this was the Spanish flu of 1918 the
deadliest pandemic of the 20th century.
Epidemics have infected societies
throughout history. Usually epidemics
come and go but some truly stand out for
their viciousness. In recent history
there has been no pandemic more
devastating than the flu of 1918.
Sometimes called the Spanish flu or
swine flu it killed about 675 thousand
in the United States alone. The outbreak
came in the midst of World War one and
the flu would actually kill more troops
than combat. The flu of 1918 was so
deadly it killed more Americans than
World War 1, World War two,
Vietnam, Korea, and the wars in Iraq and
Afghanistan combined. Yet the Spanish flu
was horrifying for even more reason. It
was very contagious and it killed
extremely quickly sometimes in as few as
12 hours. It killed people in the prime
of their lives but the most victims
being young healthy people aged 20 to 40.
Additionally, it killed some of its
victims in bizarre brutal ways
completely unlike a typical flu virus.
Some symptoms actually closely resembled
the plagues which killed millions in the
Middle Ages. But scientists have analyzed
the pathogens genome and verified it was
not black death which killed millions in
1918. It was just the flu. This video will
cover how the flu began and how its
spread across the world, the bizarre
symptoms that made it so deadly,and how
the flu pushed society to the very brink
of collapse.
If the epidemic continues its
mathematical rate of acceleration
civilization could easily disappear from
the face of the earth within a few weeks
Victor Vaughn, surgeon general of the Army, October 1918. No one can be absolutely
sure where the pandemic originated but
there are several theories. In northern
France there was an outbreak of a
flu-like disease at a British military
base in 1917. The base was located in a
swampy area with lots of waterfowl and
pigs. New flu epidemics often arise when
people have close contact with sick
birds or pigs. There was a separate
outbreak of respiratory disease among
soldiers from Southeast Asia who fought
in World War one from 1916 to 1918. Most
flus start in Southeast Asia and some
historians argue the soldiers may have
brought a new virus to Europe, but
historian John Berry makes the case in
his fascinating book "The Great Influenza",
that the flu may have originated on a
farm in rural Kansas by jumping from
infected pigs to humans. Indeed the first
officially recognized cases of the
Spanish flu emerged at a military base
in Kansas. The US had just entered World
War one and training and industry had
ramped up at a rapid pace as the war
machine fired up, but in rural Haskell
County, Kansas, a war of another type was
quietly beginning. Haskell County was in
the grip of a deadly outbreak of what
seemed to be a mysterious new disease.
People in the community farmers mostly
may have caught the new disease when a
pathogen
from sick pigs jumped species and began
infecting humans. The new virus, the swine
flu, was shockingly contagious and
extremely deadly. A local doctor was
terrified by the death toll the new
virus and contacted the US Public Health
Service for advice. His concern was noted
but nothing else was done. After all it
was a tiny rural backwater. How could it
spread far in such a sparsely populated
area? Slowly the virus began to die down
as it ran out of new people to infect. Perhaps it would have stopped there had
the times been different but 1918 was
the perfect breeding ground for a
worldwide pandemic.
In early 1918 every military base was
teeming with young men training for war.
The military hurried to build new
barracks, hospitals,training areas and
facilities to support the influx of
hundreds of thousands of men. Some of
these men were volunteers and some had
been drafted. The strange new disease was
just dying down in Haskell County when a
few young men left there headed to camp
Funston, Kansas, for training. Camp Funston,
located at modern-day Fort Riley, was
already over-capacity, with 56,000 young
men training for war. There hadn't been
time to build enough barracks for all of
them. It was the coldest winter on record
east of the Rockies yet many men were
sleeping in tents without any heat and
only thin blankets. In an effort to keep
them all warm the commander ordered all
the men to move into barracks ,violating
the health and safety rules that
dictated how much space each soldier
should have. Inside the barracks men
huddled around stoves trying to keep
warm. The men from Haskell County must
have crowded in close too, even as they
began to cough and sneeze. That's all it
took. In the overcrowded barracks, the flu
spread rapidly. It only took six days for
the outbreak to begin. The men from
Haskell County arrived on February 28th.
