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Invisible subjects: the men who fuel the demand for prostitution

If prostitution is the oldest profession in the world, then punting is the oldest consumer activity. Yet it remains broadly unexamined, perhaps because the questions it raises are too uncomfortable.

In the UK, policing of prostitution targets sex workers far more often than punters. Photo: Christopher Churchill/Gallery Stock

 

It is 1am on a late summer’s night in Tower Hamlets in east London, and the Metropolitan Police vice squad is out on patrol. Police CCTV operators have alerted the team that a street walker has climbed into a man’s car. He had paid her but is stopped before any sexual acts can occur. The woman’s name is Jessica. She is 36. Her right eye socket is heavily bruised. Swigging vodka from an old plastic bottle, she tells me that she is a crack and heroin addict and has been a prostitute since running away from her children’s home in Paddington at the age of 12. “I’ve had every bad experience you can think of – gun to my head, raped, stabbed twice,” she says.

The would-be punter is in his late thirties. He is tanned and wears a peach polo shirt, blue shorts, white Havaianas flip-flops and a wedding ring. Sitting on the bonnet of his smart estate car, he is close to tears. “I’ve had the worst three weeks of my life and this was just a mistake, the cherry on the cake.” This married, middle-class man, who has taken to the streets in the twilight hours to pay for sex with a visibly ill woman, may or may not be a typical buyer of sex. As Jessica explains, there is no one type of man. “Society seems to think that: they’ve got this perception that all punters are dirty old men in raincoats. They ain’t, they’re from all walks of life. Black, white, thin, fat, young, old – all types.” She twirls her chestnut hair around a long, petrol-blue false fingernail. “Maybe they’ve had a bad relationship, or they’re going through a bad patch in their marriage, or they just get a full-on hit: it’s dangerous, there’s the thrill of getting caught.”

If prostitution is the oldest profession in the world, then punting is the oldest consumer activity. Yet it remains broadly unexamined, perhaps because the questions it raises – about male desire and power, about society – are too uncomfortable.

Instead, organisations that monitor prostitution, from the police to NGOs and feminist lobby groups, usually focus on the sex workers, whose situation is more easily categorisable. One view is that prostitutes are victims who need help to get off the streets. Others argue that many sex workers are empowered individuals exercising their autonomy and that they simply need greater legal rights. But to consider prostitution only from the perspective of the sex worker is to obscure the economic and social power dynamics that govern the prostitute’s position. Where demand exists, supply will emerge – and it is a fact that men’s demand for sex fuels prostitution. (There are, of course, male and transsexual prostitutes and also women who buy sex, but as they are in the minority and present a different range of problems, male punters are the focus of this article.) The motivations behind paying for sex are varied and various; the punting community is a wide one, as is that of the estimated 100,000 sex workers in the UK – most of whom work indoors rather than on the streets.

Who are the men who pay for sex with women in Britain? Research is thin. Eaves, a charity that supports women at risk of violence, is one of the few organisations that has conducted a study of punters. Men Who Buy Sex: Who They Buy and What They Know, published in 2009, was based on interviews with 103 men in London who had paid for sex with trafficked and non-trafficked prostitutes. The authors noted: “Many [punters] reported that they were aware of pimping, trafficking and other coercive control over those in massage parlour, brothel and escort prostitution. These men were frequently aware of the vulnerability and risk factors for entry into prostitution including childhood abuse, lack of alternative job choices, coercive control and homelessness.”

The demographics of the self-selecting participants – who replied to advertisements for the study – were nearly equally split between three age groups: 18-to-29-year-olds, 30-to-40-year-olds, and 41-to-70-year-olds. Almost half the participants were white, 20 per cent were Asian, 11 per cent were black, and the rest were of other ethnicities. Most were in a relationship; the report did not distinguish between short-term and long-term relationships, but this finding nonetheless supports other research showing that a man seldom decides to buy sex just because he lacks a partner.

As the marketing of the commercial sex industry has moved from classified adverts in the back of newspapers to online forums, it has become possible to garner a clearer view of punters’ attitudes. A wide range of these can be inferred from PunterNet, the “premier online community for Patrons and Providers of Adult Personal Services in the UK”. The web metrics site alexa.com profiles the most frequent PunterNet users as being men aged between 35 and 44, who are educated to graduate level and are more likely to have children than the average internet user. The posts on the PunterNet site range from obscenely violent and misogynistic descriptions of experiences with prostitutes to mundane notes on the easy availability of off-road parking.

