The Great Influenza

The only actions that could have slowed or stopped influenza from spreading were extreme interventions and quarantines. Such efforts were taken as recently as 1916 to stop the spread of polio, but Blue was unwilling to try anything approaching the effort that would be needed, even as scientists and physicians recognized that the virus was hitting in waves and that America was beginning to see the onslaught of the second wave. However, given the way the virus peaked and crested, it was possible to attack the existing peaks and then move doctors and nurses to the emerging peaks. The Public Health Service moved to find doctors and asked the Red Cross to find nurses.

While there was no treatment for the viral infection, doctors could treat the virus’s secondary effects, such as bacterial pneumonia and other infections. Doctors could also drain pusses from infected patients and treat ailments that spread to the heart, but this required resources and time they did not have. Making matters worse, the pool of eligible doctors was quite small—around 100,000 total—and most of them were deemed incompetent (which was why they weren’t already being used by the army or navy). The ones who were good enrolled in a new “Volunteer Medical Service” and were sent from city to city with some success (318). Nurses proved even harder to find, and they were actually more important for patient care than doctors, given that diagnoses weren’t largely needed during the pandemic. But there were fewer nurses than physicians available. The Red Cross had been enlisted to recruit nurses to Europe and had done this so successfully that most American hospitals already had a shortage of nurses by the time of the outbreak at Devens.

In Philadelphia there was no sign of either Red Cross or Public Health Service help. The virus spread unimpeded. Lewis, in his lab, continued to look for Pfeiffer’s bacillus, as his main weakness as a scientist was that he trusted those he respected too much, and he trusted Pfeiffer. He was finding the bacillus in most autopsies, at least. With no guidance from the mayor or Krusen, and no treatment in sight, the rich families of Philadelphia began to assert themselves.

Philadelphia had several great rich families with lots of power, influence, and money. Principal among them were the Biddles, Drexels, Whartons, Martins, and Peppers, all of whom had created extensive distribution and recruitment networks to sell war bonds. The heads of these families acted without the city government to summon the heads of private organizations to the Emergency Aid office on October 7. There, they created a plan to use those same networks to distribute aid and food.

Krusen ceded control of the nurses to the group and put his own people in charge of cleaning the streets of filth and sewage. He then sent police to clear bodies out of people’s homes. The police often piled the bodies into wagons that brought to mind the plagues of medieval Europe.

Still, the pandemic continued, with at least one ill patient in nearly every home. To avoid the pandemic, people isolated themselves, spreading still more fear. The papers reported that there were nurses, but there were not enough, and with isolation and illnesses in each home, many families could not feed themselves let alone take care of the sick. The professionals who helped were heroic, but Philadelphia was unable to recruit many volunteers to help. Nearly 5,000 people died in one day during the peak of the outbreak, but no one knew it was the peak. After all, “Krusen had too often said the peak had passed,” and the “press had too often spoken of triumph over disease” for anyone to believe the official line anymore (332). Beyond deaths, the city was seeing other problems, as factories and railroads became understaffed, orphanages overcrowded, and citizens underfed.

Philadelphia was like every city on the planet, from those in New Zealand to those in Switzerland. The virus was spreading, and newspapers reported a mix of half-truths and overly sunny reports even while physicians seriously considered the disease to be the plague and not merely influenza. Indeed, the press made everything worse, as it began to publish messages against fear itself. Papers from Albuquerque to Des Moines to Little Rock to Bronxville to Phoenix all either published no news of the influenza outbreak or published reports saying influenza was on the decline or that the best advice to fight influenza was not to get scared (337).

But it was impossible to avoid being afraid of the virus. While most officials reminded the public the virus was merely influenza, the Public Health Service finally addressed the virus by distributing posters and pamphlets with the surgeon general’s advice on them. But the advice to avoid crowds and wash one’s hands came too late, as the virus was already everywhere. The Journal of the American Medical Association dismissed the statements from the papers and attacked the Public Health Service’s advice as pointless. And as the papers warned people not to be afraid, fear took over the public at large, as they no longer believed anything the papers said. Some even accused the German army of being responsible for the virus. The Public Health Service wasted time investigating the possibility that the virus was the result of germ warfare.

In Philadelphia and other cities, officials tried to figure out how to maintain order while caring for the sick, while citizens’ committees, like the one in Philadelphia, sprung up to help. Schools and churches were closed in cities across the country, and buildings were converted to emergency hospitals. Mountain and desert towns were less impacted, because many chose to close off their towns as the pandemic spread. The newspapers in Phoenix bucked the national trend and warned citizens of the truth of the pandemic. The citizens’ committee there encouraged citizens to wear masks, asked businesses to provide more space for customers, and asked the police to arrest anyone seen spitting or coughing without covering their mouths. As a result, Phoenix was barely affected by the pandemic. Still, panic came. People even began killing dogs after a rumor that dogs carried influenza.

The war ended in November, but the pandemic persisted. The war was fought in Europe, far from most Americans’ realities beyond the sacrifices all had been asked to make. But the pandemic and the fear it caused were everywhere. One Philadelphia citizen complained about the tolling church bells that rang every time a person carried a casket into church, seemingly every few minutes. She became terrified, wondering, “Is the bell going to bong for me?” (350).

There were not enough responses for physicians, nurses, and volunteers, but those who did respond tried valiantly to treat the patients they had. They tried everything, including treatments that lacked any scientific grounding, as there was no time for any kind of proper scientific method for most physicians. Some tried hydrogen peroxide, some tried the typhoid vaccine, some tried homeopathic cures. Nothing worked. Throughout the world hundreds of millions of people likely saw no physician at any point during the pandemic, leading many to try folk remedies or over-the-counter medications.

By mid-October 1918, different vaccines began to pop up, including one by Park and Williams as well as one by Lewis. The army began to distribute a vaccine created at Walter Reed Hospital, but the general civilian population was largely on its own. It didn’t matter, though, as none of the vaccines worked all that well. Nothing could cure influenza, and the only places that survived unscathed were those that practiced isolation. Some of the places most hard hit, though, were areas that had not isolated but had also not been exposed to much civilization beforehand. Indigenous communities in parts of Alaska, for instance, saw nearly half of the population die of either influenza or its effects. In remote Canadian villages on the Atlantic Coast, large percentages of the population died, as did large numbers in the jungles of South America and Guam. India was the worst-hit nation, with nearly 10% of its population lost to influenza.

As Vaughan wrote, if the epidemic went on at the rate it was going, “civilization could easily disappear from the face of the earth within a matter of a few more weeks” (365).