutions across the global South that trained a cadre of national leaders in the domains of public health and agriculture. For these reasons, the Foundation was accepted by such states as a modernizing force. 

Moreover, capitalizing on the rise in state support for international cooperation, RF expertise was pivotal to the creation of specialized International Organizations (IOs) for health (e.g. the League of Nations Health Organization(LNHO)) and agriculture (e.g. the Consultative Group on International Agricultural Research) and the spread of international networks of experts working to solve common problems. Finally, in response to the spread of neo-liberalism, RF demonstrated how the Public-Private Partnership (PPP) paradigm could provide public goods in the face of externally imposed austerity constraining public sector capacity and the failure of the free-market to meet the needs of populations with limited purchasing power. Since its inception, BMGF has greatly expanded the application of the PPP approach in both health and agriculture. 

  Consequently, the agency of RF and BMGF in the governance of global health and agricultural development is rooted in their capacity to anticipate and adapt to changes in the distribution of global political and economic power. The Foundations’ agency illustrates that one way for global governance schemes to be institutionalized and ultimately inform collective action is to work with, as opposed to contest, power asymmetries in the world order, so as not to risk losing the support of those with the capacity to undermine their effectiveness. As will be demonstrated in the empirical sections, both RF and BMGF have exhibited a common capacity to catalyse institutional innovation that has benefited historically marginalized populations in the absence of structural changes to the dominant global power structure. 

  A preference for compromise over contestation, coupled with a capacity for enabling innovation in science and governance, has resulted in broad acceptance for RF and BMGF    knowledge structures within both state and international policy arenas. This acceptance has translated into the Foundations having direct influence over (i) how major challenges related to disease and agriculture facing the global south are understood (i.e. the determinants and viable solutions); (ii) what types of knowledge matters for solving said problems (i.e. which “experts” are most suited to lead); and (iii) how collective action focused on addressing these problems is structured (i.e. the institutional frameworks).
  The two foundations’ influence in the governance of global health and agricultural development lends support to the assertions of critical constructivists that elites play a privileged role in the process of knowledge construction.3 Nevertheless the willingness of the two foundations to accommodate the expressed preferences of the most powerful states and firms within the contexts they have sought to catalyze change does not mean that the contents of their knowledge structures were intended to reinforce the many structural inequities stemming from the unequal global distribution of power. Instead, this dissertation demonstrates that their approaches to collective action have been purposefully adapted to externally imposed constraints and opportunities created by state expressed preferences within geographic and temporal contexts where they have sought to catalyze change. As transnational actors of influence, they have attained legitimacy by enabling the development of strategies and institutional frameworks devised by their own staff and/or the communities of experts they support, which have proven capable of providing public goods to vulnerable populations in developing countries when public sector authorities mandated to fill this role have been unable to do so. 

  1.2 New perspectives on public-private cooperation and knowledge power 
  The dissertation begins by briefly examining debate concerning the utility of philanthropic foundations in the context of American society. This examination is followed by a review of   what has been written to date on the subject of RF and BMGF influence over efforts to strengthen public health and agricultural systems in developing countries.
 I show how the RF’s influence over international policy related to public health and agricultural development was largely ignored by mainstream twentieth century International Relations (IR) scholars. Nevertheless, a diverse group of historians, sociologists, political scientists and public health scholars have contributed to the rich body of literature in existence chronicling RF’s many contributions to the theory and practice of international development. Typically, however, these works have been restricted in scope to particular activities (e.g. RF’s role in agricultural development) and geographical spaces (e.g. Mexico) and time (e.g. the immediate post-colonial period). Such specificity is critical for providing detail for the historical record. However, it does not lend itself to developing a broader understanding of the capacity in which the RF has excelled as an agent of change, how this has been accomplished, and why its agency has been important for the governance of collective action.  
  Over the last decade, however, three factors have culminated in a dramatic increase in IR theorists’ interest in the agency of private foundations in world politics, two of which relate to important disciplinary shifts occurring within IR itself. 

  First and most significant for this study, there is increased diversity of views of how power is distributed in the world order and what this means for solving complex global challenges. This is evidenced by the broad embrace of global governance as both a multi-theoretic perspective on the distribution of authority within the world order and a functional approach to how global collective goods problems are most effectively and fairly addressed. 4 Global governance as a perspective has emerged to address three critical shortcomings of IR theory: IR’s increasing inability to explain (i) the apparent decrease in effectiveness on the part of states and the interstate system to address critical challenges created by globalization;5 (ii) the dramatic increase of power (and sometimes authority) being wielded by non-state actors in  the governance of domains long associated exclusively with the state;6 and (iii) the competing normative agendas shaping the world order (i.e. the ideational realm).7 Global governance theorists thus view authority as having both structural and ideational aspects to it.

  Second, as evidenced by the broad embrace of constructivism as an approach by many scholars, increased attention is being paid to the origins and significance of ideas and norms shaping collective action. 

  Third, led by BMGF, a new generation of private American philanthropic foundations has emerged to focus on creating solutions for longstanding health and development challenges, which has elicited both praise and concern, thereby raising interest in their work as a topic of scholarly inquiry. 
  To date, the overwhelming majority of the scholarship that has sought to illuminate the influence of either RF or BMGF in the governance of global health and agricultural development has been undertaken by individuals employing theoretical lenses that can be classified broadly as being either liberal or critical in orientation. 
  Through the liberal lens, RF and BMGF have been portrayed in a predominately positive light. Liberals tend to see the Foundations as semi-autonomous entities that have strategically used their wealth to promote universal ideals, strengthen international institutions, and foster innovation.8 Their utility in the governance of global health and agricultural development has centered around public sector capacity building, providing support for both innovation in science and technology and inter-state cooperation,9 and more recently, bridging gaps created by states and markets adversely impacting the world  poor.10 In their capacity as “honest brokers,” liberals see RF and BMGF working to facilitate cooperation between public, private and third sectors in pursuit of creating viable solutions to complex challenges driving disease and hunger and inhibiting economic growth across the global South.11 At the same time, with no formal rule-making authority, the Foundations must convince states of the merit of their ideas in order to see them institutionalized. 

  Critical perspectives—which account for the majority of historical and contemporary analyses—tend to view the foundations as conservative extensions of the transnational elite, 12 seeking to reinforce the dominant liberal economic model via their health and agricultural development initiatives.13 Critical scholars have emphasized the inherent contradictions of the Foundations’ focus on reducing global disparities given the source of the endowments, and their affiliations with the same firms and states that have been the engineers and proponents of structural inequality in international institutions such as the World Trade Organization.14 
  Concerns expressed over RF’s historical influence in collective action range from its perceived bias for bringing technology-centred strategies to bear on problems that often have deep socio-political determinants, 15 to facilitating the blurring of private and public roles and responsibilities in global governance. 16 Contemporary critical global governance scholars, by contrast, focus primarily on BMGF. Even more than its intellectual ancestor, BMGF is viewed as a purveyor of (i) scientific determinism (i.e. expanding the biomedical  approach to public health and technological approach to agriculture); 17 (ii) market-liberalism (i.e. functioning as a vehicle for facilitating US hegemony by expanding markets for American firms); 18 and (iii) elitism in governance (i.e. skewing global research trajectories based on individual interests, 19 and undermining the legitimacy of public institutions via the promotion of informal governance mechanisms outside of IO control). 20 Its legitimacy in global governance is diminished by its private actor status, exemplified by its lack of transparency regarding how it makes decisions, 21 and that it cannot be held accountable for its actions.22 BMGF is thus considered by critical scholars to be an enabler of a top-down, technocratic approach to development, operating with insufficient accountability, transparency and legitimacy. Ultimately those employing a critical perspective consider the Foundation as incapable of challenging the structural determinants of inequality so long as it aligns itself with actors who benefit from such inequity. 
  Current concern over BMGF’s perceived lack of legitimacy, accountability and bias for technology and avoidance of social determinants of health are consistent with larger historical reservations over American philanthropic influence in development. These concerns originated in the neo-Gramscian literature in the 1980s, which also spoke to but was by no means limited to public health.23 What binds the two waves of critical literature examining the role of the Foundations in global health and agricultural development are the strong concerns expressed over the particular ideas that the Foundations have advanced   regarding the determinants of and solutions to development-related challenges, and the processes through which those ideas are advanced in the policy arena

  Critical scholars have played an important role in illuminating RF and BMGF’s influence in public policy formation related to public health and agricultural development. However by fixating on the Foundations’ status as members of the global elite operating with minimal accountability and limited transparency compared to their public sector counterparts, I argue that the critical lens has served to distract from RF and BMGF’s chief function as global governors, whilst understating their individual agency as discrete actors in world politics. 
  RF and BMGF’s comparative advantage over other actors has not simply been their ability to bring needed resources to bear on issues adversely affecting large segments of the world’s poor. Without explicitly chastising them, the Foundations have provided Northern states, IOs, and most recently pharmaceutical and agrochemical companies with institutional frameworks that work to compensate for their individual shortcomings as global governors. 
  This thesis differentiates itself from the liberal view of RF and BMGF’s power through the argument that knowledge construction has been and continues to be the basis of the Foundations' agency in global governance. While conceding that as non-state actors, the two foundations are unable to advance their agendas autonomously,24 the dissertation challenges the liberal perspective that RF and BMGF have merely been supporters of political change initiated by states. 25 In fact, they have been the catalysts of some of the most significant innovation in governance developed over the last half century, focused on the development and distribution of public goods geared towards the world’s poorest people. The combined effectiveness and political palatability of their ideas and strategies concerning how to strengthen public health and agricultural systems across the developing world has ensured those same ideas and approaches have been embraced and institutionalized by states. 
  The liberal-critical divide over the net-benefit of RF and BMGF’s involvement in the governance of global health and agricultural development underscores that the ability of a single private actor to shape how collective action problems are approached remains an issue of great theoretical and practical relevance for those who study the distribution of power within the world order. While other foundations have been examined in other sectors, to date, no single work has sought to categorize these two foundations as a novel form of transnational actor or provide an explanation for their agency over space and time in the governance of global health and agricultural development. This dissertation seeks to fill that gap. 
  By drawing attention to RF and BMGF’s agency, I am not seeking to make a generalizable argument about private philanthropic influence in world politics. Rather, I illuminate two exceptions that have attained an anomalous degree of policy influence because of their ability to shape collective action through knowledge construction. 
  The primary goal of this thesis is to demonstrate how knowledge construction has been the basis of RF and BMGF’s power and authority in global governance. The long-term relevance of RF and BMGF’s influence to the theory and practice of global governance, I argue, provides a new way of conceptualizing knowledge power broadly conceived as well as private governance as it relates to the provision of public goods. Consequently I argue that RF and BMGF have direct relevance to the broader literature on global governance theory related to public-private cooperation and knowledge power. 
  Since 1972, considerable scholarly attention has been paid to how the transnational network form has heightened the influence of non-state actors in world affairs.26 While states as a typology are still largely viewed as the most powerful and legitimate actors operating in the    world order, the hierarchy of non-state global governors remains unclear.27 Accordingly, this work seeks to contribute to a range of theoretical attempts to frame power, 28 how non-state trans-national actors employ power to achieve influence, 29 and where sites of private authority in global governance lie. 30
  Moreover the focus on both global health and agricultural development provides a unique opportunity to bridge common interests in private governance: for example, the blurring of private and public authority that is occurring across the development spectrum. Through a survey of some of the Foundations’ more prominent initiatives in the domains of global health and agricultural development, this dissertation seeks to provide a clearer understanding of the power exhibited by two unique and highly relevant actors in global affairs. 
      RF and BMGF do not fit neatly within existing actor categories in world politics. For example, RF has a legacy of providing technical advice to governments for improving services, such as disease control, which in the post-war era are almost exclusively provided by states. This advisory role is atypical for a private organization, for it is usually held by other public organizations, whether national such the United States Centers for Disease Control and Prevention, or international, such as UN specialized agencies. Yet the Foundation has also been a catalyst for bringing private sector resources to bear on these same public sector challenges, and an important underwriter of the activities of NGOs working at the grassroots level. Its proven capacity to innovate around public sector shortcomings and market failures, and its willingness and ability to interface between public, private and third sectors, in pursuit of increasing access to public goods, make it and its intellectual progeny a wholly unique form of transnational actor. Consequently, I argue that when viewed in isolation, no single theory sufficiently can explain the agency of RF and BMGF. However, when modified and fused, existing theories of power can in fact be sufficiently adapted to provide explanation for the two foundations’ influence in global governance. 
  First, this research builds on the theory of neo-functionalism.31 Proponents of neofunctionalism accurately predicted that technocratic influence over collective action would emerge from sources other than the IOs, which functionalists such as David Mitrany envisioned as the future centers of global governance.32 A lack of consensus among experts on complex issues has driven this emergence, and is explained by the fact that complexity ensures problems can be conceptualized in very different ways.33 Attaining public policy influence through expertise means demonstrating to governments the merit of embracing particular ways of understanding and solving complex problems. 
  Second, the dissertation leans heavily on the concept of epistemic community concept, often associated with Peter Haas.34 Historically, RF achieved policy influence at the national level by cultivating epistemic communities within the public sectors of the countries where the Foundation worked and building support for their unifying ideas through demonstrations of effectiveness. In this way, RF functioned as a norm entrepreneur,35 providing both visibility and credibility to particular ideas up for consideration in a competitive ideational realm. Moreover RF’s agency shows that decentralized and non-hierarchical global policy networks linking state and non-state actors are by no means a recent phenomenon.36 While this study differentiates itself from Haas’s work by showing that public policy formulating epistemic communities are cultivated within and emerge from sources other than public sectors, it nonetheless reinforces his core argument that for epistemic communities to see their ideas and norms institutionalized, states must first accept them. 
  Third, the research informing this dissertation draws inspiration from previous attempts to understand structural change,37 and builds directly on the work of Susan Strange,38 Doris Fuchs,39 and others, 40 illuminating the indirect authority of private actors differentiating itself from these works through its focus on private, not-for-profit, philanthropic entities seeking public policy influence. 
  Despite this differentiation, it is argued that the three ways of conceptualizing corporate power, as laid out by Fuchs, 41 apply equally to RF and BMGF. First, RF and BMGF’s power can be seen as being discursive, in that they have demonstrated an ability to successfully define or ‘‘frame’’ problems. Second, their power can equally be described as being instrumental, in that their frameworks for strengthening public health and agricultural development across the Global South has been repeatedly embraced by states whom they depend upon to see their goals realized. Third, their power can be conceptualized as being structural because of their ability to set both research and policy agendas. Historically RF attained agenda-setting power via the construction of epistemic communities within public sectors, which states looked to, in order to establish the rules and operational frameworks of the systems governing the provision of public goods intended to strengthen both public health and food security in both individual countries and across the Global South. Yet both RF and BMGF have attained structural power through their significant endowments, as a plethora of aspiring grantees seek their funds and are willing to work with the rules and processes favoured by the Foundations. RF and BMGF have used this structural power to bring innovative new governance approaches (e.g. productive development partnerships) to the attention of states, whose support is needed if they are to be institutionalized. Yet through the Foundations’ willingness to work within the confines of dominant paradigms (e.g. the neoliberal model), evidenced through their contemporary promotion of governance innovations that do not call for fundamental changes to the rules of the global political    economy, they may also be using their structural power to support existing structures of the global political economy which contribute to the problems they seek to overcome. 

  1.3 The Empirical Evidence
    In the first two empirical chapters, I show how RF’s influence over how public health and agricultural challenges have been addressed across the global South, has been contingent on the Foundation’s ability to perform three functions.
  First, from the second decade of the twentieth-century to the present, RF has been an enabler of science-enabled innovation. As such the Foundation has been effective in demonstrating for would-be adopters, how science and resultant technology can provide solutions to longstanding challenges perceived to be jeopardizing public health and food security and constraining economic development. 
  Second, in the immediate post-colonial era, RF’s technical expertise served as a point of entry for advising developing country governments on how their public health and agricultural systems were best organized. In all of the countries where it operated in this period, RF enabled country-level epistemic expansions, meaning the Foundation facilitated for states the training of indigenous communities of experts in select scientific disciplines. By virtue of their training, these communities of experts approached health and agricultural problems in ways that reflected and reinforced the dominant norms and ideas guiding the Foundation’s work. RF’s epistemic expansions heightened the credibility of its positions within national public policy arenas, and with the rise of collective consciousness embodied by the establishment of the League of Nations (LN), within international public policy making institutions the Foundation helped forge.
  Third RF has proven itself to be a master of private diplomacy. This means that the Foundation has repeatedly demonstrated a capacity to convene informal, private dialogue between those actors–initially states and multilateral organizations, but later civil society organizations and firms–whose individual receptivity and cooperative ability have been deemed essential for     the successful institutionalization of the Foundation’s strategies and institutional frameworks designed to strengthen public health and agriculture in developing countries
  In the neo-liberal era, Northern governments expressed a clear volition for private sector involvement in the development and distribution of global public goods. RF’s framework for creating vaccines for neglected diseases in the face of cuts to public sector research capacity accommodated this volition. The product development partnership paradigm used public funds and the promise of agenda-setting power to entice firms into innovating for the world’s poor, in order to overcome important state and market gaps. RF began successfully applying this approach in the early 1990s to such neglected diseases as HIV/AIDS, tuberculosis (TB) and malaria, which serves to demonstrate the Foundation’s unique capacity catalyze normative and institutional change in global governance in the absence of any dramatic changes in the overall distribution of political power.   
  In the second two empirical sections, I show how BMGF has embraced and expanded the scale of public-private partnerships as the basis for increasing access to public goods across the global South. While RF drew the scientific blueprints and business plans of many of the most prominent global health and agricultural partnerships in existence today, BMGF has become the primary financial backer for all of these initiatives. Moreover, in building programs from scratch, BMGF has relied extensively on RF’s network for guidance, as external advisors but also for filling leadership positions within the Foundation itself. This is particularly evident in its still nascent agricultural program. 
  Despite RF serving as an important inspiration for the Gates family in the creation of their foundation, there are substantial differences between the two organizations. RF’s credibility within the global South has been attained in large part by its long history of public sector capacity building in science, with an emphasis on providing advanced training to individuals though post graduate fellowships. While BMGF has shown considerable interest in investing in science, with some notable exceptions, it has been far more focused on end-points and silver bullets than investing in directly into the training of human resources. 
  Moreover whereas RF for much of its history decentralized its staff, those of BMGF have been concentrated at its headquarters in Seattle. For decades RF had field officers based in the countries where it has operated, who were constantly cognizant of on the ground realities, and directly involved in managing research or operational programs and training indigenous staff. BMGF by contrast has a handful of sparsely staffed regional offices and no operational programs. It has instead relied on external consultants to inform its programs, and remains dependent on intermediary organizations to implement its grants. 
  Furthermore, whereas RF’s grant making has relied heavily on building personal relationships and providing high-degrees of latitude to grantees as to how they achieve their ends, BMGF has moved towards a matrix-scale approach. Its emphasis on metrics and shorter end-points is both a product of making grants of much higher magnitude and a reflection of increasing bureaucratization within the organization, which now employs over one thousand people. 
  Finally, since its inception, BMGF has been represented on the boards of organizations it has played a lead role in creating or sustaining. With few exceptions, RF has had no representation on the board of entities it was involved in establishing. Instead, however, these new entities effectively became spin-offs of RF, with staff members leaving the Foundation to play a leadership role in the new organizations. While BMGF lacks RF’s historical memory and legacy in public sector capacity building, knowledge structures–even if unoriginal–remain the basis of its agency in global governance. However the degree to which BMGF can adapt to future shifts in the global distribution of political and economic power has yet to be determined. The implications of its agency and the significance of its contributions to global governance may only be appraised based on the first twenty years of its existence 
  In addition to providing a brief synopsis of the dissertation’s main arguments, the conclusion illuminates three broader implications of the embrace of RF and BMGF driven partnership paradigm for the governance of global health and agricultural development. 
  The first is that while PPPs have helped IOs such as the World Health Organization (WHO) and the Food and Agricultural Organization of the United Nations (FAO) perform their intended functions, they have also provided states with institutional alternatives through which to channel health and agricultural-related overseas development aid, which has indirectly undermined the IOs’ status as the lead coordinators of collective action in their respective domains. 
  Second, through PPPs, RF and BMGF have facilitated the unlocking of privately held intellectual property for the intended benefit of the public good without radical changes being made to the international trade law. However their ability to bring about such governance innovation has been limited to issue areas where they have demonstrated expertise, and trade-related intellectual property rights are just one of many drivers of global inequity adversely impacting public health and agricultural development across the global South. 
  Third, the proliferation of the PPP paradigm across the development spectrum has provided firms with new opportunities to become formally involved in the development and management of institutional frameworks guiding collective action aimed at reducing global disparities. While this has increased such firms agenda-setting power in global governance, through PPPs, the Foundations are illuminating how firms can help public authorities reduce socio-economic disparities without deriving profit or incurring financial risk. 

  1.4 Methodology 
   A combination of historical, interpretive and comparative approaches were employed to examine the central question of how the two Foundations exhibit power in global governance. This study is qualitative in approach given the emphasis it places on understanding how individuals associated with RF and BMGF perceive reality (i.e. what they perceive to be the core determinants of the problems they have involved themselves in addressing).42 More specifically, I incorporate elements of two particular qualitative research   approaches in order to answer the question of how the two foundations influence outcomes in global governance. Through the first approach, interpretive biography43, I set out to describe the attitudes and values of the professional groups working for, advising and empowered by RF and BMGF, related to public health and agricultural development. The second approach is that of phenomenology, which seeks to illuminate the interpretations of a particular phenomenon (in this case the influence of RF and BMGF in the governance of global health and agricultural development) by individuals who have experienced it (e.g. former and current program officers, decision makers within the two Foundations).44
  A comparative case study analysis, 45 of RF and BMGF’s work in public health and agricultural development, formed the basis of my explanations of how the two foundations differ. In this regard I sought to explain variation between what they do, why and how, with an emphasis on looking at the Foundations’ initiatives in a temporal context to assess the degree of commonality in their approaches. 
   Two stages of research informed this study. The first stage (from January 2010-October 2010) involved an extensive review of existing literature (monographs, journal articles, Foundation documents, and print media) on the RF and BMGF’s work in global public health and agricultural development. This was combined with a review of existing power theory broadly defined to gauge its relevance to the research question of how these two private American foundations exert influence in global governance, how this has been sustained over time, and why such agency matters.
  These reviews both informed and were supplemented by thirty-four key informant interviews (approved by the University of Waterloo’s Office of Reseach Ethics: ORE # 16468), undertaken in the second stage of research (from November 2010-January 2012). In an attempt to expose the beliefs and values informing the two foundations’ agendas and answer the principal questions that formed the basis for this project, sixty-five interview requests were sent to current and former Foundation employees, known external advisors,  representatives from state developments agencies (e.g. The United States Agency for International Development (USAID) and IOs (e.g. WHO)), organizations established with Foundation monies (e.g. The International Rice Research Institute (IRRI)), grantees, as well as non-associated professionals working in public health and agricultural development in the public, private and third sectors. Thirty-four of these individuals agreed to semi-structured telephone interviews lasting from between 25 to 150 minutes in duration.
  Subjects were selected based on the perceived likelihood of them being a rich source of information. Examples of interviewees include Akin Adesina, Former Vice-President for Alliance for a Green Revolution in Africa (AGRA); Catherine Bertini, Former Executive Director of the World Food Program; Robert Herdt, a former Vice-President of RF ; Tikki Pang, Former Director of the World Health Organization’s Research Policy and Cooperation department; Gordon Perkin, Co-Founder of the not-for-profit Program for Appropriate Technologies in Health (PATH) and the inaugural President of BMGF’s Global Health Program; Gary Toenniessen, Managing Director of RF and the founding President (interim) of AGRA; Tachi Yamata, Former President of BMGF’s Global Health Program; Ariel Pablos-Mendez, former Director of Health Equity at RF; and Robert Zeigler, Director General at the International Rice Research Institute (IRRI). 
  All interviews were ‘semi-structured’ to provide a common thematic template and a means to compare responses but also to allow for sufficient flexibility to capitalize on opportunities afforded by individual interviewees’ unique professional circumstances. This format provided an opportunity to ask both very general and very specific questions
  Examples of general questions posed to interviewees were as follows: 
  – Can you please describe the processes through which the (BMGF) Global Health program identifies funding priorities, makes grant decisions and reviews internal policies and how this may have changed in the last decade?
  – How, in your view, is the proliferation of global health partnerships occurring outside of UN framework affecting the ability of WHO to fulfill its mandate as the technical and coordinating authority for health issues in the international sphere?  
  – What, from your perspective, does accountability look like for an organization that advocates ideas, which to be realized – others must ultimately embrace or implement? 
  Issue-specific questions posed to interviewees included the following
  – Can you please speak about the evolution of the Montpellier panel (e.g. the individuals involved in establishing it, the rationale, and the role - if any played - by RF/ BMGF)? 
  – Up until recently, BMGF was a primary funder to the CIGIAR without regular member status. Accordingly, what were the motivations underlying the Foundation’s decision to become a regular member of CGIAR?
  – What is the Foundation’s view is on compulsory licensing? 
  Each interview was built on those preceding it until the data being collected no longer yielded new information, which indicated that the sample size was sufficient. All answers to the same questions were grouped and reviewed to allow for the identification of common themes. To be included in the dissertation, questions of fact required confirmation in the form of at least one published source. Because a primary focus of this project was to illuminate the ideas and norms guiding RF and BMGF, individual perspectives were included when it became clear that such perspective were representative of the views of a larger group. This confirmation came in the form of the same or similar answers to common questions. Moreover additional sources of data, such as newspaper articles and speeches, were used to ‘‘triangulate’’ information, concepts and normative perspectives. The focus of     the data analysis and interpretation was to identify themes in what were largely narrative descriptions provided by interviewees. 46 

1.5 Chapter synopses

Chapter 2 provides an overview of existing explanations for RF and BMGF’s policyinfluence in the domains of public health and agricultural development. This survey reveals that almost all analyses undertaken to date have employed either liberal or critical theoretical perspectives, which has produced two markedly different explanations of the Foundations’ power in these two domains.
  Chapter 3 demonstrates how existing theory related to public-private cooperation and knowledge power can be used to provide an alternative explanation for the two Foundations’ influence in these two issue areas.  
   Chapters 4 to 7 constitute the empirical chapters, which provide substance to the theoretical claims advanced above.
   The final chapter provides a summary of the dissertation’s main arguments and casts light on three implications of the global diffusion of the Foundation-championed public-private partnership paradigm in the governance of global public health and agricultural development.
  Chapter 2: Existing explanations for RF and BMGF agency in global governance 

  2.0 Introduction
  This chapter begins by locating private foundations as products of an American polity historically distrustful of ‘‘big’’ government yet at the same time cognizant of the need for sources of capital and innovation to fill gaps created by public and private sectors. I then examine the longstanding neglect by mainstream International Relations (IR) scholars of the Rockefeller Foundation (RF), which I attribute to the intangibility of knowledge power. Subsequently, I review the rich historiography on RF’s efforts to strengthen public health and agricultural development across the global South, which has been created by a diverse array of scholars, whose analyses I divide into two liberal and critical perspectives broadly defined. This liberal-critical divide I argue pertains equally to the Bill and Melinda Gates Foundation’s (BMGF’s) contemporary efforts to shape collective action in the same two domains. The critical-liberal divide, I contend, has meant that RF and BMGF have typically been portrayed as either members of the transnational capitalist elite working to advance the interests of their peers or as aids of interstate cooperation committed to the principles of idealism, and later liberal institutionalism. Each perspective has provided valuable and unique insights as to how the Foundations influence outcomes as well as the implications of their influence. At the same time, I argue, both perspectives have tended to overemphasize the Foundations’ loyalties while understating their individual agency   
 RF and BMGF knowledge structures have not overtly challenged political and economic power disparities in the interstate system. Yet based on their individual organizational contributions that have altered the way complex problems have been addressed through collective action, neither have they sought to reinforce the status quo. Indeed, the institutionalization of the Foundations’ strategies has led to fundamental changes in how governments have organized individual and collective responses to public health and agricultural challenges in developing countries. 
 Moreover, in the neoliberal era, the Foundations have been effective champions of PublicPrivate Partnerships (PPPs) as an approach to governing global health and agricultural  challenges. The embrace by governments of RF and later BMGF-enabled PPPs, has resulted in non-state actors–namely International Organizations (IOs), Multinational Corporations (MNCs) and Civil Society Organizations (CSOs)–changing their behaviors and cooperating for the benefit of the world’s marginalized in ways that prior to 1995 would have seemed unimaginable. This suggests that neither those working exclusively through either liberal or critical lenses have sufficiently considered the social constructivist position that knowledge construction can, in and of itself, be a vehicle for autonomous agency in world politics.
  The willingness and capacity of the Foundations to work around global power disparities is significant, as critical scholars of health and agriculture have long questioned not only the credibility of RF and BMGF’s views of how global health inequities and agricultural challenges should be overcome but also the political compromises that the two Foundations have been willing to make in pursuit of achieving their goals. Yet critical lenses, which have framed the Foundations as perpetuators of a science and technology approach to development, have done little to illuminate RF’s longstanding and BMGF’s more recent capacity to catalyse institutional innovation within the dominant system that benefits the world’s poor. 
  As non-state actors, RF and BMGF are undeniably limited in their ability to affect the global distribution of political and economic power, meaning they lack the means to catalyze ‘‘transformative’’ or systematic change, which only occurs when decision making power is conferred to those previously marginalized. However as “norm entrepreneurs,”1 they have repeatedly demonstrated that innovation in governance can reduce the adverse effects of socio-economic inequity in the absence of changes to the global power structure, which underpins such inequities. Their outputs serve to undermine claims that any attempt at innovation to solve the challenges associated with marginalization will otherwise fail because the root of the problems will remain unaddressed.2 Accordingly, RF and BMGF should not be seen as conservative actors seeking to maintain the status quo but rather catalysts of innovation in global governance.
   Ideological myopia associated with reliance on one theoretical lens appears to be the principal reason for the longstanding liberal-critical divide, which has distracted from RF and now BMGF’s capacity to catalyze change via knowledge construction. As noted by Susan Strange, analyses undertaken by scholars wedded to particular theoretical lenses tend to provide explanations consistent with the general assumptions shaping those lenses. Their conclusions are largely inevitable because their research is teleological by design.3 Historically and continuing today, the role that private actors play in attempts to resolve public challenges is a polarizing subject, which ideologically-informed research tends to amplify. This study draws from a range of theoretical perspectives in an attempt to avoid the ideological and teleological trappings associated with examining its subject through a single theoretical lens.

Freewill is a gift you do not realize or fully understand unless you fight for it …. One day the Chairman will not write the plan… but You Will rewrite The Plan ….

Maintaining, fixing and resetting ones immune system is the key to maintaining good health and protecting a person from any disease ...flush out toxins and reestablish a healthy gut flora so that you experience all the benefits of a healthy gut, including better sleep, clearer skin, bathroom regularity, and increased energy.,,,love the body you live in - Most people have no idea how the immune system actually works ....... Danette May who is one America's leading healthy lifestyle experts ,,,,

NBC Nightly News Broadcast (Full) - April 14th, 2020 | NBC Nightly News

New York coronavirus death toll surpasses 10,000,
NBC News
New York coronavirus death toll surpasses 10,000, President Trump, governors clash over authority to reopen U.S., and 80 million Americans to receive coronavirus relief funds. Watch “NBC Nightly News With Lester Holt” at 6:30 p.m. ET / 5:30 p.m. CT (or check your local listings). 1:34 New York City’s Revised Death Toll Spikes Nearly 4,000 2:24 4,300 Coronavirus Deaths In U.S. Nusing Homes 2:45 New hot Spots In Indiana, Missouri, South Dakota 3:23 New York Flattening Curve But Hospitals Strained 4:08 Lives Well Lived: Faces Of Coronavirus Pandemic 4:36 CDC: Over 9,000 Health Care Workers Tested Positive 5:05 California Gov Warns Residents To Brace For New Normal 5:53 Trump Battles Governors Over Power To Reopen America 7:36 Trump Halts U.S. Funding For World Health Organisation 8:15 Experts: U.S. Needs Far More Testing, Contact Tracing 11:13 Barack Obama Endorses Joe Biden For President 13:05 Oprah Winfrey Warns Black Community Of Covid-19 Impact 15:05 Struggling Americans Worry Relief Money Not Enough 17:09 Moms Feeling Stressed As Pandemic Puts Strain On Homes » Subscribe to NBC News: http://nbcnews.to/SubscribeToNBC » Watch more NBC video: http://bit.ly/MoreNBCNews Connect with NBC Nightly News online! NBC News App: https://smart.link/5d0cd9df61b80 Breaking News Alerts: https://link.nbcnews.com/join/5cj/bre... Visit NBCNightlyNews.com: https://nbcnews.to/2wFotQ8 Find Nightly News on Facebook: https://bit.ly/2TZ1PhF Follow Nightly News on Twitter: https://bit.ly/1yFY2s4 Follow Nightly News on Instagram: https://bit.ly/2tEncJD NBC News Digital is a collection of innovative and powerful news brands that deliver compelling, diverse and engaging news stories. NBC News Digital features NBCNews.com, MSNBC.com, TODAY.com, Nightly News, Meet the Press, Dateline, and the existing apps and digital extensions of these respective properties. We deliver the best in breaking news, live video coverage, original journalism and segments from your favorite NBC News Shows. NBC Nightly News Broadcast (Full) - April 14th, 2020 | NBC Nightly News
News & Politics

A technician works to produce vaccines for the H1N1 flu virus at a lab in Wuhan, China, in June 2009. (Reuters/China Daily)

People cross a nearly-empty street leading to the Victory Column at Tiergarten park in the city centre in Berlin, Germany

[Sean Gallup/Getty Images]

Dawn breaks over Manhattan as the city struggles to contain the number of coronavirus cases [File: Spencer Platt/Getty Images/AFP]

Bill Gates is helping fund new factories for 7 potential coronavirus vaccines, even though it will waste billions of dollars

The Microsoft billionaire Bill Gates told "The Daily Show" on Thursday that his foundation was funding the construction of factories for seven coronavirus vaccine candidates.
Gates said the foundation would end up picking only one or two of the seven, meaning billions of dollars spent on manufacturing would be abandoned.
He said that in a situation where the world faces the loss of trillions of dollars to the economy, wasting a few billion to help is worth it.
Bill Gates says he will plug money into building factories for seven promising coronavirus vaccine candidates, even though it will mean wasting billions of dollars.
On Thursday's episode of "The Daily Show," the Microsoft billionaire told the host Trevor Noah that his philanthropic organization, the Gates Foundation, could mobilize faster than governments to fight the coronavirus outbreak.
"Because our foundation has such deep expertise in infectious diseases, we've thought about the epidemic, we did fund some things to be more prepared, like a vaccine effort," Gates said. "Our early money can accelerate things."

Gates said the top seven vaccine candidates would be picked, and then building manufacturing capacity would be built for them. "Even though we'll end up picking at most two of them, we're going to fund factories for all seven, just so that we don't waste time in serially saying, 'OK, which vaccine works?' and then building the factory," he said.
Gates said that simultaneously testing and building manufacturing capacity is essential to the quick development of a vaccine, which Gates thinks could take about 18 months.
#In a Washington Post op-ed article published earlier this week, Gates said some of the top candidates required unique equipment.
"It'll be a few billion dollars we'll waste on manufacturing for the constructs that don't get picked because something else is better," Gates said in the clip. "But a few billion in this, the situation we're in, where there's trillions of dollars ... being lost economically, it is worth it."
The Gates Foundation "can get that bootstrapped and get it going and save months, because every month counts," he added.
It doesn't sound like the Gates Foundation will be funding this alone. The Gates Foundation told Business Insider it has not yet committed to funding vaccine manufacturing, and said it was exploring using "catalytic funding" to get the process moving alongside governments and other entities.
Bill Gates and his wife, Melinda Gates, have already pledged $100 million toward fighting the coronavirus pandemic, including an effort to send at-home coronavirus test kits to people in Washington state.
In his Post op-ed article, Gates urged the government to enforce stricter lockdown measures in every state and estimated that the US would need another 10 weeks of nationwide shutdowns to effectively deal with the crisis.  

A cruel wind: America experiences pandemic influenza, 1918

Iran's virus response: Government weighs its options

 Dr. Doreen Muth of Germany's Bonn Faculty of Medicine working in a biosafety lab in 2013. (Wolfgang Rattay/Reuters)

Coronavirus illustration (stock image).

A woman with her dog is seen crossing the deserted Piazza del Popolo while the Italians stay at home as part of a lockdown against the spread of coronavirus (COVID-19) in Rome [Alberto Lingria/Reuters]

Microsoft billionaire Bill Gates, who is believed to be well connected with the Rockefeller Foubdation told "The Daily Show" on Thursday that his foundation was funding the construction of factories for seven coronavirus vaccine candidates.

There is lot of opposition to the push for a mandatory Corvid-19 Vaccine, which opponents are concerned will have dangerous animal or bird diseases and an RDF Chip and other unknown chemicals to help a person be recognised by the new 5G  Microwave Electronic Technology which uses 60 Mgz or above, that may well be very dangerous for the long term health of the person who allows or is forced by law to have  the Corvid-19 Vascine injected into their blood stream, which will bypass the body's imume system.

Well respected researchers have stated that it is scientifically and medically impossible for a viris or a disease to transfer from a bird or animal, except by a vaccine injection with tissue or blood taken from a bird or animal which has viris and/or disease.​​

Microsoft billionaire Bill Gates, who is believed to be well connected with the Rockefeller Foubdation told "The Daily Show" on Thursday that his foundation was funding the construction of factories for seven coronavirus vaccine candidates.  There is lot of opposition to the push for a mandatory Corvid-19 Vaccine, which opponents are concerned will have dangerous animal or bird diseases and an RDF Chip and other unknown chemicals to help a person be recognised by the new 5G  Microwave Electronic Technology which uses 60 Mgz or above, that may well be very dangerous for the long term health of the person who allows or is forced by law to have  the Corvid-19 Vaccine injected into their blood stream, which will bypass the body's immune system. 

​Well respected researchers have stated that it is scientifically and medically impossible for a viris or a disease to transfer from a bird or animal, except by a vaccine injection with tissue or blood taken from a bird or animal which has viris and/or disease.​​

Peking Union Medical College Nursery, Beijing (China)

Doctors graduating from Peking Union Medical College, Beijing (China), 1947

John Gotti’s Hitman Exposes The Dark Side of Mafia
Former Mafia enforcer John Alite does a sit down with Patrick Bet-David to talk about how he became the Gotti Family's enforcer and how he's still alive to talk about it.

Order the book The Darkest Hour:


Order the book Gotti's Rules

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There are many life lessons to learn from someones story

. Subscribe to Valuetainment for all future notifications http://bit.ly/2aPEwD4 and to see who shows up on Valuetainment next. About John Alite: John Edward Alite also known as Johnny Alletto is an Albanian-American former Gambino family associate, informant and motivational speaker. He was an associate of the Gambino crime family and John A. Gotti.

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Category: Education

A cleric calls for the prayer at an empty Al-Rajhi Mosque in Riyadh, Saudi Arabia [Ahmed Yosri /Reuters]

​​Spanish Flu of 1918 Was Really a Bioterror Attack on Humanity
Did a Military Experimental Vaccine in 1918 Kill 50-100 Million People Blamed as “Spanish Flu”?
Health Impact News
The 1918-19 bacterial vaccine experiment may have killed 50-100 million people
by Kevin Barry, President
First Freedoms, Inc.

The “Spanish Flu” killed an estimated 50-100 million people during a pandemic 1918-19. What if the story we have been told about this pandemic isn’t true?=
What if, instead, the killer infection was neither the flu nor Spanish in origin?
Newly analyzed documents reveal that the “Spanish Flu” may have been a military vaccine experiment gone awry.
In looking back on the 100th anniversary of the end of World War I, we need to delve deeper to solve this mystery.


The reason modern technology has not been able to pinpoint the killer influenza strain from this pandemic is because influenza was not the killer.
More soldiers died during WWI from disease than from bullets.
The pandemic was not flu. An estimated 95% (or higher) of the deaths were caused by bacterial pneumonia, not influenza/a virus.
The pandemic was not Spanish. The first cases of bacterial pneumonia in 1918 trace back to a military base in Fort Riley, Kansas.
From January 21 – June 4, 1918, an experimental bacterial meningitis vaccine cultured in horses by the Rockefeller Institute for Medical Research in New York was injected into soldiers at Fort Riley.
During the remainder of 1918 as those soldiers – often living and traveling under poor sanitary conditions – were sent to Europe to fight, they spread bacteria at every stop between Kansas and the frontline trenches in France.
One study describes soldiers “with active infections (who) were aerosolizing the bacteria that colonized their noses and throats, while others—often, in the same “breathing spaces”—were profoundly susceptible to invasion of and rapid spread through their lungs by their own or others’ colonizing bacteria.” (1)
The “Spanish Flu” attacked healthy people in their prime. Bacterial pneumonia attacks people in their prime. Flu attacks the young, old and immunocompromised.
When WW1 ended on November 11, 1918, soldiers returned to their home countries and colonial outposts, spreading the killer bacterial pneumonia worldwide.
During WW1, the Rockefeller Institute also sent the antimeningococcic serum to England, France, Belgium, Italy and other countries, helping spread the epidemic worldwide.

