"What happens," he asks, "when people in South Side Chicago or Compton or the Bronx see people dying of this, while others get the care they need? What happens if the hospitals which traditionally serve the needs of the inner city begin to run out of beds? Do we think that people will sit pat in the projects and poor neighborhoods of our country and watch as their family and friends, their very communities, die? I don't see why there wouldn't be civil unrest."
What is certainly likely to repeat itself is the swiftness with which the flu raced through communities. In many cases, he said, those who are most vulnerable are the very young, the very old, and the immuno-suppressed, such as those fighting cancer, AIDS, or other devastating illnesses, to say nothing of people suffering from drug addictions and malnourishment. All of those high-risk factors are found in combination in the nation's inner cities, he said.
"With the 1918 flu, though, the exact opposite happened," he said. "Those who tended to be very vulnerable were those between the ages of 20 and 40, which really points up the folly of assuming the military might be able to help in such a crisis. What's to say members of the military wouldn't be impacted?"
In reading through coroner's records, Higgins found that account after account repeated the same pattern.
"Someone might have gone to work on Monday, developed a headache Monday night, was in bed Tuesday and Wednesday, and was dead by Thursday," he said. "Some went peacefully, through pneumonia, which they called the 'old man's friend' because it provided an easy passage. Others weren't so lucky." Many others ?ironically, the typically healthy younger patients -- fell victim to acute respiratory distress syndrome, which replicated the sense of a chemical burn searing the lungs.<