This year, more than any other in my lifetime so far, will certainly go down in history. As Covid-19 struck the U.S., frustrations wrought by an abrupt economic downturn, closures of businesses and even schools, and the roiling stress on families was juxtaposed with the usual mild social unrest that builds throughout an election year, inflamed by the pandemic and the government’s response to it. It seemed like one crisis after another, all with the backdrop of shaky, controversial attempts to partially reopen businesses and activities we traditionally patronize, and finding pandemic-approved ways to celebrate the milestones that still happened, such as drive-through graduation parties and birthday celebrations on Zoom: all leading to that most odious of 2020 phrases: “the new normal.”
During the tumultuous early weeks, when we woke up in the morning with one reality, only to watch the sun set on a completely different life where more was taken from us by the virus, I did what I always do when I need emotional comfort: I looked into history to find a much worse situation that would make me grateful for my current condition. And boy howdy, did I find it.
The 1918–1919 influenza pandemic killed more people globally than any other outbreak of disease in human history. Today, scientists and historians believe that it caused about 675,000 deaths (a comparable figure today would be approximately 1,750,000) in the U.S. alone, most of which occurred in a period of about sixteen weeks, from mid-September to mid-December of 1918. John M. Barry’s masterful book, The Great Influenza provides a riveting account of the disease and its physical and social ramifications.
What we call the “Spanish” influenza can most reliably be traced to the small town of Haskell, KS, near Fort Riley, which was home to Camp Funston during WWI. Haskell was experiencing a bout of “severe influenza” in late February 1918, which normally would have raged through its unpaved streets and died at the far edge of town, had not a few local boys been home on leave from Camp Funston. They carried the virus back to Camp Funston—a tiny spark that ignited a global pandemic when troop transports caused the virus to spread rapidly to other Army bases throughout the U.S. and, eventually, to France.
So, why not the “Kansas flu”? Throughout the world in 1918, every country engaged in the Great War used its media as a propaganda machine and censored any negative stories that might damage morale or douse support for the war effort. Spain, by contrast, remained neutral during the war, and its newspapers rightly documented the influenza’s rapid spread and devastating death toll. Citizens of other countries who read the horrible accounts in the Spanish press were largely ignorant of similar horrors occurring within their own borders and wrongly attributed the disease’s origin to Spain, simply because that is where they first heard of it.
While the Coronavirus seemed to have come on with shocking rapidity, the 1918 virus was even more intense. With entire countries shut down and millions quarantined, we were able to form connections with one another via technology—not an option in 1918. At that time, the telephone was just beginning to take hold but as the numbers of healthy telephone operators dwindled, their employers limited calls to keep the lines open for essential communications. If the conversation was too frivolous, operators would end the call. Isolated from their neighbors in small communities, with maybe a daily newspaper (if it came) to keep them informed, people were left to draw their own conclusions as they watched the virus tear through their communities.
Firsthand accounts, as you’d expect, detail the breakdown of community life. People sequestered themselves in their houses, they turned away from one another on the street, grocers did their business at the doorstep, not allowing patrons to enter the store. Still, in virtually every home, someone was ill. The Philadelphia coroner blamed the death toll on the state public health commissioner’s ban on liquor sales, claiming alcohol was the best treatment for influenza. This theory seems to have staying power as early studies have shown a near 30% increase in alcohol consumption in 2020.
Besides boozing, the nascent, largely uncredentialed medical community of 1918 presented many clever treatments that we may not want to reprise. One physician used mustard plasters to create blisters on the skin of infected patients, drained them, and mixed the fluid with morphine, strychnine, and caffeine. This disgusting concoction was then reinjected, as if the patients weren’t already suffering enough. Another doctor recommended enemas of milk mixed with a drop of creosote—a disinfectant—every 12 hours. Opiates—codeine and heroin—were routinely prescribed as cough suppressants.
The scattered, inconsistent government response was problematic then as now. In 1918, the war effort was a mitigating factor: Parades and rallies promoting the sale of war bonds continued unabated despite warnings from health officials about the disease spreading in crowds. In Philadelphia, Director of Public Health Wilmer Krusen acted at the whim of the city’s mayor in alignment with President Woodrow Wilson’s approach to the virus—which was to pretend it didn’t exist—rather than in the public interest, and the results were catastrophic.
