Lessons from the 1918 flu
Just like COVID-19, the Spanish Flu that hit Phoenix in waves starting in 1918 was deadly and spread rapidly
When one of the deadliest pandemics in world history hit Phoenix in the fall of 1918, some people poured a product called Germo into teacups, which they placed on windowsills hoping to somehow kill the virus before the virus killed them.
They scrubbed their floors with Germo too, when they could get it at the drug store. Or they scrambled to outsmart death with an assortment of reported remedies, including salty gargles, hot pepper drinks, atomizers, grapefruit, long underwear, exercise regimes, Turkish baths, homemade gauze masks and cigarettes.
The sheriff even distributed confiscated bootleg whiskey to flu patients who proffered doctors’ prescriptions. But nothing seemed to work.
No one had ever seen anything like this killer virus.
Just like COVID-19, the “Spanish flu” was characterized by a rapid spread and fatal complications – mostly pneumonias. It killed at least 675,000 in the United States.
No one knows for sure how many died worldwide – estimates range from 20 million to 100 million. The death count is often reported conservatively as 50 million. A recent New York Times opinion
piece suggested the 50 million death count, adjusted to today’s global population, would amount to 220 million people.
Some called it “Spanish Flu” and blamed Spain for starting it. Sound familiar? Regardless of its origins, the virus was spread in part by American soldiers during World War I, which was drawing to a close at the time.
Just like President Donald Trump, who early on downplayed the COVID-19 pandemic as the Democrats’ “new hoax,” President Woodrow Wilson wasn’t much of a leader during the pandemic.
Wilson stayed mostly mum as Americans died. And he reportedly encouraged factory workers to remain on the job in order to win the war.
In October, though, the U.S. Public Health Service announced the pandemic was a “crowd disease” and suggested Americans isolate themselves.
“INFLUENZA probably spreads mostly by inhaling some of the tiny droplets of germ-laden mucous sprayed through the air when ignorant or careless persons sneeze or cough without using a handkerchief,” the public health service warned. It urged Americans to cover their coughs, and to quit spitting on sidewalks and in street cars.
The pandemic hit Phoenix in four waves from 1918 to early 1920. The first wave, in March 1918, was relatively mild.
Then the virus may have mutated into a more efficient assassin.
The second wave was the killer wave. It attacked Phoenix in October and November, 2018. By October, town leaders approved an “Influenza Ordinance” that closed schools and many businesses, including the beloved movie theaters. Compliance and enforcement were patchy, though, and the virus was relentless.
In all, about 2,750 Arizonans died of the flu, epidemiologist Sushma Dahal tells me in an email. But in the second deadly wave, she said, 75% (about 2,000) of the victims died. At the time, Arizona was home to around 334,000 people.
The 1918 Arizona death toll is a conservative estimate, but if you adjust the death rate to the current population, they would amount to about 57,600 deaths.
Not even epidemiologists know for sure how many Arizonans, or how many Phoenix residents, perished in the 1918 pandemic. There was no uniform reporting system. Maricopa County hospitals and medical personnel were overtaxed.
So-called “emergency hospitals” were set up in vacant schools and other places. In Phoenix, for instance, an emergency hospital was set up in the Women’s Club to accommodate the overflow of sick and dying, which included jail inmates.
Hospital volunteers begged the public to donate old linens, night gowns, night shirts, robes and baby clothes.
Back then, Phoenix was a segregated town of about 29,000 with segregated hospitals. The poor and people of color often lived in crowded, unhealthy conditions. Then, as now, they had less access to health care. In 1918, their deaths were likely underreported and undercounted.
Dahal and her colleagues went through death certificates and report in a 2018 study of the pandemic that the virus “disproportionately affected lower socioeconomic groups.”
The Arizona Republic – then known as The Arizona Republican – doesn’t give much of a clue about how the minorities were impacted by the pandemic. The newspaper generally only reported on people of color in connection with their alleged crimes.
It was a robust paper. And just like today’s media, it helped readers diagnose their symptoms.
“The patient sickens rather suddenly feels weak, has pains in his eyes, ears and head or back and is sore all over. There is a sensation of chilliness and the temperature rises to 100 to 104.”
Sometimes, the newspaper published poems about the virus. The poems could be chirpy. Or they could be dark. Here’s one stanza:
When your back is broke and your eyes are blurred, And your shin bones knock and your tongue is furred, And your tonsils squeak and your hair gets dry, And your doggone sure you’re going to die, But your skeered you won’t and you think you will, Just drag to bed and have your chill, And pray the Lord to see you through, Because you’ve got the Flu, boy. You’ve got the Flu.
Phoenicians lived with uncertainty. They turned to their newspapers for answers. Many hung their hopes on reports of vaccinations developed by the Mayo Foundation and other groups.
The U.S. Public Health Service tried to temper those unrealistic hopes. “The public health service is watching the experiments carefully, but is not urging any form of vaccine treatment,” the agency announced in The Republic.
By mid-November, city leaders and medical authorities offered free vaccinations, but stopped short of saying they were effective. The gratis vaccinations were part of a new push by power brokers to get serious about the pandemic by banning public gatherings, adding signs to houses with flu patients, wearing masks in public, counting deaths more vigorously, washing streets, and ramping up the campaign to get Phoenicians to cover their coughs and sneezes.
But by then it was too late. The second wave of the pandemic was receding. By December, people had chucked their flu masks and were throwing Christmas parties.
“The influenza epidemic is on the decline in Phoenix,” The Republic reported. “There is an impression that the handling of it has been unfortunate.”
The newspaper took Phoenix leaders to task for mishandling the crisis with mixed messages and inconsistent orders.
People in contact with people sickened by the virus had not been quarantined, the newspaper grumbled. And at the same time, schools, businesses and movie theatres were closed for six weeks, “longer than anyplace else in the country,” to the tune of “hundreds of thousands of dollars.”
“The longer this goes on, the less people will willingly cooperate,” the newspaper concluded.
The virus returned in two mini-waves, and then petered out.
Gradually, even the newspaper lost interest.
There was so much else for Phoenicians to focus on. They grieved the dead, on the one hand. But on the other hand, the war was over, and the pandemic-ravaged American economy was recovering rapidly.
Another virus like this probably wouldn’t hit Phoenix for another century, after all.
It was so much easier to just forget.