1918 SPANISH Flu Epidemic

Order by the City of Flint Board of Health

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Lessons Learned from the 1918 Spanish Flu Epidemic

We are living through a harrowing, once-in-a-century event, the spread of a virulent virus. As human beings have begun living mostly in high population density urban areas, the control of the spread of infection has become vital to the continued existence of modern society - as the recent months of isolation and closures in order to “flatten the curve” have shown. We learned this lesson the hard way in America in 1918 during the Spanish Flu epidemics second and deadliest wave which, is estimated to have infected 500 million people worldwide and killing around 50 million.   
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The origin of the Spanish Flu is somewhat of a mystery. The most current scholarship seems to agree that it began at the British camps in France at Etaples and Aldershot and had been reported as early as 1917 in Austria. True there was some kind of flu spreading in Haskell County, Kansas sometime in late April to Early March 1918 and has often been pointed too as being the possible origins of the Spanish Flu but this is unlikely. It spread surprisingly quickly in the sparsely populated community of Haskell County and infected thousands, but it seems to have been a seasonal flu and the death rate does not come close to the Spanish Flu’s virulence.

So why do we call it the Spanish Flu if it didn’t originate in Spain? Spain was neutral during WWI and had an open press. When people began getting sick they reported the seriousness of the situation in its entirety. The United States was far more tight-lipped about the growing pandemic in fear of damaging the war effort. WWI was an unprecedented period of restriction of the free press and the Spanish Flu Epidemic is a startling example. Numbers of infected and dead were suppressed for the good of morale and the United States’s image on both sides of the war. This silence would cost the nation dearly.  It would not be until late 1918, particularly the three brutal months from September, October, and November when the second wave of infection broke, that the Spanish Flu would finally make its media debut in Michigan.

The flu was first officially reported in Michigan newspapers on August 12, 1918 in the Flint Journal on page 10. Under the title, “Wire Stories Told Briefly,” one line announced strict quarantine procedures being implemented at ports in New York to “prevent the spread of Spanish Influenza.” Two days later another line announced that there were now government guidelines for avoiding and treating the flu, but they are absent from the piece. The flu was ripping through New England and was well on its way into Michigan.

September 20th the Flint Journal published a longer article from the Associated Press with the headline “Influenza Not to be Trifled With.” With wartime censorship of the press still in effect, the article mentions that the pandemic has affected “some European countries” and has “been mild in some areas” but in others, it had caused “considerable mortality.” In the same issue the Journal ran an associated press article admitting that the flu was ripping through army training camps. A headline on September 14th, 1918 in the Flint Journal boasted of no cases reported in Camp Custer, Battle Creek but soon after publication Camp Custer fell. At Camp Custer, flu arrived around 10 a.m. Sunday morning on Sept. 29, 1918, when the first soldier was rushed to the hospital and the camp was immediately put into quarantine. Still, the news was largely dominated by positive stories about The Allied victories and the coming end of the war. Little did anyone know that they were at the very beginning of yet another battle, what would come to be known as the Second Wave.

The first wave of H1N1 was put down to a seasonal cold, annoying but not particularly deadly but something had changed. Now people were dying in droves and shockingly healthy people at that. People in their 20s and 30s were cut down by the virus at an alarming rate. In addition to the usual flu symptoms of headache, fever, sore throat, and cough some sufferers reported bleeding from their nose and ears. The skin on the victims would turn blue, then purple-black from lack of oxygen. When victims were autopsied doctors found bloody foam in the lungs which were twice the size of healthy lungs, they had essentially drowned, suffocated by their own blood filling their destroyed lungs. ​​

​Genesee Country saw some of the worst in terms of death count in Eastern Michigan. The death rate in Flint jumped 28% compared to 10% in Wayne County and the largely rural Oakland County. Genesee County, Flint, in particular, had almost doubled in size during this decade bringing the flu with the new Flinstones. Many temporary workers or new migrants to Flint lived in shacks without running water or much hygiene. As they worked in GM shops producing cars and trucks for the war they would be in cramped unventilated conditions which helped spread the disease quickly. All across the country, the average life expectancy of Americans was slashed by 12 years just during 1918.
​What caused this second wave to be deadlier and move faster than the last? The virus H1N1, after having been passed around soldiers and civilians alike, may have mutated to become much more virulent, however, a 2007 study suggested that the Spanish Flu may not have been more virulent than any other flu strain, rather malnourishment, overcrowded military camps, the movement of military and civilians in and out of war zones, poor hygiene, and the stress of WWI created weakened immune systems. Add to this a weak understanding of bacteria and virus theory among the general public and it was a disaster waiting to happen.