In late September 1918, the virus was raging through the Navy Yard in Philadelphia but hadn’t yet gripped the civilian population. Fourteen hundred sailors were infected and local buildings were annexed as temporary hospitals. A parade to sell Liberty Loans was scheduled for September 28th and, despite the urging of many citizens to call it off, Krusen allowed the parade to proceed as planned. Marchers stretched for over two miles and hundreds of thousands of people gathered along the parade route. Two days after the parade, Krusen sheepishly announced that the virus had appeared in the civilian population with the same intensity seen in the Navy Yard. On October 1, the third day after the parade, the epidemic killed 117 Philadelphians in a single day. That number would double, triple, quadruple, quintuple, sextuple until the daily death toll from influenza alone exceeded the city’s average weekly death toll from all causes—illnesses, accidents, and criminal acts combined. (Barry, 220)
The living conditions in Philadelphia in 1918 made it a ticking time bomb that exploded once the influenza struck. War manufacturing efforts had brought an influx of production workers into the city. The overcrowding led to uninhabitable slums that professionals deemed worse than those on the Lower East Side of New York. “Two, three, and four entire families would ram themselves into a single two- or three- room apartment, with children and teenagers sharing a bed. In rooming houses laborers shared not just rooms but beds, often sleeping in shifts just as they worked in shifts.” (Barry, 198) A lack of indoor plumbing resulted in dozens of families sharing a single outhouse—suddenly our springtime toilet paper shortage isn’t looking so bad, is it?
Under these conditions, the virus spread like wildfire. The Spanish influenza was more virulent than the Coronavirus and its victims succumbed with amazing rapidity. Unlike today’s illness with its 14-day incubation period and asymptomatic cases, the Spanish flu took hold of its victims within 24-72 hours of exposure and killed within days or even hours. It had a particular penchant for taking out young adults (as if the World War weren’t doing enough of that already). More people in their 20s and 30s died of the Spanish Influenza than were killed in World War I.
Some governments attempted to slow the destruction by imposing restrictions on gatherings and crowds (social distancing), limiting the passengers on street cars, and closing schools, theatres, and public places. Church services and legal courts were moved outdoors. Restaurant dining, considered a dispensable luxury today, was an essential service in 1918 when many people lacked ice boxes at home. Most people began wearing the distinctive white gauze masks we associate with the period. In San Francisco, the “anti-mask league” formed in protest of a city ordinance that mandated the wearing of masks in public and imposed penalties and even fines for those who did not comply.
Many people today have argued that the government’s mitigation efforts are unnecessarily punitive, given the relatively low number of deaths as a percentage of the overall population. The counterargument is that the measures are in place to avoid overwhelming hospitals (and morgues). This may be a lesson learned from the 1918 pandemic where the infection and death rates were staggering and completely toppled the existing infrastructure for treating the sick and burying the dead. Bodies overwhelmed hospital morgues, overflowing into corridors with no one to remove them. When undertakers became so backed up that they couldn’t process the bodies, the dying continued apace, and families were forced to store bodies until they could be dealt with—in closets, on porches, or in corners of a tenement apartment, surrounded by curious children. Imagine the psychological effects that had.
In Philadelphia, Barry writes, “the city morgue had room for thirty-six bodies. Two hundred were stacked there. The stench was terrible; doors and windows were thrown open. No more bodies could fit. Bodies lay in homes where they died, as they died, often with bloody liquid seeping from the nostrils or mouths. Families covered the bodies in ice; even so, the bodies began to putrefy and stink. Tenements had no porches; few had fire escapes. Families closed off rooms where a body lay, but a closed door could not close out the knowledge and the horror of what lay behind the door. . . . Corpses were wrapped in sheets, pushed into corners, left there sometimes for days, the horror of it sinking in deeper each hour, people too sick to cook for themselves, too sick to clean themselves, too sick to move the corpse off the bed, lying alive on the same bed with the corpse. The dead lay there for days, while the living lived with them, were horrified by them, and, perhaps most horribly, became accustomed to them. (223-224)”
Except for a few remote towns, such as Gunnison, CO, which isolated itself entirely, closing all through roads and arresting anyone who disembarked from the train, the government response was too little, too late. This had as much to do with apathy and deliberate propagandizing as the ferocity and scope of the pandemic. Gunnison, which managed to avoid even a single death, had about 1300 citizens and was located in the west, where social distancing is a way of life. Even the most robust and well-organized response would have been no match for the Spanish flu in a large, densely populated city like Philadelphia.
