The Influenza Pandemic of 1918 | The Invisible Enemy

Yankee classic from February 1982

Boston in the summer of 1918 was hot and very dry, with only 8.13 inches of rain in four months, according to the U.S. Weather Bureau. For the men in “Receiving Ship,” a naval barracks on Commonwealth Pier where as many as 7,000 enlistees boarded while awaiting assignment or returning from duty, the dry heat made sleeping a bit easier, and the cloudless blue skies prompted hundreds of them to take to Revere Beach. The news of the day was mostly about the “job of beating the Hun, a job squarely up to the U.S.” We’d been in World War I for about two years. As far as the newspapers were concerned, the glory of defeating the Boche was the only thing really worth thinking about. Between the columns about our gallant boys “over there,” the newspapers applauded the rounding up of slackers, those who hadn’t registered for draft; they mocked the suffragettes and puzzled over their cause; and firmly denounced anyone they thought was hampering the war effort — the IWW, Eugene Debs, the “Bolsheviki,” even the striking car men of the Boston Street Railway Company. “If you must kiss, filter the smack,” read one mid-August Globe article. The story that followed was about a Norwegian ship that had arrived in New York City with 100 sick passengers on board; four more had died and been buried at sea. Was this the mysterious “Spanish Influenza” that they’d heard rumors about, reporters asked? It couldn’t be, officials replied. Though in fact a new and brutal form of flu was ravaging both sides of the front, killing thousands in Europe, doctors here believed that the so-called Spanish influenza was something only the Germans could get because they were weakened by famine and life in a war zone. There was nothing to worry about here, stateside officials declared. Besides, they reasoned, flu is a winter disease familiar to everyone; and though it will put a person under for a few days, it’s certainly not deadly. “To avoid the common or garden-variety of the disease,” the Globe story concluded, “kiss through a handkerchief.” Lydia Johnson’s father, a blacksmith, decided he could profit from the boom the war had brought to the mills and factories in small-town New England, and so he moved his wife and five children down to Greenfield, Massachusetts, from the hill village of Shutesbury. The move meant they had to sell the family’s cow, and Lydia, age 8, was sorry to see her go. Out in the country the Johnson family could grow its own food, keep chickens, and cut wood for heat. In town the war had not only boosted employment, but it had shot the price of food sky-high. At summer’s end there was inflation (eggs at $0.49 a dozen, butter at $0.51 a pound) and shortages (to heat a house you needed a ration card from the Fuel Administration). On the evening of August 27, two sailors had come into Receiving Ship’s sick bay with what appeared to be textbook symptoms of the flu: chills, fever, sore throat, coughing, labored breathing. The medical officers on call took blood samples, made throat cultures, gave the standard physical exams, and ordered the men to bed. Forty-eight hours later, two doctors of the 11 at the infirmary had taken ill. On August 28, eight more sailors with the same symptoms checked into the infirmary; on the 29th, 58 more. Twenty sick men a day was enough to be considered unusual, but doctors and nurses were too busy to ponder the peculiar circumstances: they were facing a calamity. By the end of the week the number of cases was averaging 150 a day, and a steady parade of ambulances carried the sick from the modest infirmary to the modern Chelsea Naval Hospital overlooking Boston Harbor, which had a l,236-bed capacity. The disease was not confined to the Navy. Thirty miles west of Boston was Camp Devens, where much of the Yankee Division had been trained. Most of the soldiers in that division were now in France beginning America’s first major offensive of the war, the St. Mihiel battle. The task at Devens now was to train the 12th Infantry, and when General McCain arrived at the camp on August 20, he announced that the 12th would be ready to go overseas in 14 weeks. “Range firing,” he said, “will be carried on at all hours of the day while it’s light enough to see the bull’s eye.” What the general could not have known was that by the end of those 14 weeks 17,000 of his men would battle for their lives here; 800 would succumb, casualties in a war against an invisible enemy. And the losses to the 12th would be just a fraction of what was to come; the influenza pandemic of 1918 would the worst in modern history. Camp Devens, built in 1917, was home 45,000 men, 5,000 of them living in tents; in the first week of September 1918 another 4,000 recruits arrived. When drill sergeants marched them past the camp’s 2,000-bed hospital, they unconsciously lowered their voices. Something very grave was happening in there. As one Army doctor later described the scene, “There was a continuous line of men coming in from the various barracks looking extremely ill. There were not enough nurses and the poor boys were putting themselves on cots, which overflowed out of the wards onto the porches.” However, after touring Devens’ hospital with General McCain, Lieutenant Colonel McCormack, a division surgeon, insisted to the press. “There’s nothing to get fussed up over — flu’s flu.” But Dr. William Bryan, over at Receiving Ship, was more cautious in his remarks: “It’s not the fancy European kind, but it is not the old-fashioned grippe. It is sufficiently dissimilar to be a medically different trouble.” When the epidemic had run its course, doctors could look back over the situation and realize that by the second week in September three sets of symptoms seemed to be evident: (1) In the first group the disease began mildly and the patients felt as though they would