​When the second wave crashed over America in September of 1918, states responded in different ways. While some states instituted mask laws or quarantined the sick others took a business as usual approach. Spitting was made illegal in many places and could carry jail time. In San Francisco, there was $5 dollar fine, about $86 dollars today, for people found in public not wearing face masks and in Seattle “Mask Slackers” were publicly shamed and banned from public transit. St. Louis, Missouri immediately closed all schools, theaters, restaurants, and public gatherings were banned. Pennsylvania took no such precautions early on. Philadelphia even hosted a parade in late September. Three days later they had over 600 new cases of Spanish Flu in the city. They moved too late to protect the public and Philadelphia suffered one of the nation’s highest death rates. At the height of the second wave St. Louis had 1/8th the mortality rate that Philadelphia experienced despite being similar-sized cities.

Snapshot of an early Detroit Free Press article addressing the beginning of the outbreak in Michigan

A world at war in two ways: with each other and with a virus

Iconic photo of Camp Devens, in Massachussetts, during the 1918 Spanish Flu pandemic

Written by Colleen A. Marquis

About Colleen:  She is an archivist at the University of Michigan-Flint, in the Francis Willson Thompson Library.  She is also a board member of the GCHS, serving as the Archivist.

Public health initiatives and public education were vital to curbing the second wave. The American Red Cross and the United States Health Service published circulars about avoiding and treating the flu in 8 different languages. 19th-century customs like the communal water cup in classrooms or at roadside water pumps were banned. As the flu continued to spread more drastic and, today, familiar steps were taken. In Michigan by October 1918, after over 18,000 cases had already been reported, saloons and churches were finally closed by order of Gov. Albert Sleeper and the Board of Public Health. Schools were technically exempt from the forced closures but local officials made the decision to close them soon after. The all too familiar sting of a wave of cancelations for concerts, plays, and parties followed. Churches canceled services and businesses closed up. The University of Michigan football team played just five games that fall which worked out to an undefeated season to become the 1918 national champions.

It is so fascinating to learn the history and find ourselves here again, but with new tools and new challenges. But when we look at the best there are a couple of lessons from the 1918 flu that we can apply to 2020. Historical evidence shows that a non-pharmaceutical approach to curbing the illness saves lives. Research conducted by scholars at the Center for the History of Medicine at the University of Michigan and the Centers for Disease Control and Prevention makes clear that the “early, sustained, and layered” use of interventions such as social distancing, quarantining the ill, hand washing, and wearing masks worked in 1918, slowing the pandemic’s pace.​

It’s important to note that if we don’t work together we could assist in making CoVID -19 worse by spreading the disease and giving it a chance to mutate. The Spanish Flu seemed like another annoying seasonal flu in the Spring of 1918 but with our guards down, it took over and killed 50 million people worldwide. It’s also important to remember that more waves of CoVID are coming and we are not out of the woods. The Spanish Flu’s fourth and final wave was in 1920 but each wave was met with the same protective measures we are still using, and eventually, it passed, and so will this too. So wash your hands, don’t be a mask slacker, eat well, and take it easy on the stress.

Works Cited:

Julie Mack, “Michigan’s Deadliest Year: A Look back at 1918” https://www.mlive.com/news/erry-2018/10/a57843a6f96442/michigans-deadliest-year-look.html accessed 6/13/2020

Nancy K Bristow “What the 1918 flu pandemic tells us about whether social distancing works”
https://www.theguardian.com/commentisfree/2020/apr/29/us-responses-1918-flu-pandemic-offer-stark-lessons-coronavirus-now accessed 6/18/2020

https://www.battlecreekenquirer.com/story/news/local/2020/03/05/coronavirus-1918-flu-pandemic-camp-custer-battle-creek/4933400002/ accessed 6/14/2020

CDC https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2F1918-flu-pandemic%2Findex.html

David Roos “Why the Second Wave of the 1918 Spanish Flu Was So Deadly” April 2020 https://www.history.com/news/spanish-flu-second-wave-resurgence

Nick Buckley, Coronavirus: Lessons of the 1918 flu pandemic that claimed 674 soldiers at Camp Custer Published Published 3:17 p.m. ET March 5, 2020 Accessed 6/18/2020
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Influenza Pandemic - Howard Phillips https://encyclopedia.1914-1918-online.net/article/influenza_pandemic accessed 6/16/2020