In 2011 Jon Millward, a self-described “ideas detective” who analyses information relating to prostitution and pornography, data-crunched 5,000 reviews posted on PunterNet. He found that “nice”, “lovely” and “lady” were among the top five words the punters used to describe prostitutes; “breasts” was the only overtly sexual word in the top ten. Location was commonly discussed, with “clean” and “safe” among the most popular review terms. The banality of some of the most commonly recurring words cannot obscure the brutal behaviour frequently described by punters on the site.

A blog called the Invisible Men Project was set up last year to record some of the most extreme reviews from PunterNet, further illuminating the behaviour of the “invisible subjects of the sex industry”, as Eaves describes them. Most of the comments posted on the site are too lewd and disturbing to reproduce here, but the scornful tone is well captured by this contribution: “Yes she will endure hard penetration. I say endure because she does not engage with you on any level, to her it is just a matter of going through the motions . . . I was not successful in trying to animate her beyond her cold mechanical stupor.”

Millward wrote: “I don’t think punters are lacking the emotional circuitry necessary for experiencing genuine love and affection. They have just decided to bypass the usual steps men must take to go from not knowing a woman to having sex with her.” While the posts betray the dehumanising view many punters take of the women they pay for sex, 71 per cent of the men in the Eaves study admitted experiencing some degree of guilt or negative feelings about paying for sex. Almost 80 per cent viewed their use of women involved in prostitution to be an addiction – that is, uncontrollable behaviour. But over half thought that prostitution decreases the incidence of rape, because prospective rapists can be satisfied by paying for sex. Looking for further insights into punting, I contacted several men through PunterNet about their personal prostitution habits: their motivation for participating in the British sex industry, and their views on the ethics and legality of it. From these conversations, a gamut of opinions emerged – from shame, through wilful blindness, to defiance – but few agreed with one common interpretation of prostitution: as a form of commercial sexual exploitation and violence against women.

Keith, a regular contributor to PunterNet, replies to my request for an interview with an alacrity that hints at the regularity with which he views the site. He is a retired professional in his late sixties. Reflective but unapologetic about buying sex, he says over the phone: “This sounds dreadful, but I suppose I like the variety. The excitement, too.” He refuses to countenance ethical issues around paying to have sex with women, justifying his actions by saying that he only visits brothels, rather than engaging in outdoor prostitution with street walkers. “I’ve never felt sorry for working girls, because I’ve never been with one who shows she’s in a bad state. I’ve never been with a girl who looks really ill, coughing. A street walker wouldn’t appeal to me at all.

“I want to feel I’m giving pleasure to the woman. That wouldn’t be the case with a girl on the street, someone who had been trafficked or had a heavy drug dependency.”

Keith, who lives in Manchester, has a wife and grown-up children. He defends cash for sex as “a positive for my marriage” – his once “adventurous” sex life with his wife faded after she had their first child and now he views prostitutes as an acceptable stand-in. “It means I’m not forever pestering my wife and feeling resentful about her not giving me sex . . .” He adds quietly: “She makes me feel like a pervert for asking.”

He can remember the exact date he last had sex with his wife; it was over a year ago. Using sports sessions and outings with friends as false alibis, he has attempted to keep his trips to the brothel a secret from her, although he is “paranoid” that she has suspicions. It is his “greatest fear”, he says, that she would find out for certain.

Like some other punters I contacted, Keith believes that men have both a biological imperative and a right to have sex. If a man is not getting it from his wife or girlfriend, or from casual hook-ups, it is “natural” that he should desire, and be able to pay for, sex. “I try to limit myself to once every two weeks and not spend more than £80 a go,” he says. Sanguine on the subject of punters in general, he adds: “I don’t go [to a brothel] in a local part of the city, so I’m quite happy chatting to the other men in the reception area. But we wouldn’t sit there talking about which girls we see.

“Most men have regulars, but occasionally see someone new for that bit of variety. I saw one girl for about a dozen visits. Most men advise against that because you can get obsessed. I was obsessed, in love, with this lady. I’m more sensible about it now.”

