The flu that ravaged the city and world
Hundreds of lives lost to illness with no known cause, no treatment and no cure
In October 1918 alone, the deadliest month of the Spanish flu pandemic, 440 Ottawa residents perished, either from the disease itself or from associated complications such as pneumonia or pleurisy.
To put that in context, were a similar outbreak with the same mortality rate to occur in Ottawa today, 150 residents would die each day for a month.
Worldwide, the Spanish flu claimed between 20 and 40 million lives. More recent estimates put the number as high as 100 million. In Canada, upwards of 55,000 died, almost as many as the number of Canadian soldiers killed in the entire First World War.
Jules Lemieux, a 71-year-old Public Works employee, is believed to have been the city’s first fatality. The “Spanish Lady,” as the disease was sometimes called, danced him to his Notre Dame cemetery grave on Sept. 26, following a five-day respiratory illness.
Deaths from the flu were not pretty. There were fevers reaching 104 F, accompanied by chills, fatigue, headaches and inflammation of the mucous membranes. Bleeding from the eyes and ears occurred. Respiratory tract infections could develop, as did cyanosis, a blue or purple discoloration of the skin caused by a lack of oxygen in patients’ hemoglobin. Because of that, it was often referred to as Blue or Purple Death.
It was not, in fact, Spanish in origin. It picked up that name because Spain, as a neutral country in the First World War, was not subject to wartime censorship, and so news of cases from that country appeared worse than outbreaks reported from other countries.
The source of the virus is generally believed to have been South China, an avian flu that may or may not have initially been transmitted to pigs before infecting humans. One theory holds that Chinese workers brought to the western front by Allied nations to dig trenches carried the disease. Another suggests that a major troop camp and hospital in Étaples, France, where chickens and pigs were also kept, was ground zero.
Regardless of where it came from, it was certainly transmitted by troops returning home, following train routes from port cities to hometowns everywhere. As such, it was neighbourhoods closest to train routes — typically working-class ones — that were first and hardest hit.
In Ottawa, that meant largely French and Irish Catholics, although the disease otherwise played no favourites, striking with little regard to race, religion or sex.
Ottawa Senators star “Hamby” Shore, 32, became infected and died after tending to his sick wife.
Thirty-three-year-old Dr. Osler M. Graves, Carleton County coroner and medical officer of health for three or four townships west of Ottawa, also died from the flu.
Jennie Barry, the wife of Sen. Michael John O’Brien — also founder of the Renfrew Millionaires, who would go on to become the Montreal Canadiens — similarly died.
The first wave of the disease appeared in early 1918, and was generally so mild that it was often not even diagnosed as the flu. It was frequently called “the three-day fever.” There were fatalities, however, including that of In Flanders Fields author John McCrae.
The second wave, in the fall of 1918, was by far the deadliest, accounting for 90 per cent of the pandemic’s deaths. It, too, was often misdiagnosed, usually as cholera, dengue or typhoid, but this time because it was so utterly virulent.
Not only was it frequently fatal, but it was wholly unlike viruses that typically felled the very young and very old. Of those who died in Ottawa in October, 58 per cent were between 18 and 35 years of age; 28 per cent were younger than 18.
Two additional, less deadly, waves hit in the springs of 1919 and 1920. Those who had been infected during the first wave were not affected by the subsequent waves, suggesting that all four were strains of the same virus.
In Canada, there was no national plan for this sort of thing, while provinces, which were responsible for public health, typically off-loaded the responsibility to individual municipalities. With so many medical staff already serving overseas, the burden on cities was enormous. In the latter half of September 1918, meanwhile, two Ottawa deaths had been attributed to the flu, and 23 to pneumonia. In the first week of October, 41 more deaths were reported: 18 by the flu and 23 from pneumonia. Forty people died over the second weekend of October: Thanksgiving. The Board of Health, recognizing the urgency, stepped in.
Schools, churches, theatres, pubs, bowling alleys and pool halls were closed; shops were ordered closed at 4 p.m.; public servants sent home at 3 p.m. Public funerals were discouraged. Boy Scouts delivered warning pamphlets to every home in the city. A temporary ban was placed on public assemblies, and the Ottawa Electric Railway was asked to disinfect its streetcars daily with formaldehyde. Sporting events and a plowing match were cancelled.
Compliance did not always come voluntarily. Merchants complained about the shortened hours, arguing that they would actually create more congestion in their stores. Workers were laid off. Regarding school closures, some argued that the move would force many children into the streets, where they would enjoy less protection from the flu.
The cause was unknown, and there was no effective treatment. And short of a complete quarantine, there was no way to stop its spread.
The British Medical Journal seemed to support the merchants, churches and others, writing that “Every town dweller who is susceptible must sooner or later contract influenza whatever the public health authorities may do, and that the more schools and public meetings are banned and the general life of the community dislocated the greater will be the unemployment and depression.”
John W. S. McCullough, Ontario’s chief provincial health officer, agreed, urging his colleagues to adopt measured responses. He said health officers “should not be moved from their duty by public clamour, to adopt fussy and illadvised measures which only serve to irritate the public and accomplish no useful purpose.”
But when businesses petitioned to extend their hours of operation to 5 p.m., Dr. Campbell Laidlaw, chairman of the board of health, responded, “The two hours between 4 p.m. and 6 p.m. are the time human vitality is at its lowest ebb, and when the sunlight and fresh air would prove most beneficial to restored health.”
Stores, for the time being, remained closed after 4 p.m.
Lillian Freiman, wife of noted Ottawa retailer A.J. Freiman, was charged with the task of finding space to house hospital overflow. Temporary hospitals were set up at Lansdowne Park and in some of the schools that had been closed. Apart from the Victorian Order of Nurses and the Voluntary Aid Detachment of the St. John’s Ambulance Brigade, nursing responsibilities fell to numerous women’s organizations, including the May Court Club, the Ottawa Local Council of Women and the Halcyon Club.
But while those who were financially better off were often willing to donate food and supplies, fewer were actually willing to administer aid to the sick for fear of becoming infected themselves. So while the rates of infection and death appeared to be abating by the middle of October, Ottawa mayor Harold Fisher remained cautious.
“People died in Ottawa last night because they had nobody to look after them last week when they had nothing but a mild attack of flu,” he said. “People will die next week unless they have someone to take care of them tonight. Every strong able-bodied woman is needed.”
The Citizen reported that by the final week of October some hospital beds had freed up, indicating that the worst of the outbreak might have passed.
“In fact, so marked has been the improvement,” the paper reported with no apparent irony, “that many of the people who have been working so splendidly have concluded that their help was no longer needed. The result has been that there was a dearth of cars, workers and broths for the people who are still too sick to attend to themselves.”
By mid November, the board of health had repealed its restrictions, and by year’s end, when the disease had largely run its course in Ottawa, about 520 people were dead. Approximately 200 children and teenagers were orphaned; some were taken in by family members, but others became wards of orphanages.
But the Spanish flu led to some positive changes, including the creation in 1919 of the federal Department of Health, which established a public health partnership between various levels of government.
The Civic Hospital on Carling Avenue, which opened in 1924 with 550 beds, was also a post-Spanish flu initiative, led by Mayor Fisher. Its location, then on the western outskirts of the city, was openly mocked by many (ultimately short-sighted) citizens who referred to it as Fisher’s Folly.