During the pandemic of 1918-19, the so-called “Spanish Flu” killed 50-100 million people, including many soldiers.
Many people do not realize that disease killed far more soldiers on all sides than machine guns or mustard gas or anything else typically associated with WWI.
I have a personal connection to the Spanish Flu. Among those killed by disease in 1918-19 are members of both of my parents’ families.
On my father’s side, his grandmother Sadie Hoyt died from pneumonia in 1918. Sadie was a Chief Yeoman in the Navy. Her death left my grandmother Rosemary and her sister Anita to be raised by their aunt. Sadie’s sister Marian also joined the Navy. She died from “the influenza” in 1919.

On my mother’s side, two of her father’s sisters died in childhood. All of the family members who died lived in New York City.
I suspect many American families, and many families worldwide, were impacted in similar ways by the mysterious Spanish Flu.
In 1918, “influenza” or flu was a catchall term for disease of unknown origin. It didn’t carry the specific meaning it does today.

It meant some mystery disease which dropped out of the sky. In fact, influenza is from the Medieval Latin “influential” in an astrological sense, meaning a visitation under the influence of the stars.

Between 1900-1920, there were enormous efforts underway in the industrialized world to build a better society. I will use New York as an example to discuss three major changes to society which occurred in NY during that time and their impact on mortality from infectious diseases.

1. Clean Water and Sanitation
In the late 19th century through the early 20th century, New York built an extraordinary system to bring clean water to the city from the Catskills, a system still in use today. New York City also built over 6000 miles of sewer to take away and treat waste, which protects the drinking water. The World Health Organization acknowledges the importance of clean water and sanitation in combating infectious diseases. (2)

2. Electricity
In the late 19th century through the early 20th century, New York built a power grid and wired the city so power was available in every home. Electricity allows for refrigeration. Refrigeration is an unsung hero as a public health benefit. When food is refrigerated from farm to table, the public is protected from potential infectious diseases. Cheap renewable energy is important for many reasons, including combating infectious diseases.

3. Pharmaceutical
In the late 19th century through the early 20th century, New York became the home of the Rockefeller Institute for Medical Research (now Rockefeller University). The Institute is where the modern pharmaceutical industry was born. The Institute pioneered many of the approaches the pharmaceutical industry uses today, including the preparation of vaccine serums, for better or worse. The vaccine used in the Fort Riley experiment on soldiers was made in horses.

US Mortality Rates data from the turn of the 20th century to 1965 clearly indicates that clean water, flushing toilets, effective sewer systems and refrigerated foods all combined to effectively reduce mortality from infectious diseases BEFORE vaccines for those diseases became available.

Have doctors and the pharmaceutical manufacturers taken credit for reducing mortality from infectious disease which rightfully belongs to sandhogs, plumbers, electricians and engineers?

If hubris at the Rockefeller Institute in 1918 led to a pandemic disease which killed millions of people, what lessons can we learn and apply to 2018?


While watching an episode of American Experience on PBS a few months ago, I was surprised to hear that the first cases of “Spanish Flu” occurred at Fort Riley, Kansas in 1918. I thought, how is it possible this historically important event could be so badly misnamed 100 years ago and never corrected?

Why “Spanish”?
Spain was one of a few countries not involved in World War I. Most of the countries involved in the war censored their press.

Free from censorship concerns, the earliest press reports of people dying from disease in large numbers came from Spain. The warring countries did not want to additionally frighten the troops, so they were content to scapegoat Spain. Soldiers on all sides would be asked to cross no man’s land into machine gun fire, which was frightening enough without knowing that the trenches were a disease breeding ground.

One hundred years later, it’s long past time to drop “Spanish” from all discussion of this pandemic. If the flu started at a United States military base in Kansas, then the disease could and should be more aptly named.
In order to prevent future disasters, the US (and the rest of the world) must take a hard look at what really caused the pandemic.
It is possible that one of the reasons the Spanish Flu has never been corrected is that it helps disguise the origin of the pandemic.
If the origin of the pandemic involved a vaccine experiment on US soldiers, then the US may prefer calling it Spanish Flu instead of The Fort Riley Bacteria of 1918, or something similar. The Spanish Flu started at the location this experimental bacterial vaccine was given making it the prime suspect as the source of the bacterial infections which killed so many.
It would be much more difficult to maintain the marketing mantra of “vaccines save lives” if a vaccine experiment originating in the United States during the years of primitive manufacturing caused the deaths of 50-100 million people.
“Vaccines save lives … except we may have killed 50-100 million people in 1918-19” is a far less effective sales slogan than the overly simplistic “vaccines save lives.”

During the mid-2000’s there was much talk about “pandemic preparedness.” Influenza vaccine manufacturers in the United States received billions of taxpayer dollars to develop vaccines to make sure that we don’t have another lethal pandemic “flu,” like the one in 1918-19.
Capitalizing on the “flu” part of Spanish flu helped vaccine manufacturers procure billion dollar checks from governments, even though scientists knew at the time that bacterial pneumonia was the real killer.
It is not my opinion that bacterial pneumonia was the real killer – thousands of autopsies confirm this fact.
According to a 2008 National Institute of Health paper, bacterial pneumonia was the killer in a minimum of 92.7% of the 1918-19 autopsies reviewed. It is likely higher than 92.7%.

The researchers looked at more than 9000 autopsies, and “there were no negative (bacterial) lung culture results.”
“… In the 68 higher-quality autopsy series, in which the possibility of unreported negative cultures could be excluded, 92.7% of autopsy lung cultures were positive for ≥1 bacterium. … in one study of approximately 9000 subjects who were followed from clinical presentation with influenza to resolution or autopsy, researchers obtained, with sterile technique, cultures of either pneumococci or streptococci from 164 of 167 lung tissue samples.

There were 89 pure cultures of pneumococci; 19 cultures from which only streptococci were recovered; 34 that yielded mixtures of pneumococci and/or streptococci; 22 that yielded a mixture of pneumococci, streptococci, and other organisms (prominently pneumococci and nonhemolytic streptococci); and 3 that yielded nonhemolytic streptococci alone. There were no negative lung culture results.” (3)

Pneumococci or streptococci were found in “164 of (the) 167 lung tissue samples” autopsied. That is 98.2%. Bacteria was the killer.

When the United States declared war in April 1917, the fledgling Pharmaceutical industry had something they had never had before – a large supply of human test subjects in the form of the US military’s first draft.

Pre-war in 1917, the US Army was 286,000 men. Post-war in 1920, the US army disbanded, and had 296,000 men.
During the war years 1918-19, the US Army ballooned to 6,000,000 men, with 2,000,000 men being sent overseas. The Rockefeller Institute for Medical Research took advantage of this new pool of human guinea pigs to conduct vaccine experiments.

by Frederick L. Gates
From the Base Hospital, Fort Riley, Kansas, and The Rockefeller Institute for Medical Research, New York.
Received 1918 Jul 20

(Author note: Please read the Fort Riley paper in its entirety so you can appreciate the carelessness of the experiments conducted on these troops.)

Between January 21st and June 4th of 1918, Dr. Gates reports on an experiment where soldiers were given 3 doses of a bacterial meningitis vaccine. Those conducting the experiment on the soldiers were just spitballing dosages of a vaccine serum made in horses.
The vaccination regime was designed to be 3 doses. 4,792 men received the first dose, but only 4,257 got the 2nd dose (down 11%), and only 3702 received all three doses (down 22.7%).

A total of 1,090 men were not there for the 3rd dose. What happened to these soldiers? Were they shipped East by train from Kansas to board a ship to Europe? Were they in the Fort Riley hospital? Dr. Gates’ report doesn’t tell us.

An article accompanying the American Experience broadcast I watched sheds some light on where these 1,090 men might be. Gates began his experiments in January 1918.
By March of that year, “100 men a day” were entering the infirmary at Fort Riley.
Are some of these the men missing from Dr. Gates’ report – the ones who did not get the 2nd or 3rd dose?

“… Shortly before breakfast on Monday, March 11, the first domino would fall signaling the commencement of the first wave of the 1918 influenza.
Company cook Albert Gitchell reported to the camp infirmary with complaints of a “bad cold.”
Right behind him came Corporal Lee W. Drake voicing similar complaints.
By noon, camp surgeon Edward R. Schreiner had over 100 sick men on his hands, all apparently suffering from the same malady…” (5)
Gates does report that several of the men in the experiment had flu-like symptoms: coughs, vomiting and diarrhea after receiving the vaccine.
These symptoms are a disaster for men living in barracks, travelling on trains to the Atlantic coast, sailing to Europe, and living and fighting in trenches.
The unsanitary conditions at each step of the journey are an ideal environment for a contagious disease like bacterial pneumonia to spread.

From Dr. Gates’ report:
“Reactions.– … Several cases of looseness of the bowels or transient diarrhea were noted. This symptom had not been encountered before. Careful inquiry in individual cases often elicited the information that men who complained of the effects of vaccination were suffering from mild coryza, bronchitis, etc., at the time of injection.”
“Sometimes the reaction was initiated by a chill or chilly sensation, and a number of men complained of fever or feverish sensations during the following night.
Next in frequency came nausea (occasionally vomiting), dizziness, and general “aches and pains” in the joints and muscles, which in a few instances were especially localized in the neck or lumbar region, causing stiff neck or stiff back. A few injections were followed by diarrhea.
The reactions, therefore, occasionally simulated the onset of epidemic meningitis and several vaccinated men were sent as suspects to the Base Hospital for diagnosis.”(4)
According to Gates, they injected random dosages of an experimental bacterial meningitis vaccine into soldiers. Afterwards, some of the soldiers had symptoms which “simulated” meningitis, but Dr. Gates advances the fantastical claim that it wasn’t actual meningitis.
The soldiers developed flu-like symptoms. Bacterial meningitis, then and now, is known to mimic flu-like symptoms. (6)
Perhaps the similarity of early symptoms of bacterial meningitis and bacterial pneumonia to symptoms of flu is why the vaccine experiments at Fort Riley have been able to escape scrutiny as a potential cause of the Spanish Flu for 100 years and counting.

There is an element of a perfect storm in how the Gates bacteria spread. WWI ended only 10 months after the first injections. Unfortunately for the 50-100 million who died, those soldiers injected with horse-infused bacteria moved quickly during those 10 months.

An article from 2008 on the CDC’s website describes how sick WWI soldiers could pass along the bacteria to others by becoming “cloud adults.”

“Finally, for brief periods and to varying degrees, affected hosts became “cloud adults” who increased the aerosolization of colonizing strains of bacteria, particularly pneumococci, hemolytic streptococci, H. influenzae, and S. aureus.

For several days during local epidemics—particularly in crowded settings such as hospital wards, military camps, troop ships, and mines (and trenches)—some persons were immunologically susceptible to, infected with, or recovering from infections with influenza virus.

Persons with active infections were aerosolizing the bacteria that colonized their noses and throats, while others—often, in the same “breathing spaces”—were profoundly susceptible to invasion of and rapid spread through their lungs by their own or others’ colonizing bacteria.” (1)

Three times in his report on the Fort Riley vaccine experiment, Dr. Gates states that some soldiers had a “severe reaction” indicating “an unusual individual susceptibility to the vaccine”.

While the vaccine made many sick, it only killed those who were susceptible to it. Those who became sick and survived became “cloud adults” who spread the bacteria to others, which created more cloud adults, spreading to others where it killed the susceptible, repeating the cycle until there were no longer wartime unsanitary conditions, and there were no longer millions of soldiers to experiment on.

The toll on US troops was enormous and it is well documented. Dr. Carol Byerly describes how the “influenza” traveled like wildfire through the US military. (substitute “bacteria” for Dr. Byerly’s “influenza” or “virus”):

“… Fourteen of the largest training camps had reported influenza outbreaks in March, April, or May, and some of the infected troops carried the virus with them aboard ships to France …

As soldiers in the trenches became sick, the military evacuated them from the front lines and replaced them with healthy men.

This process continuously brought the virus into contact with new hosts—young, healthy soldiers in which it could adapt, reproduce, and become extremely virulent without danger of burning out.

… Before any travel ban could be imposed, a contingent of replacement troops departed Camp Devens (outside of Boston) for Camp Upton, Long Island, the Army’s debarkation point for France, and took influenza with them.

Medical officers at Upton said it arrived “abruptly” on September 13, 1918, with 38 hospital admissions, followed by 86 the next day, and 193 the next.

Hospital admissions peaked on October 4 with 483, and within 40 days, Camp Upton sent 6,131 men to the hospital for influenza. Some developed pneumonia so quickly that physicians diagnosed it simply by observing the patient rather than listening to the lungs…” (7)

The United States was not the only country in possession of the Rockefeller Institute’s experimental bacterial vaccine.

A 1919 report from the Institute states: “Reference should be made that before the United States entered the war (in April 1917) the Institute had resumed the preparation of antimeningococcic serum, in order to meet the requests of England, France, Belgium Italy and other countries.”

The same report states: “In order to meet the suddenly increased demand for the curative serums worked out at the Institute, a special stable for horses was quickly erected …” (8)

An experimental antimeningoccic serum made in horses and injected into soldiers who would be entering the cramped and unsanitary living conditions of war … what could possibly go wrong?

Is the bacterial serum made in horses at the Rockefeller Institute which was injected into US soldiers and distributed to numerous other countries responsible for the 50-100 million people killed by bacterial lung infections in 1918-19?

The Institute says it distributed the bacterial serum to England, France, Belgium, Italy and other countries during WWI. Not enough is known about how these countries experimented on their soldiers.

I hope independent researchers will take an honest look at these questions.


I do not believe that anyone involved in these vaccine experiments was trying to harm anyone.

Some will see the name Rockefeller and yell. “Illuminati!” or “culling the herd!”

I do not believe that’s what happened.

I believe standard medical hubris is responsible – doctors “playing God”, thinking they can tame nature without creating unanticipated problems.
With medical hubris, I do not think the situation has changed materially over the past 100 years.


The vaccine industry is always looking for human test subjects. They have the most success when they are able to find populations who not in a position to refuse.
Soldiers (9), infants, the disabled, prisoners, those in developing nations – anyone not in a position to refuse.
Vaccine experimentation on vulnerable populations is not an issue of the past. Watch this video clip of Dr. Stanley Plotkin where he describes using experimental vaccines on orphans, the mentally retarded, prisoners, and those under colonial rule.
The deposition was in January 2018. The hubris of the medical community is the same or worse now than it was 100 years ago.

Watch as Dr. Plotkin admits to writing:
“The question is whether we are to have experiments performed on fully functioning adults and on children who are potentially contributors to society or to perform initial studies in children and adults who are human in form but not in social potential.”

Please watch the horrifying video clip. (10)

In part because the global community is well aware of medical hubris and well aware of the poor record of medical ethics, the Universal Declaration on Bioethics and Human Rights developed international standards regarding the right to informed consent to preventative medical procedures like vaccination.
The international community is well aware that the pharmaceutical industry makes mistakes and is always on the lookout for human test subjects. The Declaration states that individuals have the human right to consent to any preventative medical intervention like vaccination.

Article 3 – Human dignity and human rights
1. Human dignity, human rights and fundamental freedoms are to be fully respected.
2. The interests and welfare of the individual should have priority over the sole interest of science or society.

Article 6 – Consent
1. Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice. (11)
Clean water, sanitation, flushing toilets, refrigerated foods and healthy diets have done and still do far more to protect humanity from infectious diseases than any vaccine program.
Doctor and the vaccine industry have usurped credit which rightfully belongs to plumbers, electricians, sandhogs, engineers and city planners.
For these reasons, policy makers at all levels of government should protect the human rights and individual liberties of individuals to opt out of vaccine programs via exemptions.
The hubris of the medical community will never go away. Policy makers need to know that vaccines like all medical interventions are not infallible.
Vaccines are not magic. We all have different susceptibility to disease. Human beings are not one size fits all.

In 1918-19, the vaccine industry experimented on soldiers, likely with disastrous results.
In 2018, the vaccine industry experiments on infants every day. The vaccine schedule has never been tested as it is given. The results of the experiment are in: 1 in 7 American children is in some form of special education and over 50% have some form of chronic illness. (12)
In 1918-19, there was no safety follow up after vaccines were delivered.
In 2018, there is virtually no safety follow up after a vaccine is delivered.

Who exactly gave you that flu shot at Rite Aid? Do you have their cell number of the store employee if something goes wrong?
In 1918-19, there was no liability to the manufacturer for injuries or death caused by vaccines.
In 2018, there is no liability for vaccine manufacturers for injuries or death caused by vaccines, which was formalized in 1986. (13)
In 1918-19, there was no independent investigative follow up challenging the official story that “Spanish Flu” was some mystery illness which dropped from the sky. I suspect that many of those at the Rockefeller Institute knew what happened, and that many of the doctors who administered the vaccines to the troops knew what happened, but those people are long dead.
In 2018, the Pharmaceutical industry is the largest campaign donor to politicians and the largest advertiser in all forms of media, so not much has changed over 100 years.
This story will likely be ignored by mainstream media because their salaries are paid by pharmaceutical advertising.
The next time you hear someone say “vaccines save lives” please remember that the true story of the cost/benefit of vaccines is much more complicated than their three word slogan. Also remember that vaccines may have killed 50-100 million people in 1918-19. If true, those costs greatly outweighed any benefit, especially considering that plumbers, electricians, sandhogs and engineers did, and continue to do, the real work which reduces mortality from disease.
Vaccines are not magic. Human rights and bioethics are critically important. Policy makers should understand the history of medical hubris and protect individual and parental human rights as described in the Universal Declaration on Bioethics and Human Rights.
Kevin Barry is the President of First Freedoms, Inc. a 501.c.3. He is a former federal attorney, a rep at the UN HQ in New York and the author of Vaccine Whistleblower: Exposing Autism Research Fraud at the CDC. Please support our work at www.firstfreedoms.org
Please direct media inquiries to kb151.
Originally published at FirstFreedoms.org. Reprinted with permission.
Comment on this article at VaccineImpact.com.

1. Deaths from Bacterial Pneumonia during 1918–19 Influenza Pandemic
John F. Brundage* and G. Dennis Shanks†
Author affiliations: *Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA; †Australian Army Malaria Institute, Enoggera, Queensland, Australia
2. World Health Organization: Unsafe drinking water, sanitation and waste management

3. J Infect Dis. 2008 Oct 1; 198(7): 962–970.
Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness
David M. Morens, Jeffery K. Taubenberger, and Anthony S. Fauci

Push Back Against Attempts at Mandatory Vaccine Legislation Apr 5, 2020 


Iran's Supreme Leader Ayatollah Ali Khamenei delivered a broadcast speech on the occasion of Nowruz, the Iranian New Year [AFP]

09:45 GMT - Spain records 510 new deaths, continuing downward trend
Spain, the European country with the most reported coronavirus infections, has confirmed 510 new deaths, the lowest daily toll since March 23.
The death toll in Spain now stands at 16,353, while the country on Saturday added 4,830 new cases, continuing a downward trend and bringing the country total to 161,852 cases.

09:30 GMT - Philippines reports 26 new deaths, 233 more infections
The Philippines has reported 26 new coronavirus-related deaths , taking the total to 247.
It also confirmed 233 new infections for a tally of 4,428. Seventeen more patients have recovered, the health ministry said in a bulletin, bringing the number of recoveries to 157.

09:20 GMT - Malaysia reports 184 new  cases, death toll rises by 3 
Malaysian health authorities have reported 184 additional confirmed cases of the new coronavirus, raising the cumulative tally to 4,530, the highest number for any country in Southeast Asia.
The latest data includes 3 new deaths, raising total fatalities from the outbreak to 73.
The ministry said 44 percent of all confirmed cases have recovered.

09:15 GMT - Indonesia reports 330 new cases, 21 deaths
Indonesia has confirmed 330 new coronavirus infections, taking its tally to 3,842, health ministry official Achmad Yurianto said.
It also confirmed 21 virus-related deaths, taking the total to 327, Yurianto told a televised news conference.

09:00 GMT - Taiwan, WHO spar again over coronavirus information sharing
Tension have flared again as Taiwan accused the WHO of playing word games in a dispute over details it sought in an email querying if the new coronavirus could be transmitted between people.
Last month, Taiwan, who is blocked from membership in international organisations by China, said it had received no reply from the WHO to a December 31 query for information on the outbreak in Wuhan, including whether it could be transmitted between people. 
In Taipei on Saturday, Health Minister Chen Shih-chung quoted the text of the December 31 email written in English that the government sent to the WHO asking for the organisation to share “relevant information” about atypical cases of pneumonia reported in Wuhan.

In a statement sent to Reuters news agency on Saturday, the WHO said,

"We have asked how they communicated this to us, because we are only aware of that one email that makes no mention of human-to-human transmission, but they haven't replied".

08:45 GMT - Rouhani urges Iranians to respect health protocols as curbs ease
President Hassan Rouhani urged Iranians to respect health protocols as "low-risk" economic activities resumed in most of the country on Saturday, state news agency IRNA reported.
So-called low-risk businesses will resume across the country from Saturday with the exception of the capital Tehran, where they will restart from April 18. Iran is the Middle Eastern country worst-affected by the new coronavirus.
"Easing restrictions does not mean ignoring health protocols ... social distancing and other health protocols should be respected seriously by people," Rouhani was quoted as saying.
Iran's government spokesman Ali Rabeie was also quoted as saying that "in case of long-term shutdown, some 4 million people could be out of work", IRNA reported.

08:35 GMT - Russia reports 1,667 new cases in last day
Russia has reported 1,667 new coronavirus cases , bringing the national tally of confirmed cases to 13,584.
The number of coronavirus-related deaths in the country rose by 12 to 106, the Russian coronavirus crisis response centre said.

08:25 GMT - Japan PM Abe calls for nightlife self-restraint

Japanese Prime Minister Shinzo Abe has called for citizens across Japan to avoid evening spots like bars and restaurants, national broadcaster NHK reported, in a ratcheting of social distancing guidance to fight the spread of the coronavirus.
The nationwide call for citizens to stay home in the evenings follows the declaration of a state of emergency in Tokyo and six other prefectures last week.
Abe has been gradually tightening guidance, seeking to lessen the impact on the economy as it is hammered by the pandemic, leading to criticism that he has been too slow to act and risks having the virus spread out of control. Tokyo, the current centre of Japan's coronavirus outbreak, identified more than 190 new coronavirus cases on Saturday, topping Friday's record high of 189 cases, NHK said.

08:15 GMT - VOA pushes back against White House 'propaganda' criticism
Publicly-funded US broadcaster Voice of America has pushed back on criticism from the White House that it is promoting Chinese "foreign propaganda" on the coronavirus pandemic.
In a statement on Friday, President Donald Trump's administration claimed VOA pushed Beijing's message by tweeting a video of celebrations at the end of Wuhan's quarantine measures, and noting the US had surpassed China's death toll.
VOA director Amanda Bennet pushed back at the criticism - while not mentioning the Trump administration - noting that the broadcaster had reported on China's efforts to initially hide the coronavirus outbreak.
"VOA has thoroughly debunked much of the information coming from the Chinese government and government-controlled media," she said in a statement.

08:00 GMT - Bangladesh extends coronavirus lockdown
In South Asia's latest moves to curb the coronavirus pandemic, Bangladesh has extended its nationwide lockdown by 11 days while Indian Prime Minister Narendra Modi will hold talks on Saturday with states to decide whether to extend its own stringent restrictions beyond next week.
In Bangladesh the army has been deployed across the country to enforce social distancing measures. The government late on Friday extended the nationwide lockdown to April 25 as the number of confirmed cases rose to 424, with 27 deaths.

India began a national lockdown on March 25.

07:50 GMT - Death death toll passes 1,000 in Brazil
Brazil, the hardest-hit Latin American country in the coronavirus pandemic, has passed the mark of 1,000 deaths, the health ministry said
The ministry's latest figures gave a toll of 19,638 confirmed COVID-19 cases, with 1,056 deaths - one fewer than it had indicated in an initial tally earlier in the day on Friday.

Health officials are bracing for things to get worse. Experts predict the outbreak will only start to peak in Brazil toward late April.

07:30 GMT - Pakistan death toll rises to 71
Pakistan’s death toll from the new coronavirus has risen to 71 after five more patients lost their lives in the last 24 hours, health authorities have said.
The total number of confirmed cases surged to 4,788 with 190 new cases reported, according to the Health Ministry. The ministry said 50 of patients are in critical condition, while 762 people recovered across the country. The northeastern Punjab province, which accounts for more than half of the country’s population, is the worst-hit area in Pakistan with 2,336 cases.

07:15 GMT - Brazil's Bolsonaro again disregards precautions
Brazil's President Jair Bolsonaro has once again caused a stir by disregarding his government's own recommendations on social distancing during the novel coronavirus pandemic.
Bolsonaro's son Eduardo tweeted a video showing his father visiting a bakery in the capital Brasilia on Thursday evening.  
In the video, the right-wing president can be seen eating, drinking and being photographed with several people standing right next to him. While some of those in the film are wearing face masks, Bolsonaro is not.  
Under local restrictions to stem the pandemic, bakeries in the capital are currently only allowed to sell their products for take-out, the news portal G1 said.

07:00 GMT - African community targeted in China virus crackdown
Africans in southern China's largest city say they have become targets of suspicion and subjected to forced evictions, arbitrary quarantines and mass coronavirus testing as the country steps up its fight against imported infections.
China says it has largely curbed its COVID-19 outbreak but a recent cluster of cases linked to the Nigerian community in Guangzhou sparked the alleged discrimination by locals and virus prevention officials.
Local authorities in the industrial centre of 15 million said at least eight people diagnosed with the illness had spent time in the city's Yuexiu district, known as "Little Africa". Five were Nigerian nationals who faced widespread anger after reports surfaced that they had broken a mandatory quarantine and been to eight restaurants and other public places instead of staying home.

As a result, nearly 2,000 people they came into contact with had to be tested for COVID-19 or undergo quarantine, state media said. Several Africans told the AFP news agency they had since been forcibly evicted from their homes and turned away by hotels.
"I've been sleeping under the bridge for four days with no food to eat... I cannot buy food anywhere, no shops or restaurants will serve me," said Tony Mathias, an exchange student from Uganda who was forced from his apartment on Monday. "We're like beggars on the street."

06:45 GMT - Italy's migrants living through an emergency within an emergency
It used to be a vast complex of illegally built apartment blocks and holiday homes on the Mediterranean, today, Castel Volturno is a run-down no-man's-land in the southern Campania region.
The town counts about 25,000 inhabitants, of whom 5,000 are registered migrants, and an estimated 15,000 are undocumented, mostly hailing from West African countries including Nigeria and Ghana, say officials.
Aid group representatives operating here have joined the town's mayor in warning about a "ticking bomb" and a "bubble of desperation" ready to burst as people now under lockdown are prevented from earning their usual daily living.
Without a solid assistance programme, the population here risks falling victim to hunger due to the virus.

06:30 GMT - Florida nursing homes ask for lawsuit protection: Report
Florida's largest nursing home organisation has a sent a letter to Governor Ron DeSantis asking for sweeping protections from legal claims related to the coronavirus outbreak, according to a report by Buzzfeed news.
In a letter to the governor, the industry group's executive director wrote that in order for nursing homes and healthcare workers to provide the best care, "it is imperative that health care facilities and health care professionals are protected from liability that may result from treating individuals with COVID-19 under the conditions associated with this public health emergency".
The request is one of the first of its kind in the US, according to the news site.

05:45 GMT - Pro wrestlers in US grapple with lockdown
The old adage insists that, in entertainment circles, "the show must go on". But what if it cannot?
It is a quandary facing many entertainers as padlocks are put on stadium gates, stage doors, and movie house entrances because of the coronavirus pandemic. The ban on large public gatherings in the interest of physical distancing has decimated the industry, including the US's pro-wrestling scene.
Kaci Lennox, an up-and-coming talent who performs in wrestling shows across Florida, is feeling the pain first-hand.
The 27-year-old told Al Jazeera: "A lot of us depend on wrestling to pay our bills. Some people just don't have money saved up."

05:20 GMT -Vietnamese airlines to resume domestic flights from Thursday

Vietnam's Bamboo Airways and VietJet Air will resume domestic flights from Thursday after the expiry of a government order for 15 days of physical distancing, the companies said.

From late March, Vietnam ordered curbs on domestic flights and adopted physical distancing nationwide to curb the spread of the coronavirus, which has infected 257 people, although none have died.

"The Hanoi-Ho Chi Minh City route will be resumed from April 16, while other routes will be back to operation from April 20," Bamboo Airways said in a statement.

Budget carrier VietJet Air also announced it was resuming flying on domestic routes from Thursday but advised customers it had only an expected schedule that may be subject to change.

Hello, this is Joseph Stepansky in Doha taking over from my colleague Ted Regencia.

05:08 GMT - South Korea to use electronic wristbands to monitor cases
In a controversial step, South Korea's government has announced that it will strap electronic wristbands on people who defy self-quarantine orders as it tightens monitoring to slow the spread of the new coronavirus.
Senior Health Ministry official Yoon Tae-ho on Saturday acknowledged the privacy and civil liberty concerns surrounding the bands, which will be enforced through police and local administrative officials after two weeks of preparation and manufacturing, the Associated Press (AP) news agency reported.
But he said authorities need more effective monitoring tools because the number of people placed under self-quarantine has ballooned after the country began enforcing 14-day quarantines on all passengers arriving from abroad on April 1 amid worsening outbreaks in Europe and the US.

04:40 GMT - Thailand reports two new coronavirus deaths, 45 new cases
Thailand has announced two new coronavirus-linked deaths, bringing to 35 the total number of deaths in the country.
The government also said that 45 new cases have been detected, making the total number of cases 2,518, of which 1,135 have been discharged.

03:56 GMT - With social distance, California's coronavirus forecast brightens
California's top public health official has said for the first time that the coronavirus might not be as devastating as state officials had feared, and Governor Gavin Newsom revealed his administration is now planning for how to reopen the state, AP reported.
But with Easter Sunday and sunny weather on the horizon, Newsom implored people to stay away from others to not undo the significant progress under his stay-at-home order. Across California, local government officials closed streets, parks and other public spaces to deter people from gathering.

03:14 GMT - Uruguay transports Australians, New Zealanders from virus-hit ship

Uruguay has started to repatriate 112 Australians and New Zealanders from a cruise ship hit by coronavirus and stranded in the La Plata River near the capital, Montevideo, since March 27, the government said.
The operation began in the evening when the Greg Mortimer, an Antarctic cruise ship operated by Aurora Expeditions, docked in the port of Montevideo.
The passengers are scheduled to board a Melbourne-bound charter flight in the early hours of Saturday. Two Australian passengers could not be transported because of their poor condition, Uruguay's Foreign Minister Ernesto Talvi said.

02:36 GMT - New York deaths jump by 777, but new hospitalisations down

Coronavirus deaths in the US state of New York jumped by 777 in one day, as the number of people hospitalised stayed relatively flat, according to AP.
More than 3,000 deaths have been recorded since Monday, bringing the statewide count to 7,844.
The number of hospitalisations increased by 290, compared to daily increases of more than 1,000 last week. The number of intensive care patients also decreased slightly for the first time since mid-March.

02:15 GMT - Ecuador announces social measures to address pandemic

Ecuadorean President Lenin Moreno has announced the creation of a humanitarian assistance account that will be funded with contributions from companies and citizens to address the economic effects of the coronavirus pandemic.
"The pandemic hit us at a critical moment, when we were trying to get ahead after a very tough economic crisis," Moreno added in a televised speech. "It hit us without a cent in the state's accounts."
Ecuador reported more than 2,196 new infections in one day on Friday, raising the total number to 7,161. Some 297 people have died, and another 311 were likely killed by the virus, according to official data.

02:10 GMT - Trump orders US military to help Italy fight coronavirus

US President Donald Trump has ordered top US administration officials to help Italy in fighting coronavirus by providing medical supplies, humanitarian relief and other assistance.
In a memo to several Cabinet ministers, Trump ordered a variety of measures, including making US military personnel in the country available for telemedicine services, helping set up field hospitals, and transporting supplies, according to Reuters news agency.

01:29 GMT - China reports 46 new coronavirus cases, higher than previous day

Mainland China reported on Saturday 46 new coronavirus cases, including 42 involving travellers from overseas, up from 42 cases a day earlier.
China's National Health Commission said in a statement that 34 new asymptomatic coronavirus cases had also been reported, down from 47 the previous day.
Mainland China's tally of infections now stands at 81,953, while the death toll rose by three, to 3,339, according to the Reuters news agency report.

01:06 GMT - Erdogan sends well wishes to Boris Johnson
Turkey's president has sent a letter to Boris Johnson, wishing the British prime minister a speedy recovery from the coronavirus, AP reported.
In his letter, Recep Tayyip Erdogan also conveyed his condolences to the families of British victims of the virus, expressed hope that Britain overcomes the "tragedy with the minimal losses" and relayed his good wishes to British health service employees treating COVID-19 patients.
Erdogan also invited Johnson, whose great-grandfather was Turkish, to visit "the land of your ancestors" to discuss "steps that will further our bilateral cooperation in the post-Brexit period".

00:48 GMT - Argentina extends lockdown on major cities
Argentina will extend the lockdown it has imposed on the country's major cities, President Alberto Fernandez has announced.
He did not specify when the lockdown, which was first mandated on March 20, would be lifted. He said the requirement that Argentines stay at home has helped control the rate of new coronavirus infections, Reuters news agency reported.

00:12 GMT - WHO looking into neurological effects of coronavirus

The WHO's emergencies chief says the agency is aware of some anecdotal reports of neurological effects in some coronavirus patients from China.
But Dr Mike Ryan said it is unclear whether the virus is directly affecting the brain or whether those neurological effects may be due to oxygen deprivation.
Ryan said while some viruses cause complications like encephalitis and meningitis when they infect the brain, there is no indication yet that this is the case with COVID-19 patients, adding that many infectious diseases can prompt deliriousness or a change in consciousness when patients' oxygen levels drop, but giving more oxygen often resolves the issue.

00:10 GMT - Hundreds pay tribute to fallen nurse in Spain
Hundreds of staff at a hospital near the Spanish capital have gathered to pay homage to a 57-year-old nurse who died Friday after contracting COVID-19, AP reported.
In a post on social media, the Severo Ochoa Hospital in Leganes said the nurse died "after days of fighting relentlessly against the illness".
The post identified the victim by his first name, Esteban, and said his widow also worked at the hospital, one of the main battlegrounds against the coronavirus.

00:01 GMT - Pope Francis leads haunting Good Friday procession amid lockdown

Pope Francis entered a torch-lit, hauntingly empty Saint Peter's Square for a Good Friday procession under a lockdown caused by a coronavirus that has claimed 100,000 lives worldwide.
The Argentine-born pontiff walked up to his podium flanked by five prison inmates from the hard-hit northern Italian city of Padua and five Vatican doctors and nurses.
Their presence was a tribute to the victims of a disease that has officially claimed nearly 19,000 lives in Italy.
Earlier, Francis had said that medics and priests who died after becoming infected while looking after COVID-19 victims "gave their lives out of love, like soldiers at the front".
I'm Ted Regencia in Kuala Lumpur with Al Jazeera's continuing coverage of the coronavirus pandemic.


Mainland China's infections now stand at 81,953, while the death toll rose to 3,339, according to the NHC [Ng Han Guan/AP]

Frederick T. Gates, was a senor adviser for the Rockefeller Foundation, and The Rockerfeller Institute for Medical Research, New York.who was involved in arranging soldiers at the Base Hospital, Fort Riley, Kansas,  to be injected with a vaccine made from blood of horses very sick with a serious deadly lung disease, the Base Hospital, Fort Riley, Kansas, and The Rockerfeller Institute for Medical Research, New York.

COVID-19 coronavirus epidemic has a natural origin
March 17, 2020
Scripps Research Institute


An analysis of public genome sequence data from SARS-CoV-2 and related viruses found no evidence that the virus was made in a laboratory or otherwise engineered.https://www.sciencedaily.com/releases/2020/03/200317175442.htm  
The novel SARS-CoV-2 coronavirus that emerged in the city of Wuhan, China, last year and has since caused a large scale COVID-19 epidemic and spread to more than 70 other countries is the product of natural evolution, according to findings published today in the journal Nature Medicine.
The analysis of public genome sequence data from SARS-CoV-2 and related viruses found no evidence that the virus was made in a laboratory or otherwise engineered.
"By comparing the available genome sequence data for known coronavirus strains, we can firmly determine that SARS-CoV-2 originated through natural processes," said Kristian Andersen, PhD, an associate professor of immunology and microbiology at Scripps Research and corresponding author on the paper.

In addition to Andersen, authors on the paper, "The proximal origin of SARS-CoV-2," include Robert F. Garry, of Tulane University; Edward Holmes, of the University of Sydney; Andrew Rambaut, of University of Edinburgh; W. Ian Lipkin, of Columbia University.

Coronaviruses are a large family of viruses that can cause illnesses ranging widely in severity. The first known severe illness caused by a coronavirus emerged with the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic in China. A second outbreak of severe illness began in 2012 in Saudi Arabia with the Middle East Respiratory Syndrome (MERS).

On December 31 of last year, Chinese authorities alerted the World Health Organization of an outbreak of a novel strain of coronavirus causing severe illness, which was subsequently named SARS-CoV-2. As of February 20, 2020, nearly 167,500 COVID-19 cases have been documented, although many more mild cases have likely gone undiagnosed. The virus has killed over 6,600 people.

Shortly after the epidemic began, Chinese scientists sequenced the genome of SARS-CoV-2 and made the data available to researchers worldwide. The resulting genomic sequence data has shown that Chinese authorities rapidly detected the epidemic and that the number of COVID-19 cases have been increasing because of human to human transmission after a single introduction into the human population. Andersen and collaborators at several other research institutions used this sequencing data to explore the origins and evolution of SARS-CoV-2 by focusing in on several tell-tale features of the virus.
The scientists analyzed the genetic template for spike proteins, armatures on the outside of the virus that it uses to grab and penetrate the outer walls of human and animal cells. More specifically, they focused on two important features of the spike protein: the receptor-binding domain (RBD), a kind of grappling hook that grips onto host cells, and the cleavage site, a molecular can opener that allows the virus to crack open and enter host cells.

Evidence for natural evolution

The scientists found that the RBD portion of the SARS-CoV-2 spike proteins had evolved to effectively target a molecular feature on the outside of human cells called ACE2, a receptor involved in regulating blood pressure. The SARS-CoV-2 spike protein was so effective at binding the human cells, in fact, that the scientists concluded it was the result of natural selection and not the product of genetic engineering.

This evidence for natural evolution was supported by data on SARS-CoV-2's backbone -- its overall molecular structure. If someone were seeking to engineer a new coronavirus as a pathogen, they would have constructed it from the backbone of a virus known to cause illness. But the scientists found that the SARS-CoV-2 backbone differed substantially from those of already known coronaviruses and mostly resembled related viruses found in bats and pangolins.
"These two features of the virus, the mutations in the RBD portion of the spike protein and its distinct backbone, rules out laboratory manipulation as a potential origin for SARS-CoV-2" said Andersen.

Josie Golding, PhD, epidemics lead at UK-based Wellcome Trust, said the findings by Andersen and his colleagues are "crucially important to bring an evidence-based view to the rumors that have been circulating about the origins of the virus (SARS-CoV-2) causing COVID-19."

"They conclude that the virus is the product of natural evolution," Goulding adds, "ending any speculation about deliberate genetic engineering."

Possible origins of the virus
Based on their genomic sequencing analysis, Andersen and his collaborators concluded that the most likely origins for SARS-CoV-2 followed one of two possible scenarios.
In one scenario, the virus evolved to its current pathogenic state through natural selection in a non-human host and then jumped to humans. This is how previous coronavirus outbreaks have emerged, with humans contracting the virus after direct exposure to civets (SARS) and camels (MERS). The researchers proposed bats as the most likely reservoir for SARS-CoV-2 as it is very similar to a bat coronavirus. There are no documented cases of direct bat-human transmission, however, suggesting that an intermediate host was likely involved between bats and humans.

In this scenario, both of the distinctive features of SARS-CoV-2's spike protein -- the RBD portion that binds to cells and the cleavage site that opens the virus up -- would have evolved to their current state prior to entering humans. In this case, the current epidemic would probably have emerged rapidly as soon as humans were infected, as the virus would have already evolved the features that make it pathogenic and able to spread between people.

In the other proposed scenario, a non-pathogenic version of the virus jumped from an animal host into humans and then evolved to its current pathogenic state within the human population. For instance, some coronaviruses from pangolins, armadillo-like mammals found in Asia and Africa, have an RBD structure very similar to that of SARS-CoV-2. A coronavirus from a pangolin could possibly have been transmitted to a human, either directly or through an intermediary host such as civets or ferrets.
Then the other distinct spike protein characteristic of SARS-CoV-2, the cleavage site, could have evolved within a human host, possibly via limited undetected circulation in the human population prior to the beginning of the epidemic. The researchers found that the SARS-CoV-2 cleavage site, appears similar to the cleavage sites of strains of bird flu that has been shown to transmit easily between people. SARS-CoV-2 could have evolved such a virulent cleavage site in human cells and soon kicked off the current epidemic, as the coronavirus would possibly have become far more capable of spreading between people.
Study co-author Andrew Rambaut cautioned that it is difficult if not impossible to know at this point which of the scenarios is most likely. If the SARS-CoV-2 entered humans in its current pathogenic form from an animal source, it raises the probability of future outbreaks, as the illness-causing strain of the virus could still be circulating in the animal population and might once again jump into humans. The chances are lower of a non-pathogenic coronavirus entering the human population and then evolving properties similar to SARS-CoV-2.Funding for the research was provided by the US National Institutes of Health, the Pew Charitable Trusts, the Wellcome Trust, the European Research Council, and an ARC Australian Laureate Fellowship.  