be better in a couple of days; a day or two later there was a rise in temperature followed by the onset of pneumonia, then death. (2) In this group the disease began somewhat severe. It was followed by pulmonary complications, then recovery. (3) The third type began as extremely severe. Breathing became very difficult, cyanosis set in. At Devens the lungs of 18-year-olds were filling with fluid; they were drowning, their faces blue from lack of oxygen. In this type, death followed in 36 to 48 hours. There was much contact between the military and civilian populations, and it was only a matter of days before the invisible enemy began its assault on Boston’s residents. Women who worked at the military installations became the first civilian victims. On September 11, the Globe carried on its back pages one of the first stories about the situation. “Catherine Callahan,” it read, “overtaxed by her work for our soldiers, died today.” But the obituary went on to say that her sister Mary, 19, was also in the hospital with pneumonia — and so was her mother! Civilian doctors were not required by law to report influenza cases to public officials, so how fast the contagion was spreading could only be guessed. Boston City Health Commissioner William C. Woodward was anxious, but he refused to convey his anxiety to the public. He issued a cool statement warning people that at the first sign of a cold they should isolate themselves, get into bed, and take cold remedies. On September 18, Woodward estimated that there were at least 3,000 flu cases in the city — 40 people had died in the past 24 hours. It was evident to doctors that despite the benefits of modern medicine, there was little they could do for the sick. Warm food, fresh air, and blankets were all the doctors could prescribe; there were no antibiotics. Nothing could prevent the epidemic from running its course. In the morning Woodward noted as a sign of hope that not one schoolchild had yet fallen victim to the plague, but with “the grippe making headway in every neighborhood, rich or poor, there was nothing to be gained by denying its presence.” Help was needed, The Public Health Service of Massachusetts telegraphed the national headquarters of the Red Cross for 15 additional nurses to be sent to Boston. By the evening of the 18th Woodward’s one comfort was gone: news of the first child to fall victim was on his desk. The city streets began to empty and grow quiet. Behind closed doors in houses and tenements everywhere were the raspy sound of coughing, the delirious voices of fever, and the whispered fears of the healthy. The flu moved from the back pages of the newspaper to page one, where it remained for weeks to come. The October weather had turned the hills and fields surrounding Greenfield Massachusetts, from their deep summer green to the red-gold-green-brown tweed of autumn. Lydia Johnson’s family had done well by moving here. Her father was bringing home $42 a week, her mother worked as a laundress, and her sister Maud, 21, had landed a job in a machine shop. Lydia, like many other children at the Main Street School, having heard that the Germans put ground glass into sugar, among other hair-raising tales, feared for her life if “they” won the war. But the danger that adults worried about was more immediate. The influenza epidemic was blazing across the state. Camp Devens was quarantined, and General Crowder had canceled the draft even though General Pershing needed more troops! And worse, everyone in town was getting sick. The policemen had taken to wearing gauze masks, which Lydia thought looked rather funny. But when she came into the house one afternoon and found Maud at home, in bed in the middle of the afternoon, she realized that something extraordinary was happening. But before she could get close to Maud to find out lust what was going on, her brother Harry warned her in a stern voice to keep quiet and at a distance. That night at dinner Lilla Johnson, 19, told the family that when the doctor called he’d said his nurse was down with the fever too. Maud’s fever rose that night, and another sister, Grace, 17, fell ill the next day. By the week’s end, Lilla and the girls’ father were also sick. But Maud’s influenza attack was the worst. Mrs. Johnson made up a special bed away from the sick half of the family for her youngest child Lydia, and when she went to work it was Harry who took charge of the infirmary. Maud didn’t have the strength to eat. Grace and Lilla couldn’t keep food in their stomachs, so he fed each of his patients clear soup. Maud’s soaring temperature posed other problems; she was becoming delirious. Listening to her fevered babble was alarming for Harry, but even worse, he had to wrestle her back into bed when she’d jump up insisting she needed to go out to the garden. In her lucid moments, Harry poured as much tea spiked with whiskey down her throat as he could. The grog kept her dull, and the calm gave Harry time to care for the others. Professionals and laymen caring for persons in Maud’s condition found the whiskey functioned as a pain-killing tranquilizer. Its effects were certainly more reliable than many of the homemade cures such as inhaling turpentine fumes, sniffing camphorated vaseline, or lying beneath poultices of garlic and onions. Whiskey was more effective even than the various vaccines than were widely distributed by doctors to cities and military hospitals. In Boston, panic was barely kept in check during October 1918. By the 16th more than 3,700 people had died. Though Lieutenant Governor Calvin Coolidge had wired Washington and received more than 1,000 additional nurses and some of the money he’d asked for, doctors and nurses were still sadly needed. All month long the city, newspapers ran front-page appeals for healthy men and women to volunteer to work as nurses, bandage sewers, ambulance drivers, laundresses, pharmacists