First reports of the 1918 Spanish Flu followed by two weeks of relative unconcern

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For perspective on our current situation, we are following the entrance of the 1918 Spanish Influenza, that paragon of pandemics, into the minds and bodies of Lehigh Valley residents who got their news through the Morning Call (the files of the Bethlehem Globe are closed to us at the moment).

So awareness of the Spanish flu “arrived” in the Lehigh Valley September 13, 1918 — through an unprepossessing and not especially alarming story on p. 17 of the Morning Call.

Over the next two weeks the news was dotted with stories every day — short Associated Press releases with headlines like these below, not immediately and not always on the front page, and sometimes two releases on a page in different positions, as if the editor was simply filling the space as releases came in without realizing their connection. All of which went to dilute impact.

Flu 2

Flu 3Flu 5Flu 7Flu 9Flu 10Flu 11Flu 12Flu 13

 

 

The news was all about someplace else. And that someplace else was in military camps — remember World War I was going on.

4,000 cases at Great Lakes Naval Station, 3,500 at Camp Devens, 857 one place, 9,313 at another, 3,000 new cases here, 500 new cases there, 1,200 in Philadelphia, 42 deaths somewhere else.

And the news was all about providing assurance. The situation was “in hand,” a “serious epidemic” was not anticipated, civilians were attacked but not in “considerable” numbers, health authorities were “confident,” the outbreak was mainly among Negroes, Pfeiffer’s Bacillus was identified as the possible cause, you could use Dover Powder for pain relief.

Dover Powder

But connecting the dots to bigger trouble was possible. First concentrated on the Northeast coast, the outbreak was recorded in Georgia, then Louisiana. High-level Army sanitation experts were deputized to “combat the disease.” Wives and mothers of afflicted soldiers began to be stricken.

Awareness of the Spanish Flu arrives in the Lehigh Valley, September 13, 1918

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For perspective on our current situation, we are following the entrance of the 1918 Spanish Influenza, that paragon of pandemics, into the minds and bodies of Lehigh Valley residents who got their news through the Morning Call (the files of the Bethlehem Globe are closed to us at the moment).

We can mark the exact day.

On Friday the 13th, 1918, readers, if they read carefully, found this on p. 17 of the Morning Call rubbing shoulders on both sides with stories about the war.

Flu 1

  • Note that our “officials” are aware of the flu’s “ravage” in Europe (as we were in China) but are slow to be sure it’s here.
  • Social distancing is recognized as the prime defense, but our “officials” hesitate to initiate such “drastic” action.
  • The government “possibly may” have a 15 Days to Slow the Spread plan to combat the disease.
  • Though the European experience is as plain as day, the disease is characterized as, though acutely uncomfortable, short-lived and not serious — how often have we heard that 80% who have the virus will self-treat without consequence — but no mention is made of death, though 675,000 Americans will eventually suffer it.

Readers of their Friday the 13th newspaper would, if they noted the story at all, feel no imminent fear.

Readers of this Monday the 30th blog, however, might well feel distressed at lessons not well learned.

Contextualizing Bethlehem’s bout with the Spanish flu in 1918

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Join Gadfly as he big-picture educates himself on the 1918 Spanish Flu in this cribbed patchwork of encyclopedia-type sources. Join him too in noting the abundance of ever too familiar similarities with our present coronavirus curse. Somebody will be writing an essay like this about us someday.

The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as “Spanish Flu” or “La Grippe,” the influenza of 1918-1919 was a global disaster.

In the fall of 1918 the Great War in Europe was winding down and peace was on the horizon. The Americans had joined in the fight, bringing the Allies closer to victory against the Germans. Deep within the trenches these men lived through some of the most brutal conditions of life, which it seemed could not be any worse. Then, in pockets across the globe, something erupted that seemed as benign as the common cold. The influenza of that season, however, was far more than a cold. In the two years that this scourge ravaged the earth, a fifth of the world’s population was infected. The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children. It infected 28% of all Americans. An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war. Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy. An estimated 43,000 servicemen mobilized for WWI died of influenza. 1918 would go down as unforgettable year of suffering and death and yet of peace.

The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years. People were struck with illness on the street and died rapid deaths. One anecdote shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza. Others told stories of people on their way to work suddenly developing the flu and dying within hours. One physician writes that patients with seemingly ordinary influenza would rapidly “develop the most vicious type of pneumonia that has ever been seen” and later when cyanosis appeared in the patients, “it is simply a struggle for air until they suffocate.” Another physician recalls that the influenza patients “died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth.” The physicians of the time were helpless against this powerful agent of influenza.

The influenza pandemic circled the globe. Most of humanity felt the effects of this strain of the influenza virus. It spread following the path of its human carriers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific. In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people. The Great War, with its mass movements of men in armies and aboard ships, probably aided in its rapid diffusion and attack. The origins of the deadly flu disease were unknown but widely speculated upon. Some of the allies thought of the epidemic as a biological warfare tool of the Germans. Many thought it was a result of the trench warfare, the use of mustard gases and the generated “smoke and fumes” of the war. A national campaign began using the ready rhetoric of war to fight the new enemy of microscopic proportions. A study attempted to reason why the disease had been so devastating in certain localized regions, looking at the climate, the weather and the racial composition of cities.