Another man I contact through PunterNet, Jim, points out that some men have difficulty finding a sexual partner. Now in his mid-thirties and working in law, he recalls, with a stammer, that he was 29 years old and desperate to lose his virginity when he first sought the services of a prostitute.

“I was very nervous the first time. It didn’t go very well because she clearly wasn’t into it, but I was so excited that that went over my head at the time,” he says. Without the easy confidence to walk into a bar or nightclub and try his luck, he justifies paying for sex and has developed a routine. He travels an hour away to visit the same working girl once every three weeks, paying £300 for a two-hour session. “She is very attractive, so I know what I’m getting, and she’s also very enthusiastic. I feel very nervous meeting a new working girl.”

The woman he visits is British, the mother of a one-year-old, and although her online profile says she is 25, she has told Jim that she is 30. He has paid her for sex for more than two years.

Despite working in the legal profession, Jim says he has no opinions on the legality of prostitution and will not be drawn on the merits and drawbacks of various legal models across the globe. He has observed, however, that in the flat his “regular” shares with other sex workers, “only one of them uses it at a time, in order to try and stay within the law”. In English law, any property used by more than one prostitute at a time counts as a brothel, which is illegal. He says they talk openly when he visits, but the “sex is the be all and end all for me”.

“I do feel guilty about doing it,” he says hesitantly. “I just feel it’s bad emotionally for women. She doesn’t seem depressed, but I don’t know. Maybe that’s an act. I sometimes think, though, it’s just one more person at the end of the day, and I do treat escorts better than a lot of other customers do.”

Right to desire: the International Union of Sex Workers joins a May Day march in Soho, London

The prevailing view of the punters I contacted for this article was that, in one way or another, a man always “pays” for sex. Many viewed marriage and relationships as intrinsically economic relationships, in which the man provided financial security in return for sex, among other rewards. Some justified their use of prostitutes as merely an equivalent transaction. One man notes: “The question shouldn’t be, ‘Why pay for sex?’ It should be: ‘Why not pay for sex?’ We pay for lots of things in life. Sex is just another commodity.”

Many prostitutes who view themselves as empowered rather than exploited might agree that sex work is a simple financial transaction for services rendered and assert their right to sell it. In her 1997 essay “Inventing Sex Work”, the prostitutes’ rights activist Carol Leigh argued from her own experience that it could be both interesting and good fun. She wrote: “Sex in my personal life became very exciting. Sex with clients annoyed me sometimes and interested me other times.”

Several of the men with whom I spoke reflected the view that the financial transaction was beneficial to women as well as to men. Some went further and appeared to endorse the old myth that prostituted women somehow manipulate men, with their “biological” or “intrinsic” need and desire for sex, for financial gain.

Some women view the work of a prostitute as no different from other forms of exploitation entailed by a rapacious capitalist system, which they claim is itself inherently demeaning. In her book The Sex Myth, Brooke Magnanti (who blogged as Belle de Jour about selling sex) argues that sex work is no different from, say, deep-sea fishing in the Atlantic; both are physically dangerous, high-risk jobs. So why, the argument goes, view prostitution as a special case?

Certainly many punters offer justifications akin to that of a sweatshop boss: they hold the economic and social power, and they believe the exploitation of that power – using it over another person – is legitimate. If a woman is poor and “wants” to sell her body, they see nothing wrong with purchasing it for sex. As one punter says: “Some of them on PunterNet talk about women like they’re a commodity, that’s true. I don’t think it makes any difference as long as you treat the lady well. At the end of the day, it is a business.”

In August the Economist, usually better known for its sobriety rather than salacious­ness, splashed “The sex business” on its cover. The magazine examined the ways in which technology is “liberating” the cash-for-sex industry and it noted, “For many, both male and female, sex work is just that: work.” It argued further that prostitution looks “more and more like a normal service industry”. Decrying the ban on the sale and purchase of sex as “illiberal”, the Economist called for the legalisation of prostitution.