and messengers. Nurses would be paid $28 a week, nurse’s aides $15, and if they came to the city from a distance, their transportation fees would be reimbursed. Henry Endicott, chairman of the State Committee on Public Safety and Acting Chairman of the Emergency Public Health Committee, encouraged people “to step forward and show their patriotism.” Officials preached that proper precautions by the public would help stamp out the disease. The State Public Health Department, like many agencies, published lists of dos and don’ts: kissing was officially frowned upon, and public sneezing, spitting, or coughing without covering one’s face were subject to fines. So many teachers were out sick that after much debate among Boston’s civic leaders, the city was forced to close the schools. Other services were faltering too. More than 165 car men of the Boston Street Railway were sick, and those still on the job had difficulty keeping the trains on schedule. The sailing of ships was delayed. People were asked not use their phones except for emergency because more than 850 operators were out. At the state house, which had become the headquarters for Endicott’s Emergency Committee, the assessment of the city’s health went from bad to worse. Theater owners unsuccessfully object to an order that forced them to close. Soda shop proprietors and saloon keepers soon received a shut-down order too. Hotels and cabarets were allowed to stay open, but dancing was forbidden. The scene at the city’s morgue was chaotic. There weren’t enough coffins and grave diggers couldn’t keep up with the death rate. There was a ban on extra chairs at funerals and wakes were discouraged. But when ministers and priests complied with the city’s request to stop holding church services on Sundays, everyone realized Boston’s fate was truly in the hands of Providence. Newspaper editorials claimed the city hadn’t been so orderly since the days of the Puritans. But the comparison was too somber to be amusing. “In spite of the wonderful weather, those who did go out for a stroll had the curious vague look of people who didn’t know what to do with themselves.” The city had to wait it out. When Lydia Johnson returned to school (it had closed during the worst week of the epidemic), the parade of hearses on their way to the cemetery had not stopped. Some of the teachers and a few of the students did not return to class. And for months to come Spanish influenza competed with the Great War as a source for tales. Lydia had one of the best stories: when Maud recovered, she told her family that while she was delirious with fever she had seen Jesus in a beautiful garden where she had struggled to go to receive his blessing. As soon as the bans on Sunday church going and Saturday night joy were lifted, Boston’s lively personality returned. By the end of October the city’s Emergency Public Health Committee and the Red Cross issued orders to 1,000 doctors and nurses to leave Boston for other cities where the epidemic was still raging. When the quarantine on Camp Devens was lifted, over 20,000 visitors poured in to visit the boys. Civilians and soldiers alike wanted to forget the gruesome experience of the past two months. The time had come to name the 12th Division, and the Globe reported that the camp favorites were “McCain’s Pride,” the “Terrible Twelfth,” and the “Deadly Dozen.” But before these boys would get “over there” and answer General McCain’s appeal to do their bit in the great cause, the war was over. For most the epidemic would not inspire awe. Instead it would become just another detail in a year that was full of crises. After Armistice Day, November 11, 1918, teachers no longer told their students: “Somewhere a soldier is risking death for you.” Francis Russell was a third-grader at the Martha Baker School in Dorchester during the epidemic. He and his classmates could hear the horse-drawn funeral carriages roll endlessly by the school windows. He watched the coffins pile up in the chapel at the New Calvary Cemetery and watched a secondhand circus tent being set up to hold the coffins that kept coming faster than the gravediggers could dig. In October, while school was out, he and two friends sneaked into the cemetery and watched a funeral. They were spotted by a white-haired man who chased them away. Years later he wrote that as he walked home through the late autumn twilight, “In that bare instant I became aware of time. And I knew then that life was not a perpetual present, and that even tomorrow would be part of the past, and that for all my days and years to come I too must one day die.” There is still no explanation for how or where this particular influenza virus originated. In the same week that it crossed the Atlantic to begin its North American tour, it also turned up in Brest, France, and Freetown, Sierra Leone. Here in the United States, the disease first established itself in military installations, where large, mobile populations, housed in overcrowded facilities, provided perfect breeding grounds for an infectious disease. Then it moved in on the nearby civilian populations. In time Baltimore, Philadelphia, New York, and San Francisco fell victims like Boston, the first and among the hardest hit cities in the country. During the last four months of 1918 more than 22,000 people died from influenza and pneumonia in Massachusetts, 4,088 of them in Boston. The normal death rate due to influenza should have been 1,800 for the state, 500 for the city. U.S. Public Health Service statistics are equally staggering: during 1918-1919, over 25 million people, more than one-quarter of the nation’s population, had the flu. But this is surely a conservative figure — medical record keeping then was not the sophisticated craft it is today. Before the flu passed, 548,000 people died of it in this country, 20 million worldwide — more than died in the Great War.