The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. The recombination of its surface proteins created a virus novel to almost everyone and a loss of herd immunity. The name of Spanish Flu came from the early affliction and large mortalities in Spain  where it allegedly killed 8 million in May. However, a first wave of influenza appeared early in the spring of 1918 in Kansas and in military camps throughout the US. Few noticed the epidemic in the midst of the war. Wilson had just given his 14 point address. There was virtually no response or acknowledgment to the epidemics in March and April in the military camps. It was unfortunate that no steps were taken to prepare for the usual recrudescence of the virulent influenza strain in the winter. The lack of action was later criticized when the epidemic could not be ignored in the winter of 1918. These first epidemics at training camps were a sign of what was coming in greater magnitude in the fall and winter of 1918 to the entire world.

The war brought the virus back into the US for the second wave of the epidemic. It first arrived in Boston in September of 1918 through the port busy with war shipments of machinery and supplies. The war also enabled the virus to spread and diffuse. Men across the nation were mobilizing to join the military and the cause. As they came together, they brought the virus with them and to those they contacted. The virus killed almost 200,00 in October of 1918 alone. In November 11 of 1918 the end of the war enabled a resurgence. As people celebrated Armistice Day with parades and large parties, a complete disaster from the public health standpoint, a rebirth of the epidemic occurred in some cities. The flu that winter was beyond imagination as millions were infected and thousands died. Just as the war had effected the course of influenza, influenza affected the war. Entire fleets were ill with the disease and men on the front were too sick to fight. The flu was devastating to both sides, killing more men than their own weapons could.

With the military patients coming home from the war with battle wounds and mustard gas burns, hospital facilities and staff were taxed to the limit. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Since the medical practitioners were away with the troops, only the medical students were left to care for the sick. Third and forth year classes were closed and the students assigned jobs as interns or nurses. One article noted that “depletion has been carried to such an extent that the practitioners are brought very near the breaking point.” The shortage was further confounded by the added loss of physicians to the epidemic. In the U.S., the Red Cross had to recruit more volunteers to contribute to the new cause at home of fighting the influenza epidemic. To respond with the fullest utilization of nurses, volunteers and medical supplies, the Red Cross created a National Committee on Influenza. It was involved in both military and civilian sectors to mobilize all forces to fight Spanish influenza. In some areas of the US, the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteer in the hospitals at night. Emergency hospitals were created to take in the patients from the US and those arriving sick from overseas.

The pandemic affected everyone. With one-quarter of the US and one-fifth of the world infected with the influenza, it was impossible to escape from the illness. Even President Woodrow Wilson suffered from the flu in early 1919 while negotiating the crucial treaty of Versailles to end the World War. Those who were lucky enough to avoid infection had to deal with the public health ordinances to restrain the spread of the disease. The public health departments distributed gauze masks to be worn in public. Stores could not hold sales, funerals were limited to 15 minutes. Some towns required a signed certificate to enter and railroads would not accept passengers without them. Those who ignored the flu ordinances had to pay steep fines enforced by extra officers. Bodies pilled up as the massive deaths of the epidemic ensued. Besides the lack of health care workers and medical supplies, there was a shortage of coffins, morticians and gravediggers. The conditions in 1918 were not so far removed from the Black Death in the era of the bubonic plague of the Middle Ages.

Bethlehem “blanket quarantine”? Been there, done that

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Gadfly is a (literary) historian by trade. The past always beckons him. In this period of coronavirus, he could consult the files of the Bethlehem Globe on the local impact of the 1918 Spanish Influenza pandemic if the Lehigh University library were open. Sigh. Gadfly does have access to Morning Call files from home, however, and he will see what they yield. For now, here’s all he finds in perhaps the main modern history of Bethlehem.

004

Bethlehem, Pennsylvania: The Golden Years, 1841-1920 (1976)

What do we see here?

  • In Bethlehem, hospital capacity eventually was not sufficient.
  • And satellite space was needed.
  • Washington School? Where was Washington School?
  • Case numbers escalated quickly to the danger point — within a month.
  • Interestingly, we had no Board of Health — remember that Bethlehem was only born as a city in 1917, inauguration of the first mayor occurred only 9 months before the outbreak.
  • By god, there was a blanket quarantine — a shelter in place.
  • Like now, schools were closed.
  • The list of other closings mentioned specifically includes watering holes and other fun entertainment and food gathering places.
  • So what exactly does “blanket quarantine” mean? Were non-essential businesses closed? Were people advised to stay home?
  • We need to remember that a war was going on!
  • The duration of the shutdown was about a month.
  • Exact number of deaths unknown.
  • I wonder where victims of the disease were buried — Roy, at Fairview?
  • Interestingly, the Southsiders handled the crisis differently.

Wow! Gadfly would love more granular detail about day-to-day life in our town during this time. He can’t wait till he can get to the Globe. Anybody have suggestions for other resources?

But let’s see what the files of the Morning Call yield.

In the meantime, is there any family lore in the memory banks of long-time city residents that you can share?

Remembering the effect of another pandemic

Gadfly’s maternal grandfather, George F. Coxe, garage foreman, died in the Spanish Flu pandemic, 1918, age 30, when my mother was five, precipitating a family slide into poverty and alcoholism that lasted decades.

This picture and this document is literally all I know about him. He disappeared from history. Leaving a gap in my DNA. Not even a gravestone to visit.

George Coxe picture

George Coxe death certificate

Has your family “escaped” such outbreaks? Ebola? H1N1? AIDS? Asian Flu? Polio?

What stories do you have to tell?

Would you share?