A society must determine its moral stance on selling and buying sex and whether it respects the rights of those sex workers who exhibit choice rather than coercion, and agency rather than victimhood, to sell it. The crucial question is this: is the commoditisation of sex merely the logical – and permissible – conclusion of capitalism; or is there something special about sex and related acts which gives us a duty to hold them above the bounds of financial transactions?

Obtaining sex by purchasing it is easy, convenient and relatively cheap (some prostitutes in London charge as little as £15, according to a 2008 report by the Poppy Project, the advocacy and support group for trafficked women; this was corroborated by Jessica, the sex worker I met in Tower Hamlets). But beyond that, there appears to be an intrinsic value to paid-for sex for some men, who are sexually aroused by the danger, thrill and power dynamics of an encounter with a prostitute.

This is especially true of men who engage with outdoor prostitution. Out on the night patrol with the vice unit in Tower Hamlets, Sergeant David Deal says: “You can’t imagine how unwell some of these women are and you can’t understand how men still take advantage of them . . . I think they like risky sex. Doing it in a car. Quickly.” He describes the wide range of punters his team frequently sees. “Blokes in suits, scumbags, rough sleepers. Most are 50 or over.”

PC James Coxshall adds: “The majority are white.” He also debunks the myth that prostitution is most common around midnight. Most brothels close by 10pm, and outdoor prostitution is common in the morning. “At 5am, when it begins to get a bit clearer, the cars begin to circle and circle. Many men use prostitutes on their way to work,” he says.

Patrolling in an unmarked police car, we stop a man in a silver Transit van after CCTV records him picking up Amanda, a 49-year-old street walker known to the vice team. Paul is 60, a slightly built south Asian Brit with sad, rheumy brown eyes, close-cropped grey hair and a beard. “I don’t have sex with her ever,” he tells me, motioning towards Amanda and acknowledging that he knows her well. “I picked her up because I just wanted to talk.” They also shared a wrap of cocaine, payment in kind for Amanda’s time. Paul admits that he pays to have sex with another street walker. “I wouldn’t know how to describe that relationship. She’s a liar and a thief, a very difficult person to be associated with . . .

“One of the things I get out of these women is just kind of a weird friendship. But these women are really disturbed socially. It’s quite a difficult thing. I don’t know why I choose to associate with her; I suppose it’s just habit. She’s attractive sexually.”

Exchanging money for sex is not illegal in the UK, although many activities associated with it are. Causing or inciting prostitution and controlling it for personal gain are offences. Kerb-crawling is technically illegal, but it must be shown that the individual was causing persistent annoyance. This month, MPs debated an amendment to the Modern Slavery Bill that would have criminalised “the buying of sex acts”. The proposed law linked prostitution to slavery and was designed to “discourage demand” for trafficked people. But the amendment, which was brought forward by the Labour MP Fiona Mactaggart and gained cross-party support, was dropped following uproar from pressure groups. Women Against Rape and the Royal College of Nursing, among other organisations, argued that banning punters would drive prostitution underground and force sex workers to move to more dangerous, remote premises. Some women’s rights groups supported the proposed change in the law, however, including Women’s Aid and the End Violence Against Women coalition, and it is unlikely to be long until proposals to implement the so-called Nordic system, which bans the purchase rather than sale of sex, resurface.

The model was first implemented in Sweden in 1999. According to a study by the Swedish Institute, a state information agency that promotes Sweden abroad, the statistics for sex buyers decreased from 13.6 per cent of the active adult male population in 1996 to 7.9 per cent in 2008, suggesting it was an effective deterrent. The ban on paying for sex reportedly made it harder for customers to seek out prostitutes openly.

Norway and Iceland implemented the model in 2009, France made the first moves to copy it in 2013 and the Northern Ireland Assembly voted in favour of it last month. Yet critics argue that the Nordic system requires excessive police investigation time to secure arrests and, worse, can increase the danger to prostitutes, as punters are more likely to conceal their identity from them. Others claim that the Nordic model is inappropriate in the UK, which has a far larger vice problem than Sweden and Norway.

