Wednesday, April 1, 2020

Tales from the 1918 Influenza Pandemic

      "There was a little girl, and she had a little bird,
         And she called it by the pretty name of Enza;
         But one day it flew away, but it didn't go to stay,
       For when she raised the window, in-flu-Enza."
                                                                          --Children's rhyme, late 1800s 

As the COVID-19 pandemic unfolds, daily we are hearing stories of suffering, selfishness, and mismanagement--yet others of courage, compassion, and self-sacrifice. With most of us at home during the day, we are glued to the computer and TV screens, watching these stories unfold. It's a roller coaster ride of emotions, from horror to inspiration, to see the images of people and places around the world affected by the pandemic.
The famous photo taken at an army hospital at Camp Funston, Kansas, filled with the first victims of the 1918 influenza pandemic.--Photo: Museum of Health and Medicine

During the ongoing stay-at-home directive, I've been entertaining and educating myself by reading The Great Influenza:The Epic Story of the Deadliest Plague in History by John M. Barry (Penguin 2004). I bought it and started reading it when it came out, but got distracted. I've read the first three sections so far, and it's fascinating, yet horrifying reading.

Some chilling facts from these sections:
--Somewhere between 50 million and 100 million fatalities are estimated worldwide.

--In April 1917 when the U.S. entered the war that had been raging in Europe for three years, the Wilson administration clamped down brutally on critics. It demanded "100% Americanism," launching an extensive propaganda campaign.

--Despite being called the Spanish flu, the disease likely first emerged in Haskell County, Kansas, farm country. It is the first recorded outbreak.

--Dr. Loring Miner (a graduate of my grad school alma mater, Ohio University) became alarmed in January 1918 in Kansas about a particularly virulent strain of flu that was circulating. He contacted the U.S. Public Health Service, which did nothing, and the regional newspaper, which suppressed the story, worried about hurting morale in wartime.

Graves of 100 wounded American soldiers who died of flu in Devon, England (March 1919)--Photo: (British) National Archives

"[T]hrough both intimidation and voluntary cooperation, despite a stated disregard for the truth, the government controlled the flow of information.
  The full engagement of the nation would thus provide the great sausage machine [i.e. the war] more than one way to grind a body up. It would grind away with the icy neutrality that technology and nature share, and it would not limit itself to the usual cannon fodder."--Barry, p.132

Look familiar? 1918 headline, Kansas. Image: U of Kansas Medical Center
Between September 14, 1918 and November 10, 1918, 27,789 Americans died in the war, while 82,306 died of the flu. No one in my parents' immediate family died. My mother, who was only two at the time, had no recollection of the pandemic. My dad, however, remembered it vividly.

Dad was 11, living with his parents and two sisters in the house on 21st Avenue, Munhall. His oldest sister, Frances, was living with her husband, expecting their first child (Gilbert "Gib" Breakwell). One by one, everyone on 21st Avenue came down with the flu--except Dad. His older sister Estella was especially sick. Frances wanted to come over to help, but Grandma, concerned about Frances and her unborn child, absolutely refused her help. So it fell to my father to care for the other four members of the family.

He recalled being very worried about Estella, who lay at death's door for a couple of days. His mother was also worried, but was too ill herself to get out of bed. Dad acted as nurse, bringing fluids and food, helping as best he could with his mother's direction.

Those were strange days. Dad, cooped up in the house, read a lot. At night, he'd sit at the rear of the house, watching crews carrying the dead in horse carts to the cemetery one short block away on 22nd Avenue. They carried lanterns, burying the bodies hastily, without ceremony--the proper burials to be postponed till the plague passed. Dad said it was an eerie sight as night after night, in the autumn darkness, the crews came to the cemetery on their grim errand.

[Note: Mary Anne Lacey Talarek adds this 1918 story from Munhall: "My dad told the story of how a man with a horse drawn wagon came up their street telling people to put their dead on the wagon."]
A funeral in St. Mary's Cemetery, corner of 22nd and West, in 1976. The Busch family home was two houses from the corner on 21st Avenue in 1918, with a clear view of both St.Mary's and Homestead (Protestant side) Cemeteries. (Photo: Ed Busch)

In Pittsburgh, people were dropping like flies during the worst months of October and November 1918.
"Pittsburgh suffered terribly during the pandemic. According to the Centers for Disease Control, the area had one of the highest, if not the highest, death rates from the flu of any city in the nation with 4,500 people dying and an astonishing rate of someone catching the flu every 70 seconds and someone dying from it every 10 minutes." (Janice Palko, "Pittsburgh Flu Epidemic of 1918")

During the 1918 pandemic, Pittsburgh was among the last cities to intervene in controlling the spread of infection. Authorities waited until a week after the flu deaths spiked to impose a gathering ban and close schools. To make matters worse, they lifted the ban shortly thereafter. In a 2007 study published in the Journal of American Medicine, Pittsburgh ranked last (that is, having the most) in the number of excess deaths, with 807 per 100,000 people.

In Winfield Township, Butler County, north of the city, is a cemetery of unmarked graves. Immigrant workers in the limestone and other industries are buried in this cemetery, with one to five bodies in each grave. No one knew who these men were, and their families probably never knew their fate.

Neighbors on 21st Avenue died from the epidemic, as did many other residents of Homestead and Munhall, but all five members of the Busch family survived, as did Frances and Jack Breakwell.
A parade marking the end of the war in Pittsburgh, November 1918. An official celebration followed--as did a spike in flu cases. Photo: Western Pennsylvania Historical Society

The other family story is set one thousand miles west of Pittsburgh, on a farm in Sergeant Bluff, Iowa. My daughter Ceridwen passed on this story told by her paternal grandfather, C.H.Christensen, known as "Chris" in his adult years. The son of Scandinavian immigrants, he was named after a close friend and neighbor, Clarence Holmen. Chris was 6 years old during the 1918 pandemic. He contracted the flu, and it hit him hard. As he lay gravely ill, hovering between life and death, he heard the low, disembodied voices of his parents talking in the next room. He realized that they were very sad. Clarence had died. In his feverish delirium, he thought they were talking about him. "I must be dead," he mused, then lapsed into semiconsciousness. Of course, when he recovered, he realized that they had been talking about his namesake, Clarence Holmen.

C.H. Christensen, around nine years old. He became a family doctor practicing in Duluth, Minnesota. At his memorial service, a former partner said that Dr. Christensen holds the record for most babies delivered in St. Louis County. (Photo courtesy Tore Christensen)

History provides us with cautionary tales and describes to us what can happen during a pandemic to the unprepared or willfully blind. But history also provides solace and hope. The 1918 Great Influenza finally ran its course, ending 18 months after it began. COVID-19 will run its course, too--but the world will never be the same.

Keep the faith. Be excellent to each other.

--Digital poster by Muhammed Aiwad K
Thanks to the doctors, nurses, EMTs, medical personnel and police officers out on the front lines.
Thanks to the truck drivers, ship and railroad crews, and grocery store workers keeping us stocked with food and other supplies.
Thanks to the cleaners making stores safer to shop in.
Thanks to the agricultural and manufacturing workers providing necessary supplies and food.
Thanks to media and communications personnel for keeping us informed.
Thank you all for your service.