  COVID-19 coronavirus epidemic has a natural origin 
Trial drug can significantly block early stages of COVID-19 in engineered human tissues
April 2, 2020
University of British Columbia
An international team has found a trial drug that effectively blocks the cellular door SARS-CoV-2 uses to infect its hosts


The findings, published today in Cell, hold promise as a treatment capable of stopping early infection of the novel coronavirus that, as of April 2, has affected more than 981,000 people and claimed the lives of 50,000 people worldwide.
The study provides new insights into key aspects of SARS-CoV-2, the virus that causes COVID-19, and its interactions on a cellular level, as well as how the virus can infect blood vessels and kidneys.
"We are hopeful our results have implications for the development of a novel drug for the treatment of this unprecedented pandemic," says Penninger, professor in UBC's faculty of medicine, director of the Life Sciences Institute and the Canada 150 Research Chair in Functional Genetics at UBC.

"This work stems from an amazing collaboration among academic researchers and companies, including Dr. Ryan Conder's gastrointestinal group at STEMCELL Technologies in Vancouver, Nuria Montserrat in Spain, Drs. Haibo Zhang and Art Slutsky from Toronto and especially Ali Mirazimi's infectious biology team in Sweden, who have been working tirelessly day and night for weeks to better understand the pathology of this disease and to provide breakthrough therapeutic options."

ACE2 -- a protein on the surface of the cell membrane -- is now at centre-stage in this outbreak as the key receptor for the spike glycoprotein of SARS-CoV-2. In earlier work, Penninger and colleagues at the University of Toronto and the Institute of Molecular Biology in Vienna first identified ACE2, and found that in living organisms, ACE2 is the key receptor for SARS, the viral respiratory illness recognized as a global threat in 2003. His laboratory also went on to link the protein to both cardiovascular disease and lung failure.

While the COVID-19 outbreak continues to spread around the globe, the absence of a clinically proven antiviral therapy or a treatment specifically targeting the critical SARS-CoV-2 receptor ACE2 on a molecular level has meant an empty arsenal for health care providers struggling to treat severe cases of COVID-19.

"Our new study provides very much needed direct evidence that a drug -- called APN01 (human recombinant soluble angiotensin-converting enzyme 2 -- hrsACE2) -- soon to be tested in clinical trials by the European biotech company Apeiron Biologics, is useful as an antiviral therapy for COVID-19," says Dr. Art Slutsky, a scientist at the Keenan Research Centre for Biomedical Science of St. Michael's Hospital and professor at the University of Toronto who is a collaborator on the study.

In cell cultures analyzed in the current study, hrsACE2 inhibited the coronavirus load by a factor of 1,000-5,000. In engineered replicas of human blood vessel and kidneys -- organoids grown from human stem cells -- the researchers demonstrated that the virus can directly infect and duplicate itself in these tissues. This provides important information on the development of the disease and the fact that severe cases of COVID-19 present with multi-organ failure and evidence of cardiovascular damage. Clinical grade hrsACE2 also reduced the SARS-CoV-2 infection in these engineered human tissues.

"Using organoids allows us to test in a very agile way treatments that are already being used for other diseases, or that are close to being validated. In these moments in which time is short, human organoids save the time that we would spend to test a new drug in the human setting," says Núria Montserrat, ICREA professor at the Institute for Bioengineering of Catalonia in Spain.

"The virus causing COVID-19 is a close sibling to the first SARS virus," adds Penninger. "Our previous work has helped to rapidly identify ACE2 as the entry gate for SARS-CoV-2, which explains a lot about the disease. Now we know that a soluble form of ACE2 that catches the virus away, could be indeed a very rational therapy that specifically targets the gate the virus must take to infect us. There is hope for this horrible pandemic."

This research was supported in part by the Canadian federal government through emergency funding focused on accelerating the development, testing, and implementation of measures to deal with the COVID-19 outbreak.

Story Source:

Materials provided by University of British Columbia. Note: Content may be edited for style and length.
Journal Reference:
Vanessa Monteil, Hyesoo Kwon, Patricia Prado, Astrid Hagelkrüys, Reiner A. Wimmer, Martin Stahl, Alexandra Leopoldi, Elena Garreta, Carmen Hurtado Del Pozo, Felipe Prosper, J.p. Romero, Gerald Wirnsberger, Haibo Zhang, Arthur S. Slutsky, Ryan Conder, Nuria Montserrat, Ali Mirazimi, Josef M. Penninger. Inhibition of SARS-CoV-2 infections in engineered human tissues using clinical-grade soluble human ACE2. Submitted to Cell, 2020 DOI: 10.1016/j.cell.2020.04.004

SARS-CoV-2 coronavirus illustration (stock image).
Credit: © Kateryna_Kon / Adobe Stock

An international team led by University of British Columbia researcher Dr. Josef Penninger has found a trial drug that effectively blocks the cellular door SARS-CoV-2 uses to infect its hosts.

France on Saturday declared that a 'plateau' had been reached, albeit at a very high level [Gonzalo Fuentes/Reuters]

 Italy coronavirus deaths at 5,476 after 651 rise:  - Live updates:

by Kate Mayberry, Virginia Pietromarchi & Linah Alsaafin - 22 Mar 2020
 Death toll from coronavirus outbreak in Italy increases 13.5 percent as no sign of let up in killer contagion.  

The death toll from the coronavirus pandemic continued its relentless rise in Europe on Sunday with Italy announcing 651 dead in one day, bringing its total to 5,476.
It was an increase of 13.5 percent but down from Saturday's figure when 793 people died.
The Canadian death toll from the coronavirus outbreak jumped almost 50 percent in less than a day, and the mayor of New York City - the US epicentre of the contagion - called the situation the greatest crisis since the Great Depression and warned hospitals would likely be overwhelmed in 10 days. 
Globally, more than 13,000 people have now died from COVID-19. An estimated 92,000 of the 304,500 people who contracted the disease globally have recovered.

Here are the latest updates:
Territories with confirmed cases of COVID-19  - Sunday, March 22

21:15 GMT - More than 100 COVID-19 deaths in the US in 24 hours
Coronavirus claimed more than 100 lives in the past 24 hours in the United States, bringing the total to 389 deaths, according to an authoritative tally from Johns Hopkins University.
The states of New York (114 deaths), Washington (94 deaths) and California (28 deaths) have been the hardest hit by far. The virus has infected at least 30,000 people nationwide.
21:00 GMT - France coronavirus death toll jumps 112 to 674
The number of people killed in France by the coronavirus outbreak increased by another 112 to a total of 674, the top French health official said. 
The rise in the death toll was identical to that of the previous day. "The virus kills and it is continuing to kill," said top French health official Jerome Salomon as he announced the new numbers at a daily briefing.
A total of 16,018 cases of infection had been recorded in France, while warning this was an "underestimate" as not all of those with the virus had been tested, even though 4,000 tests were now being done every day.
A total of 7,240 people have been hospitalised after falling ill with the virus, he added.
France has been in lockdown since Tuesday, with only essential trips outside allowed, but Salomon urged the French to show "patience".
20:50 GMT - Coronavirus death toll climbs to 30 in Turkey
Turkey confirmed nine more deaths from the novel coronavirus late, bringing the total fatalities to 30.
Health Minister Fahrettin Koca said on Twitter all the deceased were elderly people.
More than 20,000 coronavirus tests have been conducted so far on people suspected to be infected with the virus and 289 people tested positive in the last 24 hours, carrying the tally of infections to 1,236, he said.
Koca called on all the citizens to be cautious and said: "This country will not be defeated by this threat."
20:40 GMT - Qatar offers $150m to support Gaza Strip in coronavirus battle
Qatar will provide $150m to support the Palestinian-controlled Gaza Strip in its fight against the coronavirus pandemic, according to the state news agency QNA.
QNA said this package aims at "alleviating the suffering of the Palestinian people, and in support of UN relief and humanitarian programmes in Gaza".
20:05 GMT - Syria confirms first coronavirus case: minister of health
Syria said it had confirmed its first case of coronavirus, in a person who had come from abroad.
Health Minister Nizar al-Yaziji told state media the "necessary measures" had been taken.
There had been unconfirmed reports in recent weeks of coronavirus cases in Syria, whose health system, housing and infrastructure have been ravaged by nine years of civil war, but the authorities had denied them. 
19:55 GMT - Johnson tells UK: Stay apart or face tougher coronavirus measures
Britain may need to impose curfews and travel restrictions to halt the spread of the coronavirus people do not heed the government's advice on social distancing, Prime Minister Boris Johnson has warned.
Pubs, clubs and gyms have already closed, but social media on Sunday was awash with pictures of people congregating in parks and food markets, apparently ignoring advice to stay two metres apart.
Parks in London are already closing down as authorities struggle to slow the advance of coronavirus through the population, the biggest public health crisis since the influenza pandemic of 1918. So far 281 Britons have died from coronavirus, and the number of confirmed coronavirus cases rose to 5,683 on Sunday, up from 5,018 on Saturday.
Johnson was blunt as he delivered his message to the public. "Stay two metres apart. It's not such a difficult thing. Do it," he said.
"Otherwise.... there is going to be no doubt that we will have to bring forward further measures and we are certainly keeping that under constant review."
19:40 GMT - Germany's Merkel to go into quarantine after contact with infected doctor
Chancellor Angela Merkel will go into quarantine after coming into contact with a doctor who had tested positive for the coronavirus.
Merkel will continue to work from home and will submit to repeated tests over the next few days, her spokesman said. It was too soon for a conclusive test on her at the moment, he added.
Merkel on Friday afternoon received a vaccine shot against pneumococcus, a pneumonia-causing bacteria, from a doctor who later tested positive for the coronavirus.

19:30 GMT - Brazil's Bolsonaro plays down coronavirus risk as cases top 1,000

Brazil's President Jair Bolsonaro denied the country's healthcare system will collapse next month, contradicting his own health minister as the number of confirmed cases in the country rose above 1,000.
In an interview with CNN Brasil on Saturday night, Bolsonaro also expressed his frustration with several states' measures to essentially shut down commerce and restrict people's movement, saying they have gone too far and are damaging the economy.
"I think Mandetta was exaggerating," Bolsonaro said, referring to health minister Luiz Henrique Mandetta, who said on Thursday that Brazil's fragile healthcare system will collapse under the weight of coronavirus by the end of April.
Bolsonaro said "collapse" was the wrong choice of words.
"What we're doing is lengthening the infection curve. I don't believe in a collapse," he said.
19:20 GMT - Saudi coronavirus cases pass 500
Saudi Arabia recorded 119 new cases of the virus for a total of 511, the highest in the Gulf Arab region, the health ministry said.
The tally of cases in the six-nation Gulf Cooperation Council (GCC) now stands at more than 1,700. Bahrain reported a second death on Sunday, a citizen evacuated from Iran, taking the GCC's total to four.
The ministry said 72 of the new cases were Turkish nationals under quarantine in the holy city of Mecca after interacting with an infected compatriot.
18:05 GMT - First US senator tested positive for coronavirus
Rand Paul, the Republican of Kentucky has become the first US senator to test positive for coronavirus. A post on his official page said that Paul is "asymptomaniac" and was not aware of direct contact with any infected person.
Senator Rand Paul has tested positive for COVID-19. He is feeling fine and is in quarantine. He is asymptomatic and was tested out of an abundance of caution due to his extensive travel and events. He was not aware of any direct contact with any infected person.
— Senator Rand Paul (@RandPaul) March 22, 2020
17:23 GMT - Italy: Deaths rise by 651 in a day, bringing total to 5,476
The death toll from an outbreak of coronavirus in Italy has risen by 651 to 5,476, officials said, an increase of 13.5 percent but down on Saturday's figure when some 793 people died.
The total number of cases in Italy rose to 59,138 from a previous 53,578, an increase of 10.4 percent, the Civil Protection Agency said - the lowest rise in percentage terms since the contagion came to light on February 21.
Of those originally infected nationwide, 7,024 had fully recovered on Sunday compared to 6,072 the day before. There were 3,009 people in intensive care against a previous 2,857.
The hardest-hit northern region of Lombardy remained in a critical situation, with 3,456 deaths and 27,206 cases against a previously given 3,095 and 25,515 respectively.
17:00 GMT - Germany to ban meetings of more than two people
Germany will ban public meetings of more than two people unless they are about work on slowing the spread of the coronavirus, the premier of North Rhine-Westphalia state said.
"The danger lies in the direct social interaction," state premier Armin Laschet said, adding that the federal government and regional states had agreed on the stricter rules.
16:45 GMT - Bogota prison riot over coronavirus kills nearly two dozen
A prison riot in Colombia's capital Bogota left 23 prisoners dead and 83 injured, the justice minister said as detainees protested sanitary conditions amid the global outbreak of coronavirus.
Seven prison guards were also injured late on Saturday and two are in critical condition, the minister said.
The Andean nation will enter a nationwide lockdown from Tuesday night. So far, 231 people have been confirmed infected with the disease in the country and two have died.

16:34 GMT - In Pictures: India holds 14-hour coronavirus lockdown

Nearly a billion Indians stayed indoors on Sunday, heeding Prime Minister Narendra Modi's appeal to citizens to self-isolate as authorities battle to contain the fast-spreading coronavirus pandemic.
At least 324 people so far have contracted the disease while four have died in India, according to official data.

15:35 GMT - Canada death toll jumps by 50 percent in a day

The Canadian death toll from the coronavirus outbreak jumped almost 50 percent to 19 in less than a day, official figures released by the federal government showed.
Ottawa said late on Saturday that 13 people had died but by 9am Eastern Time (13:00 GMT) on Sunday that number had grown to 19, a 46 percent increase. The number of confirmed cases rose to 1,302 from 1,099.
15:20 GMT - 'Biggest US crisis' since Great Depression: NYC mayor
The mayor of New York City, which has more than one-third of the nation's coronavirus cases, described the outbreak as the biggest domestic crisis since the Great Depression and called for the US military to mobilise to help keep the healthcare system from becoming overwhelmed.
"If we don't get more ventilators in the next 10 days people will die who don't have to die," said Mayor Bill de Blasio, as the nation's most populous city saw cases top 8,000 and deaths hit 60. Nationwide cases are more than 25,000 with at least 340 dead.
"This is going to be the greatest crisis domestically since the Great Depression," he told CNN, referring to the economic crisis of the 1930s. "This is why we need a full-scale mobilisation of the American military."
"April is going to be a lot worse than March and I fear May could be worse than April," de Blasio said.
15:10 GMT - Afghanistan reports first confirmed death
Afghanistan's health ministry has reported the country's first confirmed death from coronavirus.
A 40-year-old man died in the northern Balkh province, Ministry of Public Health spokesman Wahidullah Mayar said.
Afghanistan has 34 confirmed cases of the virus and there are fears its vulnerable health system, devastated by years of war, would be overwhelmed by an outbreak.
14:15 GMT - Emirates to stop all passenger flights by March 25
Emirates, one of the world's biggest international airlines, will temporarily suspend all passenger flights starting Wednesday, it said on Sunday.
"As a global network airline, we find ourselves in a situation where we cannot viably operate passenger services until countries re-open their borders, and travel confidence returns," Emirates Chairman Sheikh Ahmed bin Saeed al-Maktoum said in a statement.
Today we made the decision to temporarily suspend all passenger flights by 25 March 2020. SkyCargo operations will continue. This painful but pragmatic move will help Emirates Group preserve business viability and secure jobs worldwide, avoiding cuts. https://t.co/fkQ59ExVxA 1/3 pic.twitter.com/j7ytftExn2
— Emirates Airline (@emirates) March 22, 2020

14:07 GMT - Coronavirus could destroy 10 million US jobs: Economists

With the economic fallout of the coronavirus pandemic still far from clear, researchers in the US are struggling to get to grips with how many American jobs could be lost to the crisis. 
Many economists suggest that even with an unprecedented intervention by the federal government and the US Federal Reserve, millions of jobs could be permanently erased within months.
On Thursday, a US government report showed that 281,000 Americans were let go from their jobs the previous week - a 33 percent spike over the last report. But many analysts believe the number is set to skyrocket.
Hello, this is Linah Alsaafin taking over from my colleague Virginia Pietromarchi.

13:15 GMT - Singapore reports 23 new cases

Singapore reported 23 new cases of coronavirus, mainly imported, taking the city state's tally of the infection to 455, according to a health ministry statement.
Authorities said they will not allow any short-term visitors to transit or enter Singapore, a move aimed at trying to contain the spread of the virus and conserve resources for citizens who are returning from other countries.
13:10 GMT - Kenya police clash with traders in attempted closure
Riot police in Kenya fired tear gas and beat protesters with sticks after traders resisted police attempts to close a crowded market in Kisumu in a measure to curb the spread of the coronavirus.
This happened after Kisumu County Governor Anyang' Nyong'o ordered traders to shut down their stalls.
Traders shouted "Nyong'o must go" and "[The] market must [stay] open", as police patrolled and ensured the market remained closed.
"Some of the traders here are willing to take their chances with the coronavirus and die because we don't have any other choice. But why should we be beaten and attacked with tear gas?" asked Mohamed Hassan, one of the traders at Kibuye Market.
12:50 GMT - Iraq orders lockdown until March 28 
Iraq has imposed a nationwide lockdown until March 28 to fight the novel coronavirus as the number of cases rose and the death toll climbed to 20.  
Most of Iraq's 18 provinces had so far imposed their own local curfews but the new measures would include the entire country, according to a new decision by the government's crisis cell. 
Schools, universities and other gathering places would remain closed, as would the country's multiple international airports, it said in a statement. 
12:30 GMT - Palestinians to self-quarantine for 14 days 
The Palestinian government ordered Palestinians in the Israeli-occupied West Bank to remain indoors for two weeks as a precaution against the spread of the coronavirus.
The order, announced by Prime Minister Mohammad Shtayyeh on television, goes into force at 10pm local time. Medical personnel, pharmacists, grocers and bakers would be exempt, he said.
12:20 GMT - Macron threatens travel ban from UK 
French President Emmanuel Macron threatened to close France's border with the UK on Friday if Prime Minister Boris Johnson failed to take more stringent measures to contain the coronavirus outbreak, French newspaper the Liberation reported.
"We had to clearly threaten him to make him finally budge," the newspaper quoted an Elysee official close to Macron as saying, referring to the Johnson administration's lenient approach to the pandemic.
The report echoed comments made by French Prime Minister Edouard Philippe, who also expressed the government's displeasure over how the UK was dealing with the crisis.

12:00 GMT - Kosovo records first death

The Kosovo Public Health Institute announced that an 82-year-old man is the country's first patient to die from the coronavirus.
"Patient already had chronic illness, cardio and pulmonary," the statement said. 
A country of some two million people, Kosovo has registered 31 cases of people infected with the virus.

11:50 GMT - Emirates suspends flights to Beijing, Seattle

Seattle and Beijing are the latest cities to be added to the UAE-carrier's list of suspended destinations, the company announced on its website. 
The state-run Dubai carrier has suspended flights to 109 different destinations, representing nearly 70 percent of its network of 159 international destinations, because of the coronavirus outbreak and its impact on travel demand.

11:45 GMT - Spain reports 394 new deaths

Spain's death toll from the coronavirus epidemic soared to 1,720 on Sunday from 1,326 the day before, according to multiple media outlets citing the latest health data.
The number of registered cases in the country rose to 28,572 on Sunday from 24,926 in the previous tally announced on Saturday, the reports added.

11:30 GMT - Australia to shut down nonessential services

Australian Prime Minister Scott Morrison has ordered the closure of pubs, casinos, gyms and other public venues starting midday on Monday to combat the coronavirus after many people appeared to disregard health warnings. 
"I am deeply regretful that those workers and those business owners who will be impacted by this decision will suffer the economic hardship that undoubtedly they will now have to face," Morrison said in a national address.
After an initial relatively slow spread, the number of infections in Australia has quickly risen, climbing to 1,098 confirmed cases and seven deaths. 
10:30 GMT - Oman bans public gatherings, shuts currency exchanges
Oman has restricted movement, banning public gatherings and limiting staffing at state entities, as it attempts to prevent the spread of the coronavirus. The Gulf state also shut currency exchange bureaus as part of its containment efforts. 
Authorities in the sultanate, which has reported 55 cases of the virus, also asked the private sector to facilitate remote working and urged commercial businesses and individuals to limit cash transactions, state television reported.
10:15 GMT - Lockdown to combat coronavirus not enough: WHO
Mike Ryan, the World Health Organization's top emergency expert, said locking down societies to stem the spread of the novel coronavirus will not suffice to exterminate it. 
"What we really need to focus on is finding those who are sick, those who have the virus, and isolate them, find their contacts and isolate them," Mike Ryan said in an interview on the BBC's Andrew Marr Show.
"If we don't put in place the strong public health measures now, when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up."
9:50 GMT - Iran's death toll from the coronavirus hits 1,685 
Iran has announced 129 new deaths caused by the novel coronavirus, raising to 1,685 the official death toll in one of the worst-hit countries along with Italy and China.
"There were 1,028 new confirmed infected cases in the past 24 hours ... and 7,913 people have recovered," said health ministry spokesperson Kianush Jahanpur.
9:30 GMT - Malaysia reports 123 new coronavirus cases, total at 1,306
Malaysia has confirmed 123 new coronavirus cases, taking the total to 1,306 cases, with 10 deaths. 
The health ministry said 34 of the new cases were linked to a religious gathering held late last month. Malaysia has the highest number of cases in Southeast Asia.
9:10 GMT - Indonesia registers 64 new coronavirus cases, 10 deaths 
Indonesia confirmed 64 new coronavirus cases and 10 new deaths, a health ministry official told reporters on Sunday, bringing the total number to 514 and 48, respectively.
Nine coronavirus patients have recovered, the health ministry spokesman, Achmad Yurianto said, bringing the total number of recoveries to 29.

9:05 GMT - Britain to start producing new ventilators
Britain has received the first prototypes of new ventilators from manufacturers who had been asked to step up to help the health service handle the coronavirus pandemic, and production of new machines should start soon, housing minister Robert Jenrick said on Sunday.
"We've been overwhelmed by offers of support. There's now a number of manufacturers who are working with us. We're in receipt of some of the first prototypes, and we expect that manufacturing can start quite quickly," Jenrick said in an interview with Sky News, adding that around 13,000 ventilators were currently available to Britain's National Health Service.
"But we do need more, and we're trying to ramp up production as quickly as we can."
9:00 GMT - Czech coronavirus cases rise to 1,047 
The number of coronavirus cases in the Czech Republic has risen to 1,047, according to the latest health ministry tally.
The country of 10.7 million people had 158 new cases on Saturday, the ministry said.
Six people have recovered, and there have been no deaths. Health workers had tested 15,584 people as of Saturday.
08:45 GMT - NHS nurse appeals to shoppers to not panic-buy
"You just need to stop it!" said a UK critical-care nurse, breaking down in tears as she left a supermarket where she has been unable to find any vegetables or fruits to eat. 
Coronavirus: UK nurse in tears over panic buying  

08:24 GMT - Romania confirms first coronavirus death
A 67-year-old man who had been suffering from terminal cancer is Romania's first death due to coronavirus. 
The deceased was confirmed to be infected on March 18 and was being treated in a hospital in the southern Romanian city of Craiova.
Romania, which has recorded 367 cases of coronavirus to date, declared a state of emergency on March 16. 
Illuminated by police car lights, a female police officer, left, wearing a protective mask stands at a roadblock in the vicinity of one of the hospital where COVID-19 infected patients are under trea]Illuminated by police car lights, a female police officer, left, wearing a protective mask stands near a hospital where COVID-19 infected patients are under treatment in Bucharest, Romania. [Andreea Alexandru/AP

08:11 GMT - Libya UN-recognised government imposes curfew

As fighting in the south of Libya's capital continues, the Tripoli-based Government of National Accord (GNA) declared a night-time curfew from 16:00 to 04:00 GMT to keep the coronavirus out of areas it controls.
The internationally recognised GNA has also ordered the closure of restaurants and cafes while parties, funerals and weddings have been banned.
No cases have been reported in Libya to date, but experts fear an outbreak could be catastrophic due to the country's gutted health system.
08:01 GMT - Iran's Khamenei sceptical about US offer to help Iran
The offer by the US to help Iran fight the coronavirus pandemic is strange, said Iran's Supreme Leader Ayatollah Ali Khamenei.
 "Several times, Americans have offered to help Iran to contain the virus. Aside from the fact that there are suspicions about this virus being created by America [...] their offer is strange since they face shortages in their fight against the virus," Khamenei said during a speech in Tehran broadcast live across Iran marking Nowruz, the Persian New Year. 
"Iran has the capability to overcome any kind of crisis, including coronavirus outbreak."
07:45 GMT - China witnessing increase in imported cases
For a fourth consecutive day, China reported an increase in the number of cases imported from overseas, mostly from Chinese people returning home.
The country recorded 46 new cases, all but one coming from outside China - a drastic reduction in the number of domestically transmitted infections.
China is stepping up measures to identify new cases, including diverting all flights due to arrive in Beijing to another airport where passengers will undergo virus screening, government agencies said.
07:24 GMT - Tokyo considering postponing Olympics: Reuters 
The Tokyo Olympics Games organisers are considering alternatives to holding the event this summer, two sources told Reuters news agency.
If confirmed, the news would mark a change in direction by the Japanese government which has so far ruled out postponing the Olympics.
While the coronavirus outbreak has disrupted sports events around the world, Japan has been steadfast in saying the Games will go on. 
07:10 GMT - Bike and automakers to halt activities in India
India's giant bike maker Hero Motocorp is about to stop operations at all its manufacturing facilities until March 31 to protect its employees from the pandemic.
With plants in India, Bangladesh and Colombia, Hero accounts for more than 35 percent of the two-wheeler market in India.
Also, US carmaker Fiat Chrysler Automobiles announced it will suspend production at its plant in the western Indian state of Maharashtra until March 31.
06:45 GMT - Russia to send help to Italy
Russian President Vladimir Putin has offered to help Italy contain the spread of coronavirus.
In a phone call with Italian Prime Minister Giuseppe Conte, Putin offered his support in the form of mobile disinfection vehicles and specialists to help the worst-hit Italian regions, according to the Kremlin.
The Russian defence ministry said military transport planes would deliver eight mobile brigades of military medics, special disinfection vehicles and other medical equipment to Italy starting Sunday.
Italy coronavirus death toll rises by 793 to 4,825
I will shortly be handing over this blog to my colleague Virginia Pietromarchi in Doha.
Here's a summary of the main developments on Sunday morning:
- Italy has announced a tightening of its lockdown with all non-essential businesses ordered to close.
- Singapore has closed its borders to short-term visitors and transit passengers.
- Australia has closed beaches, and is considering more 'draconian' measures to get people to follow social distancing guidelines.
- Gaza has announced its first two cases of the disease.

05:45 GMT - Malaysia announces ninth death
A 48-year-old doctor has died from coronavirus in Malaysia, becoming the first medical worker to die from the disease.
The man, who was being treated in the northern state of Perlis, had a history of travel to Turkey, the health ministry said. He had not been involved in treating people with COVID-19. 
The country on Sunday deployed the army to assist the police in getting people to follow a restricted movement order that is in force until March 31.

05:25 GMT - Malaysia mosque event organiser says worshippers cooperating
People who attended a mass gathering at a mosque in Malaysia that is now linked to 840 confirmed coronavirus cases across Southeast Asia are cooperating with authorities, an organiser said after the government said thousands of them were still being traced.
The four-day event is connected to 60 percent of Malaysia's 1,183 cases, as well as clusters elsewhere in the region including Brunei, Cambodia and Singapore.
"After hearing reports of thousands of participants yet to be screened, many had returned to their district health departments or hospitals repeatedly until their names and details were recorded," Abdullah Cheong, a leader of the event's organising team, said in a statement on Saturday.
05:15 GMT - Ecuador's health minister replaced after surge in cases
Ecuador's health minister stepped down on Saturday, just hours after authorities announced the number of confirmed cases had shot up to more than 500, with seven deaths.
Hours after the announcement, officials confirmed the resignation of Health Minister Catalina Andramuno, without providing details, and appointed Juan Carlos Zevallos, a doctor who has worked in several universities, as her replacement.
The labour minister also resigned, a presidential announcement said.
04:35 GMT - First two cases confirmed in Gaza Strip
The Palestinian Health Authority has confirmed the first two cases of coronavirus in the occupied Gaza Strip. 
The two people had recently returned from Pakistan.

04:10 GMT - Japan suspects new virus cluster in southwest
Japan's Oita prefecture confirmed two new coronavirus infections at a medical centre on Sunday, bringing the total at the facility to 14 and making it a suspected cluster, according to Japanese newswire Kyodo.
Two female nurses who work at the Oita Medical Center, one in her 20s and another in her 50s, were diagnosed with the coronavirus although they showed only mild symptoms, Kyodo said.
The medcal centre has already confirmed 12 cases, and the southwestern prefecture is conducting tests for about 600 staff and patients who are or were hospitalised there, they said.
Japan has recorded 1,055 cases of domestically-transmitted cases of coronavirus as of Sunday, up 40 from the previous day, according to public broadcaster NHK.
04:00 GMT - US vice president tests negative for coronavirus
The office of US Vice President Mike Pence says he and his wife have tested negative for the coronavirus.
The couple took the test after one of Pence's staff was diagnosed with the virus.
03:50 GMT - Singapore closes to short-term visitors, transit passengers
Singapore has decided to close its borders to all short-term visitors given the "heightened risk" of the coronavirus. 
The Ministry of Health says the measures are necessary because 80 percent of confirmed COVID-19 cases over the past three days came from overseas.
The country will also stop transit through Singapore. 
The measures come into effect from 23 March at 11:59pm local time (15:59 GMT). 

03:10 GMT - Scepticism as North Korea claims no cases
North Korea watchers are expressing scepticism - and some alarm - about the government's claim that the country is coronavirus-free.
Sources have informed them of a number of cases, and they worry that if it begins to spread within the wider community, the consequences would be devastating.

Al Jazeera's Kelly Kasulis has the story.

03:00 GMT - Turkey confirmed cases rise, partial curfew for vulnerable
Turkey's confirmed cases of coronavirus rose to 947, and the number of dead to 21, the health minister said on Saturday.
Health Minister Fahrettin Koca said some 2,953 tests had been conducted in the previous 24 hours.
The country is also planning a partial curfew for citizens over the age of 65 and those with chronic diseases. The interior ministry is expected to announce more details later.
02:50 GMT - Cases rise in the Philippines
The Philippines has reported 73 new coronavirus cases, bringing the total to 380, the health ministry said on Sunday.
It also announced six more deaths related to coronavirus, bringing total fatalities to 25.
Health Undersecretary Rosario Vergeire told DZBB radio that the increase in confirmed cases could be "artificial" because the government is catching up on a backlog of tests
02:40 GMT - India in 14-hour curfew to limit virus spread 
India is about an hour into a 14-hour curfew as part of its attempts to curb the spread of the virus. 
All citizens have been told to stay indoors from 01:30 to 15:30 GMT.
"Let us all be a part of this curfew, which will add tremendous strength to the fight against the COVID-19 menace," Modi tweeted minutes before the curfew commenced.
In a few minutes from now, the #JantaCurfew commences.
Let us all be a part of this curfew, which will add tremendous strength to the fight against COVID-19 menace. The steps we take now will help in the times to come.
Stay indoors and stay healthy. #IndiaFightsCorona pic.twitter.com/11HJsAWzVf
— Narendra Modi (@narendramodi) March 22, 2020

01:30 GMT - South Korea reports 98 new cases of coronavirus

The Korea Centers for Disease Control and Prevention reported 98 new cases of coronavirus, bringing the national total to 8,897.
01:20 GMT - Wuhan reports fourth day with no new cases
Wuhan, where the coronavirus first emerged late last year, said it had no new cases of coronavirus on Saturday, marking the fourth straight day without a new infection.
China reported 46 new confirmed cases, all but one of them imported from overseas.
It also said six more people died from COVID-19.
Wuhan reports ZERO new #COVID19 infection for consecutive 4 days. 46 new COVID-19 cases are reported in Chinese mainland, with 45 imported cases. pic.twitter.com/OFgwXqeyuJ
— Global Times (@globaltimesnews) March 22, 2020

01:00 GMT - Australia to consider 'draconian measures' to enforce social distancing

Australian Prime Minister Scott Morrison said states and territories would consider draconian measures to enforce social distancing after thousands of people thronged the country's beaches amid unusually warm weather.
Most of Sydney's main beaches, including Bondi Beach, were closed on Sunday.
"The measures that we will be considering tonight means that state premiers and chief ministers may have to take far more draconian measures to enforce social distancing," Morrison said in Canberra.
00:15 GMT - Conte says Italy will further tighten lockdown to tackle virus
Italy has ordered all but the most essential businesses to close until April 3.
"It is the most difficult crisis in our post-war period," Prime Minister Giuseppe Conte said in a video posted on Facebook, adding "only production activities deemed vital for national production will be allowed."
Conte did not go into detail on which businesses would have to close under the order which is expected to come into effect through an emergency decree on Sunday.
Supermarkets, pharmacies, postal and banking services will remain open and essential public services, including transport, will be ensured.
"We are slowing down the country's production engine, but we are not stopping it," Conte said.
00:00 GMT - UK urges more vulnerable to 'stay at home'
Some 1.5 million people identified by the United Kingdom's National Health Service (NHS) as being at higher risk of severe illness if they contract coronavirus are being urged to stay at home to protect themselves.
The people include those who have received organ transplants, those living with severe respiratory conditions or specific cancers, and some receiving certain types of drug treatments.
They will be contacted by their doctor and strongly advised to stay at home for a period of at least 12 weeks.
I'm Kate Mayberry in Kuala Lumpur with Al Jazeera's continuing coverage of the coronavirus pandemic. 

US coronavirus death toll overtakes Italy: Live updates
Number of deaths related to COVID-19 in the US approaches 20,000 as the number of confirmed cases passes 500,000.by Ted Regencia, Joseph Stepansky & Mersiha Gadzo
11 Apr 2020 19:13 GMT

Spain, the European country with the most reported coronavirus infections, has confirmed 510 new deaths, the lowest daily toll since March 23, when the World Health Organization (WHO) declared the coronavirus outbreak a pandemic.
Meanwhile, the US recorded a total death toll of 19,882, surpassing Italy's death toll of 19,468. Cases in the US topped 514,000 on Saturday.

The worldwide death toll is now over 107,000, with the number of infections worldwide topping 1.7 million, including more than 395,000 recovered patients.

Here are the latest updates.
Saturday, April 11
19:10 GMT - 'We need food': Tunisians struggle under lockdown
Tensions rise in Tunisia as people struggle to cope with hunger and unemployment amid the coronavirus outbreak.

18:37 GMT - France reports fall in deaths

France reported a lower daily death toll, declaring a "plateau" was reached, albeit at a very high level.
Top French health official Jerome Salomon said 353 more people had died in hospitals and 290 in nursing homes, bringing the total death toll to 13,832.
A day earlier, 554 had died in hospitals and 433 in nursing homes.
"A very high plateau for the epidemic appears to have been reached but the epidemic remains very active," he told reporters. "We must absolutely remain vigilant."

17:45 GMT - US surpasses Italy as worst-hit country

The US recorded a total death toll of 19,882, surpassing Italy in the number of fatalities from the coronavirus.
Italy has a total death toll of 19,468.
With more than 514,000 confirmed cases, the US has the highest number of coronavirus infections in the world.
In the hardest-hit state of New York, Governor Andrew Cuomo said 783 more people died, raising the total number of deaths in the state to 8,600.

17:33 GMT -  Italy records 619 more deaths

Italy recorded 619 more deaths in a single day, bringing the country's total death toll to 19,468.
The total number of infections in Italy surpassed 150,000, the Italian Civil Protection Agency reported.

17:20 GMT - Belarus enters 'concerning' new phase: WHO official
A WHO official urged Belarus to impose new measures to contain the coronavirus, concerned that the outbreak has entered a worrying "new phase" in the country.
Patrick O'Connor, who led a WHO delegation in a visit to Belarus this week said the virus had begun spreading through communities in the capital Minsk and in other parts of the country.
"Belarus is entering a new phase in the evolution of the outbreak," he told a news conference in Minsk.
Belarus has so far recorded 2,226 cases and 23 coronavirus-related deaths.

17:08 GMT - Cases in Canada reach 22,559 with 600 deaths
Canada confirmed 1,316 new coronavirus cases, raising the total toll to 22,559, according to data by the country's Public Health Agency.
It recorded 69 more deaths, taking the total death toll to 600.

17:02 GMT - Coronavirus fight a marathon, not a sprint, top British doctor says
The fight against the coronavirus is a marathon not a sprint and lifting the lockdown may involve drugs and not just vaccines, Stephen Powis, the medical director of England's national health service said.
"There is no magical solution that doesn't require difficult decisions," Powis said. "This was never going to be a sprint over a few weeks; this is going to be longer, it is going to be a marathon."

17:00 GMT - Turkey's death toll rises by 95 to 1,101
Turkey recorded 95 deaths, raising the total death toll to 1,101 with 5,138 new coronavirus cases confirmed, according to Turkey's health minister.
Turkey's total number of coronavirus cases now stands at 52,167.

6:55 GMT - Paedophiles seeking to exploit children online in crisis, UK says
Paedophiles are seeking to exploit the fact that children are increasingly going online to meet friends and do school lessons on their computers during the coronavirus crisis, Britain's interior minister Priti Patel said.

16:50 GMT - UK minister 'sorry' for front line PPE failings
Britain's interior minister said she was sorry if health workers felt there had been failings to get personal protective equipment (PPE) to the front line.
Doctors and nurses have complained that there have been PPE shortages for frontline staff and when asked directly if she would apologise for this, Home Secretary Priti Patel said: "I am sorry if people feel there have been failings."
"It is inevitable that the demand and pressures on PPE and the demand for PPE are going to be exponential, they are going to be incredibly high," she said.

15:24 GMT - US reports highest daily death toll
The US became the first country to report more than 2,000 coronavirus deaths in a single day.
It recorded 2,108 deaths, pushing the total death toll to 18,781. The US will soon overtake Italy, which has a death toll of 18,849.
Cases in the US surpassed 501,000.

15:05 GMT - Netherlands calls for software proposals
The Dutch government issued a call for proposals to develop smartphone apps or software that could be used to battle the coronavirus outbreak.
In a statement, the health ministry announced it was looking for proposals on how to conduct "contract tracing" of people who may have been exposed to the virus, while maintaining individual privacy.
The deadline is noon on April 14.

14:35 GMT - Singapore reports 191 new cases
Singapore's health ministry confirmed 191 new coronavirus cases, increasing the total number of infections to 2,299.

14:30 GMT - UK deaths near 10,000
The UK recorded 917 deaths in the last 24 hours, authorities said, raising the total death toll to 9,875.
"269,598 people have been tested of which 78,991 tested positive," the Department of Health reported.

14:06 GMT - NYC public schools remain closed for rest of school year
New York City Mayor Bill de Blasio said public schools will remain closed for the rest of the school year.
"Having to tell you that we cannot bring our schools back for the remainder of this school year is painful, but I can also tell you it is the right thing to do," he told a news conference.
De Blasio ordered public schools closed from March 16 to curb the spread of the coronavirus, with an initial goal of reopening by April 20.
But the mayor said it soon became clear that goal was unrealistic as New York City has emerged as a major coronavirus hot spot.

12:40 GMT - Expert leading Oxford team: Vaccine could be ready in six months 
A vaccine for the coronavirus could be ready by September, Sarah Gilbert, a professor of vaccinology at Oxford University told the Times newspaper.
Gilbert’s team is one of dozens worldwide working on a vaccine. She told the newspaper she is “80 percent” certain the the vaccine her team is developing could be effective and could possibly be ready by September.
Scientists have previously said a coronavirus vaccine would likely take 12 to 18 months. 

12:20 GMT - UK PM making very good progress in recovery, office says
British Prime Minister Boris Johnson is making "very good progress" in his recovery from COVID-19, his office has said.
Johnson was moved out of intensive care after three nights on Thursday and Downing Street said on Friday he had managed to start walking, although his recovery was at an early stage.
"The Prime Minister continues to make very good progress," a Downing Street spokeswoman said. 

12:05 GMT - Dutch cases rise by 1,316 to 24,413
The number of confirmed coronavirus cases in the Netherlands rose by 1,316 on Saturday to 24,413, health authorities said, with 132 new deaths.
The country's cumulative death toll is 2,643, the Netherlands' National Institute for Health (RIVM) said in its daily update.

11:50 GMT - Austrian rail company looking to put up to 10,000 workers on short-time work
Austria's state rail operator OBB is putting up to 10,000 workers, around a quarter of its staff, on short-time work due to the coronavirus, radio station ORF has reported
"Short-time working has started with OBB as of April 1, while corresponding agreements between the works council and the management of the respective companies are in progress or have been concluded," an OBB spokesman told Reuters news agency.
The number of 10,000 workers going into short-time work is a preliminary estimate, he said.The spokesman said the measures had been introduced because of a massive reduction in passenger numbers since the coronavirus outbreak.
The company, which employs around 42,000 people, has seen passenger numbers fall by more than 80 percent in recent weeks, he said.