In Sweden the National Police Board estimated in 2009 that there were 1,000 sex workers, down from about 2,500 before the Nordic model was implemented. In Norway, which has a population of five million, there were about 2,200 sex workers in 2010, according to Pro Sentret, a Norwegian government-funded organisation that collates information about prostitution. By contrast, the Home Office put the number of women working in on-street prostitution in the UK at 80,000 in 2004, based on an earlier Europap-UK survey. NGOs estimate that today there are between 60,000 and 100,000 sex workers in Britain. Recent studies show that 80 per cent of sex workers are female, while 15 per cent identify as male and 5 per cent as transsexual. Alex Feis-Bryce, director of services at the UK Network of Sex Work Projects, says: “The reason figures are so difficult to predict is that much of sex work takes place underground due to legislation and the numbers of sex workers in the trade are fluid. Some may have one or two clients a week or month, while for others it may be full-time work.” Feis-Bryce explains that the indoor sex work sector is “far larger” than that on the street. “Escorts, who work independently, make up the largest proportion of off-street sex work.”

Proponents of the Nordic model point out that whatever the challenges to implementation, criminalising punters, rather than prostituted women, sends a strong message. The human rights group Equality Now argues: “The commercial sex industry perpetuates the notion that the purchase of women and girls’ bodies is acceptable so long as a buyer can pay for it. The Nordic model challenges this construct and tries to redress these inequalities by promoting women’s and girls’ right to safety, health and non-discrimination, and by challenging men’s perceived – but non-existent – ‘right’ to buy women’s bodies for sex.” As Jessica’s story illustrates, sex workers in the UK often discover they can expect few rights to safety, especially on the street. Talking about the physical harm, fear and threats to her life in 24 years of prostitution, she said: “It’s just part of the job, unfortunately; there are some horrible men out there.” 

Lucy Fisher writes about politics and is the winner of the Anthony Howard Award 2013. She tweets @LOS_Fisher.

 

This article first appeared in the 20 November 2014 issue of the New Statesman, The deep roots of Isis

Credit: BRIDGEMAN IMAGES
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A century ago, the Spanish flu killed 100 million people. Is a new pandemic on the way?

Our leaders need to act like the outbreak has already started – because for all we know it may have.

It is hard not to have a sneaking envy of the virus. As complex creatures, we are distracted by myriad demands on our attention; we will never know the dead-eyed focus of the viral world. It is akin to the psychopath: a cold, purposeful drive to achieve its own agenda, coupled with the skills and resourcefulness to succeed. In a world threatened by nuclear war and devastating climate change, it may actually be the virus that we should fear most.

This is the centenary year of the Spanish flu outbreak, when a virus killed between 50 and 100 million people in a matter of months. The devastation was worldwide; it is only known as Spanish flu because Spain, neutral in the ongoing hostilities of World War One, was the only country without press restrictions. Across Europe, people assumed their own outbreaks originated in the only place reporting on the disaster.

A number of authors have lined up with a kind of grim celebration of influenza’s annus mirabilis. As well as chronicling the fatal reach of this organism, they all offer a warning about a follow-up pandemic that is overdue – and for which, it seems, we are largely unprepared. “Somewhere out there a dangerous virus is boiling up in the bloodstream of a bird, bat, monkey, or pig, preparing to jump to a human being,” says Jonathan Quick in The End of Epidemics. “It has the potential to wipe out millions of us, including my family and yours, over a matter of weeks or months.”

If that seems a little shlocky, you should know that Quick is no quack. He is a former director at the WHO, the current chair of the Global Health Council and a faculty member at Harvard Medical School. The book’s blurb includes endorsements from the director of the London School of Hygiene and Tropical Medicine, the president of Médicins Sans Frontières, and the president of the Rockefeller Foundation.

The numbers Quick serves up are stupefying. Bill Gates, for instance, has said it is more likely than not that he will live to see a viral outbreak kill over 10 million people in a year. In Gates’s nightmare scenario, outlined by computer simulations created with disease-modelling experts, 33 million people die within 200 days of the first human infection. The potential for exponential spread means a death toll of 300 million is possible in the first year. “We would be in a world where scrappy, ravaged survivors struggle for life in a zombie-movie wasteland,” Quick tells us in his informed, cogent and – honestly – frightening book.