This is not to give the larger government bodies a pass by any means. Their inaction and willful ignorance increased the death toll exponentially. “The federal government was giving no guidance that a reasoning person could credit. Few local governments did better. They left a vacuum. Fear filled it. (Barry, 333)” President Woodrow Wilson was a man of strong influence—some might say a megalomaniac—who, despite running on a platform of neutrality two years prior, declared war against Germany just a few months after his narrow election to a second term. Thus ensconced, he enthusiastically threw himself and all the resources at his disposal into the war effort.
Despite all the new agencies created for war production and appropriation of resources, Wilson could not spare anything for citizens affected by the pandemic. “Wilson took no public note of the disease and the thrust of the government was not diverted. The relief effort for influenza victims would find no assistance in the Food Administration or the Fuel Administration or the Railroad Administration. From neither the White House nor any other senior administration post would there come any leadership, any attempt to set priorities, any attempt to coordinate activities, any attempt to deliver resources. (Barry, 302)” Pandemic, shmandemic.
Whilst failing his constituents suffering with the Spanish flu, Wilson made himself useful by renaming sauerkraut to “liberty cabbage” and instituting Daylight Savings Time as a means to save fuel (remember this when you’re cursing at your alarm clock in March). He also established the “American Protective League,” an offshoot of the Justice Dept. that encouraged people to spy on their friends and neighbors, investigating “slackers,” “food hoarders,” and anyone who spoke German or didn’t buy enough Liberty Bonds. Even fashion withered under the sphere of Wilson’s influence, with lapels and pockets shrinking to preserve fabric for the war effort.
With the presidential priorities clearly laid out, a reluctant American fighting force joined the bloodbath in Europe—ferried by overpopulated ships that became influenza hot zones. The soldiers who weren’t sick quarantined themselves in windowless holds away from the sick ones. Bad move. “Fear of submarines forced the portholes shut at night, but even during the day the closed doors and the massive overcrowding made it impossible for the ventilation system to keep pace. Access to decks and open air was limited. . . . ” (Barry, 305) Conditions in the trenches of Europe and overcrowded camps stateside were just as bad. Combat deaths for American soldiers in WWI came in at just over 53,000 while a whopping 45,000 military personnel died of influenza.
For all his failings and his low popularity, Wilson went down in history as a successful wartime president. He was even awarded the Nobel Peace Prize in 1919 for his proposal of a League of Nations, although the U.S. never joined it. Fate is a cruel mistress, however, and the influenza came for Wilson. In April 1919, the president was in Paris with British Prime Minister David Lloyd George and French Prime Minister Georges Clémenceau engaged in tense negotiations leading up to the Treaty of Versailles. Clémenceau had a much tougher stance than the others on punitive measures for Germany (no surprise there) and insisted upon sweeping postwar French occupation. Wilson argued for a gentler approach that set the stage for his League of Nations ambitions. Clémenceau and Wilson repeatedly locked horns during the negotiations and had reached an impasse when Wilson suddenly fell ill. He was confined to his room with feverish delusions and an exhaustion so consuming that he ultimately capitulated on a number of measures, including the French occupation of Germany that some theorize spawned the German Nationalism that led to Nazism and WWII.
It’s hard to process a trauma that befalls an entire generation. The prevailing emotions—then and now—were fear and uncertainty. People stayed apart, social bonds frayed, children were adversely affected but eventually, it ended. People came together again, society healed, and—unsurprisingly—a decade of unprecedented hedonism ensued. Today, most of the world is entering a second phase of lockdown measures just as we approach the winter months. As we try to combat extreme cabin fever, we can take comfort in the things we have that our forebears did not: the means to work, educate, entertain, and communicate via modern technology and 100 years of solid scientific and medical research in disease prevention and treatment. It has been a rough year, this is true, but our ancestors had it so much worse. They survived, and so will we.
Sources and Further Reading:
Barry, John M. The Great Influenza: The Story of the Deadliest Pandemic in History. Penguin, 2004.
The Home History Project 