Less than one week later men began
flooding into sick call. Within just a
few weeks the flu swept across the base
sickening thousands and killing between
38 and 50. It was a high death rate for
the flu but it was nothing compared to
what was coming next. The virus was about
to mutate and become much much worse. Flu viruses are constantly mutating and
sometimes there will be a really big
shift or a virus that usually affects only
animals mutates so it can infect
people too. When that happens it can be
very deadly. The flu comes in waves.
That's why we have a flu season. Although
it may seem like a bad flu is done the
flu can hide for a while or go infect
people in a different part of the world
and then return even worse. In the case
of the 1918 flu, three waves of flu
devastated the world. The first wave
wasn't too bad but the second and third
waves were extremely dangerous.
The outbreak at Camp Funston came just
at the end of the flu season in the
United States, so the first wave infected
a lot of people, but then faded away. The
military wasn't worried. They were
grappling with the far more deadly
outbreak of measles at the time. The flu
virus seemed to fade away but really it
just went abroad to take on a world at
war. "It stalked into camp when the day
was damp and chilly and cold with the
hand that was clammy and bony and bold;
and its breath was icy and moldy and
dank, and it killed so speedy and
gloatingly greedy that it took away men
from each company rank." The Flu, Private
Josh Lee, 1919. Nearly all the ships
carrying American troops to war arrived
at the port in Brest, France. In April of
1918 just as the flu outbreak was dying
down at Camp Funston,an epidemic began
in Brest and slowly began spreading
throughout northern France. Despite the
illness spreading in the city more and
more troops poured in. Healthy men would
land, become infected and then ship out
to new duty stations and to the
frontline carrying the disease through
every small town and hamlet through
which the armies traveled. The flu tore
across France and followed the
frontlines into Belgium and the
Netherlands. It jumped across the lines
of war and began infecting the German
army, actually affecting the outcomes of
battle since so many troops who were too
sick to fight . It jumped from the German
army to the German people. By May it had
reached Italy where it crossed the
Mediterranean and surged into North
Africa. It also arrived in England by May
riding back on boats with troops heading
home. Infection and death rates began to
skyrocket in Spain and Portugal. The flu
gained its name, the Spanish flu, from the
early infection and high mortality rate
in Spain, where a reported eight million
died in May. Spain was neutral in World
War one and as a result it was one of
the only countries that was reporting
the news without strict government
censorship. Most countries didn't want to
reveal to their enemies that they were
battling an epidemic and didn't want to
affect their people's morale so the
government's pressured the media to hide
and downplay the severity of the virus.
However in neutral Spain
the press was free to report the news
accurately. Newspaper headlines in Spain
screamed of an epidemic that was killing
millions while other countries only
whispered of the flu. The world believed
the flu was worse than Spain when
in actuality Spain was the only one talking
about it at first. The flu continued
spreading beyond Western Europe. By July
it had jumped to Scandinavia and Greece.
The same month, the flu crept its way into a tense Russia where the Tsar and his
family had just been executed and the
Bolsheviks were battling with other
factions to see who would control the
future of Russia. A boat filled with sick
sailors arrived in Mumbai, India, at the
end of May. At first a few dock workers
reported sick then workers at the next
docks became ill and then men at the
nearby warehouses got sick and so on
into the city. Ships left those same
infested docks and spread to other ports
in Asia. Sick people boarded trains in
Mumbai and spread the disease like
wildfire along the railroad lines up
into the subcontinent and continental
Asia. The flu showed up in China around
the same time, spreading inland from a
dock in Shanghai. By June, it had arrived in
Singapore, a world trade hub where the flu
infected the dock workers and spread to
the local population from the bustling
docks.
Sailors carried the flu south into
Indonesia and north into Malaysia and
Thailand where it continued to spread. By
July, it had reached sub-Saharan Africa
with infected sailors who arrived at the
ports. It entered West Africa from ships
arriving in Freetown, Sierra Leone. It
infected eastern Africa via the port in
Mombasa, Kenya. Ships arriving into Cape
Town set the virus loose in South Africa.
