‘May we never see the like of it again’

100 years af­ter the deadly Span­ish flu, ex­pert says pan­demic can oc­cur again

Albany Times Union - Sunday - - FRONT PAGE - By Bethany Bump

When Dr. Ralph Post left the Cap­i­tal Re­gion to serve in the Great War on Aug. 24, 1918, he couldn’t have known it would be his wife back home who would end up fight­ing for her life.

But then no one ex­pected the great­est killer to emerge from the war years would be the flu.

In­deed, Frances Gray Post ap­peared to be her nor­mal self while Post was away in France. They wrote al­most ev­ery day, even af­ter she was called to care for the sick at Geneva Hos­pi­tal in the Fin­ger Lakes. The pair had met at Al­bany City Hos­pi­tal, where she was a nurse. They mar­ried in 1915, and he set up a prac­tice in nearby Ravena.

“It cer­tainly is a plea­sure to get up feel­ing rested again,” he wrote Sept. 12, af­ter sev­eral long days of rail travel in France.

“My dear boy,” she be­gan a let­ter to him Sept. 22.

The let­ters must have stopped abruptly by the sec­ond week of Oc­to­ber, when she fell ill in Geneva. A week later, she was dead of pneu­mo­nia at age 32.

The cul­prit might have been pneu­mo­nia by the end, but it al­most cer­tainly be­gan as Span­ish in­fluenza. Lo­cal obit­u­ary pages at the time were filled with the names of peo­ple

stricken by ei­ther inf luenza or pneu­mo­nia, which oc­curred as a com­pli­ca­tion of the flu, es­pe­cially in the later weeks of fall 1918.

A hun­dred years later, the 1918 in­fluenza pan­demic re­mains one of the dead­li­est dis­ease out­breaks in hu­man his­tory. Ap­prox­i­mately 500 mil­lion peo­ple world­wide — one out of ev­ery three hu­mans on the planet — be­came in­fected with the virus. Of those, at least 50 mil­lion died. It killed more Amer­i­cans — about 675,000 — than the war did.

For con­text, the dead­li­est flu out­break in the past four decades oc­curred just last win­ter, when roughly 80,000 Amer­i­cans died.

The 1918 pan­demic is of­ten for­got­ten to his­tory, eclipsed by the fi­nal stages of World War I, which it­self is a less vividly re­called war than its suc­ces­sor. Ma­jor news­pa­pers world­wide were un­der cen­sor­ship or­ders to min­i­mize re­ports of the deadly out­breaks in an at­tempt to keep up wartime morale. An ex­cep­tion was Spain, which re­mained neu­tral dur­ing the war and freely re­ported news of the flu. That’s how, though it did not orig­i­nate there, the 1918 in­fluenza earned its name.

Lo­cal papers more ac­cu­rately re­flected the scope by which Span­ish in­fluenza was dec­i­mat­ing com­mu­ni­ties.

Threat on the home­front

“Con­trary to re­ports yes­ter­day that the inf luenza epi­demic was on the wane ... in­quiry from many physi­cians proved that the ex­act op­po­site is the truth,” the Sch­enec­tady Gazette re­ported Oct. 3, 1918.

It had been sev­eral weeks since the first flu deaths of the sea­son had be­gun, but this was the first time that a real sense of dread had made its way into a lo­cal news­pa­per re­port, which that day con­firmed 62 cases and 11 houses in the city un­der quar­an­tine.

In the Cap­i­tal Re­gion, an out­break of flu was first re­ported Sept. 23 when the Gazette noted that at least 50 cases of “grippe,” as flu was called then, had been re­ported at mil­i­tary ware­houses in Rot­ter­dam Junc­tion over the pre­vi­ous two weeks. First af­flict­ing “sus­cep­ti­ble ne­gro troops,” the ill­ness was prac­ti­cally writ­ten off. In days, though, it would be­gin its spread out­side the ware­houses, af­fect­ing civil­ians of all races through­out the Sch­enec­tady area.

At one South Cen­ter Street home, an en­tire fam­ily by the name of Stein was struck. A vivid scene was de­scribed in the Oct. 3 Gazette: “The Bu­reau (of Char­i­ties) found a piti­ful con­di­tion of af­fairs at the ... home. A baby was in the crib, dead, and the rest of the fam­ily, seven, with the father and mother, all suf­fer­ing from the dis­ease.”

The next day’s re­port: “The piti­ful case of the Stein fam­ily ... has ex­cited deep feel­ing.”