11:30 GMT - Switzerland death toll rises to 831
The Swiss death toll from the new coronavirus has reached 831, the country's public health ministry has said, rising from 805 people on Friday.
The number of confirmed cases also increased to 24,900 from 24,308, it said.
11:15 GMT - Belarus soccer continues amid virus anxiety and empty stands
Belarus is the only country in Europe still playing soccer amid the coronavirus pandemic but a growing number of fans are boycotting league matches, anxious about catching the disease. 
In the western city of Grodno, local team FC Neman Grodno drew with FC Belshina Bobruisk on Friday in front of almost empty stands. Just 253 people attended, compared to last year when Neman's games drew crowds of around 1,500 people.
The Belarus football federation initially explained its decision to continue because only a small number of coronavirus cases had been recorded in the eastern European country, but more recently they have declined comment. Belarus has reported 2,226 cases, with 23 deaths.

10:50 GMT - Armenia extends state of emergency to stem coronavirus outbreak
Armenia has extended by another 30 days the state of emergency that it declared last month to curb the spread of the novel coronavirus, which has so far infected nearly 1,000 people.
Armenia has closed educational institutions, halted all public transportation and barred foreigners from entering. The former Soviet country, which has population of 3 million, has also said it will postpone a referendum on changes to the Constitutional Court until after the emergency.
The decision to extend the state of emergency, announced by Prime Minister Nikol Pashinyan, is expected to be formally approved by parliament next week. Pashinyan said that certain business activities, including fishing, agriculture and cigarette production, would still be allowed despite the state of emergency. The country has recorded 966 infections, with 13 deaths.

10:35 GMT - Iran says total number of infected reaches 70,029
Iran's total death toll from the new coronavirus outbreak has risen to 4,357, with 125 people having lost their lives in the past 24 hours, the health ministry said.
The total number of people diagnosed with the disease rose by 1,837 in the past 24 hours to a total of 70,029, ministry spokesman Kianoush Jahanpur said on state TV, with 3,987 of those infected in critical condition.
Iran is the country most affected by the pandemic in the Middle East.

10:20 GMT - India to extend nationwide lockdown: Delhi state chief minister
Indian Prime Minister Narendra Modi has decided to extend a nationwide lockdown to tackle the spread of the coronavirus, the Delhi state's chief minister has said, without saying how long the extension would be for.
Modi earlier in the day held a video conference call with several state ministers. Delhi Chief Minister Arvind Kejriwal said Modi had "taken (a) correct decision to extend (the) lockdown", without sharing further details.
"If it is stopped now, all gains would be lost. To consolidate, it is imp (important) to extend it," Kejriwal said on Twitter.
India's 21-day lockdown ends on Tuesday but several states had urged Modi to extend it further, even as concerns have risen that the shutdown has put millions of poor people out of work and forced an exodus of migrant workers from cities to villages.

10:15 GMT - WHO says looking into reports of some patients testing positive again 
The WHO has said that it was looking into reports of some COVID-19 patients testing positive again after initially testing negative for the disease while being considered for discharge.
South Korean officials on Friday reported 91 patients thought cleared of the new coronavirus had tested positive again. Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention, told a briefing that the virus may have been "reactivated" rather than the patients being re-infected. 
The Geneva-based WHO, asked about the report from Seoul, told Reuters news agency in a brief statement: "We are aware of these reports of individuals who have tested negative for COVID-19 using PCR (polymerase chain reaction) testing and then after some days testing positive again. We are closely liaising with our clinical experts and working hard to get more information on those individual cases" it said.
10:00 GMT - Virus spreads at major Kazakh oilfield's worker camp
Ten people have tested positive for the novel coronavirus at one of the worker camps located next to the giant Tengiz oilfield in Kazakhstan, the Kazakh authorities have said.
The Chevron-led consortium operating Tengiz, the Central Asian nation's number one oil producer, was not immediately available for comment on Saturday. However, the company, Tengizchevroil, said this week it had taken measures to ensure the safety of workers on the site and avoid output disruptions.
Tengizchevroil made the comment in an email to Reuters new agency on April 9 after the first case was confirmed at a 2,000-bed camp in the so-called rotational village where workers of the company and its contractors stay during their weeks-long shifts. On Saturday, the Kazakh government said that after tracing the contacts of the first infected person, nine more people have been diagnosed with the same disease.
According to the consortium, the camp has been locked down and workers can enter the Tengiz field itself only after being quarantined for 14 days. 

Domestic abuse spikes in Mexico amid virus outbreak

A health worker takes the temperature of a man who returned from Iran and is under medical observation at the border post in Taftan, Pakistan in February

[Naseer Ahmed/Reuters]

COVID-19: Brazil's Bolsonaro is putting 'lives in danger' | UpFront
COVID-19: Brazil's Bolsonaro is putting 'lives in danger' | UpFront

An anti-vaccine rally at the Arizona state capitol on May 18.- Jesse Rieser for TIME

Indian migrant workers, daily wagers, laborers and homeless people wait for food outside a

government-run shelter, as India remains under an unprecedented lockdown over the highly contagious coronavirus [Getty Images]

Illuminated by police car lights, a female police officer, left, wearing a protective mask stands near a hospital where COVID-19 infected patients are under treatment in Bucharest, Romania. [Andreea Alexandru/AP] 



In terms of human mortality, the influenza pandemic of 1918 to 1920 overshadowed World War I. Within the course of less than a year, influenza claimed the lives of twenty million human beings, more lives than all of the battlefield deaths. Although more than a half-million Americans died from the disease and its sequelae during that period, those who have written the history of the twentieth century have, with few exceptions, given only cursory attention to the pandemic. Historians have especially neglected any considera tion of the effect of the pandemic upon the mood or psycholog ical state of the nation. One writer after another has described postwar America as a tired nation, but tired in a spiritual, rather than in a physical, sense. This study suggests that the widespread postwar apathy was as much the    result of a lingering physical sickness as it was a general spiritual depression. After all, almost every family felt the effects of the pandemic.

The influenza pandemic that began in 1918 was special for several reasons.

First, wartime conditions kept the existence of the new strain of flu a secret longer than might have occurred under ordinary circumstances. Pneumonia deaths in the nation’s army camps were already abnormally high before the respiratory plague began its march across the globe. And even as the virus was prostrating hundreds of thousands of victims in Europe in the spring of 1918, Americans tried to convince themselves that the "Spanish flu" had to be the result of inadequate nutrition, a war-related disease that would remain across the ocean. Thus, when a second wave of the new strain of influenza struck the American nation in the fall of 1918, the result was panic and confusion.

Physicians did not know if they were dealing with an entirely new disease or if their patients had the more familiar "grippe." Nor was there any antidote that seemed to provide relief.

Second, the disease had the highest mortality rate among the twenty-to-forty-year-olds, the group ordinarily considered to be the healthiest and sturdiest members of society. This penchant for young adults only increased the universal uneasiness and fear of the disease. Finally, when flu came with a special fury in the fall of 1918, it remained at an epidemic level for a remarkably long time— thirty-one weeks.  Churches, theaters, and places of public amusement and assembly were ordered closed for weeks and sometimes months at a time. Campaign strategies for the off-year elections had to be radically altered. And when the war came to an end in November, influenza struck those who made the peace. The spring following the Armistice was an unhealthy time on both sides of the Atlantic, as it was the following year in 1920, when a third major wave of influenza claimed nearly another one hundred thousand American lives.

  Chapter I of this study discusses both present knowledge and the pre-1918 history of influenza. Chapter II covers the seed-time and origin of the pandemic, as well as the general concerns of the nation in early 1918. The next two chapters focus on the peak period of respiratory disease from A.ugust to December, 1918, when pneumonia rather than influenza seemed to be the killer disease. The remaining three chapters show the impact of the pandemic during the years 1918-20 on the fo aspects of American life: on individuals and family life; on politics and foreign affairs; on the medical profession, public health, community health organizations, and health education programs; on local, state, and federal governments, and on private enterprise; and last, but not least, on the mood of the nation. 

  The documentation for chapter I, which is essentially an examination of the nature of influenza, has been drawn from a voluminous medical literature. For the subsequent    chapters, dealing with the 1918-20 pandemic years, primary sources— letters, diaries, memoirs, oral histories, government documents— have been used extensively. And, of course, newspapers provided the kind of day-to-day details available nowhere else.


 "I've got the flu" is an expression so commonplace every fall, winter, and spring that it elicits little more than polite sympathy from the listener. Certainly not fear. Yet at one time earlier in this century the same words conveyed a sense of terror and perhaps of impending doom. In 1918 when pandemic influenza began to sweep across the world in one deadly wave after another, the word "flu" evoked panic in every corner of the globe.
One reason for the panic was the uncertainty about the nature of the disease itself. Was the present "visitation" the ordinary winter ailment commonly diagnosed as flu or grippe, or was the so-called Spanish flu an entirely new disease? Did people actually die from influenza, or did they succumb instead to complicating bacterial pneumonias? Was it possible to avoid the disease, and, if so, how? Did some lucky people possess an immunity to Spanish flu? And, if one became an influenza victim, what was the best antidote or type of care? In 1918 considerable mystery surrounded the elusive infecting agent, so much mystery that people were often terrified when merely walking past a coughing or sneezing stranger on the street.  

  How destructive, in terms of human mortality, was the 1918 influenza pandemic? The statistics generally quoted show   that in the thirty-one-week-long epidemic beginning in the fall of 1918, more than twenty million people died. In the United States alone approximately 550,000 died during that period. These figures, however, do not take into account those victims who died either in early 1918 or in the serious wave of the disease in the beginning months of 1920. Were those epidemic periods included, the total number of pandemicrelated deaths in the United States would be considerably increased.

  While the statistics suggest that approximately one out of every two hundred people in the nation died during the major wave of the pandemic, or about 0.5 per cent of the population, the destruction was actually far more extensive in some American communities. If the figures relating to Barre, Vermont, cited in the Public Health Reports for December 26, 1919, are accurate, the city of Barre, with a population of 10,734 in 1910, lost 385 of its people to influenza and pneumonia in 1918. Based on the 1910 population statistics, Barre lost 3.6 per cent of its population, or one out of every twenty-eight inhabitants. 

  But the 1918-20 mortality statistics for influenza and pneumonia are misleading in that they often do not represent the true number of deaths due to epidemic influenza. Studies conducted in more recent years indicate that a person with a chronic disease who died with influenza and pneumonia complications during an epidemic period has tended to be listed under the chronic disease rather than under the respiratory  affliction. This was especially true for those who suffered from chronic heart disease, tuberculosis, intracranial lesions, nephritis, diabetes, and puerperal disease. Consequently, the often-quoted mortality statistics for the 1918-19 wave of influenza only partially reflect the true ravages of the pandemic. The actual number of deaths due to the new strain of influenza was no doubt much greater. 

  In terms of human mortality, then, the 1918 pandemic must be considered a catastrophic event in history. Yet it has received scant attention from those who have written general histories of the twentieth century. Influenza claimed more lives than World War I did, but the war and the failure of the postwar Peace Conference are usually depicted as the outstanding events in the second decade of this century. Not that there isn't a wealth of literature on the pandemic: there are literally thousands of articles on the pandemic and influenza in American and foreign medical journals. And among the various surveys of infectious diseases written during the last fifty years are chapters scattered here and there about the 1918 pandemic as an epidemiological phenomenon. But thus far medical historians have seemed to show more interest in investigating the Colonial and pre-twentieth century periods of American history than in more recent medical history. One reason may be that up-tc-now scholars have been restricted in their access to public and private documents for that era. But those time restrictions happily no longer apply for the researcher in the 1970's. 

Perhaps another reason the pandemic has received so little attention is that it has often been represented as something that happened in the fail of 1918, a medical disaster of only a few months' duration. The two popular histories of the pandemic both give the impression that it was short-lived. For example, A. A. Hoehling's The Great Epidemic (1961) ends with the following observations: 

It was perhaps coincidence that with the advent of the Armistice of 1918, the pandemic was suddenly and providentially stayed. The microscopic organism responsible for Spanish influenza, against which mankind possessed such little resistance, vanished. Its "visitation" had ended. ... And where it went no one has discovered to this day. 

The latest popular history, Richard Collier's The Plague of the Spanish Lady: The Influenza Pandemic of 1918-1919 (1974),
suggests that the pandemic lasted a few weeks longer, or until 1919 began:
On New Year's Day, 1919, the people awoke to a world largely purged of its sickness. To be sure, some regions had still to experience the pandemic1s full virulence for the first time. ... But most of the world was free: to mourn their dead, to take up their lives anew, to count the cost of an unparalleled devastation. 
  Even William R. Noyes' 1968 Ph.D. dissertation, "Influenza Epidemic 1918-1919: A Misplaced Chapter in the United States Social and Institutional History," treats the pandemic as "six dreadful months of disease." It was a thirty one-week-long epidemic— an epidemic, not waves of disease. But people did not feel free of pandemic influenza during the summer of 1919; they were expecting and fearing another   wave of sickness and death. And they were right. The fear of disease heightened rather than lessened as 1919 progressed, and 1920 only increased that fear.

  Besides the general impression that the pandemic was short-lived, there has also been a suggestion that the American mortality pattern of 1918 was related to immigration. (See Robert S. Katz, "Influenza 1918-1919: A Study in Mortality," Bulletin of the History of Medicine 48 (1974): 416-22.) But immigration probably had little to do with the American mortality pattern. Scores of second, third, and fourth generation Americans died of influenza in the emergency hospitals in Washington, D.C., and elsewhere across the nation. Furthermore, to the doctors stationed at the army camps during the autumn 1918 wave of influenza, it seemed those who were dying were, more often than not, big, brawny country boys, not the pale, scrawny city boys. And, of course, the recent immigrants would have been mostly city boys, not country boys. Actually, probably none of the twenty-to-fortyyear-olds had any immunity to the new pandemic strain before it started to infect the nation. Some of them, however, may have been exposed to the new viral strain during the spring of 1918, during the seed-time of the pandemic. 
  But there has been too much emphasis on mortality statistics. Mortality statistics tell nothing of the millions who were sick and did not die. What happened to their lives as a result of the pandemic? History ought to be concerned with mortality statistics, but it is the living who    make history. It is the living who pass legislation, turn out presidents, become orphans, and lose jobs. It is the living who change the mood of a nation, not the dead.

  Some years ago, medical historian George Rosen delivered a paper on the numerous effects of disease: demographic, economic, social, political, scientific, and psychologic. Rosen was particularly interested in the psychological impact of disease, especially that produced by major or recurrent epidemics. This was a field of study that had been neglected by medical historians. What happened to the mood of a nation when sickness and death became widespread? 

# There is no question that America1s mood changed after World War I. American historians of the twentieth century are fond of writing that the Twenties ushered in a new period in the American saga. Progressivism was in limbo by 1920. Between America's entrance into the war in 1917 and the presidential election of 1920 came a change in the mood of the nation. "Onward Christian Soldiers" was a popular sentiment in 1917, but in 1920 "they weren't in a heroic mood." 

   During the spring of 1918, William Alien White wrote the following words to a young friend who was on his way to the battlefields of France:
  To Chauncey Williams, March 18, 1918. My dear Chauncey: 

I received a letter from you a few weeks ago, and was delighted to hear from you. Your father says that you are going to be home for a few days after your commission comes. You don't know how proud I am   of you. You are going into the most beautiful experiences a man may have, the chance to serve in a great cause and in a great way, and withal to serve in the most wonderful environment. You will see France at its best, because the soul of France is keyed higher than it ever was keyed before in the world. You will see men, literally hundreds of thousands of men, at their best and noblest and you will see the world in the midst of a great change. I believe that historians will look back upon this epoch as the most dynamic epoch in the world; the time when the greatest social, political, industrial and spiritual changes of men were made. It seems to me in two thousand years there have been only a few great episodes; the birth of Christ, the discovery of America, and the contest that began with the battle of the Marne have marked the three greatest changes of the world. And you are going forth to be a soldier of this great change. It is a high and blessed privilege, Chauncey, and I am glad you are taking my friendship with you. God bless you and keep you, my boy, and bring you back safe to your beloved.

  Such enthusiasm remained extant for the duration of the war, but disappeared soon after the Armistice. According to Frederick Lewis Allen, idealism vanished almost overnight. People wanted to forget the cares of the world and to enjoy themselves. They were tired and disillusioned.   

  Tired and disillusioned— words often used to describe the postwar generation. Some writers attributed the widespread malaise to the war itself, unprecedented in its bloodshed and destruction. Others put the blame on the spiraling cost of living and the greedy, unreasonable strikers, the Red Scares, and the Harding normalcy. Still others suggested that the exhaustion stemmed from disillusionment with international crusades and reform. One historian of the period stated unequivocably that "the fatigue was not physical ....Instead it was a spiritual fatigue."   

   Yet the fatigue was more than spiritual. The influenza pandemic left many people physically drained as well. Some lost their jobs or used up their life savings as they and their families fell ill for prolonged periods of time. Someone sent the following description of influenza, clipped from a newspaper article, to the U.S. Treasury Department in the fall of 1918: "What is influenza? It is a little bit of most everything. As Patrick Murphy said, 'It leaves one sick three weeks after getting well.'"

  The years 1918-20 were a time of depression and exhaustion. Yet the physical aspects of this fatigue have received scant investigation, even though historians themselves were sick. Perhaps health matters were considered an improper subject for inclusion into the history of a nation. Or the history of a Peace Conference. Paris teemed with historians in the months following the Armistice. Those who were there would become some of our most esteemed twentieth-century chroniclers of the past. Charles Seymour, whose treatise on the Peace Conference became a standard reference work, made no mention of the delays and inconveniences caused by the plethora of illnesses among the participants and organizers of the Conference. Yet sick they were. 
  The purpose of historical writing is to shed new light upon the past, to help the current generation gain a better understanding of their forebears. One way to accomplish this is to read carefully what an age has to say about   itself. People used certain words to describe their mood in the wake of the war and the pandemic.

  To Donald Richberg, the Armistice killed wartime emotions and ideals. The war turned out to be only a "long night of bestial intoxication," and then came the disillusionment. But the words he chose to describe this disillusionment are perhaps significant: "Then came the dreadful headache in the cold gray dawn; and before us lay the long day when we should struggle dizzily to put the house of carnival again in order. We would be haggard and weary in the afternoon and ready for our beds early in the evening." Dreadful headache; struggle dizzily; haggard and weary in the afternoon; ready .for our beds early in the evening— all physical * phrases, all descriptive of the classic influenza syndrome. 
  To suggest, however, that the fatigue and depression following World War I resulted solely from the effects of the influenza pandemic would be foolish. In fact, health matters were a topic of vital concern across the nation even before the onset of the pandemic. But the pandemic did have a sobering and depressing effect upon the national spirit, and it helped foster that sense of weariness so universal as 1920 became a page in history. 
  A final observation. Pandemic influenza did not appear for the first time in 1918. Influenza may possibly be as old as man himself, or even older. To better understand and appreciate the role of the 1918 pandemic in twentiethcentury history, a pair of bifocals is needed. One half of    the lens should he used to look back through history to 1918 and even earlier days, using the vision of 1976, and incorporating the knowledge and history of influenza viruses learned in the interim. The other part of the lens can then focus in on how it actually seemed to those who lived through the pandemic. Without the use of bifocals, for instance, one might be tempted to accept as truth what appeared to be truth in 1918. One might not be able to appreciate the reason why a history of the influenza pandemic of 1918 must necessarily be a history of respiratory disease, not merely influenza. Consequently, the following study is arranged to provide a dual vision.

  Chapter I will discuss both present knowledge and the pre-1918 history of influenza. What does the virus look like? How does the body respond to viral attack? What is pandemic influenza? Why does it remain a potentially serious disease? The rest of the chapters will tell the story of how respiratory disease affected American life during the years 1918-20. Chapter II will cover the seed-time and origin of the pandemic, as well as the general concerns of the nation in early 1918. The next two chapters will focus on the peak period of respiratory disease from August to December 1918, when pneumonia rather than influenza seemed to be the killer disease. World War I came to an end during this period, but the Battle of the Flu continued for a long time thereafter. The remaining three chapters will show the impact of the pandemic on various aspects of   
   American life: on individuals and on family life; on politics and foreign affairs; on the medical profession, on public health and education, and on organizations like the Red Cross; on local, state, and federal governments, and on private enterprise; and last, but certainly not least, on the mood of the nation. The story is meant to show how, over the course of nearly three years, American became a nation tired in body and spirit. 



Of all the depressing, rotten maladies this takes the cake and I wonder that anyone has been able to stand being under the same roof with me for a week. One's many bad qualities surge to the surface and among the cardinal symptoms of the disease may be mentioned paralysis of the hind legs, quarrelsomeness, irritability, loss of memory, despondency, dislocation of the attachments of the diaphragm, wasting of the gastrocnemii

​So wrote the distinguished neurosurgeon, Harvey Cushing, to describe his siege of influenza or "grippe" in December 1906." The acutely perceptive doctor recovered from his affliction that winter, apparently without complications. A dozen years later, in the summer of 1918, while serving with the Base Hospitals in France as Senior Consultant in Neurosurgery of the American Expeditionary Force, he caught the mysterious malady known as "Spanish flu" or "three-day grippe." This time, unfortunately, serious complications did result. Three weeks after his initial attack Dr. Cushing was still tottering about and complaining of double vision. An additional month passed without improvement in his gait, his "hind legs" noticeably more unsteady each day. Finally came the elevated temperature and loss of sensation in his extremities necessitating a lengthy sojourn in the hospital. The illness, which was eventually diagnosed as a vascular polyneuritis, left him a semi-invalid for the rest of his life. Both femoral arteries became permanently occluded, and after 1920 he was unable to walk more than a block or two without stopping to rest. Although a coronary occlusion was the immediate cause of his death in 1939, the most remarkable finding at autopsy was the complete occlusion of his femoral arteries. Considering the "paralysis of the hind legs" and "wasting of the gastrocnemii" (muscles in the lower leg) he complained of in 1906, his vascular damage may have begun 2 even prior to 1918

​Fortunately, not all of the victims of the so-called "Spanish flu" in 1918 suffered such serious long-term complications. In the spring of that year, an influenza infection was sometimes called a "three-day fever" because of its short duration. But the course of influenza is actually unpredictable. Diagnosis may also be difficult in the absence of an epidemic, because the clinical signs often lack definitiveness. Usually influenza is characterized by its sudden onset, often in company with chills, severe headache, fever, coryza, and cough. Sometimes there is sore throat, muscular pain, sweating, or nausea. Symptoms apparently vary from patient to patient. For instance, military records for the 1918 pandemic showed a sore throat to be an almost universal complaint. But many physicians at the time thought the throats of their patients were rarely involved. As for recovery from influenza, 

with luck it usually takes place in about a week. There may, however, be a residual weakness and depression guice out of proportion to the severity of the disease, especially among adults. Children usually seem to regain their strength more rapidly than their elders.

Why is influenza such a problem? Besides being a difficult disease to diagnose with certainty at the bedside, its prognosis is unpredictable. While the more fortunate victims recover in about a week, rapid death does sometimes occur, usually the result of pneumonia. Although perhaps most people think of influenza and pneumonia as two separate diseases, sometimes they are not. The term pneumonia, in fact, merely indicates an inflammation in the lungs. It is a disease process rather than a disease. There are more than fifty different causes of pneumonia, the most common being bacteria, viruses, chemical irritants, vegetable dusts, and allergies. Influenza viruses can invade the lungs; if they do then the victim will have a viral pneumonia. In that case the prognosis must be guarded because antibiotics are ineffective.

At other times, an influenza victim's recovery may be complicated by the onset of a bacterial pneumonia. In fact, it is theoretically possible for a person to have a viral pneumonia and a bacterial pneumonia at the same time. If this were the case, antibiotics would help to clear up only the bacterial problem. Consequently, influenza is potentially a grave disease. 

In the rest of this chapter, some of the aspects of the influenza riddle will be mentioned briefly. Following a description of viral invasion, replication, and antigenic structure, will be some discussion of the body's defense system, the developing nomenclature for influenza viruses, the disease in history, some of the unusual aspects of the 1918 pandemic, non-human types of influenza viruses, and the problem of treatment and prevention. 

First of all, uncomplicated influenza is usually limited to viral involvement of the cells of the upper respiratory tract, the mucous membranes of the nasopharynx, the conjunc4 tiva, and, less often, the lower alimentary canal. If influenza viruses do enter the respiratory system, they usually try to invade the superficial susceptible cells, and it is within these cells that the viruses reproduce, a process taking about six hours. If replication takes place, the newly-synthesized viruses that leave the superficial respiratory cells may travel to distant areas of the body, where they in turn invade other body cells, and then the common clinical symptoms reflecting involvement of the central nervous system (a headache, for instance) may appear.

​Sometimes, however, the influenza viruses are unable to enter the superficial nasopharyngeal cells. The invading viruses are sometimes stopped from entering the cells by one part of the body's immune (or defense) system, the circulating antibodies (protein substances) produced by earlier attacks of a similar virus, or by protective vaccines. But even if some flu viruses do enter the superficial cells, the process of viral replication may not occur. Without viral reproduction, a generalized infection fails to occur. Yet such a brief encounter with influenza viruses is usually enough to trigger the body's defense mechanism to react against a foreign protein substance, which is what a virus is. Foreign protein substances are called antigens; therefore an invading virus may be considered an antigenic agent which stimulates the host to produce defensive antibodies. 

It is important to understand that some viruses are complex antigenic substances. They contain not one, but several, antigenic substances. These antigenic substances vary in importance in determining whether or not the victim will have a clinical case of influenza.

To appreciate the complex antigenic character of the influenza virus, a description of the virus itself is useful. The usually spherical virus particle, which is sometimes referred to as a virion, is three-fourths protein: seventy-five per cent protein, one per cent ribonucleic acid (RNA), sixand-a-half per cent carbohydrate, and eighteen per cent lipid. Within the core, or nucleocapsid, of the virion is the ribonucleic acid (RNA), the genetic material of the virus. Related to this viral (RNA) is the major nucleoprotein (NP) antigen, the antigen used for classifying influenza viruses into Types A, B, and C.

Surrounding the nucleocapsid of the virus are double layers, an inner protein and an outer lipid membrane. On the outer membrane are two types of spike-like projections, glycoproteins called hemagglutinin (H) and neuraminidase (N). These glycoproteins, which are morphologically and antigeni7 cally distinct substances, are also major antigens. Their discovery, of course, made the classification of influenza viruses into Types A, B, and C inadequate. Since the identification of the (H) and (N) antigens, it has become evident that there are still other minor protein substances within 8 viruses.

Influenza viruses, then, are complex antigenic agents which stimulate the host to produce defensive antibodies. But antibodies are not the only substance produced by the body in response to the invasion of flu viruses. The process set in motion when influenza viruses enter the nasopharyngeal cavity is a much more complicated phenomenon, still incompletely understood. Influenza viruses are unlike bacteria in that the cells of the victim, or host, are indispensible in the virus's reproductive process. Bacteria like streptococci may enter the cells of their victims, but they do not require the aid of host cells to duplicate. The influenza virus must enter the host cell to reproduce. What happens within the 9 host cell is shown in figure 1

As figure 1 demonstrates, the virus breaks up into protein fragments after entering a respiratory cell, and then is re-assembled. Multiplication of the virus, perhaps as much as a one-hundred-fold increase in approximately five hours, also takes place within the cell. Then the newlysynthesized viral particles go forth to infect other cells, causing cell destruction in the process."

​Thus influenza viruses are complex antigenic agents that lack independence because of their special relationship with the ceils of the hosr. Those host cells have a vital role to play in the infective process and in the life cycle of the virus. If an influenza virus is going to cause a case of flu, for instance, it must first find a host cell with suitable mucoprotein receptors on its surface. Next, the virus must penetrate the cell membrane, a process that probably involves a compatibility of the lipoproteins of both virus and cell. Once inside, the virus is then synthesized by the cell.'*"'*' Finally, the reassembled virus particle acquires a lipid envelope or membrane, during the budding stage, of host-cell origin (see figure 1). Consequently, viral infection depends upon cooperative host cells.

In addition, host cells produC6 a protein substance, unrelated to antibody production, in response to viral invasion. This substance, which is called interferon, plays a critical role in arresting the reproduction of viruses within the cells. Interferon does not protect cells from infection by viruses. Rather it seems to be released by the infected cell and aids in preventing synthesis of new viral particles. This host defense mechanism, nonetheless, seems to promote a biological paradox: recent studies indicate that the doublestranded RNA (dsRNA) of the host cell that stimulates the production of interferon may actually hasten the destruction or death of uninfected cells, thus increasing the toxic 12 effects of the viral infection. 

​A further complication in the story of the body's defense mechanism against the influenza virus is the puzzling way the antibody system operates. Many viruses, including  the measles virus, stimulate the production of enough lasting antibodies to prevent re-infection. One infection with the measles virus, whether natural or vaccine-induced, usually prevents future attacks. The antibody production provoked by the influenza virus, however, seems to have only limited effectiveness, probably because so many variant strains circulate. Moreover, the antibodies first produced in response to influenza may be those most effective against a prior flu infection, a phenomenon sometimes referred to as the "doctrine 13 of original antigenic sin." It would appear that one's strongest antibody response relates to the strain of influenza first encountered in one's youth, rather than to the current invading strain. In 1968, for example, young children who were infected by the new "Hong Kong" influenza virus produced large numbers of antibodies against it, but children aged tento-twelve, when attacked by the same "Hong Kong" strain, produced greater quantities of antibodies against the 1957 "Asian flu" virus. The ten-to-twelve-year-olds eventually produced effective antibodies against the 1968 virus as well, but their highest antibody response was to the virus preva14 lent in their childhood. This phenomenon repeated itself in every other age group— a seemingly inefficient defense system. 

​Some scientists have suggested that the body's antibody response to influenza infection may be the result of an "immunologic memory," or perhaps is genetically programmed.^ Equally puzzling is the fact that the virus apparently does  not always have to make exact copies of itself. Laboratory studies have shown that the virus particles emerging from the host ceil after synthesis can have a different structural makeup from that of the invading virus. This may happen in various ways. If, for instance, the cell is exposed to two different viral strains, the emergent virus particles may be a combination of the two, rather than exact replications of the invaders. Another possibility is that the (RNA) fragments of a single virus have the capacity to restructure themselves (or be restructured) in a slightly different manner within the host cell. The new virus thus reassembled would then have the capacity to cause widespread disease, because the population would lack immunity to the new combination. If this is how new viral strains emerge, then the process is partially controlled by man himself. His cells certainly play an active role in the proliferation of viruses, and those same cells may help to determine the antigenic nature of the strains in circulation. One scientist has even speculated that the influenza virus might be a tool of the body used to send messages from cell to cell, that variations in the virus represent the evolution of the host cell rather than the virus. 16 The real answer lies in the future. 

​Many virologists do not believe, however, that new strains of influenza viruses make their appearance at particular points in time, infect the population and then vanish, never to be encountered again. Scientists believe instead that there is a finite number of possible protein fragment combinations that can occur within a cell, and that they may 17 recur in somewhat of a cyclic pattern. 

​Actually, knowledge about influenza viruses is a fairly recent development, dating back only to the 1930’s. First to successfully isolate a human influenza virus was the British research team of W. Smith, C. H. Andrewes, and P. P. Laidlaw. Their 1933 discovery marked the culmination of fifteen years of international scientific endeavor to find the cause of 18 influenza. But within twenty years of the British findings, it became apparent that there were many influenza viruses, many in the sense that their structure and antigenic content varied. In 1947, for instance, scientists found a third (NP) antigen. Consequently, what was needed was some orderly system of nomenclature to explain the antigenic variation. The earliest classification system adopted was a product of the World Health Organization (WHO). WHO decided that influenza viruses should be described according to the (NP) antigen. As a result, the new nomenclature was simple: Type A, B, and C viruses. In addition to a description of the (NP) antigen, the name of the virus was to contain the place of origin, the strain serial number, and the year of isolation. An example of the recommended nomenclature was the name given to the 1957 "Asian flu" strain: A/Singapore/1/57.19

​This simple nomenclature was adequate through the 1950's, when virologists considered the envelope surrounding the core of the virus contained a single antigenic substance, the hemagglutinin (H) antigen. When virologists discovered the existence of the neuraminidase (N) antigen in the 1960's, the classification of influenza viruses into Types A, B, and C no longer seemed adequate. Strains of Type A viruses apparently could contain new (H) or (N) antigens on their surfaces, and sometimes both changed at once. For example, between 1933 and 1957 two different (H) antigens had been in circulation, but only one (N) antigen. In 1957, however, a viral strain emerged with changes in both outer antigens. The (N) antigen that appeared in 1957 is still circulating in 1976, but the (H) antigen changed again in 1968.

Why is it important to know about antigenic changes in the virus? Because when major antigenic changes occur, widespread epidemics of influenza result. Indeed, these epidemics are called pandemics because they are worldwide. Large numbers of people everywhere have no antibodies in their system against the new antigen. Consequently, the virus finds it relatively easy to enter the victim's respiratory system and begin to replicate. 

​Pandemic influenza seems to occur about every ten years or so, but influenza is still a problem in between pandemics. Between the major "shifts" in the antigenic nature of the virus in circulation, new viral strains emerge representing "drifts" in the antigenic material. These drifts exhibit minor structural changes, but do not alter the (H) and (N) antigens attached to the outer layer of the virus. Drifts in the antigenic makeup of the virus usually cause epidemics or local outbreaks rather than pandemics, although they, too, 20 can be somewhat global m distribution

It is the group of Type A viruses that apparently cause pandemic influenza. The term pandemic now refers to influenza outbreaks exhibiting changes in the (H) and/or (N) antigens. Inter-pandemic outbreaks of influenza may be recurring epidemics of the pandemic strain, or drifts from the pandemic strain. Table 1, which shows the revised WHO nomenclature for Type A viruses, lists the major shifts and some of the 21 drifts that have occurred since the lS30's,

​The two tables pose some interesting questions for the student of influenza. Do new Type B viruses appear regularly every three to five years? Among the Type A viruses, how many (H) and (N) subtypes and combinations are possible? Does the (N) antigen change with every second (H) alteration, or with the third? Is there, in fact, a pattern to antigenic construction, or will time prove them to be merely random selections?

Shortly after the postulation of the "doctrine of original antigenic sin" in 1953, the theory that antibody production, particularly against the (H) antigen, was greatest against the strain or subtype of influenza circulating in one's early years, scientists found evidence to suggest that antigenic variation might occur in a cyclic pattern. In 1957 laboratory studies on the sera of people who were young children around 1890 revealed the presence of antibodies against the (H2) antigen of the 1957 "Asian flu" virus. Evidently (H2) antigen had circulated in the past. Support for the cyclic theory came again in 1968, when people born between 1898 and 1900 had antibodies reacting with the 1968 (H3) "Hong Kong" strain. Those born between 1898 and 1900 had those antibodies circulating in their bodies even before the 23 new 1968 (H3N2) virus appeared. Did those findings mean that people born somewhere around 1910 would demonstrate antibodies against the next pandemic strain of influenza to appear after 1968? Or did the next antigenic change not occur until 1918? And what was the antigenic connection between the deadly 1918 strain and the strain or strains circulating in the 1930's? 

While the cyclic nature of influenza viruses may still be a puzzle, there is no question that the disease known as influenza is an old affliction, old in the historical sense. Influenza has long fascinated students interested in the history and geography of disease, particularly because serious respiratory epidemics, serious in terms of fatalities, have been a recurrent phenomenon. A major problem for medical historians, however, has been the interpretation of old records. Symptoms and the clinical course of many of the recorded diseases are often so vague and incomplete that it is impossible to distinguish between influenza, for instance, and pneumonic plague. 

​The written history of influenza probably starts in the Middle Ages. Influenza pandemics (meaning many deaths occurred) have been found to have occurred during 1173 in Italy, Germany, and England. The same countries had two serious respiratory epidemics in the fourteenth century and three in the next century. Historians also suggest that the astroloyical designation "influenza," or "influence of the stars," dates back to the fourteenth century, although the 24 name was uncommon until the eighteenth century. 

​​During the fifteenth and sixteenth centuries, Italian physicians recorded five serious epidemics of pulmonary disease. Because the death toll each time was high, the Italian diagnosticians described the disease as pneumonic plague. Recent scholars have discounted the diagnosis of plague in those early epidemics, however, for the mortality rates seem to have been in the range of about ten-to-thirty per cent. Had pneumonic plague been the disease in circulation, the fatality rates would have been eighty per cent or better. (Before the advent of antibiotics, pneumonic plague was a highly fatal disease.) Nineteenth and twentieth century medical historians have decided that the Italian episodes 25 were probably outbreaks of influenzal pneumonia. 

It is possible, of course, that the medieval physicians used the word "plague" to describe any epidemic with a high mortality. In that sense influenza sometimes is a "pneumonic plague." During pandemic episodes many people die from the pneumonic process in their lungs. But today pneumonic plague refers to a specific disease caused by bacteria, not viruses. The disease now known as plague, in either bubonic or pneumonic form, is the result of infection by an organism called Pasteurella pestis. Since the discovery of the Pasteurella organism in 1894, the diagnosis of plague has been specific. But the use of the word "plague" to describe any serious disease was still common for many years after that, especially during the 1918 influenza pandemic.

​An example of the problem medical historians have had in trying to trace episodes of influenza is shown in the vagueness of table 3, from Virus and Rickettsial Diseases: With Especial Consideration of Their Public Health Significance (1940). When Dr. John Mote put the table together, he used the term pandemic to describe only the episodes of influenza having high fatality rates and those that seemed to travel rapidly through the inhabited parts of the world. 26 TASLE 3. Historic Epidemics and Pandemics of Influenza.

1510 First well-described European influenza epidemic

1557 Epidemic coming from Far East and spreading over Europe

1580 First pandemic beginning in the Far East and spreading over Europe (no record in America) 1

593 Epidemic limited to Europe

1647 First American epidemic, limited to Western Hemisphere

1655-1658 Epidemic starting in America in 1655 and spreading to Europe

1675 Epidemic in England and France (? of influenza)

1698 Epidemic limited to North America

1709-1712 Severe epidemic period limited to Eastern Hemisphere

1729-1733 World pandemic occurring in successive waves and spreading from east to west

1757-1762 Epidemic starting in North America and spreading to South America and Europe

1767 Epidemic concurrently in North America and Europe

1772 Epidemic limited to Western Hemisphere

1775-1776 Epidemic limited to England and parts of Europe

1780-1782 Epidemic in North America,

1780, spreading to Europe, and

finally becoming pandemic in Russia in

1782 1788-1790 Severe pandemic starting in Prussia and spreading west

1798-1803 Severe epidemic starting in North America and spreading east

1830-1833 Pandemic starting in China and spreading west 1836-1837 Pandemic starting in Russia and spreading south and west

1847-1850 Pandemic of undetermined origin

1857-1858 Epidemic on both hemispheres

1873-1875 Epidemic limited to Western Hemisphere

1889 World pandemic starting in Far East and spreading west

1918 World pandemic of questionable origin 

​But Mote's chart omitted many other epidemics of influenza recorded in history. For instance, Thomson and Thomson's two-volume monograph on influenza, which was published in the 1930's, mentioned epidemics in America in 1811, 1815-16, and 1824-26. Today an historian of influenza would probably be much more inclined to include those nineteenth century epidemics in his compilation, for they support the current theory that pandemics occur in approximately ten-year cycles. 

Mote also tried to trace the chronology of epidemics and pandemics. Generally the early pandemics were recorded as starting in the Far East, moving west into Russia or traveling via the great trade routes to the bustling ports of eastern and western Europe, and thence to the Western Hemisphere. Influenza was a disease that traveled east to west, probably originating in some obscure Chinese village. The great pandemic of 1889-90 was suggested as having started in Bokhara, Turkestan, or in China, perhaps simultaneously in 28 both places. On the other hand, Greenland had an early epidemic in 1889. But in 1918 many medical authorities still believed China to be the real home of influenza. When China evidently suffered less severely from influenza in the fall of 1918, the Western editor of the China Medical Journal thought the Chinese were so familiar with influenza that they possessed an immunity other peoples lacked. China, he thought, was, in fact, the "fountain head of epidemic dis- „29 eases.

Since the Mote and Thomson and Thomson studies, American medical historians have delved into the history of epidemic diseases in the colonial period of the country, using more traditional historical sources— letters, diaries, etc.

Those sources seem to suggest that pandemics of respiratory diseases did indeed occur regularly in ten-to-fifteen-year cycles. Although these documents present certain problems to the historian— the difficulty of trying to distinguish between "pleuretical disorders/." "peripneumonias," and influenza, for example— they nonetheless indicate serious epidemics of respiratory disease occurred regularly throughout the 30 early history of the country.