From these ports, influenza ripped its
way across the continent devastating the
population. By July it had also reached
Peru and begun spreading across South
America. By August it had returned to
North America. By October it had reached
New Zealand and Japan. By November, a lethal outbreak was surging across Colombia,
Argentina, Uruguay and Chile.
Despite quarantines on ships entering
port, dock restrictions and a concerted
effort at containment, it finally spread
into Australia by 1919 . In less than a
year the deadly flu had surged
around the world. The flu was able to
spread so efficiently for many reasons
including the movement of vast companies
of troops around the world and the
conditions those troops were living in.
World War 1 was desperately brutal and
trench warfare made for horrific living
conditions and for the perfect breeding
ground for disease. Men lived out in the
open with no protection from the
freezing winter the pounding rain or the
sweltering sun. Troops at the front lines
lived in filthy trenches for months at a
time where they had to eat, sleep and
answer all the calls of nature within
close contact with each other. When it
rained the trenches filled up with water
that became rank and foul as it had
nowhere to drain. Men's feet rotted in
their boots, a condition called trench
foot. Dead bodies lay decomposing in
no-man's land between the two armies.
When it rained, water would wash
excrement, decomposing body parts and
filth down into the trenches where the
men lived. Constant bombing turned up the
dirt and turned the ground into a sloppy
swamp .The mud became so bad that in some
places it was like quicksand .Planks were
laid down for the men to walk on. There
were cases of horses, pack mules and even
soldiers slipping off the walkways and
drowning in the mud before they could
struggle out of their heavy gear. By the
end of the war over 9 million combatants
and 7 million civilians would die
thus it's not surprising that when a
violent new virus arrived it became an
even more deadly foe than the enemy
soldiers. At some point in the summer of
1918 the flu mutated to become more
deadly. It gave some people the normal
symptoms of fever, chills, nausea, aches
and diarrhea and many got sick then
recovered like a normal flu. Some were
sick longer or died after catching a
secondary infections such as pneumonia.
However many people became violently ill with
strange symptoms. In fact in the July
1918 edition of the medical journal "The
Lancet", doctors argued that this strange
epidemic couldn't be the flu because the
symptoms didn't fit. Italian doctors
argued the same. In some people Spanish
flu caused fevers that were so high
people hallucinated.
Some writhed in agonized muscle
pain so bad that doctors thought they
had dengue, also called "break-bone fever".
It made some people temporarily or even
permanently blind, deaf or paralyzed. Some
lost the ability to smell. Some had
strong vertigo and would fall over if
they tried to walk. Extreme ear
infections developed very quickly going
from the first pain to the eardrums
rupturing within only a few hours. Some
had terrible headaches and double vision.
Severe mucus excretions and inflammation
made it hard for victims to breathe some
people coughed so hard they tore their
abdominal muscles. Doctors doing
autopsies saw lungs so damaged that they
resembled those of people who died from
poisonous gas in the war. Some people
developed a symptom most physicians had
never seen before. Tiny puffs of air would leak out from
tears in the lungs and get trapped beneath
the skin puffing up in little pockets
all over their bodies. When they moved
the pockets would crackle like a bowl of
rice krispies according to one nurse.
Some people developed hemorrhagic fever
which, like Ebola, causes its victims to
bleed. An army report described the flu
as a rapidly escalating infection and
lungs choked with blood, fatal in from 24
to 48 hours. Some people bled from their nose, their
ears and their eyes. Some people with the
1918 flu became so oxygen starved they
began to turn blue or even looked black,
a condition called cyanosis. People
reportedly turned so dark that it was
difficult to distinguish white people
from people of color. For this reason the
flu picked up the nickname "the blue
death" and many wondered if the black
death had returned. When people began
turning blue doctors knew they wouldn't
survive more than a few hours. The flu
was also terrifying because it could
kill so quickly. Many victims died within
a day or two or even hours of showing
their first symptoms. According to a
story recounted in the book "The Great
Influenza", a man in Cape Town, South
Africa, boarded a streetcar just as a
conductor died. During the three-mile
ride to his house, six more people on the streetcar died.