Other cities were be­gin­ning to ex­hibit sim­i­lar feel­ings of dread. In Saratoga Springs, three deaths from the flu were re­ported on Sept. 30. In Co­hoes, city pub­lic health of­fi­cer Dr. John Archi­bold told the Co­hoes Re­pub­li­can news­pa­per on Oct. 4 that the flu “seems to be gain­ing some ground.” On Oct. 7 in Al­bany, just two days af­ter City Health Of­fi­cer Dr. Arthur Saut­ter de­clared the city “un­usu­ally for­tu­nate” with few cases, he re­ceived re­ports of 6,000 cases from lo­cal physi­cians.

Dras­tic pre­ven­tion

It was at this point that Cap­i­tal Re­gion cities be­gan or­der­ing pub­lic spa­ces to close — in­clud­ing schools, the­aters, movie houses, churches, li­braries, lodges and sa­loons.

Quar­an­tine was im­posed at in­fected homes, while cafes, restau­rants and ice-cream par­lors were or­dered to ster­il­ize their glasses and dishes. Re­stric­tions were put in place on the num­ber of pas­sen­gers that could be car­ried on Sch­enec­tady trol­ley cars, and Lib­erty Loan war bond parades planned by the city’s two largest em­ploy­ers, Gen­eral Elec­tric and the Amer­i­can Lo­co­mo­tive, were post­poned in­def­i­nitely.

Of­fi­cials seemed to fi­nally take the out­break se­ri­ously.

“There should be no dis­po­si­tion to re­gard this epi­demic with other than full com­pre­hen­sion of its se­ri­ous­ness,” an Oct. 7 Gazette ed­i­to­rial read. “It is not a case of a cold from bad weather, but a real epi­demic that kills be­fore its grip on a per­son is re­al­ized.”

In the first weeks of au­tumn, res­i­dents were fall­ing ill in the morn­ing and dead by night­fall. The flu’s fe­roc­ity was alarm­ing, and so was its tar­get de­mo­graphic: healthy adults ages 20 to 40.

What be­gan as an in­fec­tion of the up­per res­pi­ra­tory tract spread deep into the lungs. Vic­tims coughed up blood as they strug­gled to breathe. Their eyes and ears bled. Their faces turned blue, their bod­ies black.

It was their own im­mune sys­tems that had done it, pro­duc­ing an ex­cess of ex­tremely toxic mol­e­cules known as cy­tokines.

“Your body pro­duces these to at­tack in­fec­tion,” said in­ter­na­tional flu ex­pert Dr. Robert Web­ster, whose book “Flu Hunter: Un­lock­ing the Se­crets of a Virus,” was pub­lished this year. “Most of the time, cy­tokines do their job and you re­cover. But in 1918, the body was tricked into over­pro­duc­ing these cy­tokines — and it was healthy peo­ple who pro­duced them most ef­fi­ciently.”

As the virus spread, peo­ple’s im­mune sys­tems man­aged to ad­just and fight it off with an ap­pro­pri­ate re­sponse. But even then, the ill be­came sus­cep­ti­ble to bac­te­rial pneu­mo­nia, which was not as easy to treat then.

In Sch­enec­tady, streets were sprayed with dis­in­fec­tant and fu­ner­als were re­stricted to im­me­di­ate fam­ily only. Over­loaded with cases, the city was forced to re­open the re­cently closed Mercy Hos­pi­tal; cots were set up in hall­ways and un­used wards were opened at El­lis Hos­pi­tal. Morgues be­came over­crowded, and un­der­tak­ers ran out of cas­kets.

In Al­bany, a more del­i­cate dance was per­formed. On Oct. 8, the City Coun­cil made it a mis­de­meanor to cough or sneeze in pub­lic with­out cov­er­ing one’s mouth. Vi­o­la­tors could face a $500 fine and the pos­si­bil­ity of a year in prison. Any­one who spit in pub­lic risked ar­rest as well as a $10 fine.

Just two days later, though, Mayor James Watt struck an op­ti­mistic tone. He en­cour­aged res­i­dents to turn out for a pa­rade on Oct. 12 and a John Philip Sousa con­cert in Wash­ing­ton Park on Oct. 13.

“If the peo­ple of Al­bany will for the time be­ing for­get that in­fluenza ex­ists, the epi­demic will be halted,” Watt told a re­porter. “One can worry him­self into con­tract­ing the dis­ease.”

The same day, 332 new cases were re­ported in the city and 14 peo­ple died. The school district vol­un­teered its nurses to help, and the dean of Al­bany Med­i­cal Col­lege of­fered its med­i­cal stu­dents.

A city in dis­tress

Sch­enec­tady was par­tic­u­larly be­lea­guered by the virus. Doc­tors and nurses had been work­ing around the clock, and re­ported see­ing new cases ev­ery hour, ac­cord­ing to the Oct. 11 Gazette.

