‘May we never see the like of it again’
100 years after the deadly Spanish flu, expert says pandemic can occur again
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.”