When the driver died, the man got off the
streetcar and walked home.
"We've had a number of cases where people were perfectly healthy and died
within 12 hours."
Charles Edward Winslow, epidemiologist
and professor at Yale University. In late
summer of 1918 the flu virus returned to
America but this time it was far more
deadly. In August, a ship full of sick
people arrived in a New York City from
Europe. Four men had already died at sea
and 200 more people on the ship were
sick. Many were taken to hospitals but
they weren't quarantined. In the
following week several more ships full
of sick people arrived. The same was
happening in other deep-water ports like
Boston, Philadelphia and New Orleans. At the same time as the virus was arriving and
spreading in ports, ships left those same
ports headed for Canada, Central America,
the Caribbean and South America, carrying
infected people. In early September there
was an outbreak at Navy Pier in Boston.
The pier was quarantined but officers
still moved between bases. An officer was
probably responsible for carrying the
flu to nearby Camp Devens. At first, just
a few men reported sick and then within
only a few days an epidemic broke out. By
mid-September, thousands of men were sick,
in many cases violently so. Of those who
were sick, seventy-five percent were so
ill they had to be hospitalized. The
sheer number of patients overwhelmed the
medical staff of the military hospital.
The hospital had been designed to treat
a maximum of 1200 troops at one time, yet
more than 6,000 patients were crammed in.
Cots were stuffed into every available
space, in hallways and offices, even on
outdoor porches. The doctors and nurses
fell ill and there were simply not enough healthy
people to care for the thousands of sick
people. So many died that they couldn't
all fit in the hospital morgue. The dead
were stacked up one on top of another
like firewood in the hallway outside the
morgue. Every day they were carted away
and every day the hall filled up again. The Army Medical Officers issued an
order that no men should be sent to or
shipped out of camp Devens.
However that's not what happened. A group of officers left camp Devens headed to
Camp Grant in Illinois. Despite the rules
against it, the chief officer there had
authorized overcrowding due to a
shortage in barracks, once again giving
the ideal environment for the disease to
spread. Shortly after arriving the
officers from camp Devens became sick. The men were quarantined but it was
already too late. Within two days of the
first cases, the flu was widespread
throughout the camp. Within four days of
the first case, men started dying. Within
five days, doctors and nurses became sick
and started dying. By six days there were
4,000 men admitted to the hospital and
they converted ten barracks into
temporary hospitals. By seven days they
were running out of medicine,
disinfectant and other medical supplies.
By nine days they converted nine more
barracks to serve as hospitals, bringing
the number up to twenty. They didn't have
enough beds sheets or ambulances to
carry all the infirm. When they ran out
of beds, soldiers were ordered to
stuff straw into sacks to use as
mattresses for the sick. They still
didn't have enough. They tried to make
enough face cloth to cover people's
mouths to fight the spread of germs but
they ran out of cloth. The Red Cross set
up a station to notify relatives that
their loved ones were dying or dead. Now
relatives poured into the midst of a
deadly epidemic. Healthy relatives were
escorted by coughing service members to
identify dead bodies in the morgue. They
crowded into the overfilled hospitals to
visit loved ones. Desperate parents and
wives tried to bribe nurses and
orderlies to give special care to their
soldier. It became such a problem the
head officer issued a warning about
accepting bribes. Those relatives would
leave the camp and carry the infection
out into the civilian community, into
local towns, on to cross-country trains,
and ultimately back to their own
hometowns. Civilian health officials
called for an emergency quarantine of
Camp Grant, but the virus was already out.
Four days after the first reported case,
a trainload of troops had left Camp
Grant to go cross country to Camp
Hancock near Augusta, Georgia. For the
journey of almost 1,000 miles,
the men were packed tightly into train
cars with poor ventilation. In the tight
quarters, men coughed and became feverish.