“I would give $50 for the chance to go home and sleep for 12 hours,” Dr. E.J. Senn told the news­pa­per af­ter his 62nd call of the day. “I have not had two hot meals in two days. I just grab a sand­wich and a cup of cof­fee and jump in the ma­chine and be­gin the weary round of sick, sicker and sick­est.”

New cases and deaths eased over the next few days, only to take a turn for the worse Oct.

23, when city health of­fi­cer Dr. Wal­ter Clark re­ported there had been 17 deaths and 346 new cases in the past two days.

“I want to feel op­ti­mistic, but Satur­day things looked bet­ter, and to­day we are still fac­ing a very crit­i­cal sit­u­a­tion,” Clark said.

Else­where, the sit­u­a­tion was mixed. In Co­hoes, things had wors­ened, and talks of a makeshift hos­pi­tal at one of its aban­doned schools, the Og­den Mill or the city Ar­mory were dis­cussed. Al­bany, how­ever, was see­ing a de­cline in new cases and deaths, and Saut­ter, the city health of­fi­cer, or­dered an end to the pub­lic gath­er­ing ban.

The next day, the State Health De­part­ment re­leased a re­port re­veal­ing Sch­enec­tady had been the hard­est hit in the Cap­i­tal Re­gion, with 311 deaths from in­fluenza or pneu­mo­nia as of Oct. 22, trailed by 226 in Al­bany, 154 in Troy and 92 in Rens­se­laer.

Re­lief in sight

Mon­day, Oct. 28 — a new week — brought new hope.

The Gazette ran a head­line, “Empty Beds Show De­cline of Epi­demic,” and for the first time in weeks, doc­tors con­firmed they had no new cases re­ported in Sch­enec­tady. The next day, the ban on pub­lic gath­er­ings was par­tially lifted.

Sim­i­lar re­ports were com­ing from other nearby com­mu­ni­ties. By Nov. 1, Al­bany hos­pi­tals said they had no new deaths and plenty of beds avail­able. The­aters were al­lowed to re­open on Nov. 7, and schools on Nov. 9.

In the early morn­ing hours of Nov. 11, Cap­i­tal Re­gion res­i­dents learned that Ger­many had agreed to stop fight­ing. The war was over. Peo­ple flooded the streets in spon­ta­neous parades, and cel­e­brated all day.

The pub­lic min­gling of so many peo­ple seemed to set off a sec­ond out­break, but the new cases were all mild — an in­di­ca­tion that peo­ple’s im­mune sys­tems had ad­justed to the Span­ish in­fluenza by then.

In the months that fol­lowed there were iso­lated out­breaks, al­though an­other mild wave struck in Jan­uary. Re­lief that the war was over seemed to dis­place mem­o­ries of the deadly epi­demic, and news­pa­per re­ports re­turned to cov­er­ing the typ­i­cal hap­pen­ings of their com­mu­ni­ties.

Ger­ar­dus Smith, pres­i­dent of the board of di­rec­tors at El­lis Hos­pi­tal, sum­ma­rized this sense of re­lief over the end of the epi­demic in a year-end re­port on the hos­pi­tal’s op­er­a­tions: “May we never see the like of it again.”

Flu ex­pert Dr. Web­ster’s study of the virus leads him to a less op­ti­mistic con­clu­sion. While mod­ern medicine is bet­ter equipped to care for peo­ple with the flu, the virus is par­tic­u­larly dif­fi­cult to pre­vent with vac­cine due to its abil­ity to mu­tate quickly, he said.

“The ques­tion I get asked most fre­quently is whether it’s pos­si­ble for a 1918 virus to emerge in the world to­day,” he said. “It is not only pos­si­ble, it is just a mat­ter of when.”

Paul Buck­owski / Times Union

Dr. Ralph Post’s por­trait is part of a World War I and Span­ish flu ex­hibit at Brook­side Mu­seum in Ball­ston Spa.

Pho­tos by Paul Buck­owski / times union

Anne Cloth­ier, direc­tor of ed­u­ca­tion at the Saratoga County His­tor­i­cal So­ci­ety’s Brook­side mu­seum, dis­cusses nurse frances Gray Post and her hus­band, dr. ralph Post, whose let­ters, pho­tos and ar­ti­facts are in­cluded in an ex­hibit about World War i and Span­ish flu at the mu­seum.

dr. ralph Post used this gas-mask kit when he served in the u.s. Army in france dur­ing World War i in 1918. it is in­cluded in the ex­hibit at the Brook­side mu­seum in Ball­ston Spa.

frances Gray Post’s photo al­bum is on dis­play at the Brook­side mu­seum in the ex­hibit high­light­ing the im­pact of the 1918 Span­ish flu pan­demic that killed in 50 mil­lion peo­ple world­wide and 675,000 in the u.s.

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