According to American medical historian John Duffy, the first influenza epidemic in North America probably dates back to 1647, when John Winthrop recorded the following observations:

An epidemical sickness was through the country
among the Indians and English, French and Dutch. It
took them like a cold, and light fever with it. Such
as bled or used cooling drinks died; those who took
comfortable things, for the most part recovered, and
that in a few days. Wherein a special providence of
God appeared, for not a family, nor but few persons
escaping it, had it brought all so weak as it brought
some, and continued so long, such was the mercy of
God to his people, as few died, not above forty or
fifty in the Massachusetts, and nearly as many at

Similar epidemics evidently occurred in the 1660's, but the number of fatalities were either unremarkable or not written down. Another "general catarrh" swept Western Europe 32 and North America about 1675. The next pandemic was evidently more severe, striking England and Ireland in 1688 and Virginia the following year. This time the outbreak was 33 so serious that "the people dyed— as in a plague." The Virginia epidemic curiously seemed to affect only that colony, or at least went unrecorded in the others. 

After a period of about ten years, influenza reappeared in the colonies in 1697, and Cotton Mather took pen in hand to record its existence in January of 1699:

The sickness...extended to allmost all families. Few or none escaped, and many dyed especially in Boston, and some dyed in a strange and unusual manner, in some families all weer sick together, in some towns allmost all weer sick so that it was a time of distress.34

The 1697-99 viral strain apparently was unusually lethal. In Fairfield, Connecticut, seventy people out of a population of less than a thousand died within a threemonth period. Fortunately, few colonial towns recorded such 35 high mortality rates. 

Duffy’s colonial research indicates that the next "mortal sickness" of a respiratory character happened about ten or eleven years later in 1711-12, and that Virginia had 3 6 another "sickly time" in the early 1720's. These early historical records show that a "winter disease" (most likely influenza) came about every ten years or so, just as in our own time major shifts in the antigenic nature of the influenza virus have occurred in 1947, 1957, and 1968.

#The Mote chart also suggests that no serious epidemics or pandemics occurred between 1889 and 1918, or for approximately thirty years. Since Mote's time, however, investigators of American epidemics have found a considerable number of influenza epidemics recorded during that thirty-year period. Table 4, from Knight, (ed.), Viral and Mycoplasmal Infections of the Respiratory Tract (1973) , lists a series 37 of epidemics between the pandemics of 1889 and 1918. 


pidemics and Pandemics of Infiuenza in the United States - 1889 to 1969.

•Y e a r  D escription o f O u tb re a k  E t io l o g y  {In flu e n z a A  {In flu e n z a B

1889 1895 Pandemic A Asian-like virus? (H2N?)

1886, 1897 Epidemics Etiology unknown

1889, 1900 Large epidemics A, Hong Kong (H3?) A, H equi 2 N equi 2 and H2N?

1901, 1903, 1905, 1907, 1908, 1910, 1915, 1916, 1917, 1918 Epidemics Etiology unknown

1918 1920 Pandemic A swine-like virus (H s w lN l)? 1922 Epidemic B ?

1923, 1926 Epidemics A,'swine-like virus (H s w lN l)? 1928 Epidemic B ?

i 929, 1931 Epidemics A/swine-like virus (H s w lN l)? 1932 Epidemic B ?

1933, 1935 Epidemics A, PR, 8-like strains (HCN1)

1936 Epidemic B ? 1937,

1939 Epidemics A /derivative (HCN1)

1940 Epidemic B LEE

1941, 1944 Epidemics A /derivative (H0N1)

1945 Epidemic B1 B O N , KR1 1946,

1947 Epidemics A F M l ( H lN l)

1950, 1951 Epidemics B1 BON-like 1951,

1953 Epidemics A /d e riv a tiv e (H lN l)

1957 1958 Pandemic A/Asian (H 2N 2)

1960 Epidemic A Asian derivative (H 2N 2)

1962 Epidemic B2 1963, 1965, 1966 Epidemics A Asian derivative (H 2N 2)

1966 Epidemic B2

1968 Epidemic A/Asian derivative (H 2N 2)

1 9 6 8 -1 9 6 9 Pandemic A /H ong Kong (H3N2)

1969 Epidemic B2 •

O utbreaks listed before: 1910 a je d a ta from Massachusetts (Collins, S. D., and Lehmann, Ju Excess deaths from influenza and pneumonia and from important chronic diseases during epidem ic periods, 1 9 1 8 - 1951. Public Health Monog r. =10, 1953.) f Designation o f outbreaks cf type A influenza before 1933, indicated by question marks, are from M asurel, N.: Serological characteristics of a "new " serotype of influenza A virus: the Hong Kong strain. Bull. W H O , 41:461, 1969. J Type B outbrecks b e fo re 1940, indicated by question marks, w ere predicted by the Commission on Acute Respiratory Diseases (Amer. J. Hygiene, 43:29, 1946). 

A few reasons might be offered to explain Mote's omission of the epidemics between 1889 and 1918. In the first place, Mote decided to include only those epidemics that seemed to have global significance and were marked by high fatality rates. The fatality rates of the epidemics in the United States after 1889 were apparently unremarkable. But perhaps a more compelling reason for Mote's omission has to do with what the medical community's approach to influenza was during the period from 1889 to 1918. Shortly after the pandemic of 1889, the noted European bacteriologist, R. J. F. Pfeiffer, identified a bacillus (a rod-shaped bacteria) as the causative organism in influenza. Pfeiffer's organism, which is sometimes called the Pfeiffer bacillus or the influenza bacillus, is properly designated Hemophilus influenzae. Pfeiffer's discovery convinced physicians around the world that influenza bacilli were the cause of influenza epi- , • 38 demies. 

Pfeiffer, of course, represented the medical scientist in the Age of Bacteriology, which began about 1875. All diseases had natural causes, and bacteria were the primary cause of disease. It was the mission of the scientist to discover those bacteria, and then to find a cure or antidote. Since the Pfeiffer bacillus was blameless in influenza, the disease often went undiagnosed or misdiagnosed after 1892. Certainly when the mysterious "Spanish flu" began to sweep around the world in 1918, many physicians believed Pfeiffer's bacillus was its cause.

The etiology of influenza was, indeed, one of the most serious and frustrating problems to arise in 1918. Equally puzzling was the relationship between influenza and pneumonia. Influenza bacilli had been found so often in throat cultures that they had come to be associated only with upper respiratory infections. Influenza bacilli seemed to cause only minor respiratory disease. The disease known as pneumonia, on the other hand, which was often fatal, was the result of infection by another type of bacteria called pneumococci. Pneumococci so often caused serious lung infections that their very name signified they produced disease in the lungs. Actually, however, Hemophilus influenzae, pneumococci, and many other bacteria can cause pneumonia.

When the pandemic of 1918 began, many medical scientists were also unaware that there was a "normal flora" of bacteria present in the mouth. Bacteria were disease producers. Consequently, when so many of the throat cultures made from ailing soldiers and sailors grew out influenza bacilli and different types of pneumococci, the laboratory men assumed those organisms were responsible for the ongoing disease process. It was not until the spring of 1919, for instance, that bacteriologists at the Rockefeller Institute discovered that perfectly healthy individuals, about thirty per cent of a control group, harbored influenza bacilli in their naso39 pharyngeal area.

​As 1918 began, one of the first observations made by those who were studying the serious pneumonia problem in the nation's army camps was that pneumococci did not seem to be causing the post-measles pneumonias. Instead of pneumococci, streptococci seemed to be at fault. As a result the pneumococcal vaccine, which had been the only vaccine developed to combat pneumonia, was going to have a limited value. The army's pneumonia problem grew when still a third type of pneumonia, viral pneumonia, took its toll among the military during the last year of the war. Medical science knew so little about bacterial pneumonia in 1918 that it was a tragedy to have a highly fatal type of viral pneumonia circulating at the same time. The story of the 1918 influenza pandemic is as much the story of pneumonia as influenza, for almost everyone who died from the pandemic disease had a pneumonia ao of viral or bacterial origin . 

Another mystery in 1918 was where and how the pandemic began. The earliest epidemics of the so-called Spanish flu seemed to erupt simultaneously or in rapid succession on three continents— Europe, North America, and Asia. In the United States the first epidemics evidently broke out in March and April at the ar:ay camps and among the naval personnel along the East coast. But while these outbreaks were in process, highly contagious influenza was claiming many victims in France— and in China. But medical records for China were almost non-existent (and hardly reliable to the 41 Western expert) m 1918.

​Because the earliest epidemics apparently occurred simultaneously in the United States and in France, epidemiologists began to question seriously the theory that China was the seedbed of pandemic influenza. For many years after the 1918 pandemic the theory that pandemic influenza probably has multiple foci of origin became popular. Influenza watchers gradually accepted the idea that the next great pandemic would appear simultaneously all over the world. It would have multiple foci of origin.

​But influenza was not a reportable disease in the early months of 1918. Physicians did not report cases of influenza to local or state boards of health. Perhaps the earliest cases of influenza only appear to have started among the army and navy personnel because the military and naval records were, with few exceptions, the only records kept of outbreaks of influenza. All the military records actually point out is that epidemics of influenza did erupt early in 1918. The records should not be interpreted to mean that pandemic influenza seeded itself in the army camps and only then infected the civilian sector. The real problem for the student of the pandemic is that so few records of respiratory epidemics were kept in the early months of 1918. Yet the U.S. mortality rates for the spring of 1918 show unmistakably that many urban areas across the nation had high death rates during March and April. Army, navy, and civilian populations probably had concurrent epidemics in early 1918. In the wake of the 1918 pandemic, however, China seemed to be absolved

​Perhaps even more puzzling than where the pandemic started was its peculiar mortality pattern. During the pandemic the virus was somewhat selective. About fifty per cent of those who died were between twenty and forty, persons in the prime of life. People of all ages were attacked by the virus; in fact, the highest incidence was, as usual, in the age group five-to-fourteen. But the fatalities were too often soldiers, pregnant women, and healthy young war-workers. Children were more apt to lost their parents than their grandparents.^ 

Medical scientists in 1918 had no explanation for this mortality pattern. Those who had lived through the 1889-90 pandemic recalled that in 1889 most of the fatalities were the older members of society. Why were the young adults so affected this time? There were no answers, only an awareness that history was repeating itself. During an emergency meeting of medical experts in the fall of 1918, New York State Commissioner of Health Dr. Hermann M. Biggs told those in attendance that the 1918 pandemic resembled the pandemic of 43 1830-33 in that it took the lives of so many young adults. His remarks seem to suggest that there may also be a cycle in mortality patterns

However, in 1918 wartime conditions may have affected, to some degree, the unusual mortality pattern. Society was on the move. Scores of young people had left their rural surroundings to move to the large industrial centers for work in defense plants. Young men in the service, particularly those from the country, were exposed to a host of bacterial and viral agents they had never encountered before.

The increase in infectious diseases, especially respiratory diseases, was a natural by-product of war.

But World War I was not responsible for another unusual aspect of the 1918 variety of flu— the severe after-effects of the pandemic disease. Although influenza is normally a short-term illness, in 1918 many victims were ill for months. Some people never completely regained their health. Often accompanying the pandemic disease were complications (such as pneumonia) and long-term sequelae (such as a loss of smell and taste). During the 1918 pandemic many victims had vascular damage; still others had impaired central nervous systems. Some of this damage was minor. People complained of excessive fatigue or perhaps a lack of appetite. But other victims had neuralgias, polyneuritis, and even psychoses. Still others had tachycardia, meningitis, retinitis, and paralysis. And the number of "sudden deaths" during and A A after the pandemic was remarkable.*'

​In some of the recent influenza pandemics, physicians have found an occasional case of encephalitis or "brain fever" accompanying flu. But in 1918 an extraordinary number of cases of encephalitis occurred. The encephalitis seemed to be a new and separate disease first described by a Viennese physician named von Economo in 1917. This new encephalitis became uncommonly prevalent in England and France in the late winter of 1918, after the worst wave of the pandemic had subsided. The English thought at first that the new "nervous disease," characterized by paralysis of the facial muscles, including those of the eye, might be a result of botulism, food poisoning from spoiled canned 45 food. More striking than the paralytic symptom, however, was an overwhelming lethargy, a remarkable drowsiness. This sleepiness was such a constant symptom that doctors called the disease "lethargic encephalitis." Cases of the so-called sleepy sickness appeared in the United States in early 1919. Between 1919 and 1923 many hundreds, perhaps thousands, of cases occurred across the country. In 1924 the new encephalitis reached epidemic proportions in Japan, where four thousand of the seven thousand victims died

Within a year or so after the new disease put in its appearance, the name lethargic encephalitis seemed a misnomer. Some patients were not lethargic at all. They were hyperkinetic instead of hypokinetic, that is, they had increased muscular activity in the form of tics, twitchings, 47 and choreas. Still another group of patients suffered from a third form of the disease— hiccoughs lasting for days. Consequently, doctors decided that "epidemic encephalitis" might be a more appropriate name to describe the strange disease.

​In the 1920's, Dr. Simon Flexner, Director of the Rockefeller Institute for Medical Research, developed a special interest in epidemic encephalitis, particularly its possible connection with influenza. Flexner believed that epidemic encephalitis was a serious disease because of its after-effects. While the paralyzed muscles of the face tended to improve with the passage of time, those elsewhere in the body did not. Sometimes there were marked mental changes in the victim, changes capable of altering the personality, or resulting in the syndrome known as Parkinson’s disease, paralysis agitans. Furthermore, Flexner thought that many insubordinate and recalcitrant children and young offenders against the law had been victims of epidemic encephalitis, "from which recovery has been seeming and partial 49 only."

​The Rockefeller director came to the conclusion, over the course of a number of years, that influenza and epidemic encephalitis were unconnected viral diseases.^ It had been mere coincidence that they had erupted at the same time, at the end of the war. In recent years, however, scientific investigators have postulated a link between influenza virus infection and postencephalitic parkinsonism. Parkinsonism appeared in about eighty per cent of those suffering from epidemic encephalitis in the post-World War I year s. ^ In the early 1970’s, immunofluorescent techniques demonstrated the presence of influenza virus antigen in postencephalitic parkinsonian brain. The viral antigen was not found in the brain of those suffering from ideopathic Parkinsonism. These findings suggested that the two types of Parkinsonism might have different etiologies. To support this theory was the fact that postencephalitic parkinsonism was a disease rarely encountered any more, while ideopathic Parkinsonism was as common as ever. The findings suggested that the epidemic encephalitis of post-World War I years was a peculiar aspect 52 of the 1918 influenza pandemic.

The recent scientific findings, mentioned above, also suggested that some pandemics may cause more brain damage, that some influenza strains may possess more virulence, more toxicity, than others. There is, however, little evidence to support the theory that some influenza viruses are more toxic than others.

​Equally puzzling is the question why the sharpest toxic reactions, at least in terms of fatalities, took place in the twenty-to-forty-year-old group in 1918. Perhaps the "doctrine of original antigenic sin" contains the key. Perhaps host cell response is really the chief determinant of the severity of influenza pandemics. Only recently have scientists begun to posit the theory that resistance may be tied more to the presence of circulating anti-neuraminidase (anti-N) than to 53 anti-hemagglutinin (anti-H). It is unfortunate that the only (N) change in the twentieth century that can be verified occurred in 1957. While the presence of certain antibodies in the older members of society suggest that a new (N) antigen appeared in 1918, there is as yet no proof that it did.

​Still another aspect of the riddle of influenza is why "swine flu" appeared as if it were a new disease during the major wave of the 1918-20 pandemic. First reported by Iowa veterinarian J. S. Koen, the disease affected millions of swine in the autumn of 1918. Although Koen apparently thought that swine caught their influenza from humans, the 54 disease became known as swine influenza or "hog flu."

But many other animal species had influenza in 1918. Equine influenza, in fact, had been a serious problem for the military all through the war, even before the pandemic began. In the fall of 1918 reports came from Africa that scores of baboons were dying from the pandemic disease, and from Northern Canada that influenza was "decimating the big game." At Yellowstone National Park the bison, elk, and other animals became ill, and some died . 

Type A influenza viruses are recoverable, in fact, from several domesric and wild animal species, and from birds as well. During the last twenty years scientists have discovered about one hundred Type A variants among the birds. Interestingly enough, the first influenza virus to be discovered was a non-human strain. In 1931, two years before the British research team isolated the first human Type A virus, an American scientist, Richard E. Shope, isolated a Type A virus 56 from swine ill with influenza. 

Following Shope's work on hog flu, positive evidence that Type A viruses could infect other animals came in 1956. In that year a Type A virus caused an epidemic among the horse population in Czechoslovakia. Seven years later a second Type A virus pathogenic for horses was found in the 57 United States. 

​At first, flu viruses seemed to be species specific. But the early studies on the potential infectivity of animal viruses for humans were based on only the (H) antigen. Studies made after the discovery of the (N) antigen revealed several species of birds shared the same (N) antigens with humans. More recently scientists have learned that human influenza viruses are pathogenic for many animals— dogs, cats, chickens, calves, and bears. Thus the old belief that many 5 8 animals had influenza in 1918 seems to have some basis There has also been a continued interest in and curiosity about swine influenza because the disease erupts among the swine population every autumn, and the viral strain affecting swine has remained the same since 1931. Some virologists therefore believe that the virus discovered in 1931 was probably the same one that affected swine in 1918, and that it may have been antigenically related to the 1918 human pandemic strain. Because this swine strain seems to have been in circulation since 1918, some scientists suggest that animal reservoirs of infection may exist, that old strains probably never disappear, but remain viable in some non-human species, potentially capable of combining with some circulat59 ing human strain. Interspecies combination have been produced in the laboratory, and quite recently have been found to occur under natural conditions. Another speculation is that the more virulent strains, such as the 1918 variety, 60 may be the result of interspecies recombinations. If this is so, then a deadly pandemic could occur at any time, produced by a chance combination of interspecies viral antigens in some unsuspecting individual anywhere on our planet.

#Another theory is that the lungworm-earthworm cycle in swine might be the mechanism responsible for their annual reinfection with influenza.^ When the 1957 pandemic, which appeared to start in Kweichow, China, and then became global within a year, erupted, there was renewed interest in the old theory that influenza pandemics were a product of the Far East. WHO consequently encouraged attempts to find the possible existence of an animal reservoir in Central Asian swine. At least one distinguished virologist, however, thought that "the idea of the influenza virus lurking in some remote Mongolian pigsty and bursting out from time to time is an entertaining one, but will scarcely bear critical exam62 inaticn." He and other skeptics cited 1918 as an example of pandemics arising from multiple foci. But when the next pandemic began in Hong Kong in July of 1968, the theory of a Far Eastern origin, human or animal, received more support. The significance of the swine flu virus remains pretty much a mystery, except for the fact that it can cause disease in man. 

​#What, then, was noteworthy about the pandemic of 1918? First, it frightened people because no one knew its cause or how it related to pneumonia. Second, it took the American nation by surprise because wartime conditions helped to keep its presence a secret for months. Third, about fifty per cent of the deaths were among people aged twenty-to-forty. Fourth, many victims of the 1918 pandemic had long sieges of illness and serious after-effects. Finally, the 1918 strain of influenza apparently affected non-human species as well.

The remaining topic to be discussed in this chapter is the treatment and prevention of influenza. Some medical scientists today think that the recurrence of another pandemic with so many fatalities, approximately twenty million in 1918, is highly unlikely. The basis for such optimism is the belief that many of the pandemic-related deaths in 1918 were the result of secondary bacterial infections. Such bacterial infections could be prevented or controlled today 6 3 by the administration of antibiotics. 

Yet some of the pathologists who did the autopsies on soldier after soldier or on one pregnant woman after another in the fall of 1918 thought that the bronchopneumonias they were finding were not bacterial in nature. Just how many victims the influenza virus did kill in 1918 will remain a mystery. Whatever their number, however, miracle drugs would not have spared their lives. No cure exists for influenza; flu viruses do not respond to antibiotics. The age-old prescription is still valid: go to bed, keep warm, take aspirin to keep down the temperature and drink plenty of liquids. 64 With luck the infection will clear up in a few days. 

​Up to now, the search for some chemical agent that might be a safe prescription has been unsuccessful. Some chemical agents that can destroy influenza viruses kill the body's cells in the process. These chemicals act as toxic agents. But viruses themselves have a toxic effect upon the body. Giving a drug to the patient that will increase the toxic process going on in the body seems potentially dangerous. Influenza, for example, sometimes affects the body's hematopoietic system, the blood-producing system. Influenza sometimes decreases the output of white blood cells, and sometimes the platelets. Many drugs have the same facility. Some drugs would therefore increase the risk of bone marrow failure. It might also be recalled that when the body produces interferon in response to viral invasion that this response is essentially a toxic process. With both cells and viruses acting as toxic agents, adding a third source of toxicity from chemicals does not seem the solution.

​If there is no chemical cure for influenza, there has been progress in the fight against the disease. Not cure but prevention is, after all, the primary goal. The usual approach to the prevention of communicable diseases since the turn of the century has been vaccination, and for the most part, vaccines have done remarkably well in ridding the world of its worst plagues— smallpox and diphtheria, for example. But influenza has presented more of a problem because of its constantly changing antigenic structure. An effective vaccine must include all of the current strains in circulation. Since a vaccine takes time to prepare, whenever a new variant strain arises many people get sick. Vaccines work best against stable infecting agents, like the measles and mumps  viruses. Thus vaccination has only partially solved the perennial influenza problem. 
There is consolation, however, in knowing that some of the aspects of the 1918 pandemic could never occur again.
Worldwide surveillance of epidemic disease is now such a vital part of medical practice that pandemic influenza could not be the silent foe that it was for months in 1918. Any sudden increase in the death rate from respiratory diseases now usually sets off a chain reaction of investigation in local and state boards of health, in federal health agencies, and in various medical laboratories around the globe.

In conclusion, influenza is hardly a minor disease. When new pandemic strains emerge, much of the nation (and world) goes to bed. National economies are temporarily affected, and the classrooms empty out. The social, political, and economic repercussions of epidemic disease may indeed be far-ranging. In the next chapter is the story of how influenza became a "silent foe" across America during the spring of 1918. Wartime conditions had contributed to an increase in respiratory infections anyway, and physicians were unaware that the grave pneumonia problem was being compounded by the new pandemic virus. Even when "Spanish flu" took on global significance in the late spring and summer that year, Americans dismissed it as a European disease. Only when millions of people, in and out of military service, fell almost simultaneously under the impact of the virus in the early fall of 1918 did influenza become recognized as the nation's prime public health problem.

A lifeguard explains the closure of Bondi Beach to surfers and swimmers after thousands of people flocked there in recent days, defying social distancing advice over COVID-19 [Loren Elliott/Reuters]

Type your paragraph here.

Medical staff outside the Jinyintan Hospital, Wuhan, in January. (Reuters/Stringer)  

Italy to remain in lockdown until at least May 3

Singapore's Changi Airport, one of Asia's major hubs, has emptied as the coronavirus has prompted border closures

[File: Edgar Su/Reuters]

German Chancellor Angela Merkel leaves a media statement on the spread of the new coronavirus disease (COVID-19) at the Chancellery in Berlin

[Michel Kappeler/Reuters]

Boris Johnson Britain's Prime Minister speaks during a news conference on the ongoing situation with the coronavirus disease (COVID-19) in London.

[Ian Vogler/Reuters]

Boris Johnson tested positive to Corvid-19 and was taken to hospital for medical care

Men Arrested In Bangkok For Selling Over 45,000 Fake COVID-19 Test Kits
09 Apr 2020


 It’s not just COVID-19 itself that we should be cautious of, but also of those who take advantage of innocent people during this harsh period of time.
On 8th April 2020, Police Lieutenant General Permpun Chitchob, the Assistant Commissioner–General reported a case of fake COVID-19 test kits, masks, and thermometers being sold. The case was handled along with officials from the Consumer Protection Police Division (CPPD) and officials from the Food and Drug Administration (FDA).

The men were later identified as Chen Lei and Wein Pinpin, 2 Chinese nationals who were arrested inside their residence in Bangkok for smuggling fake COVID-19 test kits into Thailand.
The captured evidence includes over 45,000 fake COVID-19 test kits, 1,200 infrared thermometers, and 350,000 face masks. These items were sold without permission at higher prices in Bangkok and nearby districts, and they were valued at over ฿33m.

The worst part is that anyone getting checked for COVID-19 with these test kits would receive a negative result. Realising that they “don’t” have the virus, these people could then unknowingly spread the virus to others. The Food and Drug Administration is now working on finding out where these fake items were made and who was involved in bringing them into Thailand.

Even if you’ve been tested negative for the virus, it’s best to stay indoors and monitor yourself for now – no matter what your test results say. This is to ensure everyone’s safety.

If you want to get checked but aren’t sure where to go, here are a list of reputable hospitals that are offering tests: 
[Fake COVID-19 Test Kits]
Image credit: Thansettakij [Fake COVID-19 Test Kits]

Wikipedia Exposed Media - WEM www.wikipediaexposed.org


Firefighters and members of the public applaud medical workers in New York City [Caitlin Ochs/Reuters]

Cracks in the Foundation: Frederick T. Gates, the Rockefeller Foundation, and the China Medical Board


Cracks in the Foundation: Frederick T. Gates, the Rockefeller Foundation, and the China Medical Board
John S. Baick
The Journal of the Gilded Age and Progressive Era
Vol. 3, No. 1 (Jan., 2004), pp. 59-89
Published by: Society for Historians of the Gilded Age & Progressive Era
Page Count: 31

Topics: Philanthropy, Christian missionaries, Progressive Era, Gilded Age, Medical schools, Medical education, Baptists, Modern medicine, Conferences 
  Cracks in the Foundation: Frederick T. Gates, the Rockefeller Foundation, and the China Medical Board  
John S. Black
The Journal of the Gilded Age and Progressive Era
Vol. 3, No. 1 (Jan., 2004), pp. 59-89
Published by: Society for Historians of the Gilded Age & Progressive Era

DR Frederic L. Gates family history

Topics: Philanthropy, Christian missionaries, Progressive Era, Gilded Age, Medical schools, Medical education, Baptists, Modern medicine, Conferences 
  Cracks in the Foundation: Frederick T. Gates, the Rockefeller Foundation, and the China Medical Board  
John S. Baick
The Journal of the Gilded Age and Progressive Era
Vol. 3, No. 1 (Jan., 2004), pp. 59-89
Published by: Society for Historians of the Gilded Age & Progressive Era

As his lengthy career neares an end, Rockelfeller advisor Federick T. Gates made a bold bid and unsuccessful preoposal to the trustees of the Rockerfelller Foundation in 1924, asking them to invest $265 million in the China Medical Board,
Founded un 1914 the China Medical Board (CMB) was one of the earliest nevtures of the  Rockerfelller Foundation, the most promiinent of the Progressive-Era's giant secular Philanthropic foundations, The CMB was also the last major  hilanthropic fundation, the CMB was also the last major  philanthropic efforts by  Rockelfeller advisor Federick T. Gates, the man responcible for shifting the Rockelfellers from denominational charity to international  philanthropy. 
After a decade in excistence, the CNB had not come close to realizing the hopes of the founder. Only with this massice, unprecended infusion of capital, Gates explained, could his dream "sping into existence full panoplied."
This drwam was never fully realized because of its astonishingly grandioise scale and complexity: its goas was to make Chinese medical car the finest in the world, and in the process close the chasm that he saw between denomominational Christianity and the needs of the modern world.
Although the story of the
Medical Board is the story of a failed visions, it also affords a glimpse of the cracks at the base of  modern Americam philanthropy.
American secular capitalist  philanthropy. has its origins in the ildefined forder between the Gilded Age and the Progessive Era, as newly-created foundations- brazingly confident in their inevitable success - sought to use their funders' immense wealth to change Amercian society and the world. These foundations embody some of the hallmarks of progressive thinking, sich as the faith in experts and their ability to address social problems, but these new instituions also reveal many of the weaknesses of the era, including elitism, arrogange and naivere.
It is ironic that these institutions were called foundations, for they were far from deep or secure, but enmeshed in the agendas of their founders, officers and the nations. As a crucial building block for the Progressive Era, foundation were almost laughably flawed in ntheir conceptipon and contradictions, Inded, a closer examination of the mosy notable of these foundations- the Rockerfeller Foundation - reveals profound crack in matter of idealogy and implelemation.
To understand this tension, one should start with  Federick T. Gates, the diribing force behind the creation of the  Rockerfeller Foundation. Gate was less a representative Progressive figure than a transitional figure from the Gilded Age to the Progessive Era. His creation of the China Medical Board is an important study to examine the opportunities and contractictions of capitalist philanthropy. The  Rockerfeller Foundation has been suject to a breaod range of scholarship ranging from the hagiographic. The history of one piece of the Rockerfeller Foundation suggests that there is a need to revose and complicated our understanding of one of earliest and most influentialof the secualr completelely tax free charitable foundations.
The China Medical Boardhas been attacked by critocs as a clear example of American imerialism, and laundered by its supporters as an admirable effort of American benevolance, It has also been overshadowed by Rockerfeller ventures such as the  Rockerfeller INsitute for 
Medicial Research and the General Education Board has been attacked by critics  as a clear example of American imperialism, and launcdered by its supporters as an admirable effort of American benevolance. It has been overshadowed by Rockerfeller venutre such as the Rockefeller Insitute for Medical Rsearch and the General Education Boars. This artcle argues that the story of the China Medical Board (CMB) reveals the tensions present in the formative period of American Hisory. By lookimng at the origina of one of the  Rockerfeller Foundation's earliest yet lease well known and understood venture. one can see the cracks in the foundation of the world's most significant secular philanthropic institution. To understand the history of thw CMB is to delve into a series of public and private negotiations that stretched from New York to Peking. These negotiations involved some of the most prominent members of the American medical and Prodestant establishment, and originated within the general conscience and passionate vision of Federick Taylor Gates.
To create the  China Medical Board (CMB), which officially sought to revolutionize medical care in China, Gates assembled an ectectic coatiton of forces that was often at cross-purposes to his own. His "closely guarded" missioms was pne that has euded both the citics and defenders of the CMB, a mission that was simultaneusly radical and naive; converting Western missionaries by shifting their efforts from ministering to sould to ministering to the bodies of the "hated heritic."
Rather  than viewing China through the nineteenth century missionary lens of a mass of heathens to be converted, Gates placed  his faith in his own notion of Christianity and in the growing sect of American science.
Federick T. Gates, like his Puritan forbears, was armed with an enmormouslt powerful sense of how to recorder the world, and if the Rockerfeller Foundation was not a "city on a hill" by name, it surely was in spirity. It is perhaps not surporising that a descendant of the Puritans would seek to reorder Prodestant Christianity, but it is surely indicative pf the times  that his primary spiritual touchstones would include not just the scriptures but also scientific monographs.
At the intersection of Philanthrophy, imerialism, business, religion, and science, the  China Medical Board (CMB)was the last major effort of the Rockerleffer advisor   Federick T. Gates, who has been reshaping Rockefeller  Philanthrophy,over decades, shifting the direction fromn religious charities to decidedly more secular pursuits like medical research and education, In his final  philanthrophic effort,  Federick T. Gates would return to the ambiguous question of religion which had plagued him all his life and seel to answer it with what he saw as the clarity of modern medicine.
 Federick T. Gates was a member of the first generation of "foundation officers", one of a handful of professiona who were creating the new field of large-scale, private, secular philanthropy. This was a time when an increasing reliance on such notions as "expertise" meant the ascent of such groups as physicians and academics, a time when moral authoity and leadership were migrating from such traditional sources as religious organizations and missionarfies to new secular ministers like philanthropists and "experts". 
 Federick T. Gates's efforts on creating (and evebtually losing control of) the China Medical Board iklluminate the shifting terrain of authority and power in philanthropy in the early tweniteth centrury.

Life Before Rockefeller
. Federick T. Gates's early years were marked by two concerns that would finally come togther in the China Medical Board; religion and medicine,   Federick T. Gates wa born in upstate New York in 1853, the son of an evanelical Baptist minister, and a descedant of a long live of Pilgrims and Puritans in which religious orthodoxy burned brightly.   Federick T. Gates's poor rural childhood was filled with illness and death, amd the inexplicable death of a brother was a tragedy that would scare the entire family. Gate would later judge sucg episodes as preventable, but to  Federick T. Gatesas a child these moments were simply pieces of a difficult life. It would not be until he reached the position of Rockerfeller advisor that he would fully grasp the weakness of Americam medicine.
As   Federick T. Gatesmatured, he grew increasingly disenchanted with organized religion, a sa life shaped by an evangelical fairth left   Federick T. Gates wanting, with "no other result than agitation and resistance."

 Federick T. Gates  resisted many of the tenents of what he called "doctrinal speculation", and felt no "deep sense of guilt ... and little fear of hell." 

If   Federick T. Gates  rejected some of the forms of orgnaized Christiamity, he did develop a self-religeous moral code and a paternalistic sense of repsoncibility, and what he lacked in specific doctinal faith he compensated with his burning conviction that Chritianity was about a "life of disinterested public service."  Gated attended the Univeristy of Rochester in the 1970's, an experience which reinforced both his desire to ender piblic service and suspecions about denominational Chistianity. In upstate New York, howeverm a man of modest means has few outlets for such nondemoninational enangelical fervor.
Despite the doubts that  Federick T. Gates had, the need for stability and a religeous income were strong. Following the path of least resistance,  Federick T. Gates trained at the Roclester Theological Seninary and entered the ministry. It was a practical move for a yound man who wanted to achiece a measure of independence, but this was a job rather than a calling. His formal preparation for a life of the cloth included practical and soemwhat cynical advice on preaching. As a new pastor, he was taught, should amass a proverbial "barret" full of several hundred sermons, and draw on this barrel for a weekly sermon, After a few years, the barrel would be empty, and the pastor career  in Minneapolis  in 1980, were he proceeded to empty the barrest for a few years. Althigh these were years marked by "uninperrupted prosperity that sharly contrasts with his poor rural childhood, Gates quickly tired of his Minneapolis pastorite. Gates was also struck by the limitations of medicine, as his first wife died of an airment "never .... proper;y diagnosed by our physician...".
To add insult to his loss, Gates was approached by what he derisively called the "usual quota of faith healersm Christian Scientists, and medical non-descripts (sic)" seeking support from their paster, and "actively canvassed" by homeopathic physicians seeking public validation from the local minister.
A new opportunity came in the form of Baptist fundraising.
Gates speculated that it was his "irrepressible" nature and "interest in everything" that led him to gain influence on "various influencial boards and meetings."
Gates "mastered in minute detail the history and present condition of every mission field in Minnesota," and received favourable attention from church leaders and preominent lay Baptists. 
Gates distingshed himself in rasing money for education. noting that his work was "the only successful money-reraising campaign that Baptists had seen for many years."
Gates revitalized and otherwise parochial field, and his ability to marshal facts, figures, and disparate individuals would serve him well in his later career.
Gate came to the attention of national Baptist fundraising efforts and helped in the effort to found what would become the University of Chicago, leading to his first contacs with the businessman and Bapist John D. Rockefeller, Besides convincing Rockefeller to give millions in suport, Gates made a strong and lasting impression on someone who was searching for help with his charitable work. In 1891, Rockefeller hired Gates.
Gates' decision to turn his stern Baptich unbringing to another carrer was not unusual for his generation, for a face of dawning Progressive impulse led some to follow such ubcreasingly secular oaths as liberal proestanism was being redrawn in these years, and the dawning Pregressive impulse led some to follow such increasingly secular paths as liberal Protesrantism and the Social Gospel. Yet Gates did not accept the offer without doubts, for Rockefeller philanthropy in the early 1890's was denoninaltional and modest, with no hint of the massive, focused giving that would mark the great philantropic foundations of the era. But the job was a step further waye from the limiyed horizons of Gates's upbringing.
  Federick T. Gates  and the Rockefellers