They infected each other swiftly and the
virus swept along the train. The train
stopped repeatedly along the journey to
refuel and the men who could still walk
got off the train to get a break from
the hacking coughs of the sick and
delirious men. There they interacted with
railroad workers and curious locals
who'd come to see the troops. They
infected town after town for almost
1,000 miles. When they finally arrived in
Georgia, 2,000 of the 3,000 men were so
sick they needed to be hospitalized
immediately. They started a new outbreak
at Camp Hancock. Historians don't know
how many of the men from the train died
but one report from Fort Leonard Wood
claims 10%. Yet when hundreds began dying, the medical staff at the hospital
stopped keeping careful records. They
were just too overwhelmed by all the
dead.  "One robust person showed the first
symptoms at 4 o'clock p.m. and died by
10 o'clock a.m." The Journal of the
American Medical Association. The same
thing would happen at bases across
America. At Camp Custer in Michigan, 2,800
troops reported sick in a single day. At
the same time, hundreds of thousands of
troops were still shipping out to Europe.
By this point the government knew how
dangerous the flu was so they tried
to contain the virus on ships. Visibly
sick men were not allowed on the ships
but this didn't make much difference in
the end. The flu virus incubates for a
few days before any signs of infection
are visible. On board the ships, the men
were locked into their bunk rooms for
most of the voyage across the sea. Armed military police enforced the
segregation. On most ships about 400 men
were locked into each crowded bunk room
in cramped quarters with little
ventilation. Although the troops were
segregated from others in the ship, they
still shared the same mess hall where
they all ate. They would file through
breathing the same air and touching the
same tables and chairs as the group
before. On one ship called "the Leviathan",
the flu broke out almost immediately
despite the quarantine efforts. Within
two days it had overwhelmed the ship's
medical services. The doctors and nurses
were laid up sick alongside their
patients
delirious, coughing and blood pouring
from their bodies. The blood pooled on
the floor and the nurses who were still
well enough to work walked through the
puddles leaving bloody footprints on the
deck. Finally there were so many sick men
that they began laying them on the deck
of the ship out in the elements.
They even lay there in storms because
the well were too overwhelmed to move
them and the ill were too sick to move
themselves. At first the deaths came
spaced apart and the officers took
careful notes in the captain's log of
the Leviathan. At first, they wrote the
date and time of death, the name and rank
of the deceased, their unit and cause of
death, but only one week after leaving
New York, the officers were so overwhelmed they
wrote only name and time of death. The
captain's log shows two deaths at 2:00
a.m., one at 2:02 a.m,. two at 2:15 a.m. It
continued like that around the clock. The
healthy must have been terrified, locked
onto a ship filled with a deadly plague
with nowhere to escape. They began
burying men at sea. At first they were
solemn ceremonies, but after so many the
funerals became routine. They would read
a name, say a brief prayer and slide the
body off the boat, then on to the next. The same was happening on every boat.
carrying troops across the ocean medical
Advisors begged the military to stop the
troop movements, but the war machine
needed men. At the same time, it was
infecting the civilian population from
port to port, and along the railway lines.
However the very worst outbreak probably
occurred in Philadelphia and it was made
immeasurably worse by mismanagement
by leaders who ignored warnings from public health doctors. Had public health
measures been implemented, perhaps much of the death and suffering could have
been avoided. Philadelphia in 1918 was
teeming with people.Hundreds of
thousands had swarmed the city because
of the new job opportunities working at
steel plants, docks, railroad yards and
industries that supplied the war. Without
enough housing for the influx, poor
people were crowded into squalid, filthy
slums that lacked indoor plumbing.
Multiple families would cram into one
apartment and share an outhouse in an
alleyway with hundreds of people.