If you can’t imagine what that is like, you could try asking the Yupik people of Alaska, who were devastated by the 1918 Spanish flu. You might not get an answer, however, because they remain traumatised, and have made a pact not to speak about the pandemic that shattered their ancient culture.  (A pandemic is a disease that spreads across continents; an epidemic is usually contained within a country or continent.)They aren’t the only long-term sufferers. The Vanuatu archipelago suffered 90 per cent mortality and 20 of its local languages went extinct. Those in the womb in 1918 were also affected. A baby born in 1919 “was less likely to graduate and earn a reasonable wage, and more likely to go to prison, claim disability benefit, and suffer from heart disease,” reports Laura Spinney in Pale Rider.

Such arresting snippets of the flu’s legacy abound in Spinney’s thoughtful, coherent take on the 1918 outbreak. The book’s subtitle suggests that the Spanish flu changed the world, and Spinney certainly backs this up. Societies broke down and had to be rebuilt; recovering populations were reinvigorated by the simple calculus of Darwin’s “survival of the fittest”; public health provisions were first imagined and then brought into reality; artists and writers responded to a new global mood by establishing new movements.

Not every outcome could be spun as a positive. Scientists, for instance, were humiliated by their inability to halt the flu’s progress, creating an opportunity for quack medicines to arise and establish themselves. Some of our greatest writers lived through the trauma, but could never bring themselves to discuss it in their stories. Virginia Woolf noted that it was “strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature”.

Spinney’s background as a science writer shines through: her handling of the workings of the flu is detailed and deft. She brings both the influenza A virus (the only type responsible for pandemics) and the human immune system to life, laying out the biochemical processes that kill and cure with clarity and care. She exposes the chilling roots of often-used but seldom-explained viral names such as “H1N1” (Spanish flu) or “H5N1” (bird flu). H is for haemagglutinin, the lollipop-shaped appendage that allows a virus to break into a cell and take over the means of production. N is for neuraminidase, the “glass-cutter” structure that allows replicated viruses to break out again and unleash hell upon the host. So far, we know of 18 H’s and 11 N’s and they all have ever-evolving sub-types that make a long-lasting general vaccine against the flu an elusive dream: “Every flu pandemic of the 20th century was triggered by the emergence of a new H in influenza A,” says Spinney.

For all her technical expertise, Spinney has a light touch and a keen eye for the comic. She relates how a ferret sneezing in the face of a British researcher in 1933 exposed influenza’s ability to travel between biological species, for instance. She also excels with the bigger picture, detailing the century of scientific detective work that has allowed us to piece together the genetic elements of the 1918 virus and gain insights into its creation. It seems to have jumped to humans on a farm in Kansas, via domestic and wild birds indigenous to North America. There may also have been some ingredients from pigs, too, but that’s not settled.

Spinney’s afterword questions whether our collective memory for such events ever reflects the truth of the moment. “When the story of the Spanish flu was told, it was told by those who got off most lightly: the white and well off,” she tells us. “With very few exceptions, the ones who bore the brunt of it, those living in ghettoes or at the rim, have yet to tell their tale. Some, such as the minorities whose languages died with them, never will.”

That said, Catharine Arnold has done a remarkable job of relating the tales of a diverse set of sufferers, crafting an arresting and intimate narrative of the 1918 pandemic. She pulls the accounts of hundreds of victims into a gripping tale that swoops down into the grisly detail, then soars up to give a broad view over the landscape of this calamitous moment in human history.

Arnold’s remembrances come from the unknown and from celebrities. A Margery Porter from south London emphasised that “we just couldn’t stand up. Your legs actually gave way, I can’t exaggerate that too much.” John Steinbeck described the experience of infection as almost spiritual. “I went down and down,” he said, “until the wingtips of angels brushed my eyes.”

The reality was, inevitably, less poetic. A local surgeon removed one of Steinbeck’s ribs so that he could gain access to the author’s infected lung. Most victims’ bodies turned blue-black as they died. Healthcare workers reported appalling scenes, with delirious patients suffering horrific nosebleeds. “Sometimes the blood would just shoot across the room,” a navy nurse recalled. If their lungs punctured, the patients’ bodies would fill with air. “You would feel somebody and he would be bubbles… When their lungs collapsed, air was trapped beneath their skin. As we rolled the dead in winding sheets, their bodies crackled – an awful crackling noise with sounded like Rice Krispies when you pour milk over them.”

