STUMP » Articles » Memory Monday: The Spanish Flu Peak in October 1918 and More » 29 October 2018, 20:47

100 years ago in Cincinnati: Our history: City suffered through deadly 1918 flu pandemic

October 1918 was the worst month and marks when the disease finally reached Cincinnati.

On Oct. 5, the Cincinnati Board of Health voted unanimously to close all churches, schools, theaters and public meeting places until the danger of the epidemic had passed. Saloons stayed open but had to serve liquor in bottles only, to be taken home to drink.

“Cincinnati is endeavoring to prevent an epidemic of Spanish influenza,” Mayor John Galvin said. “There is no epidemic here. We are doing what other cities should have done – we are preventing.”

The precautions may have slowed the flu down, but didn’t stop it.

On Oct. 27, four weeks into the local epidemic, The Enquirer reported 395 deaths the previous week (150 was the normal death total for a week), 262 from the flu. More cases were reported daily. Thousands of children were orphaned.

“Twenty-five percent of the cases at the General Hospital have been fatal,” reported Dr. Walter E. List, the hospital superintendent. “We have been handicapped by the illness of nurses and attendants, but the nurses on duty have been working 14 to 16 hours a day since the epidemic started. Their sacrifice and self-denial have been marvelous.”

As the rate of new cases began to slow, the public became restless and protested the quarantine.

On Nov. 11, the day the armistice was signed ending World War I, the Board of Health agreed to lift the influenza restrictions.

More cases popped up among schoolchildren, so schools were closed again and children were restricted from theaters and streetcars until the epidemic finally passed.

This “wave” pattern was common in many cities – Boston, Baltimore, New York…

Flu sickened 500 million people last century. Don’t let it make you sick | Quigley

England, France and US officials were concerned about the large numbers of healthy young men and women getting sick and dying, but they didn’t want the enemy to find out. German officials also noted a big increase in illness and death among their troops, and they also tried to keep that secret. No one wanted public and military morale to sink as they fought each other for world supremacy.

Only Spain, a neutral country during World War I, reported the shocking news. So it got the blame.

The influenza pandemic, which sickened 500 million people, one third of the world’s population, and killed about 50 million worldwide didn’t originate in Spain. And that country wasn’t hit any harder than other nations, but it’s always been known as the Spanish flu pandemic of 1918.

It hit the United States so hard that life expectancy here dropped 12 years in two years, averaging only 36.6 years for men and 42.2 years for women. Today it’s 80 for men and 84 for women.

The highest death rates from the flu were among previously healthy young people between 20 and 40 years old. Usually it’s the youngest and oldest who are most at risk, but this flu strain behaved differently.

Thus the heavy blow to life expectancy. Back in 1918, childhood mortality to diseases such as diphtheria was still high. But if you got past childhood, infectious diseases weren’t too bad in the U.S. Until the Spanish Flu.

In October of that year more than 100,000 Americans died of flu. Numbers remained high until hot weather arrived again in 1919. All in all, 675,000 Americans died of flu and flu-related problems in an 18-month period.

Besides secrecy, many other things added to the high mortality. Viruses hadn’t been discovered yet, so doctors had no idea where or how the illness originated. There were no antibiotics to treat secondary infections like pneumonia, and there was little agreement among physicians about the best way to stop the spread of infection.

Clinics and hospitals weren’t prepared to handle a mass influx of very sick people, so most remained at home, often infecting other family members.

Schools, homes, ships, and army camps had poor hygiene and crowded living quarters. Bathing, laundry and dishwashing were difficult and there were no such things as disposable tissues or antibacterial wipes. Some towns mandated the wearing of face masks in public. New York City enacted an ordinance to fine or jail people who didn’t cover their mouths while coughing. (And no one realized that covering one’s mouth with a hand only increased the likelihood of spreading infection.)

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Search the family bible or walk through any graveyard and you’ll note how many deaths occurred from 1917 through 1919. Some were men who died in WW1, but you’ll probably be surprised to learn that the US lost more military personnel to disease (63,114) than to combat (53,402.)

Well, I am not surprised.

But that’s because I like keeping tabs on what killed people.

PUBLIC SERVICE ANNOUNCEMENT: GET A FLU SHOT

Look, getting a flu shot is unlikely to stop the next pandemic (given it’s unlikely to be normal seasonal flu gone rogue), but it’s just a good idea. Lots of people die of flu & flu complications each winter, mostly older folks dying of pneumonia as a result of the flu. But even kids and otherwise healthy adults die of the flu. A cytokine storm sounds like an unpleasant way to die. (not that there are loads of pleasant ways)

Commentary: No time like the present for a flu shot

The 2017-2018 flu season resulted in more than 700,000 hospitalizations in the United States, and 183 deaths in children. Overall hospitalization rates (for all ages) during 2017-18 were the highest ever recorded by the Centers for Disease Control and Prevention (CDC) surveillance system.

Eighty-five percent of U.S. flu deaths among children occurred in those who were not vaccinated against influenza. Overall, the 2017-18 influenza vaccine was deemed 40 percent effective against the influenza A and B strains.