The cause for which  Federick T. Gates would come to fell most passionate was the advancement of modern scientific medicine. As a Rockerfeller advisor,  Federick T. Gateswould complete his jorney away from the doctrinal faith of his father, with medicine becoming his new denomination. But before  Federick T. Gatescould envision a future in which modern medicine would be in the vamguard of cililization, he would first put in years of work for the Rockefeller family.
Rockefeller biographer Ron Chernow argues that Gates was one of several 1890's hires that Rockefeller made to distance himself from the earlier, bruising work that had made Standard Oil so powerful and notorious. These new men could act both with clean consciences and clean slates. Gates in particular, as a former minister, possessed a moral standing with which Rockefeller was eager to associate. And though Gates would soon some to occupy a large role in Rockefeller business, Gates was kept separate from the often unclean affairs of Standard Oil.
Gates's job was to bring order to Rockefeller charity, which was deluged with tens of thousands of requests each year. Gates focused on larger gifts to state and national bodies, shifing giving from what he called "retail" to "wholesale". It is illuminating to see Gates emply such corporate vernacularm for he brought the corporate managerial innovations of the Gikded Age - what business historian Alfred Chandler has called the "visible hand" - to Rockefeller philanthropy. 
Gates was a pionee in bringing these practiced to  philanthropy, effectively becoming the manager of the business of Rockefeller  philanthropy. Rockelfeller, whose own Standard Oil had benefited so much from a similary strategy, hearily approved. Gates was a victim of his own success, for Rockefeller would soon rely on Gates for financial as philanthropic efforts.
The demands of Gates's dual  philanthropic-business caeer nonetheless ledt Gates with a singular platform to implement his own idead, for he had earned the trust of John D. Rockefeller.
In 1987, Gates began a fundamental reorganization of  Rockefeller philanthropy, going beyond his cdentralization efforts toward a shift into entirely new fields. Gates embarked on an investigation of American medicine, returning to a theme that had troubled him his entire life. Gats had long held the belief "that medicine as generally taught and practiced in the United States was practically futile".
Gates plowed through Dr. Willian Osler's Princibles and Practice of Medicine, a thousand page survey of American medicine first published in 1892. Osler was the preminent phusicial at the nation;s finest medical school, John Hopkins. The book, Gated explained, confirmed my suspicion" about the poor condition of medicine in America, especially the almost total ignorance about disease. Here was an answer to the bedelling questions of illness and death that had plagued him, and here was a bastion to replace his eroding Baptist faith.
Gates' conversion was continuing, with Osler as his spiritial text and the transformation of American medicine his new mission, But speading the new faith would not be a simple task, for this was an era before professional expertise in fields like medicine was recognized and vakued. medicine was a local matter, and the vast majority of phusicians were poorly trained, Gates would also have to overcome the doubts of Rockefeller himself, who is described by a biographer as being "emotionally wedded to traditional medicines." Indeed, the man who would be prodded by Gates into being a great patrol of modern medicine "smoked mullein leaves.. to heal respiratort problems and never lost a residual suspicion of emdical doctors." Yet despite these obsticles, gates oversaw - and perhaps more accurately, managed - the 1901 creation of the Rokefeller Insutute for Medical Research, which would dramatically change the field of medical research. The Rockefeller Institute was also the fist philanthropic foundation to have its own director and board, a hallmark of Gate's desire to bring business practices into benevolence.
But if the  Rockefeller Institute was a sign of Gates's new faith, it did not directly address the practice of medicine in America, not did it address his frustration with American Christianity. In 1905, gates convinced Rockefeller to at least gice another denomination, granting a request for $100,00 to the Boston-based Congregational Board of Forteigh Missions. This was Gates' first effort at shifting Rockefeller toward the nexus of religion and medicine missionaries,
Thus bequest let to a national backlash, as news of the gift was interpreted by Progressive journalists and Protestant religious leaders alike as an unsolicited attempt by Rockefeller to use his "tainted money" to improve his image. Indeedm the words "tainted money" would trigger in the public imagination for years. This incident rekindled all of gates's distruct for American denominational Christianity. By the time the Cpongretional Board acknoweledged that the gift had been solcited, the damage had aleray been done both to the Rockefeller's reputation and to the efforts of missionary boards to raise money from Rockefeller. it would be "ten years before the greated foreigh boards" would get "their great gifts for medicine and education in foreigh lands" in the form of the Chinese Medical Board (CMB).
A plausable argument can be made that Gates's decision to focus on China was because Gates wished to aviod the tangles shein of American Progressivism. Although Gates approved of many of the general tehemse of Progressism - the search for root causes, the reliane on experts - Gates was aware that Rockerfeller was viewed by many Progessives as one of the great problems of the day.
Gates was deeply scare dby the "Tained Money" episode, and his reuctance to engage in new domestic philanthropic work in such an atmosphere in understandable. Yet when Gates turned  Rockefeller philanthropy to llok toward China, his effort should be seen in a far larger context than just avoiding Progressive vitriol, It is clearlt in the  Chinese Medical Board (CMB).that Gates's faith in modern medicine, his doubts about sectarina Christinaity, and hus skipps and influence as  Rockefeller's    philanthropic manager would come together. It is also in the CMV that one can locate Gates as a note in a general chorus of American interest in China.
Looking Towards China
In the early twentieth century, Americans commonly viewed China as at once a vexing problem, and a tremendous opportunity. Businessmen, including the Rockefellers, eyed China as the most important new market. Missionaries saw China as the most important battle for a wat to save hundreds of millions of souls. And political leaders, with the Philippines and American possession since 1898, saw China as tantalizing;y close. There was a growing sense that the two nations has a "special relationship" that both allowed and requires the U.S to shape China.
Gates's interest in China dates back to his college years in the 1870's when some of the mosy "powerful" and "formative" lessons he learned included those about the condition of China. Gates was taught that the English and Russian rivalry for dominance in East Asia would lead to the "break up of the froxzen cicilazations of the East." By the early twentieth centrury, this rivalry included all the major Western powers, including the United States.
Against this background of personal and national interest, Gates received a 1906 proposal calling for te creation of a nondenominaltional Christian university in China. The two leas writers were Ernet Burton, Gates's classmate at the Rochester Theologocal Seminary, and Harry Pratt Judson, president of the University of Chicago.
China, they aregued, was the key to the world's future, and it was America's responcibility to educate the Chinese. They added that a Christian univeristy would bolster the American missionary presence. Includinf with the proposal was a letter from a Baptist misisonary, who dreamed that the proposed univeristy would finction as the headquaters for a new "Christian Crusade," pitting the forces of God and good - "the great missionary body" - against the teeming "heathen" Chinese masses, thus advancing the "far-flung battle-line" of  "our Western civilization."
Burton and Judson were both acquainances of Gates. but it is clear tha they were not well-acquainted with the sentiments of the exminister, Gates's drift from denominational Christianity was complete by 1906, and he had already reached the conclusion that "Chrust had neither founded nor intended to found the Baptist Church, nor any church," 
Gates must have seen the proposal - especially the letter from the Baptist missionary - as a reminder of the parochial nature of sectarian Christianlity, And - as he would later reveal to a few close associates - he dismissed entirely the importance of coverting the "heathen" masses.
Gates made no promises, but suggested that he was seriously considering funding a trip to study the proposal's feasibility. Gates also began researching the matter himself. In the same maner that made Gates such an effective manager in the recognition of Rockefeller philanthropy and business, Gates would not act until he had investigated the subject throroughlt. He would spend over a decade considering what role Rockefeller philanthropy should play in China.
A crucial element of this research was anticipating the actions of missionaries and religious groups. Over the next few months, gates canvassed relious leaders. Gates explained to one missionary leader that  " I am just now studying the question of the best methods of promoting the welfare of the Chinese, "  and considered a conference to discuss the question, a conference that would materialise secen years later. Gates also dangles the possibility of a large Rockefeller investment, " perhaps a considerable expenditure covering an indefinte period," With such comments, Gates quickly gained the attention of religious groups.
One such group was the China Centennial Conference, a meeting in Shanghai that drew representatives from every major Protestant missionary group and is cinsidered the "last major collective expression if their theology by Prodestant missionies in China." Reverend Arthur Smith wrote to Gates on behalf of the conference, and warned that any charitable effort in China much involve the cooperation of missionaries. Smith smugly added in another letter that the only "suitable men available" for philanthropic work in China were in the "missionary ranks."
Gates received several letters like this as word of  Rockefeller philanthropic interest in China speard. One Bapist missionary confided to Gates his hops of expanding "our own Baptist work  .. on the foundations we have alreayd laid." Americam religious leaders and missionaries were transfixed by the possiblity of Rockefeller support, and were clear in their intent to exercise control, Baptists in particualar thought they had the inner track with Gates.
After a year of research and inquiries, Gates finally approved the research trip to China. the 1908-1909 Rockefeller-funded Oriental Education Commission conclded that founding a non denominational university in China was impossible, for it would face opposition from missionaries who would see it as a treat to proselytizing. The Commission therefore advcoates a focus on medicine. Wallace Buttrick, the first director of the China Medial Board, would cite the Oriental Education Commissiom report as central to the creation of the CMB, claiming that the report turned Gates' thoughts to medical work in China.
Giving such significance to the Oriental Edication Commission report fails to take into account Gates;s own motivations. Gates knew that any Rockefller philantropic effort in China would attract the attention and meddling of missionaries. Furthermore, Gates was constantly seeking ways to advance modern scientific medicine, and did not need to be told about the potential impact on a nation that he saw as "wholly inacquained with modern medicine, and weltering in unrelived suffering from disease and semipstarvation."
An alternative explantion is that Gates used the Commission's report to justify an action he had already panned, and perhaps had in mind as early as the "tainted money" scandal in which Gates had designated Rockelfeller aid for medical missionairies. On the surface, gates was simply investigating a new philanthropic opportunity. Gates' true motivation, as it would emerge over the coming years, was more original and subersive: Gates meant to elevate the pratice of medicine in China and similatameously use medicine to convert the medical missionaries to the cause of science.
As Gates would argue in private Rocefeller reports and explain later in his private papers, the missionaries in China were trappen in the "bondage of tradition and ... an ignorance and misguided sentiment in the supportging churches."
To understand Gates's effort, one must first appreciate the scope and gaaols of the Western missionaries, Christian missionaries had been in China for centuries, and prdestant missionaries had become the dominant Christian missionaries by the mid-ninetheent century. Although the missionaries had worked diligently for generations, little progress had been made in terms of conversations, a prime benchmark used by missionaries themselves. By the twentienth century China had become one of the most popular missionary targesrt in the world,a nd thousands of men and women flocked to join the missions, especially from the United States and parts of Western Europe. If the missionaries had made few inroad in proselytizinf, however, they had made marked progress in the field of medicine, and the hundreds of medical missionaries raely lacked for patients.
The medical finction of these medical missionaries was secondary to their untimate goal of converting the Chinese to become Christian Baptists. The practice of Western medicine had become a focal point for evangelization, and missionaries implicitly and explicity linked Western "miriacles" to the teachings of Christianity. Insead of focusing on the health of patients, medical missionaries urged sick and dying patients to convert. One historian of American missionairies in Chinaa notes that for the medical missionaries, "evangelical standards came before "professional standards" , so much that one prominaent doctor recommended accepting fewer patients so "(we) have better opportunity to help them spiritually." This process might have been a violation of their ethical charge as physicians, for some were medical doctors, but it caused little distress among medical missionaries whose promary concern was the soul, not the body.
Gates saw in Americal medical missionaries in China the confluence of the two great forces that shaped his life; sectarinaism, his bete noire; and medicine, his hope for human progress, Gates was clearly offended by the use of the latter to advance the cause of what Gates considered "evangelistic propaganda," but Gates also saw this offensive situation as an opportunity, Using the power of his position with the Rockefellers, Gates sought to transform both practices to conform to his vision.
Gates's interest in China ansd medicine was alsi energized by the Flexner Report. Issued by the Carnegie Foundation for the Advancement for Teaching in 1910. Abraham Flexner's harsh criticism of medical education in North  American was lauded by many outside of medicine, such as Gates, who saw the entire field as ripe for reform. The report was pme pf the most conspiricuous early efforts of a philantropic foundation to shape national affirs. Yet many of those in the field of medical education were outrages by Flexner's presumption in judgeing the field so harshly and so publicly. In his work to change the pratice of medicine in China into a labratory for medical reform.
Before Gates made any sustantive plans, Gates had to wait for the creation of a permenent Rockefeller  philantropic foundation. The history of the Rockefeller Foundation has been frequently told, but what has been overlooked is that one of Gates' objects in establishing this foundation was expending aid to China, Gates meany to spend millions of dollars - amnd eventually hundrens of millions - on ain to China over an indefinite perion. Such as effort requires a permanent base. One of his most important allies in creating the foundation was John D Rockefeller. r,. who had trained under Gates' careful eye for years. Rockefeller, J. assumed control of the family business when gates chose to focus entirely in philanthropy in 1912. Gates may have been pressed by a sense of personal urgency, as his health began to deteriorate. But he was also increasingly focused on what become the China Medical Boars. In 1913, with the creation of the Rockefeller Foundation, the time had come to turn back to China.
Yet besides successfully shifting Rockefeller  philanthropy toa permanent basis, Gates had also losy some of his acces to power and influence. Gates had been the dominant voice in  philanthropic matters for two decased, but with the creation of the  Rockefeller Foundation, he was only one of nine trustees. Where Gates once had the ear of Rockefeller, Sr., Gates now had a board of trustees with Rockefeller, Jr. as president. Gates would continue with his philanthropic mission, but the process had changes. The China Medical Board would end up Gates' last geat project, a symbol of Gates;s power and Gates' weakness.
The China Conference

Soon after the  Rockefeller Foundation was created, Gates called for a conference in New York on the question of China. In keeping witgh the Progressive Era, gates assembles the expoerts in the fields involve: missionaries, academics. and  philanthropic advisors. Those in attendance at the January 1914 China Conference including harvard President Emeritus Charles Eliot; President Judson of the University of Chicago; Jerome Greene, Secretary of the Rockefeller Fiybdation; John R. Mott, representing the International Committee oft he YMCA; Wallace Buttrock, head of the Rockefeller-funding General Education Board' Professor Paul Monrow of Columbia University's Teachers College, an authority on Chine education; professor Thomas Chamberlain of the Univerity of Chigago, a member of the Rockefeller-funded Oriental Education commission; and Robert Speer of the Presyterian Board of Foreign Missions .
Pesiding over the meeting was John D, Rockefeller, Jr., who announced that he wished to gain the counsel of experts before making any moves in China. Charles Eliot argued that the best work the Rockefeller Foundation could do - not just in China, but in the entire world - was to advance the cause of Chinese education in general and medicine in particulae, John Mott focused on "our ministry" and derided the "new educational and medical schemes and enterprises" because they failed to reply on the weaqlth of experience" of missionaries.

Subject: DR Frederic L. Gates family history

  The medical industry do not want to wake up and start using oxygen masks
instead of ventilators. which are a lot cheaper as well, as they are only an oxygen mask attached to an oxygen cylinder... 
because the medical industry is controlled by the same people  and organisations that have created this Coronavirus Corvid-19 Pandemic .. which is the same people  and organisations that have created the Spanish Flue Pandeminic that killed 50 to 100 million in 1918 ..
They need for any many people to die in hospitals and nursing homes with ventilators as possible to be able to keep the world scared of the Corvid-19 pendemic to be able to have an excuse to keep the world locked down, to bankrupt the world in a new created biggest dpression the world has ever seen
rto be able to role out their 
New World Order
with their New
One world E cashless E money
and emerging clandestine totalitarian world government 
and own the rest of the world they do not own for penies in the dollor
so that evryone is either in unemployment benefits only if they abey the rules
or working for a few billion dolalr companies that will stil exist
reduce the useless eaters
that are no needed to run the New WorLd Order
kill people who are a nuisance to them
No one will blink an eye lid as to who dies nowand they will say 
"Oh he got sick of Corvid-19 .. we took him to hospital and sedated him to sleep with drugs
put him on a ventilator and he nver wake up....."
They are tuning hospitals and doctors into the same thing that
Gas Chambers were used fro in WWII
all right in the public eye
with the doctors and medical industry woking under false and deliberatoely false and wrongful protocols
on how to treat these people .... 
with the   false and deliberatoely false and wrongful protocols and medical claims
written by high up people in the medical industry on the payroll of
the Rockefeller Foundation
the Bill Gates Foudation etc
   (ventillators costs $50,000 plus each and those that supply ventilors including China and many americzan companies such as GE, are making a killing from supplying ventilators to the the USA and around the world with the pice rising all the time because of the high demand)  
Bill Gates is the man and his so claled non profit organisation is gearing up to suiply the so called magican vaccine the will save the world from the so called Corvid-19 Coronavirus..
It is rather amazing the Dr Frederic L. Gates was the perspm who helped the
Rockerfeller Medical Foundation created a so called vaccine in 1918 that was taken from the blood of sick horses with a bad contagious lung disease called Distemper
Dr Gates at the army fort is Kansas gave the soldiers there a vaccine from blood of sich norses who had Dispemper. which rips a horses' lung apart.. so what would it do to a human lung..
these no contaminated soldiers were sent out to the trenches and around the world to spread the sickness which only transfered from horses to humans by an actual injection as a so called vaccine ...
many of the soldiers died before they go to the war in France
many contaminated others in the trenches which were unsanitart holes where it was easy to spread the sickness
many of the soldiers and other they contaiminated the sickness with... that didnot die appreared to have recovered but because carriers of the sickness..
to help spreak it around the world...
Frederic L. Gates
From the Base Hospital, Fort Riley, Kansas, and The Rockerfeller Institute for Medical Research, New York.
Received July 200th, 1919.
Author’s note: Please read the Fort Riley paper in its entirety so you can appreciate the carelessness of the experiments conducted on these troops.)
Between January 21st and June 4th, 1918. Dr Gates reports on an experiment where soldiers were given 3 does of a bacterial meningitis vaccine. Those conducting the experiments on the soldiers were just spitballing dosages of a vaccine serum made in horses.
The vaccination regime was designed to be 3 doses. 4792 men received the first done, but only 4,257 got the 2nd dose (down 11%), and only 3,702 received all three doses (down 22.7%). A total of 1,090 men were not there for the 3rd dose.    

 Revisionist History: Vaccines and the "Spanish Flu" of 1918-19
The 1918-19 bacterial vaccine experiment may have killed 50-100 million people
by Keven Barry,  President First Freedoms, Inc.. November 7, 2018
Part 1 of a 5 part series

The Disease Was Not Spanish
While watching an episode of American Experience on PBS a few months ago, I was surprised to hear that the first cases of 
" "Spanish Flu" occurred at Fort Riley, Kansas in 1918. I thought, how is it possible this historically important event could be so badly misnamed 100 years ago and never corrected?  

Frederic L. Gates
From the Base Hospital, Fort Riley, Kansas, and The Rockerfeller Institute for Medical Research, New York.
Received July 200th, 1919.
Author’s note: Please read the Fort Riley paper in its entirety so you can appreciate the carelessness of the experiments conducted on these troops.)
Between January 21st and June 4th, 1918. Dr Gates reports on an experiment where soldiers were given 3 does of a bacterial meningitis vaccine. Those conducting the experiments on the soldiers were just spitballing dosages of a vaccine serum made in horses.
The vaccination regime was designed to be 3 doses. 4792 men received the first done, but only 4,257 got the 2nd dose (down 11%), and only 3,702 received all three doses (down 22.7%). A total of 1,090 men were not there for the 3rd dose.  
The  "Spanish Flu" kills an estimated 50-100 million people during a pandemic in 1918-19. 
What is the story we have told about this pandemic isn't true?

What if, the killer infection was neither the flu not Spanish in origin?
Newly analyzed  documents reveal that the "Spanish Flu" may have been a military vaccine experiment gone awry. In looking back on the 100th anniversary of the end of World War 1, we need to delve deeper to solve this mystery.

The reason modern technology has not been able to pinpoint the killer influenza strain from this pandemic is because influenza was not the killer.
More soldiers died during WWI from disease than from bullets.
The pandemic was not flue. An estimated 95%9 or higher) of the deaths were caused by bacterial pneumonia, not influenza/a virus.
The pandemic was not Spanish. The first cases of bacterial pneumonia in 1918 trace back to military base in Fort Riley, Kansas.
From January 21-June 4, 1918, an experimental bacterial meningitis vaccine cultured in horses by Rockefella Institute got Medical Research in New York was injected into soldiers at Fort Riley.
During the remainder of 1918 as those soldiers - often living and traveling under poor sanitary conditions- were sent to Europe to fight they spread bacterial at every stop between Kansas and the front line trenches  in France.  

One study describes soldiers "with active infections (who) were aerosolizing the bacteria that colonized outposts their noses and throats, while others -often, in the same "breathing spaces" - were profoundly susceptible to invasion and rapid spread through their lungs by their own or others' colonizing bacteria." (1)  

The  "Spanish Flu" attacked healthy people in their prime. Bacterial pneumonia attacks people in their prime. Flu attacks the young, old and immune compromised.
During WWI, the Rockefeller Institute also sent the antimeningococcic serum to England, France, Belgium, Italy and other countries, helping spread the pandemic worldwide.  

During the pandemic  of 1918-19, the so-called  "Spanish Flu" killed 50-100 million people, including many soldiers. many people do not realize that disease killed far more soldiers on all sides than macine guns or mustard gas or anything else typically associated with WWI.  

I have personal connection to the  "Spanish Flu". Among those killed by disease in 1918-19 are members of my parents' families. In my father's side, his grandmother Sadie Hoyt died from  pneumonia in 1918. Sadie's sister Marian also joined the Navy. She dies from "the influenza" in 1919. On my mother's side, two of her father's sisters died in childhood. All of the family members who died lived in new York City. I suspect many American families, and many families worldwide, were impacted in similar ways by the mysterious  "Spanish Flu"..
In 1918, "influenza" or flu was a catchall term for disease of unknown origin. It didn't carry the specific meaning it does today. It meant some mystery disease which dropped out of the sky. In fact,  influenza is from the Medieval Latin "influential" in an astrological sense, meaning a visitation under the influence of the stars.

Why Is What Happened 100 Years Ago Important Now?
Between 1900-1920, there were enormous efforts underway in the industrial world to build a better society. I will use New York as an example to discuss three major changes to society which occurred in NY during that time and their impact on mortality from infectious diseases.
What happened to these soldiers?
Where they shipped Est by train from Kansas to board a ship to Europe?
Were they in the Fort Riley hospital?

Dr Gates’s report doesn’t tell us.

An article accompanying the American Experience broadcast I watched sheds some light on where these 1,090 men might be. Gates began his experiments in January 1918. By March of that year. “ 100 men a day” were entering the infirmary at Fort Riley. Are some of these the men missing from Dr. Gates’ report - the ones who did not get the 2nd or 3rd dose?
Shortly before breakfast on Monday, March 11, the first domino would fall signaling the commencement  of the first wave of the 1918 influenza. Company cook Albert Gitchell reported to the camp infirmary with complaints of a “bad cold”. Right behind him came Corporal W. Drake voicing similar complaints. By noon, camp surgeon Edward R. Schreiner had over 100 sick men on his hands all apparently suffering from the same malady …” (5)
Gates does report that several of the men in the experiment had flu like symptoms: coughs, vomiting and diarrhea after receiving the vaccine. These symptoms are a disaster for men living in barracks, travelling on trains to the Atlantic Coast, sailing to Europe, and living and fighting in trenches. The unsanitary conditions at each step of the journey are an ideal environment for a contagious disease like bacterial pneumonia to spread.  
From Dr. Gates’s report
“ …. Reactions …. Several cases of looseness of the bowels or transient diarrhea were noted. This symptom had not been encounteres before. Careful inquiry in individual cases often elicited the information that men who complained of the effects of vaccination were suffering from mild coryza, bronchitis at the time of injection …”
 “Sometime the reaction was initiated by a chill or chilly sensation, and a number of men complained of fever  or feverish sensations during the following night. Next in frequency came nausea (occasionally vomiting), dizziness, and general “aches and lains” in the joints and musles, which is a few instances were especially localized in the neck or lumbar region, causing stiff neck or stiff back. A few injections were followed by diarrhea. The reactions, therefore, occasionally simulated the onset of epidemic meningitis and several vaccinated men were sent as suspects to the Base Hospital for diagnosis.” (4)
According to Gates they injected random dosages of an experimental bacterial meningitis vaccine into soldiers. Afterwards, some of the soldiers had symptoms which “simulated” meningitis, but Dr. Gates advances the fantastical claim that it wasn’t actual meningitis.
The soldiers developed flu-like symptoms. Bacterial meningitis, then and now, is known to mimic flue-like symptoms. (6) Perhaps the similarity of early symptoms of bacterial meningitis and bacterial pneumonia to symptoms of flu is why the vaccine experiments at Fort Riley have been able to escape scrutiny as a potential cause of the Spanish Flu for 100 years and counting.  
 (ventillators costs $50,000 plus each and those that supply ventilors including China and many americzan companies such as GE, are making a killing from supplying ventilators to the the USA and around the world with the pice rising all the time because of the high demand)
Frederick Lamont Gates (1886-1933) | WikiTree FREE Family ...www.wikitree.com › wiki › Gates-2143May 24, 2015 - Explore genealogy for Frederick Gates born 1886 Minneapolis, ... He married Dorothy Olcott in Duluth, MN in 1917, and they had five children together. ... and Mrs. William J. Olcott of Duluth, Minn., and Dr. Frederick L. Gates, ...
‎Biography · ‎Sources · ‎Residence · ‎Marriage
 Frederick Lamont Gates
Born 17 Dec 1886 in Minneapolis, Hennepin County, Minnesota, United States of America [map]
Son of [father unknown] and [mother unknown]
[sibling(s) unknown]
Husband of Dorothy (Olcott) Elsmith — married 11 Sep 1917 (to 17 Jun 1933) in Duluth, Minnesota, United States of America [map]
Died 17 Jun 1933 in Cambridge, Middlesex, Massachusetts, United States of America [map]   
Frederick was born in 1886 in Minneapolis, Minnesota, the son of Frederick Taylor Gates and Emma Lucile Cahoon. When he was about five years old, his family moved to Montclair, NJ, where his father worked as a business manager for John D. Rockfeller. Frederick spent the remainder of his childhood there. He graduated from xx high school in about 1905, did his undergraduate studies at Yale University (1909) and a medical PhD from Johns Hopkins (1913). He then pursued a career in research working for the Rockefeller Institute of Medical Research (which his father had helped to establish). He married Dorothy Olcott in Duluth, MN in 1917, and they had five children together. He served in World War I teaching and doing research in the U.S. as part of the Medical Corps. After the war, he continued his research position at Rockefeller, eventually based at Harvard University in Cambridge, MA. He died there tragically in 1933 after falling and fracturing his skull. He is buried in the Mount Hebron Cemetery, Upper Montclair, NJ.
More detailed stories about Frederick can be found in the Gates family genealogy by Robert Cady Gates: George Gates of East Haddam Connecticut and some of his Descendants, 2002, Published by Robert Cady Gates; available at: Gates genealogy.

This profile is a collaborative work-in-progress. Can you contribute information or sources?

Robert Cady Gates. 2002. George Gates of East Haddam Connecticut and Some of his Descendants. Published by Robert Cady Gates, P.O. Box 7032, Hudson, FL 34674-7032. Accessed 10 June 2015 at: Gates genealogy provides information about Frederick's family, including his children and grandchildren.


"United States Census, 1900," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:M9JD-5Z9 : accessed 8 June 2015), Frederick Gates in household of Fred P Gates, Montclair town Ward 3, Essex, New Jersey, United States; citing sheet 4A, family 53, NARA microfilm publication T623 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,240,970. Name: Frederick Gates; Gender: Male; Age: 14; Marital Status: Single; Race: White; Race (Original): W; Relationship to Head of Household: Son; Relationship to Head of Household (Original): Son; Birth Date: Dec 1886; Birthplace: Minnesota; Father's Birthplace: New York; Mother's Birthplace: Wisconsin; Household (Role Gender Age Birthplace): Fred P Gates, Head, M, July 1853, 47, married, yrs married: 14; New York; parents' birthplace: f:NY, m:Conn; manager; Emma C Gates, Wife, F, Apl 1855, 45, married, yrs married: 14 (erroneously entered at 7 for number of children); Children born:7; living:7; Wisconsin; parents' birthplace: NY; no occupation; Frederick Gates, Son, M, Dec 1886, 14, single, Minnesota; parents' birthplace: f:NY, m:Wisconsin; at school; Franklin Gates, Son, M, July 1888, 12, single, Minnesota; parents' birthplace: f:NY, m:Wisconsin; at school; Russell Gates, Son, M, June 1890, 10, single, Illinois; parents' birthplace: f:NY, m:Wisconsin; at school; Alice Gates, Daughter, F, Sep 1891, 9, single, New Jersey; parents' birthplace: f:NY, m:Wisconsin; at school; Lucia S Gates, Daughter, F, Nov 1893, 7, single, New Jersey; parents' birthplace: f:NY, m:Wisconsin; at school; Grace S Gates, Daughter, F, July 1895, 5, single, New Jersey; parents' birthplace: f:NY, m:Wisconsin; Percival Gates, Son, M, Jun 1897, 3, single, New Jersey;parents' birthplace: f:NY, m:Wisconsin; Mary Henery, Servant, F, Feb 1881, 19, single, New Jersey; parents' birthplace: f:Ireland, m:NJ; waitress; Mary Rourke, Servant, F, Nov 1876, 24, single, Ireland; parents' birthplace: Ireland; Yr immigration: 1892; yrs in USA: 8; cook; Florence A Cahoon, Sister-in-law, F, Apl 1850, 50, Single, Wisconsin; parents' birthplace: NY; no occupation; Florence Cahoon, Niece, F, Feb 1881, 19, single, Texas; parents' birthplace: f:NY, m:Illinois; no occupation. Address: 172 Union St. Owned house, no mortgage. Everyone reads/writes/speaks English.

"New Jersey, State Census, 1905," index, FamilySearch (https://familysearch.org/ark:/61903/1:1:KMWN-YDY : accessed 26 May 2015), Frederick Gates in household of Frederick T Gates, , Essex, New Jersey, United States; citing p. 25, line 20, Department of State, Trenton; FHL microfilm 1,688,596. Name: Frederick Gates; Gender: Male; Age: 18; Birth Year (Estimated): 1887; Page: 25. Household (Role Gender Age Birthplace): Frederick T Gates, M, 51; Emma Gates, F, 50; Frederick Gates, M, 18; Franklin Gates, M, 16; Russell Gates, M, 14; Alice Gates, F, 13; Lucia Gates, F, 11; Grace Gates, F, 10; Percival Gates, M, 8; Florence Cahoon, F, 55; Winnie Nolan, F, 21; Mary Morris, F, 26; Esther Landber*, F, 22.

"United States Census, 1910," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:MKY3-7C9 : accessed 25 May 2015), Frederick L Gates in household of Frederick T Gates, Montclair Ward 3, Essex, New Jersey, United States; citing enumeration district (ED) 197, sheet 11B, family 198, NARA microfilm publication T624 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,374,896. Name: Frederick L Gates; Gender: Male; Age: 23; Marital Status: Single; Race: White; Race (Original): White; Relationship to Head of Household: Son; Relationship to Head of Household (Original): Son; Birth Year (Estimated): 1887; Birthplace: Minnesota; Father's Birthplace: New York; Mother's Birthplace: Wisconsin; Household (Role Gender Age Birthplace): Frederick T Gates, Head, M, 56, 2nd marriage, yrs married: 24, New York; parents' birthplace: NY; Buss. Mgr, John D. Rockefeller, wages, not out of work; wks out of work:0; not a veteran; Emma Gates, Wife, F, 54, 1st marriage, yrs married: 24; children born:7; living:7; Wisconsin; parents' birthplace: NY; Frederick L Gates, Son, M, 23, single, Minnesota; parents' birthplace: f:NY; m:Wisconsin; Franklin K Gates, Son, M, 21, single, Minnesota; parents' birthplace: f:NY; m:Wisconsin; Russell C Gates, Son, M, 19, single, Illinois; parents' birthplace: f:NY; m:Wisconsin; Alice F Gates, Daughter, F, 18, single, New Jersey; parents' birthplace: f:NY; m:Wisconsin; Lucia L Gates, Daughter, F, 16, single, New Jersey; parents' birthplace: f:NY; m:Wisconsin; Grace L Gates, Daughter, F, 14, single, New Jersey; parents' birthplace: f:NY; m:Wisconsin; Percival C Gates, Son, M, 13, single, New Jersey; parents' birthplace: f:NY; m:Wisconsin; Florence A Cahoon, Sister-in-law, F, 59, single, Illinois; parents' birthplace:NY; Lena Tarka, Servant, F, 34, single, Finland; parents' birthplace: Finland (Fin.); Immigration yr: 1902; cook, private family, wages, not out of work: 0 wks; Winifred Nolan, Servant, F, 24, single, Ireland; parents' birthplace: Ireland (English); immigration yr: 1901; waitress, private family, wages, not out of work: 0 wks; Margaret Cassidy, Servant, F, 22, single, Ireland; parents' birthplace: Ireland (English); immigration yr:1905; chambermaid, private family, wages, not out of work: 0 wks. Address: 166 South Mountain Ave. Owned house, no mortgage, Everyone speaks English/reads/writes. All children attended school.

"United States Census, 1910," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:M2ND-9K1 : accessed 25 May 2015), Frederick L Gates, Baltimore Ward 11, Baltimore (Independent City), Maryland, United States; citing enumeration district (ED) 159, sheet 17B, family , NARA microfilm publication T624 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,374,569. Institution: YMCA; Name: Frederick L Gates; Gender: Male; Age: 23; Marital Status: Single; Race: White; Race (Original): White; Relationship to Head of Household: Lodger; Relationship to Head of Household (Original): Lodger; Birth Year (Estimated): 1887; Birthplace: Minnesota; Father's Birthplace: Minnesota; Mother's Birthplace: Wisconsin; Occupation: none; Reads/writes, speaks English; Attended school. Other boarders listed.

"New Jersey, State Census, 1915", index, FamilySearch (https://familysearch.org/ark:/61903/1:1:QV93-T7WB : accessed 25 May 2015), Frederick L Gates in entry for Frederick T Gates, 1915. Name: Frederick L Gates; Gender: Male; Birth Date: Dec 1886; Birthplace: Minnesota; Household (Role Gender Age Birthplace): Frederick T Gates, M, New York; Emna L Gates, F, Wisconsin; Frederick L Gates, M, Minnesota; Franklin H Gates, M, Minnesota; Russel C Gates, M, Illinois; Alice F Gates, F, New Jersey; Lucia Louise Gates, F, New Jersey; Grace Lucile Gates, F, New Jersey; Percival Taylor Gates, M, New Jersey; Florence Cahoon, F, Illinois; Mary Olsen, F, Sweden; Agnes Larsen, F, Sweden; Ida Anderson, F, Sweden.

The Duluth News Tribune (Duluth, Minnesota) 9 Dec 1917, accessed at Rootsweb.ancestry.com

Most Prominent Wedding of Season at St. Paul's, Avenue of Pines and Gothic Lines of Easter Lilies Are Setting at Gates-Olcott Marriage: Tall cathedral candelabra twined with southern smilax and an avenue of northern pine from chancel rail to altar, where Easter lilies backed the Gothic arch, made a long aisle of green for the bridal procession and a lovely setting for the marriage service of Miss DOROTHY OLCOTT, daughter of Mr. and Mrs, William J. Olcott, and Dr. FREDERICK LA MONT GATES of New York at St. Paul's Episcopal church last night. Dr. A. W. Ryan read the service. Gowned in white satin made en traine, with a tulle veil held by a filet of orange blossoms, the bride, carrying a bouquet of lilies of the valley, leaned upon the arm of her father as they moved along the "avenue of pines" toward the altar. The ushers, William Harrison, E.F. Chapin jr., W.C. Agnew jr., Fred E. Wolvin, Leo Schmied and Horace F. Ferry of Superior, led the bridal procession. They were followed by the bridesmaids, Miss Alice Gates, sister of the bridegroom, and Miss Janet Rane of Waban, Mass., a cousin of the bride, who wore duplicate gowns of green satin and tulle, and carried big bouquets of pink snapdragon. Miss Elizabeth Olcott, as her sister's maid of honor, was gowned in apricot shade of taffeta and she carried snapdragons to match her gown. Following her came the little flower girl, Sallie Simonds, daughter of Mr. and Mrs. Thomas Simonds, formerly of Superior, wearing a white frock with green tulle bow and carrying lilies of the valley. Before the ceremony which began at 8 o'clock, an organ program, especially selected by the bride, was played. The music was under the direction of Miss Mary Syer Bradshaw. The processional was the Lohengrin Bridal Chorus, which was sung by Miss Bradshaw, Mrs. August Frey, Mrs. James F. Walsh, Mrs. C.B. Gilbert, A.R. Burquist, Dr. F. A. Amundson, George Suffel and D.G. Gearhart. Following the betrothal service when the bridal couple passed from the chancel to the altar, Miss Bradshaw sang a bridal prayer, "Oh Heavenly Father," (Coombs). The "Northfield Benediction" was sung after the benediction, and the "Tannhauser" march was played as recessional. A reception followed the service at the home of Mr. and Mrs, Olcott, East First street. The guests were received in the music room where tall silver vases held American Beauty roses forming a rarely beautiful color combination with the French gray tone of the room. The drawing room had its rich coloring emphasized by huge bowls of gladioli and snapdragon. In the dining room the bridal white reigned. From the cut crystal center light hung wreathed in asparagus fern showers of white sweet peas and lilies of the valley and crystal candlesticks held tall tapers that lights the sideboard where the wedding cake reposed in a wreath of ferns. Mrs. Olcott was gowned in dark blue satin and silver. Mrs. Gates wore a robe of rose point over cream satin. The bride's going away costume was a sport suit of brown and orange, Her bridal bouquet was made of many small bouquets which she gave to her bridal party and mother and mother-in-law. Dr. Gates and his bride have gone east where they will be at home in New York late in the autumn. Dr. Gates is an associate of the Rockefeller institute and is a graduate of Johns Hopkins and Yale universities. Mrs. George W. Strickler and daughter, Marian, of Minneapolis, were guests of Mrs. W.C. Winton over the wedding. Eugene M. Best and daughter, Alice, of Minneapolis, were also wedding guests who were entertained by Mr. and Mrs. Edward Mendenhall. A large party, comprising the out-of-town guests at the wedding, will be the guests of Mr. and Mrs. Olcott on a trip to the range today. They will all leave for their homes tomorrow. The visitors are Mr. and Mrs. F.T. Gates of Montclair, NJ, parents of the bridegroom, and their daughters, Alice, Grace and Lucia, and their son, Percival; Mrs. F.W. Rane of Waban, Mass., and Mrs. C.M. Hammond of Detroit Michigan, sisters of Mrs. Olcott; Mrs. Eugene G. Clapp and daughter, Mary, of Boston; Mrs. Louise Cornell of Orange, NJ; Mrs. Frank B. Kellogg, Mr. and Mrs. F.G. Otis, Mr. and Mrs. Benjamin F. Meyers of St. Paul and Mr. and Mrs. C.C. Bovey of Minneapolis."

Ancestry.com. New York, Abstracts of World War I Military Service, 1917-1919 [database on-line]. Provo, UT, USA: Ancestry.com Operations, Inc., 2013. Original data: New York (State). Adjutant General's Office. Abstracts of World War I Military Service, 1917–1919. Series B0808. New York State Archives, Albany, New York. Accessed 8 Jun 2015. Name: Frederick L Gates; Birth Place: Minneapolis, Minnesota; Birth Date: 17 Dec 1886; Service Start Date: 5 Dec 1917; Service Start Age: 30; Residence: 140 W 58 St, NY, NY; Called into active service as: 1st Lt MC (Medical Corps); Remained in MC to discharge; Principal stations: Ft. Riley, Kansas; Army Med. School, Washington DC; Rockefeller Institute, NY; Served overseas: none; Hon. disch. 20 Jan 1919.

"United States Census, 1920," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:MJBL-TFZ : accessed 25 May 2015), Frederick Gates, Manhattan Assembly District 15, New York, New York, United States; citing sheet 10B, family 286, NARA microfilm publication T625 (Washington D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,821,212. Name: Frederick Gates; Gender: male; Age: 33; Marital Status: Married; Race: White; Race (Original): White; Relationship to Head of Household: Head; Relationship to Head of Household (Original): Head; Birth Year (Estimated): 1887; Birthplace: Minnesota; Father's Birthplace: Iowa; Mother's Birthplace: Wisconsin; Household (Role Gender Age Birthplace): Frederick Gates, Head, M, 33, married, Minnesota; parents' birthplace: f:Iowa, m:Wisconsin; Doctor, research wages; Dorothy Gates, Wife, F, 28, married; Michigan; parents' birthplace: f:NY; m: Michigan; occupation: none; Oleott Gates, Son, M, 0 (10/12), New York; parents' birthplace: f:Minn; m:Mich; Anna Bloom, Maid, F, 24, single, Wisconsin; parents' birthplace: Sweden (Swedish); maid, family, wages. Address: 140 West 58th St.; Rental
"New York, State Census, 1925," index, FamilySearch (https://familysearch.org/ark:/61903/1:1:KSCW-4CN : accessed 25 May 2015), Frederick L Gates, Pelham, A.D. 01, E.D. 05, Westchester, New York, United States; from "New York, State Census, 1925," database and images, Ancestry (http://www.ancestry.com : 2012); citing state population census schedules, 1925, p. 2, line 34, New York State Archives, Albany. Name: Frederick L Gates; Gender: male; Age: 38; Nationality: United States; Race: White; Relationship to Head of Household: head; Birth Year (Estimated): 1887; House Number: 1370; Page: 2; Line Number: 35. Address: 1370 Roosevelt Ave. Other household members: Frederick L Gates, head, w, m, 38, US, cit, doctor scientific research, wages; Dorothy O Gates, wife, w, f, 33, US, cit; Alcott Gates, son, w, m, 8, US, cit, school; Barbara Gates, daughter, w, f, 4, US, cit; Frederick F Gates, son, w, m, 2, US, cit; Dorothy Gates, daughter, w, f, 0 (330 days), US, cit; Helen Snitzner, servant, w, f, 23, Germany, alien, housemaker; wages, Greta Junke, servant, w, f, 42, Germany, alien, nurse, wages. Census Date: 1 June 1925.
"United States Census, 1930," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:XQG1-CYZ : accessed 25 May 2015), Frederick L Gates, Cambridge, Middlesex, Massachusetts, United States; citing enumeration district (ED) 0066, sheet 24A, family 438, line 25, NARA microfilm publication T626 (Washington D.C.: National Archives and Records Administration, 2002), roll 917; FHL microfilm 2,340,652. Name: Frederick L Gates; Gender: male; Age: 43; Marital Status: Married; Race: White; Race (Original): White; Relationship to Head of Household: Head; Relationship to Head of Household (Original): Head; Birth Year (Estimated): 1887; Birthplace: Minnesota; Father's Birthplace: New York; Mother's Birthplace: Wisconsin; Household (Role Gender Age Birthplace): Frederick L Gates, Head, M, 43, married, marriage age: 30; Minnesota; parents' birthplace: f:NY; m:Wisconsin; Research, college, own account, employed, veteran, World War; Dorothy O Gates, Wife, F, 39, married, marriage age: 26; Michigan; parents' birthplace: Michigan; Olcott Gates, Son, M, 11, New York; parents' birthplace: f:Minn; m:Mich; Barbara Gates, Daughter, F, 9, New York; parents' birthplace: f:Minn; m:Mich; F Taylor Gates, Son, M, 7, New York; parents' birthplace: f:Minn; m:Mich; Dorothy Gates, Daughter, F, 5, New York; parents' birthplace: f:Minn; m:Mich; Deborah Gates, Daughter, F, 3 (3+10/12), New York; parents' birthplace: f:Minn; m:Mich; Bertha J Jakobsen, Nurse, F, 29, single, Massachusetts; parents' birthplace: Norway; nurse, private family; wages; employed; Penelope Mcdonnell, Waitress, F, 25, single, Ireland; parents' birthplace: Ireland; Immigration yr: 1923, pending citizenship application; waitress, private family, wages, employed; Bridget Faherty, Cook, F, 27, single, Ireland; parents' birthplace: Ireland; Immigration yr: 1923, pending citizenship application; cook, private family, wages, employed. Address: 31 Fayreweather Street. Rental, $250. with radio. All read/write/speak English,
New York Times (New York, NY), 27 June, 1917. Olcott-Gates Engagement. Montclair, N.J., June 2. Announcement has been made here of the engagement of Miss Dorothy Olcott, daugther of Mr. and Mrs. William J. Olcott of Duluth, Minn., and Dr. Frederick L. Gates, son of Mr. and Mrs. Frederick T. Gates of 66 South Mountain Avenue, Montclair. Miss Olcott was graduated from Smith College in the class of 1913, and has just received the degree of Master of Arts from Columbia University. Dr. Gates was graduated from Yale in 1909, and the Medical Department of Johns Hopkins University in 1913. He is an associate of the Rockefeller Institute for Medical Research in New York City, and was recently commisioned [sic] a First Lieutenant in the Medical Section, Officers' Reserve Corps."
Ancestry.com. U.S. Passport Applications, 1795-1925 [database on-line]. Provo, UT, USA: Ancestry.com Operations, Inc., 2007. Accessed 8 Jun 2015. Name: Frederick Lamont Gates; Birth Date: 17 Dec 1886; Birth Place: Minneapolis, Minnesota; Age: 28; Passport Issue Date: 1915; Passport Includes a Photo: Yes; Residence: Montclair, NJ; Occupation: medical research; planned travel: Japan, Korea, China, all to visit medical schools and hospitals. Application sign date: 30 Jun 1915; Description: 5 ft, 7 in.; square forehead, gray eyes, straight nose; straight mouth, pointed long chin, dark brown hair, fair complexion, long face. Residence: 66 So. Mountain Avenue, Montclair, NJ. Identified by Wallace Buttrick, Director of China Medical Board, Rockefeller Foundation, of White Plains, NY, acquaintance of 24 yrs. Attestation: notes Frederick is staff of Rockefeller Institute for Medical Research, appointed by China Medical Board to initiate work in China.
"California, San Francisco Passenger Lists, 1893-1953," index and images, Family Search (https://familysearch.org/ark:/61903/1:1:QV1W-ZPNC : accessed 26 May 2015), Frederick L Gates, 1915; citing San Francisco, San Francisco, California, United States, NARA microfilm publication M1410 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm . Name: Frederick L Gates; Event Type: Immigration; Event Date: 1915; Event Place: San Francisco, San Francisco, California, United States; Gender: Male; Age: 28; Status: Single; Birth Year (Estimated): 1887; Ship Name: Tenyo Maru, sailing from Yokohama, 11 Dec 1915. Occupation noted as 'Phys.'
"New York, New York Passenger and Crew Lists, 1909, 1925-1957," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:KX96-P9Y : accessed 26 May 2015), Frederick L Gates, 1925; citing Immigration, New York, New York, United States, NARA microfilm publication T715 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,755,493. Name: Dorothy O Gates; Event Type: Immigration; Event Date: 1925; Event Place: New York, New York, United States; Gender: Female; Age: 34; Birthplace: Bessemer Mich; Birthdate: 20 Jun 1891; Ship Name: Leviathan; Birth Year (Estimated): 1891. Leaving Southampton, 3 Nov 1925, arriving NYC 10 Nov 1925. Residence: 1370 Roosevelt, Pelham Manor, NY. Traveling with Frederick L. Gates, age: 38, Birthplace; Minneapolis, Minnesota, Birthdate: 17 Dec 1886.
"New York, New York Passenger and Crew Lists, 1909, 1925-1957," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:24FX-235 : accessed 26 May 2015), Frederick L Gates, 1930; citing Immigration, New York, New York, United States, NARA microfilm publication T715 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,756,454. Name: Frederick L Gates; Event Type: Immigration; Event Date: 1930; Event Place: New York, New York, United States; Gender: Male; Age: 43; Birthplace: Minneapolis Minn; Ship Name: Bermuda; sailing from Hamilton, Bermuda, 15 Apr to NYC, 17 Apr 1930. Birth Year (Estimated): 1887. Crossed out, so presumably did not embark.
"New York, New York Passenger and Crew Lists, 1909, 1925-1957," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:24FX-146 : accessed 26 May 2015), Frederick L Gates, 1930; citing Immigration, New York, New York, United States, NARA microfilm publication T715 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,756,458. Name: Frederick L Gates; Event Type: Immigration; Event Date: 1930; Event Place: New York, New York, United States; Gender: Male; Age: 43; Birthplace: Minneapolis Minn; Birthdate: 17 Dec 1886; Residence: 31 Fayeweather St. Cambridge, Mass. Ship Name: Arcadian; Sailing from Bermuda 20 Apr to NYC 22 Apr 1930. Birth Year (Estimated): 1887.