The killer in 1918 was often not the flu virus itself but the “cytokine storm” of an immune system overreacting to the infection. Strong, fit young people, with their efficient immune systems, were thus particularly at risk, their bodies effectively shutting themselves down. Then there were the ravages of opportunistic bacteria that would lodge in the devastated tissue, causing pneumonia and other fatal complications. Arnold paints a grim but vivid picture of exhausted gravediggers and opportunistic funeral directors cannily upping their prices. The morgues were overflowing, and morticians worked day and night. In the end, mass graves were the only answer for the poverty-stricken workers attempting to bury their loved ones before they, too, succumbed.

No one was spared from grief or suffering at the hands of the “Spanish Lady”, as the flu came to be known. Louis Brownlow, the city commissioner for Washington DC, reported nursing his stricken wife while answering telephone calls from desperate citizens. One woman called to say that of the three girls she shared a room with, two had died, and the third was on her way out. Brownlow sent a police officer to the house. A few hours later, the sergeant reported back from the scene: “Four girls dead.”

Some of the other stories Arnold has unearthed are equally heartbreaking. A Brooklyn boy called Michael Wind wrote of the moment his mother died after less than a day of being ill. He and his five siblings were at her bedside, as was their father, “head in hands, sobbing bitterly”. The following morning, knowing that he was soon to die too, their father took the three youngest children to the orphanage.

Arnold writes beautifully, and starkly, of the tragedy that unfolded in the autumn months of 1918: “the Spanish Lady played out her death march, killing without compunction. She did not discriminate between statesmen, painters, soldiers, poets, writers or brides.” She chronicles the Lady’s path from the United States and Canada through Europe, Africa and Asia, culminating in New Zealand’s “Black November”. The book is utterly absorbing. But how do we respond to its horrors and tragedies? What are we to do with our collective memories of such visceral, world-shattering events? Learn from them – and fast, argues Jonathan Quick.

Unlike Arnold and Spinney, Quick is not content to be a chronicler or a bystander. He is, he says, both terrified at the looming disaster and furious at the lack of high-level reaction to its threat. He is determined to create a movement that will instigate change, mimicking the way activists forced change from governments paralysed by, and pharmaceutical companies profiteering from, the Aids pandemic. Quick has channelled his fury: The End of Epidemics is, at heart, a call to arms against influenza, Ebola, Zika and the many other threats before us.

 

So what are we to do? First, our leaders need to act like the outbreak has already started – because for all we know it may have. We must strengthen our public health systems, and create robust agencies and NGOs ready to monitor and deal with the threat. We must educate citizens and implement surveillance, prevention and response mechanisms, while fighting misinformation and scaremongering. Governments must step up (and fund) research.

We can’t develop a vaccine until the threat is manifest, but we can prepare technology for fast large-scale production. We can also invest in methods of early diagnoses and virus identification. Invest $1 per person per year for 20 years and the threat will be largely neutralised, Quick suggests. Finally – and most importantly – there is an urgent need to create grass-roots support for these measures: citizen groups and other organisations that will hold their leaders to account and prevent death on a scale that no one alive has ever experienced. Is this achievable? Traumatised readers of Quick’s book will be left hoping that it is.

For all the advances of the last century, there are many unknowns. Scientists don’t know, for instance, which microbe will bring the next pandemic, where it will come from, or whether it will be transmitted through the air, by touch, through body fluids or through a combination of routes.

While there is considerable attention focused on communities in West Africa, East Asia or South America as the most likely source of the next outbreak, it’s worth remembering that most scientists now believe the 1918 influenza outbreak began on a farm in Kansas. Quick suggests the
next pandemic might have a similar geographical origin, thanks to the industrialised livestock facilities beloved by American food giants.

Viruses naturally mutate and evolve rapidly, taking up stray bits of genetic material wherever they can be found. But it’s the various flu strains that live inside animals that bring sleepless nights to those in the know. They can exist inside a pig, bat or chicken without provoking symptoms, but prove devastating if (when) they make the jump to humans. As more and more humans live in close proximity to domesticated animals, encroach on the territories inhabited by wild animals, and grow their food on unprecedented scales, our chance of an uncontrollable epidemic increase.