Sometimes people shared not only
apartments but beds,
even sleeping in shifts. The boarding
houses would rent out beds for six or
eight hours at a time. When one worker
woke up to go to work, another worker
would get into the newly vacated bed and
sleep, same sheets and all. The streets
were notoriously filthy, with rat
infestations and gutters filled with
trash, animal and even human feces. With
people living in overcrowded conditions,
exhausted from hard labor and weak from
poor nutrition, dirty water and bad air
quality, it was a perfect breeding ground
for an epidemic. "I had a little bird its
name was Enza. I opened the window and
in-flu-enza." Children's jump-roping song,
1918. A ship full of sick sailors arrived
into the Philadelphia Navy Yard in
mid-September. Within a few days, the Navy hospital was overrun and the Navy began
sending sailors to civilian hospitals in
the city. As sailors began dying, the flu
spread to civilians. Two days after the
first sailor arrived at the hospital,
multiple doctors and nurses felt fine as
they started their shifts yet collapsed
and became desperately ill within hours.
However, the health board for the city
didn't want people to panic.
They downplayed the severity of the
disease. After the death of several
sailors and civilians, the Health Board
confidently declared the disease had
reached its zenith and already begun to
decline. It hadn't even gotten started. At
the same time, the federal government was
desperate for money from war bonds to
fund the war. People would buy bonds,
essentially loaning the government money
for a promise of being paid back later
with interest. Every city had a quota of
bonds they had to sell and Philadelphia
was ready to hold the Liberty Loan
parade to sell war bonds. Public health
doctors begged the city to cancel the
parade, terrified that it would cause the
outbreak to become an epidemic. The city
government ignored them. On September
28th, hundreds of thousands of people
jammed into the downtown streets to
watch the parade. In that huddled crowd
all crushed together, it only took a few
coughing, sneezing people to launch the
epidemic. Within seventy-six hours, just
three days later, the city's 31 hospitals
had run
out of bed space. They were completely
full. Some hospitals tried to cram in
more by laying patients on cots in the
hallways, in offices, and outdoor balconies.
In some cases the sick were laid on the
floor next to a dying patient. Once the
patient died the body was taken away and
the new patient would be lifted into the
same bed, still warm from the previous
occupant. The city opened several
temporary emergency hospitals but it
wasn't enough. Hospitals started refusing
to accept any more patients. People lined
up outside, begging to be let in. Some
died standing in line. Even for those who
got in, care was non-existent for most
people. The hospitals ran out of medicine.
The doctors and nurses were overtaxed
and they were dropping from the flu. They
were desperate for help. People with no
medical training volunteered. Physicians
and nurses came out of retirement.
Medical schools closed and first-year
medical students were put in charge of
an entire floor of a hospital. One
medical student reported that during the
height of the outbreak, one-fourth of all
the patients in the hospital died every
day. Nurses were so overtaxed they began
adding toe tags to the living so they
could tag several at once. Once a patient
turned blue it was only a matter of
hours to death, so they felt confident in
tagging them. Sometimes there wasn't any
time for an intervention some people
died within 24 hours of contracting the
flu. A nurse that Mount Sinai Hospital
started her shift in the morning and
suddenly fell ill. She died 12 hours
after first feeling sick. The number of
dead kept growing. Five days after the
city held the Liberty Loan parade,
city leaders finally acted. The Health
Department banned all public meetings.
Churches schools and theaters were
closed. They left the bars open but
those too were closed the next day. The
courts closed and city services shut
down. It took only a few days for the
city's operations to completely grind to
a halt. Within just 10 days, Philadelphia
went from a few hundred cases of flu and
a couple deaths per day, to hundreds of
thousands of people sick and hundreds
dying every day, all because they ignored
public health guidelines.
By three weeks after the parade, the
death toll stood at 4500. So many died
that they couldn't be buried fast enough.
Grave diggers were sick or refused to
bury flu victims. The bodies started
piling up inside morgues and funeral
homes. Some undertaker's raised their
prices 500 percent to try and cash in.
Most ran out of coffins. One funeral home
that hadn't run out, hired guards because
people were trying to steal the coffins.
People began wrapping their dead in
blankets or sewing together flour sacks
to use as shrouds. No one came to take
the bodies and there was nowhere to
bring them so the dead stayed in the
homes. People wrapped them in blankets
and set them in closed off rooms. The
bodies were laid on porches or stacked
in back alleys. In the poor, overcrowded
tenement houses where multiple families
lived in one apartment, there were no
porches or spare rooms to put the bodies.
