What I learned from the 1918 Spanish flu pandemic

There are a lot of misunderstandings about what the real dangers are due to the current H1N1 (Swine flu) outbreak, not only by those who are fearing it too much but also by those who are not taking logical precautions. Perhaps we can take a look into the past to get a glimpse into our future.

Over the last several days, I've been doing some research in the collections at James Madison University as well as reading the book Influenza 1918, based on the PBS documentary that appeared of the same name. I wanted to find out what the Spanish flu outbreak looked like in my city (Harrisonburg, Virginia), as well as how people reacted and what lessons we can take from it all.

First, let's set the scene. The 1920 census lists the population of Harrisonburg at 5,875. In the fall of 1918, America was completely gripped with patriotic fever as World War I reached a crescendo. In the town of Harrisonburg, German Street had been renamed to Liberty Street. The Fourth Liberty Loan campaign was in full swing and hot debate raged over whether banks should publish the names of people taking part to shame their non-lending neighbors into supporting "our boys". News of the spreading Spanish flu began to come through the wire services, and on September 28 the local newspaper (the Daily News-Record) reported that the flu was in surrounding Rockingham County, with forty cases reported in nearby Dayton where the outbreak began at Shenandoah Collegiate Institute.

By October 8, the disease had spread in Harrisonburg and the DNR reported

that the Normal School (now JMU) and the public schools would be closed for two weeks: "It developed that out of one hundred and thirty pupils at the High School there were only forty present yesterday, the absentees being in the great majority of cases either being ill themselves [or helping sick family]. The percentage of sickness, it was stated, was not so great in the graded schools as in the High School, and was least of all among the pupils of the colored school." In the same article, it was mentioned that it was "confidently expected" that classes would resume after the two-week period was over.

In the same issue, the newspaper's editor apologized for shortening the normal six pages to four, noting that six of the small paper's staff were out of commission from flu.

The next day's paper said that half of the hospital's staff were out sick, and that there were as many as five hundred cases of sickness in the city already. By October 17, that number had jumped to 1,500 cases, including thirteen named deaths. One death was Cecil Burtner who, delirious with flu, shot himself.

Churches and the local theater had closed, too, as well as several local restaurants and businesses whose employees were out sick. The local Red Cross organized an Emergency Influenza Committee to deliver food to sick families. Although the paper repeatedly declared that the worst seemed to be over, the numbers of sick and dead continued to rise and even more serious outbreaks were reported in nearby cities and towns like Strasburg and Elkton. By October 22, the paper reported that 2,500 of the town's residents were sick, and by the end of the month 26 dead were named as victims of Spanish flu.

There was a lot of medical misinformation dispensed during that month, both by the federal and state governments (who thought the disease was bacterial rather than viral) and by drug companies hoping to hawk their products, like Calomel and Vaporub. One local chiropractor, Dr. Albert Souder, even boldly proclaimed that flu was caused by pinched nerves. "Remember, if your spine is right you will not have the influenza nor any other disease," he advised, adding, "Go see your chiropractor." Many families stuck with old home remedies like asafetida and mustard plaster, which had varying degrees of effect and side effect.

Ultimately, the disease weakened its hold on the city just in time for the November 11 armistice, which sent jubilant crowds into the streets and set off a series of thanskgiving ceremonies. Schools reopened in early to mid-November, and life continued on. There were a few other outbreaks locally in December of that year, but nothing so big as the October epidemic.

Besides the sad stories, like the family of five that suddenly died in nearby Goods Mill (reported in the October 4 DNR) and the family at Naked Creek where a woman buried two daughters and two grandchildren on the same day (told in an oral interview with Benjamin Coffman), there were stories of neighbors doing their best to help neighbors, and health workers giving their all to serve their communities. Elmer Atkins, of nearby Sperryville, spoke in an interview conducted in 1979 about his entire family, except for his dad, being sick. A neighbor would come by twice a day, "no closer to the house than I'd say 200 yards," to see what supplies were needed. The Red Cross chapter in Harrisonburg reported that it had visited four hundred, distributed two hundred gallons of soup or broth, and deliver fifty gallons of milk in the preceding weeks.

So what does all this have to do with the current outbreak and potential future outbreaks of infectious disease? First and foremost, take it seriously. There is a tendency to downplay these kinds of stories, even in the midst of clear epidemics, which works against taking sensible precautions. Second, don't expect that things will function normally during an outbreak - things will close, and you will not have the same access to supplies as usual, especially if you are sick yourself. Third, don't worry that everyone will die. In the end, even the Spanish flu only killed a small percentage of the people it struck.

I implore everyone reading this to have a plan to deal with disrupted food supplies and overwhelmed health care systems. Don't blow it off as media hype, but use it as an opportunity to reflect and prepare.