The meat factories known as “Concentrated Animal Feeding Operations” (CAFOs) are particularly problematic. They provide cheap meat, poultry, dairy and
eggs from animals kept in what Quick terms “concentration camp conditions”, simultaneously creating the perfect breeding ground for new and dangerous pathogens. Pigs, he points out, eat almost everything, so their guts are the perfect mixing bowls for a new and deadly influenza strain. “CAFOs were the birthplace of swine flu, and they could very likely be the birthplace of the next killer pandemic,” Quick warns.

There are other possibilities, though – bioterror, for instance. Bill Gates is among
those who have warned that terrorist groups are looking into the possibility of releasing the smallpox virus in a crowded market, or on a plane. Then there is the possibility of a scientist’s mistake. In 1978 a woman died after smallpox was released from a laboratory at the University of Birmingham, UK. In 2004 two Chinese researchers accidentally infected themselves with the SARS virus and spread it to seven other people, one of whom died. In 2014, a cardboard box full of forgotten vials of smallpox was found in a National Institutes of Health facility in Bethesda, Maryland. A year later, the US military accidentally shipped live anthrax spores to labs in the US and a military base in South Korea. It’s not impossible that human error could strike again – with catastrophic results.

Such possibilities lie behind our discomfort with what scientists have to do to further our understanding. Researchers in Rotterdam, for instance, wanted to know whether the deadly H5N1 bird flu could develop a capacity for airborne transmission like the common cold virus. Having failed to modify its genetics to achieve this, they began to pass an infection between ferrets, the animals whose response to the virus most mimics that of humans. Ten ferrets later, healthy animals were catching the virus from the cage next door. Knowing how easily H5N1 can become airborne is exactly the kind of discovery that will bolster our vigilance. It is, after all, many times more fatal than the H1N1 strain that caused the Spanish flu. At the same time, there was a huge – but understandable –
furore over whether the research should
be published, and thus be available to potential bioterrorists.

We might have to live with such dilemmas, because it is important to be ready to challenge the killer virus when it arrives. As we have seen with Aids and the common cold, developing vaccines takes time, and there is no guarantee of success, even with a concerted research effort.

****

Will we be ready? Quick suggests that our best chance lies in the world’s business leaders realising what’s at stake: economies would be devastated by the next pandemic. In 1918, Arnold points out, the British government was telling citizens it was their patriotic duty to “carry on” and make sure the wheels of industry kept turning. The result was a perfect environment for mass infection. Political leaders made similar mistakes across the Atlantic: on 12 October President Wilson led a gathering of 25,000 New Yorkers down the “Avenue of the Allies”. “That same week,” Arnold reports, “2,100 New Yorkers died of influenza.”

It’s worth noting that Spanish flu did not abate because we outsmarted it. The pandemic ended because the virus ran out of people it could infect. Of those who didn’t die, some survived through a chance natural immunity, and some were lucky enough to have maintained a physical separation from those carrying the invisible threat. The virus simply failed to kill the rest, enabling their bodies to develop the antibodies required to repel a further attack. A generation or two later, when the antibody-equipped immune systems were in the grave, and humans were immunologically vulnerable (and complacent) once again, H1N1 virus re-emerged, causing the 2009 swine flu outbreak.

As these books make clear, this is a history that could repeat all too easily in our time. Of the three, Pale Rider is perhaps the most satisfying. It has greater complexity and nuance than Arnold’s collection of harrowing tales, fascinating though they are. Spinney’s analysis is more circumspect and thus less paralysing than Quick’s masterful exposition of our precarious situation. But the truth is we need all these perspectives, and probably more, if we are to avoid sleepwalking into the next pandemic. Unlike our nemesis, humans lack focus – and it could be our undoing. 

Michael Brooks’s most recent book is “The Quantum Astrologer’s Handbook” (Scribe)

Pale Rider: The Spanish Flu of 1918 and How it Changed the World
Laura Spinney
Vintage, 352pp, £25

Pandemic 1918: The Story of the Deadliest Influenza in History
Catharine Arnold
Michael O’Mara, 368pp, £20

The End of Epidemics
Jonathan D Quick with Bronwyn Fryer
Scribe, 288pp, £14.99

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 20 November 2014 issue of the New Statesman, The deep roots of Isis