They set them in the corners or stacked
them in the alleyways next to the shared
outhouses and drinking water pumps.
Sometimes people were so sick that the
person in bed next to them would die and
they couldn't gather the strength to
take the body away. The city began to
smell, the stench of death hanging
heavily in the air.
Finally families begin digging their own
graves to bury their dead. Everyone was
terrified. People avoided each other.
There were cases of children whose
parents got sick and the children
starved because no one would go near
them in case the child was sick. This was
particularly a problem since those who
were most likely to die were people aged
between 20 to 40, many of them parents.
People couldn't get food because no
trucks were delivering goods in the city.
The streets fell silent. Every business
was closed. People hid inside their homes.
The street cars stopped. The police cars
stopped. The entire city ceased to
function.
"You were constantly afraid. You were afraid because you saw so much death
around you.
You were surrounded by death.
When each day dawned you didn't know
whether you would be there when the sun
set that day. It wiped out entire
families from the time that the day
began in the morning to bedtime at night,
there wasn't any single soul left."
William Sardo, Washington, D.C.
The Philadelphia city government was by now non-functional.
Wealthy Philadelphia
families appealed to the federal
government for help but there was no
help to send. Cities all across America
were buckling beneath the weight of the
epidemic, and the federal government was
busy managing the outbreak on military
bases and among troops in Europe. With
the city government failing to act, the
women of elite Philadelphia families,
many of the same who'd organized the
Liberty Loan parade, banded together to
start outreach efforts. They gathered
together civic leaders from across the
city to start planning. They set up a
special hotline to answer questions
about the flu, but had a hard time
keeping it staffed because so many
employees were sick. They set up local
neighborhood leaders who would organize
distribution of food and medical care.
They set up soup kitchens in the schools
and food delivery to sick people when possible. Five hundred people volunteered their
cars to be used as ambulances and to
deliver food and drive doctors around to
treat the sick. However there was a
desperate need for more volunteers and
most people were too afraid to get
involved. Leaders begged for more help
but people turned away. The fabric of
society began to break down.
City leaders, who hadn't bothered to
attend meetings of the outreach effort,
finally got involved. They seized the
city's emergency fund to pay for
supplies and pay health workers. They
opened additional morgues and sent out
policemen to try and clear the piled-up
bodies. Like the ancient plagues, people
carried their dead out to the streets.
There the bodies were loaded onto open
trucks or horse-drawn wagons. There were
no coffins, so they stacked them one on top
of the other. Also like in the days of
the plague, they stopped trying to bury
people individually and began digging
mass graves where hundreds of bodies were
dumped in. The city used construction
equipment to dig long trenches and push
the bodies in. Someone would stand by the trench say a
prayer and then the steam shovels would
push dirt over the piles of bodies. By
late October, the epidemic was finally
beginning to loosen its death grip on
the city. In its aftermath it left a
death toll of 13,000. It also left
thousands of orphaned children, a
shortage of food and goods, and a stalled
city that had to slowly grind its most
basic services back into motion.
Finally, it left a changed people, filled
with fear, wearied by war and disease, and crushed by grief.
"The people of Phoenix are facing a crisis. Almost every home in
the city has been stricken with the
plague." Arizona Republican (newspaper), November 8th, 1918.
In other cities and towns across
America the news was the same. In New
York City, 33,000 people died before the
statisticians stopped counting. Some
small towns tried to keep the virus out
by quarantining themselves. They shut down
all businesses and canceled public
gatherings. People were ordered to stay
in their homes and not touch or visit
others. Some towns made it illegal to
shake hands. In other towns, police were
dispatched to nail signs on the doors of
homes where people were sick. The signs
said "influenza" in red letters. Rumors
spread in Phoenix, Arizona, that dogs spread the disease. Policemen killed dogs in the
streets and people killed their own pets.