"New York, New York Passenger and Crew Lists, 1909, 1925-1957," index and images, FamilySearch (https://familysearch.org/ark:/61903/1:1:24NW-RFS : accessed 26 May 2015), Frederick Lamont Gates, 1931; citing Immigration, New York, New York, United States, NARA microfilm publication T715 (Washington, D.C.: National Archives and Records Administration, n.d.); FHL microfilm 1,756,671. Name: Frederick Lamont Gates; Event Type: Immigration; Event Date: 1931; Event Place: New York, New York, United States; Gender: Male; Age: 44; Birthplace: United States; Ship Name: Western Prince; Saling from Buenos Aires, 5 Mar to NYC, 27 Mar 1931; Birth Year (Estimated): 1887. Birth: 17 Dec 1886, Minneapolis, Minn.; Passport #2317; Residence: 31 Fairweather St, Cambridge, MA. No other family members.
FindAGrave.com Memorial #35217973, accessed 24 May 2015. Name: Dr Federick Lamont Gates; Event Type: Burial; Event Date: 1933; Event Place: Upper Montclair, Essex, New Jersey, United States of America; Photograph Included: Yes; Birth Date: 17 Dec 1886; Birth place: Minneapolis, Hennepin County, Minnesota, USA; Death Date: 17 Jun 1933; Death place: Cambridge, Middlesex County, Massachusetts, USA; Affiliate Record Identifier: 35217973; Cemetery: Mount Hebron Cemetery, Upper Montclair, Essex County, New Jersey, USA; Inscription: "Frederick Lamont Gates, 1886-1933, Franklin H. Gates, 1888-1945, Russell C. Gates, 1890-1964, William Kent Pudney, 1891-1966, Lois L. Gates, 1901-1988, Marilyn Gates Crandell, 1923-1996, Russell C. Gates, Jr., 1925-2002, (at base) GATES"
See also:
Gates Family Tree, which has a detailed story about Frederick.

Yemen confirms first coronavirus case, braces for outbreak

China Medical Board  controlled and funded by The Rockefeller Foundation since the  The Rockefeller Foundation founded it on 1914

FEBRUARY 16, 2020
China Medical Board Commits US$2 Million to Help China Control the Novel Coronavirus Epidemichttps://chinamedicalboard.org/ 
Since the outbreak of the Novel Coronavirus Pneumonia, the China Medical Board (CMB) has been dedicated in identifying effective and meaningful support to China in consultation with the Chinese government, collaborating institutions in China, and international partners. Two priority areas are identified: to protect front-line medical staff and reduce nosocomial infection and to strengthen longer-term capacity in responding to emerging infectious diseases.


Medicine in China
The China Medical Board (CMB) was created in 1914 as one of the first operating divisions of the Rockefeller Foundation (RF). Provided with a $12 million endowment and separately incorporated as CMB, Inc. when the Foundation was reorganized in 1928, the Board's aim was to modernize medical education and to improve the practice of medicine in China.
Doctors graduating from Peking Union Medical College, Beijing (China), 1947
Surveying China
China was a long-standing interest of both John D. Rockefeller, Sr. (JDR Sr.), and his son. For decades they and their fellow Baptists had supported missionary work in Asia. Beginning in the early 1900s, Frederick Gates encouraged them to devote even more attention to that region. In 1908, five years before the Foundation was created, the Rockefellers funded a commission headed by Edward D. Burton, a University of Chicago professor of theology. He and other educators traveled to China to explore the potential for philanthropic work there. 
In its final report the Burton Commission argued that a Western-sponsored educational program in science and medicine for elite Chinese students could succeed, despite a difficult political climate. One of the first actions of the newly created RF was to organize a conference about China in New York in early 1914. The Foundation later dispatched two additional survey groups, the China Medical Commissions of 1914 and 1915, to gather more information about how such an educational program could operate.  
Following the model established by Abraham Flexner’s survey of U.S. medical education, the 1914 Commission set out to appraise medical education in both missionary and Chinese schools. It found appallingly low standards throughout the country. The report concluded that “the country is so vast, and the resources available for dealing with the problem are so limited as yet, that the need of outside assistance is still very great.”[1] The CMB was formed to meet those challenges, and Wallace Buttrick was named its first director.
The Foundation’s approach to Chinese medical education would inevitably follow the general patterns for reforming U.S. medical education advocated in the 1910 Flexner report and most fully embodied in the Johns Hopkins University School of Medicine. Medical education in China would be scientifically rigorous and adhere to Western standards. And, in a decision with long-term consequences, instruction would occur in English. Consequently, the school could reach only a small, elite percentage of the population. Yet in a country of 400 million people then served by fewer than 500 well-trained doctors, such an approach stood to be criticized. Nevertheless, the CMB set out to build a medical school in China that it hoped to make the equal of Johns Hopkins.
Building for the Future
The RF entered China with an ambitious goal: to build modern medical schools in both Peking and Shanghai. By purchasing the Union Medical College from the London Missionary Society in 1915, the Foundation took its first steps toward that goal. Over the next six years the Foundation assembled a faculty of fifty professors and upgraded and enlarged the facilities of what was soon called the Peking Union Medical College (PUMC). Particular attention was paid to the school’s architecture and campus plan. According to the RF’s 1917 Annual Report, “While the buildings will embody all the approved features of a modern medical center, the external forms have been planned in harmony with the best tradition of Chinese architecture. Thus they symbolize the purpose to make the College not something foreign to China’s best ideals and aspirations, but an organism which will become part of a developing Chinese civilization.”[2]

Snow covered Peking Union Medical College, Beijing (China)
PUMC opened its doors in 1919, under the de facto directorship of Roger S. Greene, resident director of CMB. The 70-acre campus would ultimately encompass more than 50 buildings, including a hospital, classrooms, laboratories, and residences. But in New York Rockefeller officials grew concerned about the mounting costs of PUMC and were soon forced to scrap their plans for Shanghai. From an initial construction estimate of $1 million in 1915, expenses ballooned to $8 million in capital expenditures by 1921. The operating budget more than doubled between its first year of operation and 1921. Nevertheless, the medical school and its new campus were deemed worth celebrating. John D. Rockefeller, Jr. (JDR Jr.) led an impressive delegation to China for the 1921 dedication ceremonies.
PUMC’s initial contributions toward the improvement of medicine in China, though consequential, were inevitably limited in scale. Its graduating classes were small, in part because its standards remained high and its curriculum at the outset was exclusively in English. Between 1924 and 1943, PUMC produced only 313 doctors, more than half of whom would continue their studies abroad through CMB fellowships. Upon their return many of these doctors ultimately became leaders in medical administration, teaching and scientific research both before and after the Chinese Revolution.
PUMC also transformed the nursing profession in China. When PUMC opened, there were fewer than 300 trained nurses in the country, many of them affiliated with various missionary organizations and most of them male. Because the Chinese had never considered nursing to be an appropriate profession for women, the task of PUMC was both to train qualified women nurses and to elevate the status of the profession. Those responsibilities fell to a twenty-eight-year-old nurse from Johns Hopkins, Anna D. Wolf. She arrived in 1919 to create a training program for nurses and to organize the hospital’s nursing staff. Recruiting her initial faculty from the best U.S. nursing schools, she devised pre-nursing and nursing curricula. Within five years she established a school capable of meeting U.S. accrediting standards.[3]   

Peking Union Medical College Nursery, Beijing (China)
The RF’s Annual Report had been clear from the beginning about the CMB’s ambitions for PUMC: “It is the purpose and hope of the China Medical Board to co-operate with the various existing agencies in the gradual and orderly development of a system of scientific medicine in China.”[4] But some staff members at PUMC believed the school’s primary task was the more urgent health needs of the Chinese people.

John Grant, a professor of public health at PUMC from 1921 to 1934, sought to offer medical services beyond the campus walls. He collaborated with the city’s police in 1925 to create a public health station serving the 100,000 people living in Peking’s first ward, the neighborhood surrounding PUMC. As Grant knew, the station also provided learning opportunities for students at the university. He persuaded his faculty colleagues that PUMC students should spend a four-week rotation there.  
Grant's interest in pursuing broader public health work in rural areas found responsive allies in New York. Selskar Gunn, who had worked with the International Health Division in Eastern Europe before joining RF's Division of the Social Sciences, traveled to China in 1931 to assess the Foundation's work. While there he met Yan Yangchu (known to his American associates as Jimmy Yen), a pioneer in mass education and leader of the Rural Reconstruction Movement, with which Grant was already working.  After several trips to China, Gunn produced a report that envisioned a coordinated program of basic education, health, and economic development.
Gunn was critical of PUMC and of RF's and CMB's disproportionate investment in it. By 1933 almost $37 million had been spent on an institution that would never solve China’s most pressing health problem: the severe shortage of trained medical personnel. A 1931 League of Nations Health Organization survey had concluded that China would need 50,000 physicians in order to have just one doctor per 8,000 people.

Few as they were, the cadre of professionals produced by PUMC would play important roles in shaping China’s health system. In 1946 an observer wrote to Raymond Fosdick, commenting on the small number of PUMC graduates. “Both doctors and nurses are in positions of leadership and many of them are effective in leadership…we found plenty of evidence that this small group had had an influence quite out of proportion to its size.”[5]
But many in China had expected more. A Chinese Ministry of Education assessment of PUMC in the mid-1930s urged not only that enrollment be increased but also that more classroom instruction be in Chinese. Other recommendations soon followed: increase the courses in public health, parasitology, and bacteriology; teach Chinese medical terminology; and publish papers in both Chinese and English so that they would reach a larger audience.
Henry Houghton, who had directed PUMC during its formative years in the 1920s, returned in 1934 to address these criticisms. But by the mid-1930s relations with some departments of the Chinese government had soured. Tensions between the New York office and PUMC had led to the firing of Roger Greene, and there were continuing difficulties in transforming PUMC into a more fully Chinese institution. By 1937 Houghton and his colleagues were making substantial moves toward bilingual instruction, reducing the numbers of Western faculty, and placing Chinese professors in positions of departmental leadership. Plans for a graduate medical school were also under discussion with the Ministry of Education, but the Japanese invasion in 1937 interrupted this work.

Surviving War and Revolution
A 1938 memorandum summarized the devastating impact of the war on medical training. “The effect of the war on Medical Education is almost incomprehensible. Only 5 of the 33 medical, pharmacy and dental colleges existing before the war continue unaffected. The remainder have either been suspended destroyed or forced to remove, in instances thousands of miles. This is an almost complete national disruption.”[6]
At PUMC limited teaching continued for a time even though some prominent faculty and staff fled in 1937 to southwest China to assist with war-related training and rural health programs. The school closed completely only after the U.S. declaration of war on Japan in December 1941. The Japanese occupied the grounds of PUMC, imprisoning Houghton for the war’s duration. Heroically, the nurses moved their school in its entirety to Chengdu and reopened there in 1942.  
PUMC resumed limited operations in 1947, but RF staff debated the Foundation’s role as nationalist and Communists factions fought for supremacy. Could they stay above the fray and continue their work? What was the Foundation’s role likely to be as a new political order took shape? Alan Gregg saw that Communism, which in the U.S. represented a challenge to capitalism, meant something else to the Chinese. Communism in China battled a feudal order. He concluded that this “puts American aid in combating Chinese Communism into some odd attitudes and curious commitments.”[7]
In 1947, amid the uncertainty about PUMC's future, the Foundation made a terminal grant of $10 million to the CMB. But in 1951 the People’s Republic of China nationalized PUMC and severed ties with the RF and CMB, Inc.
Between 1915 and 1951, the RF and CMB, Inc. spent well over $50 million on medical initiatives in China, nearly $45 million of it to establish PUMC. Other missionary hospitals benefited from smaller Foundation contributions. Fellowships helped doctors and nurses to travel abroad for advanced training. Medical texts were translated, and medical libraries were built. But the greatest RF legacy was PUMC and the enduring contributions its graduates have made to China's health system. PUMC's buildings, dedicated in 1921, still stand in the center of Beijing. A bust of JDR Sr. greets visitors to PUMC’s auditorium. The hospital still ranks as one of China’s most advanced. Today, the Chinese Academy of Medicine operates from the campus.

[1] Internal Memorandum, The Rockefeller Foundation, March 7, 1915, Rockefeller Archive Center (RAC), RG 2, Family Records, Series O, Box 11, Folder 92.
[2];The Rockefeller Foundation, Annual Report 1917 (New York: The Rockefeller Foundation, 1917) 224. (Link to PDF on Rockefeller Foundation Website)
[3] Mary Brown Bullock, The Oil Prince’s Legacy (California: Stanford University Press, 2011) 58-59.
[4] The Rockefeller Foundation, Annual Report 1919 (New York: The Rockefeller Foundation, 1919) 260. (Link to PDF on Rockefeller Foundation Website)
[5] Letter from C. Sidney Burwell to Raymond B. Fosdick, September 4, 1946, RAC, RG1, Series 601, Box 2, Folder 15.
[6] Memorandum from John B. Grant to Selskar Gunn, November 11, 1938, RAC, RG 1, Series 601, Box 3, Folder 26.
[7] Letter from Alan Gregg to Raymond Fosdick, July 2, 1946, RAC, RG1, Series 601, Box 2, Folder 15.

Natalya and Lacey Evans battle it out in WWE's Crown Jewel event at King Fahd International Stadium, Riyadh, Saudia Arabia. [File: Ahmed Yosri/Reuters]

Frederick Taylor Gates who was a senior director and advisor for the Rockefeller Foundation, has been accused of injecting vaccines into US Soldiers taken from blood from horses who had a serious lung infectiomn disease.

It is suggested by researches that injecting vaccines into US Soldiers taken from blood from horses who had a serious lung infectiomn disease. helped cause the Spanish Flu Pendemic that killer 50 to 100 million people.

​Frederick Taylor Gates (July 22, 1853, Maine, Broome County, New York – February 6, 1929, Phoenix, Arizona) was an American Baptist clergyman, educator, and the principal business and philanthropic advisor to the major oil industrialist John D. Rockefeller, Sr., from 1891 to 1923.[1]

​On January 21, 1889, Gates met the lifetime Baptist, John D. Rockefeller, Sr. He proved to be central to the suggestion and subsequent design of the funding plans for the creation by Rockefeller, Sr. of the Baptist University of Chicago; he subsequently served for many years as a trustee on its board.[1

Gates then became Rockefeller's key philanthropic and business adviser, working in the newly established family office in Standard Oil headquarters at 26 Broadway, where he oversaw Rockefeller's investments in a series of investments in many companies but not in his personal stock in the Standard Oil Trust.
From 1892 onwards, faced with his ever expanding investments and real estate holdings, Rockefeller Sr. recognized the need for professional advice and so he formed a four-member committee, later including his son, John D. Rockefeller, Jr., to manage his money, and nominated Gates as its head and as his senior business adviser. In this capacity Gates steered Rockefeller Sr. money predominantly to syndicates arranged by the investment house of Kuhn, Loeb & Co., and, to a lesser extent, the house of J. P. Morgan.[3]

Gates served on the boards of many companies in which Rockefeller had a majority shareholding; the latter then held a securities portfolio of unprecedented size for a private individual. Although Gates is recognized today as a philanthropic advisor, Rockefeller himself regarded him as the greatest businessman he had encountered in his life, skipping such prominent figures of the time as Henry Ford and Andrew Carnegie.[4]
When he ceased being a business advisor to Rockefeller in 1912, Gates continued to advise him and his son, John D. Rockefeller, Jr., on philanthropic matters, at the same time serving on many corporate boards. He also served as president of the General Education Board, which was subsequently merged into other Rockefeller family institutions.[5]
Gates focused exclusively on philanthropy after 1912. He moved Rockefeller from doling out retail sums to specific recipients to the wholesale process of setting up well-funded foundations that were run by experts who decided what topics of reform were ripe. In all Gates supervised the distribution of about $500 million. Although Rockefeller himself believed in folk medicine, the billionaire listened to his experts, and Gates convinced him that he could have the greatest impact by modernizing medicine especially by reforming education, sponsoring research to identify cures, and systematically eradicating debilitating diseases that sapped national efficiency like hookworm.
In 1901, Gates designed the Rockefeller Institute for Medical Research (now Rockefeller University), of which he was board president. He then designed the Rockefeller Foundation, becoming a trustee upon its creation in 1913. Gates served as president of the General Education Board, which became the leading foundation in the field of education.[6]
By 1912, however, John D. Rockefeller, Jr. was taking control of philanthropic policies, with Gates slipping to second place. Although Gates never quite lost his religion,[7] he began shifting the direction from religious charities to decidedly more secular pursuits like medical research and education. Gates designed the China Medical Board (CMB) in 1914. Rather than viewing China through the traditional missionary lens of millions of heathens to be converted, Gates placed his faith in science. He complained the missionaries in China were trapped in the "bondage of tradition and an ignorance and misguided sentiment in the supporting churches."[8] They had made few converts and fumbled the opportunity to spread Western science. There were hundreds of medical missionaries but they linked Western medical "miracles" to the teachings of Christianity. Instead of focusing on preventive health, they urged sick and dying patients to convert. Gates planned to take over the Peking Union Medical College and retrain missionaries there.Working at the intersection of philanthropy, imperialism, big business, religion, and science, the China Medical Board was his last major project.
In 1924, Gates overreached, asking the Rockefeller Foundation Board to invest $265 million in the China Medical Board. The fantastic sum would make Chinese medical care the finest in the world and would eliminate denominationalism influence from the practice of medicine and charity work in China. The Board refused and Gates became a victim of his own progressive emphasis on the "rule of experts." The experts on China and medicine disagreed with him, and he was marginalized, causing his resignation from the CMB.[9]

Gates was a progressive and committed to the Efficiency Movement. He looked for leverage whereby a few millions of dollars would generate significant changes, as in the creation of a new university, the eradication of hookworm because it reduced efficiency or the revolution in hospitals caused by the Flexner Report.[10]

March 30, Tunisian citizens gathered to protest against the lockdown and to claim the financial aid [File: Fethi Belaid/AFP]

Intelligence officials weigh possibility coronavirus escaped from a Chinese lab
Jenna McLaughlin
National Security and Investigations Reporter
Yahoo News•April 14, 2020


WASHINGTON — Although the the U.S. intelligence community early on dismissed the notion that the coronavirus is a synthesized bioweapon, it is still weighing the possibility that the pandemic might have been touched off by an accident at a research facility rather than by an infection from a live-animal market, according to nine current and former intelligence and national security officials familiar with ongoing investigations.
After extensive research, scientists in the U.S. and elsewhere have determined that the new strain of the coronavirus discovered in China in December is, as Chinese officials have maintained, of natural origin, but they are taking seriously that its route to human infection may have started in a lab in Wuhan. 

“It’s definitely a real possibility being bandied about at the high levels of the administration,” said one of the sources, who has knowledge of China and national security.
“We are actively and vigorously tracking down every piece of information we get on this topic and we are writing frequently to update policymakers,” an intelligence official told Yahoo News. The intelligence community “has not come down on any one theory.”

While Chinese officials were quick to link the origin of the disease to infected animals at the Wuhan Seafood Market, which was formally closed on Jan. 1, scientists have not traced the initial exposure back to any specific animals. Therefore, an alternative possibility remains — that a natural virus sample being studied at a research laboratory in Wuhan infected a researcher who spread it in the community, or it escaped via hazardous waste or a lab animal.  
There are reasons to be wary of that theory. It may serve as a propaganda tool for politicians who want to fan tensions with China, and many scientists still argue that a natural outbreak is the most likely possibility, dismissing any alternative theory. But finding the source of the outbreak could also be vital in understanding how it spread and how to prevent the next potential pandemic.
In December, Chinese health officials began to publicly worry that the mysterious cluster of pneumonia patients in Hubei province might be a sign of something ominous. On Dec. 31, the Wuhan Municipal Health Commission formally notified the World Health Organization’s country office in China about the worrying trend.

Since those initial reports, more than a million people around the world have tested positive for the new, highly infectious strain of coronavirus and its resulting disease, COVID-19. More than 100,000 have died.
According to multiple news outlets, the intelligence community was gathering information on the outbreak as early as November. By the new year, the White House was being briefed on the potential that the virus would spread globally. Chinese officials were hiding some of the details, intelligence officials said, but they feared things could get much worse. President Trump, however, waited until March to recommend nationwide extreme social distancing measures to slow the outbreak. 

While the severity of the potential pandemic wasn’t understood back in November and early December, sources tell Yahoo News there has been intense internal interest in the source of the outbreak. While the intelligence community is not discounting a range of potential transmission vectors, including contact between humans and animals, officials are seriously pursuing the possibility that a natural sample of the virus escaped a laboratory. 
“It’s absolutely being looked at very closely at the highest levels,” said one intelligence source with knowledge of the investigations. The British government is reportedly considering the same possibility. 
One reason for the suspicion is the lack of information coming from China. Beijing’s quick denials of involvement, and the decision to immediately identify the Wuhan Seafood Market as the source, raised eyebrows among some U.S. intelligence officials.
“I find it very funny that China very quickly blamed the market,” said one recently retired intelligence official. 
The Chinese government did not respond to multiple requests for comment made through its foreign ministry and its embassy in the U.S. 
In fact, some of the very first cases of COVID-19 were not linked to the market, and there are a number of important research institutions in Wuhan where infectious diseases are studied.
Those include the Wuhan National Biosafety Lab, the first publicly acknowledged lab with the highest biosafety standards; the Wuhan branch of the Chinese Centers for Disease Control and Prevention; and the Wuhan Institute of Virology, home to one of the world’s top research groups on bat coronaviruses, where scientists have studied thousands of samples.
The Wuhan Institute of Virology, which collaborates with researchers and institutions around the world, including the U.S. National Institutes of Health, is a key site for the Global Virome Project, a global initiative focused on preventing the next pandemic by researching DNA and RNA of viruses in animals that could potentially infect humans. While that group does not typically work with intact virus samples, according to David Relman, a microbiologist at Stanford University, “it is possible” that the researchers could have collected a virus sample from a bat and been researching it within the lab. 

The new virus’s genome most closely resembles a bat coronavirus discovered in July 2013 in Yunnan province in China, information made public by the Wuhan Institute of Virology only on Jan. 23 of this year. The progenitor of the current virus, says Richard Ebright, a molecular biologist at Rutgers University, could be either the 2013 bat sample or another bat coronavirus that is closely related and hasn’t been discovered or disclosed as of today. 
Not all scientists agree with this possibility. Writing in Nature, a team of five scientists argued that the new virus, SARS-Cov-2, emerged too recently to have been identified, isolated from other virus samples, cultured and then accidentally released from a lab. Because there is so much variety in types of coronavirus in bats and other species, virus specimens are “massively under-sampled,” wrote the authors, making it less likely Chinese researchers discovered this specific strain. “We do not believe that any type of laboratory-based scenario is plausible,” they concluded.
However, even Chinese researchers initially pointed to the possibility of a lab accident in a study published in February on ResearchGate. “The killer coronavirus probably originated from a laboratory in Wuhan,” wrote researchers — although they also raised the possibility of natural transmission. “Safety level may need to be reinforced in high risk biohazardous laboratories,” continued Botao Xiao and Lei Xiao of Guangxhou’s South China University of Technology. Botao Xiao later withdrew the paper, telling the Wall Street Journal he did not have evidence for his theories. 

Two Chinese universities recently posted online notices placing restrictions on publishing academic research on the origins of the coronavirus, though those have since been removed from the internet. 
Public videos and articles have revealed poor safety standards on the part of some Wuhan researchers, including being exposed to bat urine and failing to wear proper protective equipment. Additionally, there have been incidents of SARS samples escaping from Chinese labs in the past.

Retired Air Force Brig. Gen. Robert Spalding, a senior fellow at the Hudson Institute and a former National Security Council official who worked on China issues in the Trump administration, told Yahoo News he believes a lab accident is a “definite possibility.”

“They have had prior accidental releases of the SARS virus. Also it seems the bats were not local to Wuhan. I do not know if the US government is looking into this,” he wrote in an email. But if the Wuhan National Biosafety Lab scientists were dabbling in potentially dangerous research, “Beijing would not want to call attention to [it],” he concluded.
Zheng-Li Shi, who leads the group studying bat coronavirus samples at the Wuhan Institute of Virology, published a paper in 2016 in the Journal of Virology detailing experiments on two bat coronaviruses with features needed for human infections. According to the paper, the scientists maintained biosafety level two standards while conducting the research, which is in line with the international standards for coronavirus samples except for SARS and MERS. 

There are four different biosafety levels. Level four is reserved for the most dangerous and infectious diseases, such as Ebola. Under biosafety level two, samples are considered “moderate-risk,” according to the CDC, leading to minimal requirements for hand-washing sinks, automatically locking doors and methods to decontaminate waste. 
Those standards may have been inadequate for coronavirus samples, experts argue.
“Virus collection, culture, isolation, or animal infection at BSL-2,” given the infectiousness of the coronavirus, “would pose a high risk of accidental infection of a lab worker, and from the lab worker, the public,” wrote Ebright in an email to Yahoo News. 

Ebright is one of many scientists who have pushed the global community to improve its handling of dangerous pathogens, a problem not just for China but for labs worldwide. USA Today in 2015 conducted a wide-ranging investigation of accidents, safety violations and potential disasters in U.S. labs, and found problems ranging from infected lab mice escaping to failures with protective gear. 

Relman, who has advised the government on emerging infectious diseases, told Yahoo News that whether the virus escaped from a lab or not — something he personally views as less likely — he hopes the pandemic will spur higher lab safety standards worldwide. “Standards are not clear enough, not uniformly practiced, and are not keeping up with advances in biological technologies — which, in theory, allow many more people to experiment with these viruses,” he wrote.

The possibility that the pandemic originated in a lab was first discussed publicly in mid-February as China hawks and Trump allies began to push the bioweapon angle. The New York Times reported that the main proponent of the lab accident theory is President Trump’s deputy national security adviser, Matthew Pottinger, a former Wall Street Journal reporter in China with a reputation for hawkish views on Beijing. Pottinger, through an NSC spokesperson, declined to comment. 

Republican Sen. Tom Cotton of Arkansas publicly promoted a range of theories, including that the virus could have been a “deliberate release” or an “engineered bioweapon” that was accidentally leaked. However, Cotton, who sits on the Senate Intelligence Committee, also noted that the culprit could have been “good science, bad safety” or a mistake made in the course of honest research on “diagnostic testing or vaccines.”

Current and former intelligence officials familiar with internal briefings declined to provide details but noted the lab accident theory being promoted by Cotton may not be so crazy. “Tom Cotton is presenting some useful stuff there,” said one recently retired intelligence official when asked about the theory.
Another former intelligence official in touch with current officials told Yahoo News that Trump began calling the virus the “Wuhan virus” after intelligence briefings he received on its origin. Critics said this term, which is not used by the scientific community, was bolstering xenophobic attacks on Asian-Americans and Asians worldwide at a time when international cooperation is required to investigate the outbreak.  

The possibility that the virus leaked during a lab accident “is being seriously considered” within the U.S. government, according to another recently retired senior national security official, who pointed to the State Department’s 2019 compliance report on arms control, nonproliferation and disarmament. The report notes that Chinese officials have failed to reassure inspectors they are obeying the Biological Weapons Convention, including by not providing information about research on “numerous toxins with potential dual-use application.” 
The State Department did not respond to requests for comment on whether compliance concerns extend to potential lab accidents of dangerous virus samples. But in late March, Yahoo News reported that the FBI detected samples of the SARS virus and flu in Chinese scientists’ luggage, presenting a “biosecurity risk” for both deliberate acts of terrorism and potential accidents during research.

According to the Washington Post, U.S. State Department employees visited the Wuhan virology lab in 2018 and sent a cable back home listing safety concerns about the lab’s bat coronavirus studies. Similar concerns were presented about the Wuhan National Biosafety Lab in 2017, though writers at the prestigious scientific journal Nature have since appended a notice arguing that their reporting on past safety concerns should not be used as evidence that a lab accident led to the 2020 pandemic. 

Sources declined to discuss any evidence, if it exists, that points to a potential lab accident, but the intelligence community is not ruling it out. 

“Absent a credible whistleblower or verified primary communication intercept, it will not be possible to prove the origins with certainty,” said Relman, the Stanford microbiologist. “However, with more relevant data, the likelihood of a natural virus versus accidental origin can be strengthened or diminished.”

One former senior CIA official said that if the virus did originate from a Chinese research institution, the U.S. intelligence community will eventually be able to prove it. “There will be disaffected Chinese sources,” the former official said. 
“Disasters are good for us,” the former CIA official continued. “The crappier the regime, the better it is to recruit sources there.”
Hunter Walker contributed reporting to this story.
Sen. Tom Cotton of Arkansas. (Nicholas Kamm/AFP via Getty Images) 
 Dr. Doreen Muth of Germany's Bonn Faculty of Medicine working in a biosafety lab in 2013. (Wolfgang Rattay/Reuters)

Medical staff outside the Jinyintan Hospital, Wuhan, in January. (Reuters/Stringer)  
A technician works to produce vaccines for the H1N1 flu virus at a lab in Wuhan, China, in June 2009. (Reuters/China Daily) 

In China, Coronavirus Shows Alarming Signs Of Resurgence | TODAY#China #Coronavirus #TodayShow  
1,969,783 views •Apr 14, 2020
China is reporting an alarming spike in new case of COVID-19 – and that has other countries worried about the unpredictability of the coronavirus. TODAY senior international correspondent Keir Simmons reports from London. » Subscribe to TODAY: http://on.today.com/SubscribeToTODAY » Watch the latest from TODAY: http://bit.ly/LatestTODAY About: TODAY brings you the latest headlines and expert tips on money, health and parenting. We wake up every morning to give you and your family all you need to start your day. If it matters to you, it matters to us. We are in the people business. Subscribe to our channel for exclusive TODAY archival footage & our original web series. Connect with TODAY Online! Visit TODAY's Website: http://on.today.com/ReadTODAY Find TODAY on Facebook: http://on.today.com/LikeTODAY Follow TODAY on Twitter: http://on.today.com/FollowTODAY Follow TODAY on Instagram: http://on.today.com/InstaTODAY Follow TODAY on Pinterest: http://on.today.com/PinTODAY #China #Coronavirus #TodayShow In China, Coronavirus Shows Alarming Signs Of Resurgence | TODAY
CategoryNews & Politics

Discovery and characterization of the 1918 pandemic influenza virus in historical context
Discovery and characterization of the 1918 pandemic influenza virus in historical contextJeffery K Taubenberger,* Johan V Hultin, and David M Morens
Author information Copyright and License information Disclaimer
See other articles in PMC that cite the published article.
The 2005 completion of the entire genome sequence of the 1918 H1N1 pandemic influenza virus represents both a beginning and an end. Investigators have already begun to study the virus in vitro and in vivo to better understand its properties, pathogenicity, transmissibility and elicitation of host responses. Although this is an exciting new beginning, characterization of the 1918 virus also represents the culmination of over a century of scientific research aiming to understand the causes of pandemic influenza. In this brief review we attempt to place in historical context the identification and sequencing of the 1918 virus, including the alleged discovery of a bacterial cause of influenza during the 1889–1893 pandemic, the controversial detection of ‘filter-passing agents’ during the 1918–1919 pandemic, and subsequent breakthroughs in the 1930s that led to isolation of human and swine influenza viruses, greatly influencing the development of modern virology.
The announcement in 2005 that a virus causing fatal influenza during the great influenza pandemic of 1918–1919 had been sequenced in its entirety [1], in the laboratory of co-author JKT, has prompted renewed interest in the 1918 virus. The ongoing H5N1 avian influenza epizootic, and the possibility that it might also cause a pandemic [2], increase the importance of understanding what happened in 1918. However, in reviewing the scientific approach to unlocking an old puzzle, it is important to note that the sequencing of the 1918 virus took place after more than century of exhaustive and sometimes disheartening efforts to discover the cause of influenza (Figure 1). Indeed, the influenza search not only pre-dated the great pandemic of 1918, but also attracted the efforts of some of the greatest researchers of the 19th and 20th centuries. Along the way, the new fields of bacteriology and virology were advanced, and a productive marriage between microbiology, epidemiology and experimental science began. In describing here the 10-year effort (1995–2005) to sequence the genome of the 1918 pandemic influenza virus, we attempt also to place it within this important historical perspective.Open in a separate window
Figure 1
A timeline of key dates in the history of influenza occurrence and characterization

Framing influenza as a clinical and epidemiological entity
In the pre-microbiological era (before 1876) there was much confusion about the causes of both the common communicable diseases like colds, smallpox, and measles, and the great epidemic diseases like cholera and plague. Epidemiological notions of carriers and intermediate vectors were not easily envisioned, preventing many observers from accepting a unified concept of infectious diseases, some of which were directly transmissible from person to person (for example, smallpox), others of which were acquired from intermediate vector hosts (for example, plague), still others of which were acquired from contaminated environmental sources (for example, cholera) or were acquired by more than one of the mechanisms just noted (for example, smallpox and cholera).
In the pre-microbial era, influenza had been considered among the more confusing of the pandemic diseases for several reasons: (i) the signs and symptoms were non-specific, leading to confusion with other conditions; (ii) interpandemic influenza-like illnesses were often attributed to other upper respiratory infections (URIs), fuelling ongoing debates about whether interpandemic influenza existed at all, or whether URIs were the same thing as interpandemic influenza; (iii) pandemics occurred sporadically and unpredictably, prompting debates about whether a new influenza-like disease was the same as the one seen decades ago; and (iv) mortality statistics, which began to appear in developed nations in the mid-1800s, showed high mortality only for the first year or two of a pandemic, seeming to support the belief that interpandemic influenza did not occur.
Each of four major influenza pandemics before 1918, however, incrementally advanced scientific understanding of the disease. The 1781–1782 pandemic evolved so rapidly, and was so widespread, that explosive outbreaks of febrile respiratory illness in the general population alone became a distinguishing characteristic, supporting the notion of a specific disease entity. The 1789–1799 pandemic, coming soon thereafter, emphasized this recently learned lesson. The 1830–1833 pandemic, though less impressive, arrived at about the same time as the second cholera pandemic (1831–1833), of which the inevitable march toward Europe was followed for over a year in the daily newspapers, helping to establish a deep popular epidemiological concept of pandemic diseases. The influenza pandemic of 1847–1851 nearly coincided with the next (third) cholera pandemic (1849–1855): this was the pandemic in which British epidemiologist John Snow (1813–1858) first characterized the epidemiology and waterborne transmission of cholera [3]. The 1847–1851 influenza pandemic was also the first to occur in an era of national vital statistics: the British disease registry, set up in 1836, was able to characterize the general epidemiological pattern of influenza mortality for the first time.
After the 1847–1851 pandemic, however, there was little recognizable influenza in succeeding decades, and little evidence in the mortality records that people in the expected risk age groups, infants and the elderly, were dying from any respiratory disease. If not forgotten, pandemic influenza became by the late 1880s a curious memory related by elder physicians to young medical students and house staff. Then, in 1889, the most explosive and widespread influenza pandemic up to that time appeared suddenly and returned with uncharacteristic perseverance for several years thereafter, causing as many as five successive annual mortality peaks between 1889 and 1894 [4]. However, the 1889 pandemic (now thought to have been caused by an influenza A virus with an H3 subtype haemagglutinin [HA], as determined by archaeserology [5] and supported by recent archaevirology; see below) also occurred in an era ready to study it scientifically. By that time virtually all developed nations had vital statistics systems in place, and thus the levels and pattern of mortality could be documented. More importantly, biomedical research had just entered the microbiological era [6]. By 1889, in the middle of an age of great scientific excitement and progress, researchers were ready to apply their experiences to discovering the cause of an important disease, influenza, for which there had been no clinical material available for nearly 35 years.
A reputed cause of influenza identified in 1892
It was in 1892 that the venerated physician/bacteriologist Richard Friedrich Johannes Pfeiffer (1858–1945), in partnership with physician/bacteriologist Shibasaburo Kitasato (1852–1931), both working in Berlin under Robert Koch (1843–1910), reported the discovery of a new bacterium [7], which Kitasato was able to cultivate and sustain on artificial media [8], and which both scientists claimed to be the cause of pandemic influenza. When their initial, brief, 1892 report was followed up by more extensive data in 1893 [9], the scientific world was taken by storm; it seemed to many that Pfeiffer had taken all of the necessary steps to establish Bacillus influenzae, as he called it, as the true aetiological agent of influenza. (B. influenzae was usually referred to as ‘Pfeiffer’s bacillus’ in the literature of the late 19th and early 20th centuries, and is now known as Haemophilus influenzae).
However, although B. influenzae was clearly a pathogenic organism, and was often cultured from fatal cases of influenza, other investigators were unable to confirm Pfeiffer’s strong association, a problem compounded by the apparent disappearance of pandemic influenza within a year or two of Pfeiffer’s discovery. The verdict was unclear, but the notion that B. influenzae was the true cause of influenza persisted up to the time of the next pandemic in 1918 (see below), when Rockefeller scientists Peter Kosciusko Olitsky (1886–1964) and Frederick L Gates (1886–1933) provided strong evidence against a causal association, documenting that the infective influenza agent survived passage through filters that excluded B. influenzae [10].
Despite this bacterial blind alley, it is important to note that most of the deaths during the 1918–1919 influenza pandemic were associated with secondary bacterial invaders (for review of clinical and pathological features of the 1918 pandemic see [11]), among them H. influenzae, which Pfeiffer had discovered. Pfeiffer, a budding 38-year-old researcher at the time of his discovery, went on to have a long and distinguished career as an originator of typhoid vaccination, the discoverer of bacteriolysis (‘Pfeiffer’s phenomenon’), a conceptualizer of endotoxin, the discoverer of the pathogenic organism Micrococcus (now Moraxella) catarrhalis, and a tropical disease investigator of plague (in India) and malaria (in Italy; [12–14]). Kitasato, who had already discovered the cause of tetanus (1889) and had co-developed, with Emil von Behring (1854–1917), both tetanus and diphtheria antitoxins in 1890 [15,16], went on to co-discover the bacterial cause of plague in 1894 [17], and to support his protégé Kiyoshi Shiga (1871–1957) in elucidating the cause of shigellosis in 1898.
Interpandemic advances in virology (1892–1918)
The field of virology can be said to have been born in 1892, the same year in which Pfeiffer published his claim for B. influenzae as the cause of influenza [7]. Before that time the word virus had for many decades been used non-specifically to describe a hypothetical communicable agent, without denoting any particular size, morphology or physical characteristics. By the 1890s most communicable diseases were assumed to be caused by bacteria, and establishing causality required culturing them on artificial media. In the 1880s Louis Pasteur (1822–1895) had failed to isolate the causative agent of rabies, but when an effective vaccine was produced few doubted that rabies was caused by a bacterium that, for whatever reason, had not yet been cultivated. Then, in 1892, the young Russian botanist Dmitrii Ivanovski (1864–1940) showed that tobacco mosaic disease was caused by an unseen agent that passed through filters with pores too small to admit bacteria [18]. Six years later, in 1898, the Dutch botanist/microbiologist Martinus Willem Beijerinck (1851–1931) showed that this agent could be serially passed in a manner that indicated it was a replicating agent, with replication occurring only in living plant tissue [19]. Presciently, Beijerinck speculated on the existence and mechanism of replication of what we now call viruses, writing that ‘the contagium, in order to reproduce, must be incorporated into the living protoplasm of the cell, into whose reproduction it is, in a manner of speaking, passively drawn’ [20].
By the turn of the 19th/20th century, Chamberland and Berkfeld filters were being manufactured and used in research laboratories, allowing microbiologists to filter infectious fluids to remove bacteria that were presumably too large to pass through their pores. Using this technology, a variety of ‘filter-passing’ agents were identified in short order, including the agents of foot and mouth disease of cattle (1897–1898; [21,22]), bovine pleuro-pneumonia [23], rabbit myxomatosis [24], and African horse sickness (1900, [25]). An ever-increasing number of filter-passing agents were soon linked to many other plant, animal and human diseases: in 1903 Émile Roux (1853–1953) counted nine of them [26] and by 1906 Paul Remlinger (1871–1964) had raised the number to 18 [27].
However, the situation was complicated by the discovery that not all filter-passing agents were uncultivatable in bacterial media. The agent of bovine pleuro-pneumonia, for example, was cultivated early on (it is now known to be a mycoplasma). In 1917, George B Foster Jr claimed that a filter-passing agent caused the common cold, even though he simultaneously cultivated ‘minute coccoid bodies’ and had to admit that he could not distinguish between these bodies and an ‘ultramicroscopic’ (undetected) virus as the true cause [28]. On the eve of the 1918 influenza pandemic, distinct concepts of viruses and bacteria as separate and fundamentally different infectious entities were not yet mature. According to historian Lise Wilkinson, this problem ‘delayed… the virus concept in the first decades of the [20th] century’ [20], and it undoubtedly complicated the picture when the 1918 pandemic appeared.

