by Paul R. Spitzzeri
Given how little attention has been paid to the centennial of the First World War, it is unlikely that there’ll be much thought given to another destructive force that struck the world in fall 1918: the so-called “Spanish Influenza” epidemic. The virus did not emanate from the European country, but the nation, neutral during the war, reported freely on the epidemic and was unfair saddled with identification with it.
A couple of weeks ago, I was in my local library bookstore, where I’ve been buying most of my books the last several years, and came across Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It, written by science journalist Gina Kolata and published by Farrar, Straus and Giroux in 1999.
Kolata, who has a master’s in applied mathematics, studied molecular biology at M.I.T. for a year-and-a-half and her understanding of complex scientific and medical terminology and concepts added to her ability to write clearly and compellingly for a general audience makes the book an excellent read. Since Flu was published, she has been a Pulitzer Price finalist twice for her work in science reporting, so her credentials are very impressive.
Actually, only the first few dozen pages or so are directly about the pandemic that moved quickly through the world and led to a virulent form of pneumonia in which victims literally drowned because of mass amounts of fluid in their lungs. The flu killed an estimated 50 million people worldwide, out of about a half billion, fully a third of the estimated 1.5 billion people, who contracted the illness, according to the Centers for Disease Control and Prevention.
The CDC estimates that about 675,000 Americans, out of a little more than 100 million in the total population, died of the flu and its complications. Imagine the scale of destruction a similar pandemic would wreak today in our world of roughly 7.5 billion people.
Kolata related that the flu struck in spring 1918, but was a much milder form than that which hit in late August and spread rapidly. Notably, the disease moved quickly because of the movement of American sailors and soldiers during the waning days of the war. By the end of September, she continued, influenza was running rampant at military installations on the east coast and elsewhere and she cited a doctor who observed that, at one camp in Massachusetts, there were about 100 men dying each day.
From military personnel the epidemic moved into the general population. In Philadelphia, thousands died by mid-October and the flu was in virtually every part of the planet, except Australia and some remote islands. Kolata cited examples of the ravages of the epidemic, including a particularly graphic description of the sufferings of one young adult (a part of the population hit especially hard) by his brother Thomas Wolfe, who went on to become one of America’s greatest novelists:
Ben’s thin lips were lifted, in a constant grimace of torture and strangulation, above his white somehow dead-looking teeth, as inch by inch he gasped, a thread of air into his lungs. And the sound of this gasping—loud, hoarse, rapid, unbelievable, filling the room, and orchestrating every moment in it—gave to scene its final note of horror.
From that first wave of milder flu that hit in spring 1917, to the second and staggering round that came in September and a final wave in the first several months of 1919, the pandemic caused such havoc that life expectancy in the U.S. plummeted by a full dozen years. Death rates were shocking for people in the 20-40 year range, the population least likely to be felled by illnesses usually most affecting the very young or the aged.
Kolata noted that, though the development of germ theory and other medical advances had allowed for tremendous strides in combating many diseases and illnesses, medical experts were staggered by the onset of the virus in 1918. It had been a quarter-century since the last major flu epidemic (here in greater Los Angeles, Nicolasa Workman, her daughter Antonia Margarita Workman de Temple, and the latter’s eldest child, Thomas W. Temple died of flu in late January/early February 1892 during the epidemic).
The state of medical knowledge and scientific investigation was still very limited in 1918 and the bulk of Kolata’s book deals with attempts by a few dedicated researchers over the next eight decades to figure out what caused the virus. Written like a mystery story, this thread is well worth reading about, though the story ended in 1999 while efforts were still underway.
As for greater Los Angeles, the first signs of the epidemic were, as was the case elsewhere, noted towards the last couple weeks of September 1918. Local authorities, led by city health commissioner Dr. Luther Powers, moved quickly to limit activity, implementing policies that shut down schools for several weeks and closed high-concentration areas of people such as movie theaters, churches, and other places of public gathering. Gauze masks were recommended and, in some cases, extreme measures were adopted. For example, Long Beach passed a no-kissing ordinance, though this well honored in the breach.
Media outlets reported heavily on the pandemic and the Los Angeles Times, the newspaper with the largest circulation in the region, supported the efforts of officials to limit the spread and destruction of the flu. Yet, being a particularly pro-business paper, the Times began to chafe at the restrictions as the weeks wore on. Its dominant publisher, Harrison Gray Otis, assisted by son-in-law Harry Chandler, was a founder of a powerful business association which questioned the extensive bans imposed on movie theaters and other businesses.
In fact, the Times would regularly report on the diminution of the epidemic, frequently citing “slightly” fewer cases of influenza and resulting deaths in its reports and editorializing that it was time to loosen the restrictions as the year came to a close and the holidays, with the prospect of lower commercial activity looming, approaching.
In early December, health authorities decided to end the ban on theater operations and the rejoicing in the paper and, presumably, generally in the public was palpable. Yet, despite the frequent claims that the epidemic was waning, that third wave hit and corrective measures had to be taken. By spring 1919, however, the pandemic finally did ease.
One of the more disturbing elements of the battle to combat the flu in Los Angeles was an attempt by about white 125 nurses at the county hospital to resign because of a decision by the Board of Supervisors to allow black nurses to work at the facility. After several weeks, most of the white nurses decided to rescind their resignations, but the episode is a reminder of another virulent problem, rampant racism, in the body politic of greater Los Angeles.
Kolata related in her book that, in the 1990s, there was little interest and a lack of material available concerning the influenza epidemic of 80 years before. To her, it was as if a nation, already embroiled in that final months of the world war, was rent asunder by the destruction caused by the epidemic and decided to try and forget the horrors it wrought.
Matters have changed somewhat in the last two decades since Kolata’s book when it comes to commemorating the flu pandemic of 1918. For example, the CDC’s web page, “Remembering the 1918 Influenza Pandemic” has an excellent and concise summary of the epidemic and links on that page provide additional useful information and resources, including a timeline and a fascinating photo gallery.
With respect to conditions in Los Angeles during the pandemic, there is a page on the Influenza Encyclopedia’s sub-site, “The American Influenza Epidemic of 1918-1919” that is a great summary of what took place locally. The encyclopedia is maintained by the University of Michigan Center for the History of Medicine and Michigan Publishing, an arm of the university library.
27 September 2018 add-on: New reports show that last winter’s flu season was the deadliest in the U.S. in four decades, with 80,000 people succumbing to complications.