Towns in Colorado set up barricades on
the roads and men guarded them with
shotguns, preventing anyone from coming
in. Other towns couldn't stop the trains
from rolling through on their local
platforms but they refused to let anyone
step off the trains. Anyone who did was
thrown in prison and quarantined. It
didn't work. The virus still slipped in.
The only place major city that escaped the worst of the wrath was San Francisco, and
historians credit that to aggressive
response by the local government who
listened to their public health
officials. Public health director William
Hassler quarantined all naval stations
before they had any reported cases. He
knew it was only a matter of time. He
ordered all public schools and gathering
places closed. He divided the cities into
separate districts with distinct support
staff, so as to segregate outbreaks. He
laid out plans and organized the flu
response before the flu ever hit the
city, so they would be ready when it did.
The city's government, medical and civic
organizations banded together to educate
citizens on prevention such as
hand-washing, avoiding public places and
wearing a face mask. While Philadelphia's
government was still denying there was a
problem, San Francisco authorities were
distributing 100,000 face masks. Police
enforced the facemask rule at gunpoint
and actually shot people who refused to
wear masks in the streets. As the second
wave diminished throughout the country,
San Francisco rejoiced for having missed
the flu. The fluid would mutate once more and
rage through the world for a third time but
infecting and killing fewer people. This
time, it would be less severe. This time
it did hit San Francisco because they
thought the flu was already over. The
third wave hit the South, West and
Midwest hard, but for the rest of America.
the worst of the flu had passed. Even as
America woke from the nightmare, the
epidemic had left its imprint. Right at
the height of harvest time, farmers had
been too sick to farm and workers didn't
show up to gather the food in. Food that
was harvested rotted in warehouses
because there was no one to transport it.
There was a lag while the country tried
to catch up on shipping food and goods
and store shelves and markets stayed
empty for some time because goods hadn't
been delivered. As winter rolled in,
there was a shortage of coal and other
goods. However the weary country still
rejoiced for an armistice was signed on
November 11th 1918.
The war was finally over even as the
plague and its effects lingered on. In
the US, it killed about 675 thousand. The
flu killed an estimated 3 percent of the entire
world population. In Latin America, the
flu killed 10 out of every 1,000 people.
In Africa, about 15 out of every 1000
died, and in parts of Asia, the death rate
was as high as 35 per thousand. In Tahiti,
it killed ten percent of the population,
and in Western Samoa,
20 percent of the population died.
In India alone, it killed about 20
million people. You may be asking
yourself, could a deadly flu like that
happen again? It's important to
understand that the Spanish flu was
devastating for a number of reasons
unique to that time. However, the
essential formula for epidemic still
exists. Viruses sometimes jump species, for instance
from pigs to humans. This could
happen at any time anywhere in the world,
and of course flu viruses are constantly
mutating. Usually mutations are minor but
occasionally a big mutation can happen.
This has happened a few times in recent
history. For instance the Russian flu of
1889 killed about 1 million people, the
Asian flu of 1957
killed about 2 million and the Hong Kong
flu of 1968 also killed about 2 million.
Then in 2018, exactly 100 years after the
outbreak of Spanish flu, the mutation
brought a particularly deadly flu to the
US and Australia. As of 2018, there is one
strain of Avian flu, an h5 type, that has
managed to infect humans, but so far it
cannot jump between people. However, that
particular strain of flu is frightening
in its potential, according to Donald
Burke, MD, former director of the Johns
Hopkins Center for Immunization Research.
Of the people who have been infected, it
has been deadly in over 75 percent of
cases. If that type of flu adapted to
human-to-human infection, it could be
catastrophic. So could it happen again? Yes, it could.
As Burke said, "When it comes to the
probability of a pandemic flu, I think
everyone would say it's not if. It's when."
However there's reason to be hopeful.
When a new kind of flu emerged in 2009, a
swine flu just like the Spanish flu,
officials did not waste any time
acting. Public officials acted swiftly,
putting emergency epidemic plans into
operation. We were lucky that the 2009
swine flu, though very contagious, was not
a deadly strain, and it showed us that
response matters a great deal. In fact,
the way we respond to the next big
epidemic could mean the difference
between life or death.
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