Advances in understanding avian influenza
At the time of the 1918 influenza pandemic, no-one suspected that the cause of the human disease was derived from an avian infectious agent. Strong associations between some human influenza epidemics and equine epizootics in the 19th century [29] had been noted, but a human–swine influenza link had not been established, and indeed was not to be noted until the detection of swine epizootics in China and the United States during the autumn 1918 wave of the influenza pandemic [30,31]. Highly pathogenic avian influenza (then called ‘fowl plague’) had been recognized as a disease entity since 1878 [32], but was not well known to physicians or biomedical researchers. Between 1901 and 1903, Italian and Austrian researchers, working independently, identified filterable agents as the cause of avian influenza [33–35]. (Of unexpected importance, one team even noted that epizootics in domestic chickens were associated with epizootics of pneumoenteritis in pigs, transmission of disease to pet birds, and onward from pet birds to humans [35]. It is also interesting to note, in light of contemporary concerns about the spread of H5N1 avian influenza [2] that a 1901 Austrian epizootic in domestic chickens had been linked to importation of pet birds from Italy [33].) Schäfer identified fowl plague virus as influenza A in 1955 [36]. Additional avian influenza A viruses were identified in the 1960s [37]. Webster and colleagues proposed that pandemic influenza viruses might be related to avian influenza viruses in 1967 [38]. Slemons isolated influenza A viruses from wild ducks in 1974 [39], and it is now generally agreed that wild aquatic birds are the natural reservoir for influenza A viruses (reviewed in [40]).
Research efforts to identify the cause of the 1918–1919 pandemic
As noted, at the time of the 1918 influenza pandemic, biomedical thinking about influenza was dominated by Richard Pfeiffer’s 1892 claim that B. influenzae was its cause [7]. Indeed, in 1918 Pfeiffer was still active and vocal in making the case for the organism he had discovered [41,42]. That it was not universally cultivated from all influenza cases did not discredit Pfeiffer’s claim, because B. influenzae was difficult to grow under the conditions of the day.
The majority of individuals who died during the 1918 pandemic succumbed to secondary bacterial pneumonia [43–45], caused by Streptococcus pneumoniae, Streptococcus pyogenes, H. influenzae, Staphylococcus aureus, and other organisms. Moreover, a subset died rapidly after the onset of symptoms, often with either massive acute pulmonary haemorrhage or pulmonary oedema, and often in fewer than 5 days. In the hundreds of autopsies performed in 1918, the primary pathological findings tended to be confined to the respiratory tree: death was due to pneumonia and respiratory failure. These findings are consistent with infection by a well adapted influenza virus capable of rapid replication throughout the entire respiratory tree with little clinical or pathological evidence for systemic virus infection [45].
The autumn wave of the 1918 pandemic proceeded so quickly that standardized research to investigate the cause could not easily be set up. Nevertheless, during the autumn and winter many researchers attempted to confirm or disprove Pfeiffer’s claims, the latter by looking for filter-passing agents, something not possible during the previous 1889 pandemic. The first to succeed, on 1 September 1918, were Nicolle and Lebailly, who claimed to have transferred disease to two healthy volunteers via filtered sputum from a patient in the third day of his illness [46]. Despite equivocal results from other investigators, between December 1918 and March 1919 Yamanouchi and colleagues seemed to confirm and extend the results of the French investigators in inoculation experiments with 24 human volunteers [47]. Six of these volunteers had recovered from influenza; the remaining 18 volunteers, who had not had detectable illness beforehand, all developed influenza-like symptoms after a 2–3 day incubation period, including those receiving filtered and unfiltered nasopharyngeal inoculations of pooled infectious sputum.
Negative or more equivocal results, as well as supporting results, were soon published [48–69] and an air of cautious scepticism prevailed. Although one reviewer could claim about human influenza in 1920 that ‘[i]t is perhaps fair to state that the trend of opinion has gradually been in favour of the theory that the primary infecting agent is a filter passer’ [61], many others, particularly clinicians sceptical of claims for invisible and hypothetical agents, did not agree, and the question of influenza aetiology remained open for another decade. By the early 1920s, annual influenza recurrences had died down, and influenza again became an indolent endemic winter disease. With little clinical material available, and perhaps with a desire to forget the horrors of the recent pandemic, influenza research quieted down and further attempts to elucidate the aetiology were left to but a few investigators

Swine influenza and the discovery of porcine and human influenza viruses

It has often been true in science that breakthroughs come from unexpected quarters. In 1931 Rockefeller Institute investigator Richard E Shope (1901–1966) published the first three of a series of landmark papers [70–72] establishing the aetiology of ‘swine influenza’ or ‘hog flu’, the new epizootic disease of pigs that had been noted initially during the autumn wave of the 1918 influenza pandemic [30,31]. It is now believed that the pandemic virus appearing in 1918 was transmitted from humans to pigs, at that time splitting off into two lineages, one human, the other porcine [73] (reviewed in [74]). Both lineages persist today, the classical swine influenza lineage having evolved continually since 1918, and the human lineage having caused pandemic and endemic influenza from 1918 to 1956. The human line apparently disappeared entirely around 1957 only to reappear in 1977, after possible release from a freezer [75], and has continued to circulate endemically in humans up to the present time.
Shope’s studies were important in their own right, but perhaps more so because they stimulated American and British research groups to take up, once again, the search for the cause of human influenza. In 1933 Alphonse Raymond Dochez (1882–1964) and colleagues produced apparent influenza via human nasopharyngeal inoculation and succeeded in cultivating and serially passing a virus in primary chick embryo cultures, demonstrating that passage material still produced human disease [76]. Several weeks later a British group that had been collaborating with Dochez, led by Sir Christopher Howard Andrewes (1896–1988), who had trained at the Rockefeller Institute in the 1940s, Wilson Smith (1897–1965) and Sir Patrick Playfair Laidlaw (1881–1940), reported isolation and serial propagation of human influenza virus in ferrets [77], introducing the great advantage of both a living culture medium and an animal model. (The human virus was found to cause a catarrhal disease in ferrets after a 2-day incubation period.) The papers of these two influential groups, along with the ongoing work of Shope and colleagues [70–72], led to an explosion of research in the field of virology, which has continued unabated until the present time.
The modern characterization of the influenza A virus
The work of Shope, of Dochez and colleagues, and of the Mill Hill group led by Andrewes, Smith and Laidlaw, resulted in the publication of hundreds of research papers during the 1930s, making influenza the most studied and best understood viral disease of its time. This body of work is too voluminous to review here, but it can be said that efforts to characterize influenza were a driving force behind the development of whole fields of investigation and new research methods, including virology, serology and immunology, experimental animal models, and modern vaccinology and passive immunotherapy [78,79]. By the 1940s influenza B and distinctive strains of influenza A had been identified, vaccines and immune serums had been produced and tested, and a generation of young scientists had been stimulated to embark on careers in virology, among them Thomas Francis (1900–1969), who did perhaps more than any other scientist to characterize influenza, Sir Charles Stuart-Harris (1909–1997), who joined the Mill Hill group and worked productively with many British and American colleagues, Sir Frank Macfarlane Burnet (1899–1985), the great Russian virologist Anatolii Smorodintsev (1901–1986), Maurice Hilleman (1919–2005), and even Jonas Salk (1914–1995), whose early work with influenza vaccines [80] proved to be important in his development, more than a decade later, of the first widely used poliomyelitis vaccine. By 1950, virology had truly come of age, and two generations of scientists could look back on the tragedy of the 1918 influenza pandemic with the seemingly impossible wish that they could study it with modern concepts and the new tools at hand.

Recovery and sequencing of the 1918 influenza virus
Archaevirological search for the 1918 influenza in 1951

One of the co-authors (JVH) was a student at the University of Iowa in 1949, beginning a PhD program in microbiology. In 1950, Dr William Hale (1898–1976), of Brookhaven National Laboratory, visited the University. During a discussion about the 1918 influenza pandemic, he commented ‘someone ought to go to the frozen north to find a victim from 1918 in a permafrost grave’. Immediately after that meeting, Hultin contacted his faculty advisor, Dr Albert McKee (1913–), with a dissertation proposal: to find such a permafrost grave in Alaska. Hultin began by collecting information from Alaska, most importantly from the palaeontologist Otto Geist (1888–1962). With Geist’s help, Hultin contacted several Alaskan missions about their 1918 experiences.
By 1951, all such mission communications had been received. Three sites along the coast of the Seward Peninsula were selected for further study: Nome, Wales, and Brevig Mission. The selection was based on epidemiological evidence indicating high pandemic fatality in the Inuit population. In Nome more than half of the native population had died, in Teller 53%, in Brevig Mission (then called Teller Mission) 90%, in York 100%, and in Wales 55% [81]. Because the mode of burial is of great importance for the preservation of victims, it was most fortunate that gold miners from Nome, skilled in penetrating the permafrost, had been employed by the Territorial government. They had moved from village to village during the winter of 1918–1919, and had managed to bury all of the victims in mass graves 2 m deep.
In June 1951, an expedition consisting of Hultin, McKee, and the team’s renowned pathologist Jack M Layton (1917–), left for Alaska. At Brevig Mission the permafrost conditions were promising, and permission to perform an exhumation was obtained. The team, joined in Alaska by Geist, made rapid progress digging. Reaching a depth of 2 m, a layer of bodies was discovered, placed side by side. Layton opened the rib cages of four bodies, exposing frozen, dark red, expanded lungs. Generous biopsies from eight lungs were obtained and, while still frozen, placed in sterile containers that were then put into thermal jugs and kept frozen with carbon dioxide snow from fire extinguishers. The instruments used were sterilized in boiling water at the graveside; surgical masks were used, as were sterile gloves.
In the microbiology laboratory at the University of Iowa, this material was cultured in embryonated eggs using available containment procedures of the time, including use of face masks, gloves and special pipettes, with all work done under a negative-pressure hood. Five susceptible ferrets received nasal instillations. The ferrets showed no signs of illness. Cultures from the lung material of some of the specimens grew H. influenzae and S. pneumoniae. Histological analyses showed a predominating pattern of acute viral pneumonitis, although some sections showed acute bacterial pneumonias. All of the available specimens were processed but no influenza virus was recovered. Unfortunately, all of the materials from this project were subsequently discarded. As Alfred Crosby stated in his book America’s Forgotten Pandemic, ‘the most direct assault on Spanish influenza had failed’ [82]. He also wrote [83]: ‘It has been the dream of scientists working on influenza for over a half century to somehow obtain specimens of the virus of Spanish influenza, but only something as unlikely as a time capsule could provide them.’
Archaevirological search for the 1918 influenza in 1995
Forty-five years later, in 1995, the search for this time capsule was resumed when co-author JKT began a project to recover RNA fragments of the 1918 influenza virus from formalin-fixed, paraffin-embedded (FFPE) autopsy tissues in the collection of the National Tissue Repository of the Armed Forces Institute of Pathology (AFIP). In the mid-1990s the Molecular Pathology Division of the AFIP had been engaged in developing and optimizing diagnostic molecular assays for neoplastic and infectious diseases that could be applied to FFPE tissues [84]. Projects undertaken simultaneously to characterize novel morbilliviruses from marine mammal epizootics [85], using both poorly preserved unfixed tissues and FFPE necropsy tissues, helped clarify protocols to perform genetic analyses of RNA viruses from sub-optimally preserved tissues.
Thus, by 1995, technical advances were in place that would support efforts to recover genomic material from 1918 influenza victims. The event that persuaded Taubenberger’s team to turn their attention to influenza was the publication of a study describing the genetic basis of British chemist/physicist John Dalton’s colour-blindness using DNA extracted from autopsy tissues from 1844 [86]. This led to the idea of attempting a similar project using some significant archival tissue sample for molecular genetic analysis. Genetic material from the 1918 influenza virus seemed an obvious choice because of its great scientific and historical significance.

A search of the AFIP tissue archives revealed over 100 autopsy cases of 1918 influenza victims. Over 70 had tissue samples associated with them. Review of the case records and histological examination narrowed the likely influenza-RNA-positive cases to 13. Of these, one case was found in 1996 to be positive for influenza A RNA fragments <140 bp in length. Sequence fragments of four gene segments from this case were published in 1997, confirming the H1N1 subtype and demonstrating the lack of a cleavage site mutation in HA [87]. Although the initial results were promising, by 1997 there was concern that unless additional positive case material was found, it might not be possible to determine the entire genomic sequence of the 1918 virus. A second round of screening of AFIP cases in 1997 revealed a second positive case; simultaneously, the Taubenberger laboratory received new case material from a frozen lung sample of a 1918 victim from Brevig Mission, Alaska, contributed by co-author JVH, as described below.
After reading the initial paper in 1997 on the characterization of RNA fragments obtained from the first AFIP 1918 case, Hultin wrote to Taubenberger, detailing the Iowa expedition’s work at Brevig Mission in 1951, and offering to return to Alaska for a second exhumation to secure additional specimens for molecular analysis. At a special meeting of the Brevig City Council, permission to reopen the graves was granted. One of the victims found was an obese female whose body was well preserved. On further excavation, two skeletons were found, one on either side of her. It is likely that the subcutaneous fatty tissue of the obese woman had preserved the internal organs from decomposition during occasional short periods of thawing within the permafrost. Her lungs displayed the gross appearance of those seen in acute viral pneumonitis, expanded and dark red in colour. Samples of frozen lung were placed directly in fixatives, including ethanol and guanidine.
The material from this frozen tissue yielded influenza RNA fragments of a slightly smaller size than those from the two FFPE cases (no greater than 120 bp), but had the advantage of providing more starting material. The HA1 domain of the HA gene was sequenced from all three cases [88], and they differed from each other by only a single nucleotide over 1,200 bases. Because the viruses were therefore probably nearly identical in sequence, it was decided to sequence the remaining seven gene segments from the Alaskan case material.

Determining the complete coding sequence of the 1918 virus took 9 years, including publication of the neuraminidase (NA) segment in 2000 [89], the non-structural segment in 2001 [90], the matrix segment in 2002 [91], the nucleoprotein segment in 2004 [92] and the three polymerase gene segments in 2005 [1]. The search for additional 1918 influenza-RNA-positive cases was also expanded by screening FFPE autopsy tissue blocks from the collection of the Royal London Hospital. Several additional 1918 cases were found, and sequencing of the HA1 domain of HA again revealed extremely high sequence identity between the isolates [93].

Reconstruction of the 1918 virus
The development of reverse genetics technology for influenza viruses in 1999 [94,95] made it possible to perform experiments with viruses containing one or more 1918 influenza genes. This was crucial, because sequence analysis alone offered no clues to the pathogenicity of the 1918 virus. Since 2001, a series of experiments has been conducted in a multicentre, collaborative project to model virulence in vitro, and in animal models using viral constructs containing one or more 1918 genes produced by reverse genetics. The collaborators on this NIAID-funded program project include co-author JKT, Drs Adolfo García-Sastre, Peter Palese and Christopher Basler of Mount Sinai School of Medicine, David Swayne of the US Department of Agriculture (USDA), Terry Tumpey of the US Centers for Disease Control and Prevention (CDC), Michael Katze of the University of Washington, and Ian Wilson of Scripps Research Institute, and their staffs. All work in this collaborative project using 1918 viral constructs has been conducted in BSL3+ containment laboratories at the USDA Southeast Poultry Research Laboratory, or in BSL3+ containment laboratories of the CDC [90,96–98].

Viral constructs bearing at least 1918 HA and NA genes in a background of modern, non-mouse-adapted human H1N1 virus, are all highly pathogenic in mice [97–101]. Furthermore, expression microarray analysis performed on whole lung tissue of mice infected with the reconstructed 1918 virus or viral constructs containing at least the 1918 HA and NA genes showed marked upregulation of murine genes involved in apoptosis, tissue injury, and oxidative damage [100,101]. These findings were unexpected because the viruses with the 1918 HA and NA genes had not been adapted to mice. Control experiments in which mice were infected with modern human viruses produced limited viral replication and little disease, but the lungs of animals infected with the 1918 HA/NA construct showed bronchial and alveolar epithelial necrosis and a marked inflammatory infiltrate, suggesting that the 1918 HA (and possibly the NA) contain virulence factors for mice, but that the full virulent phenotype is only observed with the completely reconstructed virus [98,101].

The viral genotypical basis of this virulence has not yet been mapped, and its relevance for human pathogenesis also remains unclear. The murine pathology, although reminiscent of some of the acute viral pneumonia pathology seen in 1918 autopsy studies [11], is nevertheless distinctive. The roles of the other 1918 proteins, singularly and in combination, are currently unknown. However, the reconstructed all-eight-gene 1918 influenza virus is more virulent than constructs containing fewer 1918 genes, suggesting contributions of each gene segment to virulence [98,101]. Experiments to further map the genetic basis of virulence of the 1918 virus in various animal models are planned. These experiments should help define the viral component of the unusual pathogenicity of the 1918 virus, but cannot address whether specific host factors in 1918 accounted for unique influenza mortality patterns, such as increased fatality in 20–40 year olds and possible protection in the elderly [11].

Viral sequence data now suggest that the entire 1918 virus was novel to humans in, or shortly before, 1918, and that it was not likely to have been a reassortant virus such as those that caused the 1957 and 1968 pandemics [102]. Rather, the 1918 virus is an avian-influenza-like virus that appears to have been derived in toto from an unknown source [1,92,103] because its eight genome segments differ from contemporary avian influenza genes, especially at synonymous sites. Influenza virus gene sequences from a number of fixed specimens of wild birds collected circa 1918 showed little difference from avian viruses isolated today and consequently did not suggest these birds were the source [104,105]. These findings also suggest that avian viruses undergo little directed evolution in their natural hosts even over long periods.

In collaboration with Dr John Oxford, a new project to expand knowledge of human influenza virus circulation before 1918 was initiated in 2004, using additional samples from the post mortem tissue archives of the Royal London hospital. Recently, several pre-1918-human-influenza-A-RNA-positive cases have been identified and initial genetic characterization is ongoing (unpublished). The goal of this project is twofold: (i) to determine what subtype(s) circulated in humans before 1918, and (ii) to determine whether any previously human-adapted influenza gene segments were retained in the 1918 pandemic virus. Concurrently, autopsy specimens from influenza cases from the 1920s and 1930s are also being examined to characterize the early evolution of human H1N1 viruses prior to the first H1N1 isolations in the 1930s; several influenza A RNA-positive cases from the 1920s have already been identified and are now being studied. If there are specific genotypic traits that gave the 1918 virus its particular virulence for young adults, comparing it experimentally with less pathogenic descendant viruses from the early 1920s might be especially informative.

Conclusions and future work
The current projects to understand the origin of the 1918 influenza pandemic virus and its virulence characteristics rest on a solid foundation of influenza virology and epidemiology developed over the last century. It is hoped that additional insights into the mechanisms of viral host adaptation and the mechanisms of how influenza viruses cause disease in their human and experimental hosts will come from future work with the reconstructed 1918 virus. Looking backward in time, but also looking forward into the future, we can see that science stands in the middle of a long and continuing line of effort to comprehend history’s most devastating human disease. We must also be aware that revealing the biology of a pandemic that occurred nearly 90 years ago is not just a historical exercise. It may well help us prepare for, and even prevent, the emergence of new pandemics in the 21st century and beyond.


For assistance in obtaining historical manuscripts we are grateful to Steven Greenberg, PhD and the staff of the History of Medicine Division, to Deirdre Clarkin and the staff of the Public Services Division, National Library of Medicine, and to Betty Murgolo and the staff of the National Institutes of Health Library.

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Do numbers lie? Data and statistics in the age of coronavirus | The Listening Post 

Less than usual pedestrians cross the Shibuya crossing after the government announced the state of emergency for the capital following the coronavirus disease outbreak in Tokyo, Japan]
Less than usual pedestrians cross the Shibuya crossing after the government announced the state of emergency for the capital following the coronavirus outbreak in Tokyo, Japan [Issei Kato/Reuters]

​Technology-enabled disinformation is corrosive to democratic processes and institutions. There is no way to put the genie back in the bottle – increasingly we may be unable to have shared understandings of the world – or trust that videos, photos, audio recordings, ‘scientific’ studies or legal documents are authentic. Civility in civic discourse and integrity are increasingly quaint notions. Authoritarians will weaken checks and balances, turn courts into extensions of those in power and thus undermine representative democracy – enabled by the manipulation of digital media to stoke fear and mask inconvenient truths. We’re already at a point when even educated citizens in first-world societies are unable to distinguish fact from fiction. And we’re already seeing fear of the ‘other’ stoked to the point where inhumane treatment of children is accepted in this country. Extreme partisanship is putting all of our democratic institutions at risk to the point that shared power and orderly transitions may not exist in 10 years. Civil unrest seems inevitable. We have institutional actors denying and actively disabling climate science and hiding public information about the consequences of climate change, for example. We can look forward to less cooperation among nations, more mass migrations, drought, food shortages, economic disruption and more manipulation of public sentiment. Drones, for example, may soon deliver packages but may find even more utility as delivery systems for bombs and as means to invade personal and political boundaries. Democracy only works if there is an informed citizenry. And right now, we have a booming misinformation infestation eating away at citizenship and democratic institutions.”

Who will pay for the financial fallout of the coronavirus pandemic? | Inside Story


More than 500,000 in US infected with coronavirus

Turkey imposes 48-hour curfew in major cities to curb virus

Kurt Blome, (31 January 1894, Bielefeld, Westphalia – 10 October 1969) was a high-ranking Nazi scientist before and during World War II. He was the Deputy Reich Health Leader (Reichsgesundheitsführer) and Plenipotentiary for Cancer Research in the Reich Research Council. In his autobiography Arzt im Kampf (A Physician's Struggle), he equated medical and military power in their battle for life and death. Blome was tried at the Doctors' Trial in 1947 on charges of practicing euthanasia and conducting experiments on humans.He only admitted that he had been ordered in 1943 to experiment with plague vaccines on concentration camp prisoners. In reality, starting in 1943 he "assumed responsibility for all research into biological warfare sponsored by the Wehrmacht" and the S.S.

In 1943 Blome was studying bacteriological warfare, although officially he was involved in cancer research, which was however only a camouflage. Blome additionally served as deputy health minister of the Reich. Would like you to send investigators?"

It is believed that American intervention saved Blome from the gallows in exchange for information about biological warfare, nerve gas, and providing advice on to the American chemical and biological weapons programs [22] In November 1947, two months after his Nuremberg acquittal, Blome was interviewed by four representatives from Camp Detrick, Maryland, including H.W. Batchelor, in which he "identified biological warfare experts and their location and described different methods of conducting biological warfare."
In 1951, he was hired by the U.S. Army Chemical Corps under Project 63, one of the successors to Operation Paperclip, to work on chemical warfare. His file neglected to mention Nuremberg. Denied a visa by the U.S. Consul in Frankfurt, he was employed at European Command Intelligence Center at Oberursel, West Germany.[24] He worked there on a never-declassified top secret project labeled in Blome's foreign scientist case file as "Army, 1952, Project 1975".

​Throughout the war, the German and Japanese biological warfare programs exchanged information, samples, and equipment by submarine. The last of these submarines departed from Japan as late as May 1945. The Japanese destroyed many of the records about these contacts and the biological warfare program prior to their own surrender in August 1945. In the 1930s, Hitler had ordered a group of officers led by Otto Muntsch to study Japan's use of chemical and biological weapons against China. These programs of scientific cooperation and exchange were formalized in a series of agreements in 1938–39. Hojo Enryo, a Japanese Army doctor and expert in biological weapons "frequently visited the Robert Koch Institute as well as companies under German occupation to collect information about research on bacteriological warfare" and gave a lecture on this subject at the Berlin Military Academy of Medicine in October 1941.[18] Gerhard Rose, who was "the German expert on tropical diseases and epidemic typhus" and later a defendant at the Nuremberg Doctors Trial, supplied samples of the yellow fever virus to Unit 731 that they had been unable to obtain from the United States.[19] Blome's own institute in Posen was very similar in design to Unit 731's facility in Pingfan, Manchuria.[20]

The first documentary movie on CCP virus, Tracking Down the Origin of the Wuhan Coronavirus

As the world is gripped by the ongoing pandemic, many questions remain about the origin of the Chinese Communist Party (CCP) virus—commonly known as the novel coronavirus. Join Epoch Times senior investigative reporter Joshua Philipp as he explores the known facts surrounding the CCP virus and the global pandemic it caused. In his investigation, Philipp explores the scientific data, and interviews top scientists and national security experts. And while the mystery surrounding the virus's origin remains, much is learned about the CCP's cover-up that led to the pandemic and the threat it poses to the world. Editor's note: We approached this project with an open mind. From the start, the Chinese Communist Party (CCP) has not been forthcoming with information about the virus. In the early days of the outbreak, medical professionals who sounded the alarm were reprimanded by police for spreading "rumors." When the situation became uncontrollable, the CCP said the virus originated at the Huanan Seafood Market. But when it became clear that patient zero had no connection to the market, the CCP shifted its narrative to suggest that the virus originated in the United States and was brought to China by the U.S. military. As a leading voice in covering China for the past 20 years, we understand very well the CCP's deceptive nature and its cover-ups. With this outbreak, we saw a case of history repeating—in 2003, we exposed the CCP's cover-up of the SARS epidemic in China, far ahead of other media. In this documentary, we seek to present viewers with the known scientific data and facts surrounding the origin of the virus—which continues to be a mystery. We don't draw any conclusions. But we point out that serious questions remain about the CCP's handling of the virus outbreak and its true impact within China and around the world. -------- BUY US A COFFEE ☕ We're working day and night to cover the CCP virus outbreak for you. Donating as little as the amount of a cup of coffee will help keep our media going. https://ept.ms/coffee Subscribe to NTD: http://bit.ly/32BQed4 For more news and videos visit ☛ http://ntd.com Follow us on Twitter ☛ https://twitter.com/news_ntd Add us on Facebook ☛https://www.facebook.com/NTDTelevision/ Support NTD: https://www.ntd.com/support-us.html

Frederick T. Gates, the Rockefeller Foundation

Between January 21st and June 4th of 1918, Dr. Gates reports on an experiment where soldiers were given 3 doses of a bacterial meningitis vaccine. Those conducting the experiment on the soldiers were just spitballing dosages of a vaccine serum made in horses.
The vaccination regime was designed to be 3 doses. 4,792 men received the first dose, but only 4,257 got the 2nd dose (down 11%), and only 3702 received all three doses (down 22.7%).

​By March of that year, “100 men a day” were entering the infirmary at Fort Riley.
Are some of these the men missing from Dr. Gates’ report – the ones who did not get the 2nd or 3rd dose?
“… Shortly before breakfast on Monday, March 11, the first domino would fall signaling the commencement of the first wave of the 1918 influenza.
Company cook Albert Gitchell reported to the camp infirmary with complaints of a “bad cold.”
Right behind him came Corporal Lee W. Drake voicing similar complaints.
By noon, camp surgeon Edward R. Schreiner had over 100 sick men on his hands, all apparently suffering from the same malady…” (5)
Gates does report that several of the men in the experiment had flu-like symptoms: coughs, vomiting and diarrhea after receiving the vaccine.
These symptoms are a disaster for men living in barracks, travelling on trains to the Atlantic coast, sailing to Europe, and living and fighting in trenches.
The unsanitary conditions at each step of the journey are an ideal environment for a contagious disease like bacterial pneumonia to spread.

​From Dr. Gates’ report:
“Reactions.– … Several cases of looseness of the bowels or transient diarrhea were noted. This symptom had not been encountered before. Careful inquiry in individual cases often elicited the information that men who complained of the effects of vaccination were suffering from mild coryza, bronchitis, etc., at the time of injection.”
“Sometimes the reaction was initiated by a chill or chilly sensation, and a number of men complained of fever or feverish sensations during the following night.
Next in frequency came nausea (occasionally vomiting), dizziness, and general “aches and pains” in the joints and muscles, which in a few instances were especially localized in the neck or lumbar region, causing stiff neck or stiff back. A few injections were followed by diarrhea.
The reactions, therefore, occasionally simulated the onset of epidemic meningitis and several vaccinated men were sent as suspects to the Base Hospital for diagnosis.”(4)
According to Gates, they injected random dosages of an experimental bacterial meningitis vaccine into soldiers. Afterwards, some of the soldiers had symptoms which “simulated” meningitis, but Dr. Gates advances the fantastical claim that it wasn’t actual meningitis.
The soldiers developed flu-like symptoms. Bacterial meningitis, then and now, is known to mimic flu-like symptoms. (6)
Perhaps the similarity of early symptoms of bacterial meningitis and bacterial pneumonia to symptoms of flu is why the vaccine experiments at Fort Riley have been able to escape scrutiny as a potential cause of the Spanish Flu for 100 years and counting.

The reason modern technology has not been able to pinpoint the killer influenza strain from this pandemic is because influenza was not the killer.
More soldiers died during WWI from disease than from bullets.
The pandemic was not flu. An estimated 95% (or higher) of the deaths were caused by bacterial pneumonia, not influenza/a virus.
The pandemic was not Spanish. The first cases of bacterial pneumonia in 1918 trace back to a military base in Fort Riley, Kansas.
From January 21 – June 4, 1918, an experimental bacterial meningitis vaccine cultured in horses by the Rockefeller Institute for Medical Research in New York was injected into soldiers at Fort Riley.
During the remainder of 1918 as those soldiers – often living and traveling under poor sanitary conditions – were sent to Europe to fight, they spread bacteria at every stop between Kansas and the frontline trenches in France.
One study describes soldiers “with active infections (who) were aerosolizing the bacteria that colonized their noses and throats, while others—often, in the same “breathing spaces”—were profoundly susceptible to invasion of and rapid spread through their lungs by their own or others’ colonizing bacteria.” (1)
The “Spanish Flu” attacked healthy people in their prime. Bacterial pneumonia attacks people in their prime. Flu attacks the young, old and immunocompromised.
When WW1 ended on November 11, 1918, soldiers returned to their home countries and colonial outposts, spreading the killer bacterial pneumonia worldwide.
During WW1, the Rockefeller Institute also sent the antimeningococcic serum to England, France, Belgium, Italy and other countries, helping spread the epidemic wo

SARS-CoV-2 coronavirus illustration (stock image).

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Annie Jacobsen, "Operation Paperclip"
Politics and Prose   - http://politics-prose.com

Author Annie Jacobsen presents a fascinating topic from her new book, Operation Paperclip, and takes questions from the audience. This event was recorded February 26, 2014 at Politics & Prose bookstore in Washington, D.C. Founded by Carla Cohen and Barbara Meade in 1984, Politics & Prose Bookstore is Washington, D.C.'s premier independent bookstore and cultural hub, a gathering place for people interested in reading and discussing books. Politics & Prose offers superior service, unusual book choices, and a haven for book lovers in the store and online. Visit them on the web at http://www.politics-prose.com/  Category: Education 

Dr Blome was Hitler's Biological Weapons Maker and deputy surgeon General of the Third Reich admitted that he had seen experiments what let to later atrocities E.G. mass sterilization, gassing of Jews - Dr Blome  worked n a Bubonic plaque as a biological weapon.

Kurt Blome (31 January 1894, Bielefeld, Westphalia – 10 October 1969) was a high-ranking Nazi scientist before and during World War II. He was the Deputy Reich Health Leader (Reichsgesundheitsführer) and Plenipotentiary for Cancer Research in the Reich Research Council. In his autobiography Arzt im Kampf (A Physician's Struggle), he equated medical and military power in their battle for life and death. Blome was tried at the Doctors' Trial in 1947 on charges of practicing euthanasia and conducting experiments on humans. He only admitted that he had been ordered in 1943 to experiment with plague vaccines on concentration camp prisoners. In reality, starting in 1943 he "assumed responsibility for all research into biological warfare sponsored by the Wehrmacht" and the S.S. It was generally accepted that he had indeed participated in chemical and biological warfare experiments on concentration camp inmates.

​As part of the Nazi biological warfare program code-named Blitzableiter (Lightning Rod), Blome's institute was therefore "a camouflaged operation for the production of biological warfare agents", By May 1944, the institute had sections devoted to physiology-biology, bacteriology and vaccines, radiology, pharmacology, cancer statistics and a tumor farm,

Blome worked on methods of storage and dispersal of biological agents like plague, cholera, anthrax, and typhoid, and also infected prisoners with plague in order to test the efficacy of vaccines. At the University of Strassburg, a "special unit" headed by Prof. Eugen von Haagan and employing researchers like Kurt Gutzeit and Arnold Dohmen, tested typhus, hepatitis, nephritis, and other chemical and biological weapons on concentration camp inmates.[7] Gutzeit was in charge of hepatitis research for the German Army, and he and his colleagues carried out virus experiments on mental patients, Jews, Russian POWs and Gypsies in Sachsenhausen, Auschwitz and other locations. In October 1944, Himmler also ordered Blome to experiment with plague on concentration camp prisoners. In 1943, Blome proposed spreading malaria "artificially by means of mosquitoes" and experimented on prisoners at Dachau and Buchenwald with lice in order to cause typhus epidemics.[

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Some information claimed by experts who have spoken out against the mainstream medical views  and

protocols to the so called  Corvid-19 Coronaviris , which is being called by some as "The Corvid-19 Coronaviris Scam "
1. There is no such on disease called Corvid-19 that can define the sickness and death of a large amount of people around the world

2. It is scientifically  and medically impossible for an animal or bird virus to jume from a bird or animal to a human being because all virises are created specifically by the body of a bird, animal or human to help the body of the bird, animal or human eradicate contaminations in cells that the body of a bird, animal or human creates for this purpose and the bird, or animal virus or disease can not enter the human body, except by direct injection into the blood stream of a human in the form of some type of vaccination.

3. A direct injection into the blood stream of a human in the form of some type of vaccination. of an animal disease or virus of any kind has the effect of bypassing the human natural immume system .... which is the only way a viris or disease from a bird of animal can cause such virus or disease to make a human seriously sick and die from such a bird or animal virus or disease .... 

4. If a human eats animal flesh from an animal that has a disease or viris.... the human immune system will create a viris in the contaminated cell which is like a heavy duty solvent (a heavy duty bacteria) to erradicate the contamination in the cell .... so the only way to bypass the human immune system is to inject the blood or tissue of a bird or animal that has a viris or disease. This seems to be what Fererick L, Gates on behalf of the Rockefella Medical Institute did to soldiers for the Base Hospital, Fort Riley, Kansas in 1918 that appears to have been the cause of the Spanish Fle Pendemic that killed 50 to 100 million people .

5. Accoding to Dr Cameron Kyle-Sidell who was in charge of a care unit in a new York Hospital, he believes that the way ventilators are being used is killing up to 80% of the patients that are claimed to be suffering from Corvid-19 Coronaviris ...and in fact Dr Cameron Kyle-Sidell  believes his patients were just lacking enough  oxygen in their lungs and blood because he observed they seem to be suffering from a type of altitude sickness .. and just needed extra oxygen ... say from an ozygen mast connected to an oxygen cylinder instead of a ventilator set a too high pressure that is ripping what was a healthy lung apart.. causeing uop to 80% of so called "Corvid-19 Corornaviris Patients never to wake up again once they are sedated and then placed on ventilator set at a too high pressure for the healthy lungs to handle ...causing rips, tears and/or wholes in what was otherwise a healthy lung...

6. 5G Microwave Technology which is 60 GHz or higher can consume oxygen and this may well be the reason that so many people around the world are lacking enough oxygen and appear to be suffering from a type of altutude sickness and attaccks on their immune system ..... the over 200 5G satelittes now circling planet earth and the thousands of 5G Towers appear to bew causing people around the world to get sick and their bodies contaminate and ther human body is creatign a type of coronaviris to help the contaminated cells to help the contaminated cells to eridicate such contamination ... this causes the person to feel sick for a time while the body creates a viris to eradicate any contamination in the cells.

7. There is talk that vaccines were administered to people in China not long before the so called Corvid-19 outbreak in China ... such vaccines may have had some form of animal or bird, bat etc disease or virsi which because is was injected straight into the blod stream, would have bypassed the human immune system .. they these vaccinated people could be spreading a type of animal disease or virus around the world, similar to Ferderick L. Gates in 1918 injecting US Soldiers with blood to tissue from from sick horses .... which appears to have caused the Spanish Flu which killed 50 to 100 million people around the world in 1918/1919 .. more people died of the Spanish Flu than died by gun fire or poisiness gas during the WW1.

8. It appears all the so called medical experts promoting the mainstrean views and protocols regarding the so called "Corvid-19 Coronavirus" are in one way or another funded by the tax free charitable foundations in the USA such as the Rockefella Foundation,  

who seem to also be beind trying to force what is commonly .. called the "New World Order" which will have a One World Government, A One World Army and a One World cashless E Money Currency which is only accessable through a RFD Chip injected in the body when the Corvid-19 Vaccine is injected into each human being on planet earth ..
Spanish Flu of 1918 Was Really a Bioterror Attack on Humanity


During the mid-2000’s there was much talk about “pandemic preparedness.” Influenza vaccine manufacturers in the United States received billions of taxpayer dollars to develop vaccines to make sure that we don’t have another lethal pandemic “flu,” like the one in 1918-19.
Capitalizing on the “flu” part of Spanish flu helped vaccine manufacturers procure billion dollar checks from governments, even though scientists knew at the time that bacterial pneumonia was the real killer.

It is not my opinion that bacterial pneumonia was the real killer – thousands of autopsies confirm this fact.
According to a 2008 National Institute of Health paper, bacterial pneumonia was the killer in a minimum of 92.7% of the 1918-19 autopsies reviewed. It is likely higher than 92.7%.

Trump threatens to adjourn Congress to make recess appointments

Apr 15th 2020 


President Trump said Wednesday that he was considering taking the unprecedented step of adjourning both houses of Congress in order to make recess appointments to fill government posts, citing the emergency created by the coronavirus outbreak.
“If the House will not agree to that adjournment, I will exercise my constitutional authority to adjourn both chambers of Congress,” Trump said at a Rose Garden briefing of the coronavirus task force. “The current practice of leaving town while conducting phony pro-forma sessions is a dereliction of duty that the American people cannot afford during this crisis. It is a scam what they do.”

Noting that the Senate, which has the responsibility for confirming executive-branch appointments, had “left Washington until at least May 4,” Trump said that “the Constitution provides a mechanism for the president to fill positions in such circumstances, the recess appointment, it’s called.”
Officials appointed in this manner can serve until the end of the following Senate session, although if Trump is not reelected in November the next president may choose to replace them with his or her own appointees.

Trump cited Michael Pack, who he nominated to head the U.S. Agency for Global Media in June of 2018.
“He’s been stuck in committee for two years, preventing us from managing the Voice of America, very important. And if you heard what is coming out of the Voice of America, it’s disgusting. The things they say are disgusting toward our country.”
Democrats have blocked Pack’s confirmation because they see him as a threat to the independence of the agency he would run. While Trump said, “We especially need [these people] now because of the pandemic,” he did not specify how Pack’s appointment would help with the effort to curb the coronavirus outbreak in the U.S.

While past presidents have made recess appointments when Congress was adjourned, and used their Constitutional powers to call Congress back into session, Trump would be the first in U.S. history to try to adjourn both chambers in order to fill vacant government positions.
“Perhaps it’s never been done before, nobody’s even sure if it has, but we’re going to do it. We need these people here. We need people for this crisis and we don’t want to play any more political games,” Trump said.

The president appears to be referring to Article II, Section 3 of the U.S. constitution, which grants presidents the right to adjourn Congress "in case of disagreement between them, with respect to the time of adjournment.”

Such a move would be immediately challenged in court, however, and the logistics of carrying out such a plan immediately drew scrutiny.

While Trump appealed to Congress to put politics aside and approve his nominees, he pinned the blame for what he said were “many, many positions that are unstaffed” on Democrats, who he said “are holding them up.” At the same time Trump boasted of the number of judges he has been able to have confirmed in the Senate.

“We’ve gotten judges because we’ve gone through the process. I guess we’re up to 448 federal judges and that we’ve gotten because we’ve focused on it,” Trump said.

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