The predominant influenza A strain in 2017-18 was H3N2, and we anticipate that H3N2 will be a dominant strain in 2018-19. Unfortunately, a death from influenza has already been reported this fall. The most important protection from influenza is the flu vaccine, yet year over year only 40 percent of Americans get the annual flu vaccine.

You cannot get influenza from the flu shot. The flu shot is safe to get during pregnancy. Infants as young as 6 months of age can get the flu shot, as should children, adolescents and adults. Older adults should receive “high dose” flu vaccination. While efforts are underway to develop a “universal vaccine” against Influenza – meaning one immunization that would protect against multiple strains of influenza – it is not yet available.

Everyone in my family got the flu shot already – I got it at work, Stu got it at a regular doc’s office (he can deal with dead virus vaccines, which is what the flu shot is), and I took the kids to an urgent care clinic. In all 5 of our cases, the shot was fully covered by our insurance, but even if you have no such coverage, the shots tend to be about $20.

The only effect for all of us was a sore red spot on our upper arms that disappeared after one day.

OCTOBER 1918: CAN’T HIDE THE PANDEMIC

So yes, the story has been that it’s been very quiet in the media about the pandemic throughout the year, and yes, that’s partly due to wartime issues.

But it was also due to volume of deaths: there had been a wave in spring 1918, especially in Europe, but it wasn’t the peak that would come in the fall.

The number of deaths increased through September, but reached horrific levels in October 1918. For many places on the East Coast, it was October for the peak of the infection wave. And no, they couldn’t keep it quiet in the news. It was everywhere, and it was at a much higher level than most epidemics of the time.

Interestingly, though, it blew through town fast. People got sick quickly, died quickly (if they were going to die), and the wave was generally over not too long after it started in a particular location.

You can see this via the Brewster Standard in September and October 1918. Brewster was very rural back then (and the area near it is still fairly rural), so there weren’t a lot of people to get sick or die. But there definitely were some local people who died — no town escaped the pandemic.

I will begin with the first mention of the flu epidemic, at the end of September 1918:

That was on the front page. If you read it carefully, you’ll notice there’s a lot of stuff that is plain incorrect… but they didn’t know it at the time.

The next week, the flu story was on page 4.

The story was back on page 1 on October 11.

Note that the details are getting more concrete.

THE SPANISH FLU OBITUARIES

So, this is interesting: October 11 is the first of the Brewster Standard where I could identify Spanish flu deaths. One of these is ambiguous, the others… not at all.

Note the age of all these people. In prior weeks, the obits were for people in their 70s and 80s. This is for people in their 20s and 30s… the ones most hard hit by the Spanish flu.

Also:

I’m skipping the next week (October 18) for now… because it’s really long. I’m putting that entry at the end.

TAIL END OF THE EPIDEMIC?

So… the last paper for October 1918 in Brewster didn’t have anything particular about the flu.

Except for two ads.

I laughed a bit at that. Of course the medicine guys are going to flog their wares. One of the medicines – the flaxseed oil – was probably benign. Not so much the bloodroot prep.

BLOODROOT information:

Bloodroot is a plant. People use the underground stem (rhizome) to make medicine.

Bloodroot is used to cause vomiting, empty the bowels, and reduce tooth pain. It is also used to treat croup, hoarseness (laryngitis), sore throat (pharyngitis), poor circulation in the surface blood vessels, nasal polyps, achy joints and muscles (rheumatism), warts, and fever.

Some people apply bloodroot directly to the skin around wounds to remove dead tissue and promote healing. During the mid-1800s, bloodroot extracts were applied to the skin as part of the Fell Technique for treatment of breast tumors.

In dentistry, bloodroot is used on the teeth to reduce the build-up of plaque. Plaque is a film of saliva, mucus, bacteria, and food particles that can promote gum disease.

That sounds nasty.

A FAQ FROM 1918

I skipped over October 18, but there was a huge article on the Spanish flu in that issue.

It started on page 1… and continued onto another page (filling up half that page). This is extremely unusual at the time – at least for the Brewster Standard. Given the extremely small type, most of the articles not only stayed on one page, they were in one column (and less than a full column).

I had to clip 10 separate shots of this paper, given the length of this piece. Again, a lot of this is known – NOW – to be incorrect, but I do believe it was the best information at the time.

What is interesting is how rapidly this came and went. The flu pandemic did keep going on into 1919, and even 1920 in some places, but that’s because it hadn’t gotten there yet. But once it reached a location, it burned through the local population rapidly.

I want to address one thing: the mortality rate. A lot of people died from this, but it’s not Black Death levels (and seriously, that level of mortality is extremely rare in history).

According to this CDC article, the case mortality was 2.5%. That may sound low, but they note: flu mortality is usually less than 0.1%. This is a huge order of magnitude difference.

Also, less than 1% of the U.S. population dies each year. You would notice a 2.5% death rate, no matter how small that sounds to you.

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Happy Halloween!