1918Gov Docs and the Influenza Pandemic of

The Public Health Service also produced at least three posters for public display. Much as the use of facemasks today, this 12.6” x 11.9” poster encourages the use of handkerchiefs when appearing in public. 8

References 1. John M. Barry. The Great Influenza:

The Epic Story of the Deadliest Plague in History. New York: Viking. 2004, 171. 2. Ibid., 4 3. “Influenza Pandemic of 1918-19,”

Britannica Academic, Encyclopaedia

Britannica, 4 Mar. 2020 academic.eb.com/levels/collegiate/aarticle/ influena-pandemic-of-191819/2537.

Accessed 9 Jun. 2020 and Ibid., 450. 4. “Influenza a Probable Cause of Fever of Undetermined Nature in Southern

States,” Public Health Reports, Vol. 33, No. 25 (June 21, 1918), 1003. 5. “Measures for the Prevention of the

Introduction of Epidemic Influenza,”

Public Health Reports, Vol. 33, No. 37 (Sept. 13, 1918), 1540-1544. 6. “Epidemic Influenza (‘Spanish Influenza’): Prevalence in the United

States,” Public Health Reports, Vol. 33, No. 39 (Sept. 27, 1918), 1625- 1626. 7. See “Epidemic Influenza: Prevalence in the United States,” “Equipping

Emergency Hospitals,” “American

Public Health Association Meeting

Postponed,” and “Home Nursing

Should Be Encouraged.” Public Health

Reports, Vol. 33, No. 42 (October 18, 1918), 1763-1769. 8. Monthly Catalogue United States

Public Documents, No. 287, (Nov. 1918), 243. 9. “Sure Cures for Influenza,” Public

Health Reports, Vol. 33, No. 46 (Nov.8, 1918), 1932. 10.Ibid., 1933.

4

Government Documents and the Influenza Pandemic of 1918-1919

By Tim Dodge, Auburn University

The coronavirus pandemic has redefined our lives in 2020. Although states are reopening in an attempt to counteract the disastrous economic fallout caused by the pandemic, as of this writing, confirmed cases of COVID-19 and deaths are still rising in many states including Alabama. The pandemic is truly international in scope but just looking at the United States, one sees a confused and inadequate federal response. Most unfortunately, the disease has become politicized as is seen most starkly in the conflicting messages of those who would totally reopen the economy versus those who advocate caution. The pandemic has also revealed longstanding racial disparities in terms of access to healthcare. As of this writing there is no proven cure nor a vaccine available.

As we struggle to maintain our health, our economy, and, perhaps, our sense of national unity, it might be instructive to see how the federal government responded to a similar pandemic a century ago. This will be done via a sampling of federal government documents.

Although sometimes referred to as the Spanish flu, the influenza pandemic appears to actually have started in the United States with Philadelphia being one of its first identified locations in March 1918. John M. Barry suggests the disease became known as the Spanish flu because, as a neutral nation during World War I, Spain’s newspapers were not being censored. Thus, they ran numerous stories about the disease when King Alfonso XIII fell ill. Other countries became aware of the Spanish newspaper stories and people started calling the disease the Spanish flu. 1 In terms of magnitude the 1918-1919 pandemic was extraordinary with worldwide deaths estimated at anywhere from 20 million to 100 million, although 50 million seems to be the most likely number. 2 Estimates of the number of deaths in the United States range from 550,000 to at least 675,000 with the latter figure being most commonly cited. 3 One also needs to bear in mind the population of the world and the United States was considerably smaller than today, perhaps, only about one-third the population of today, so these numbers reflect a truly horrific rate of mortality.

The most frequent mention of influenza appears in the weekly Public Health Reports (HE 20.30: from the U.S. Marine Hospital Service). The first hint that something was amiss appears in the June 21, 1918, issue with a very short notice under the title “Influenza a Probable Cause of Fever of Undetermined Nature in Southern States.” 4 Nothing concerning influenza appears until September 13 when an in-depth article appears reporting on the appearance of “the so-called Spanish influenza” in a number of European countries and in some ships appearing in U.S. ports. 5 One might say the epidemic officially arrived when reported in the September 27 issue of Public Health Reports as a front page article although it notes, “influenza is not a reportable disease in most of the States.” 6 The epidemic was a full-blown crisis starting with the October 4 issue. By October 18 every single state was reporting cases. In addition, Public Health Reports started featuring articles that went beyond reporting prevalence to things such as setting up emergency hospitals, the postponement of conferences, and “an effort to reduce unnecessary calls on the overworked physicians” (this was an era when doctors still made house calls). 7 All of this resonates with our situation in 2020.

Congress produced a number of documents concerning the pandemic. This includes three hearings (two by the Senate Committee on Appropriations and one by the House Committee on Appropriations), eleven House and Senate Documents ranging from agency reports to authorization for statistical compilations, 21 documents pertaining to the introduction of bills concerning influenza between October 1918 and February 1920, and dozens of references found in the Congressional Record during the years 1918-1920. References to the pandemic also appear in the Naval Medical Bulletin (N 10.11/1:) in rather technical articles as well.

Just as there have been some misleading claims for the curing of the disease today (hydroxychloroquine being the most obvious example), so too were there such “sure cures” for influenza debunked by Public Health Reports in November 1918. Among the “sure cures” were “isotonic sea water,” “ozone therapy,” and “harmonic vibrations.” 9 In another eerie parallel to the present, the article also seems to address the politicization of the disease: “Comes also the mental scientist who regards the epidemic as engendered by fear. ‘This sort of infectious suggestion is a crime against the public, is treason to our Government, and the traitors responsible for it shall not be allowed to go unpunished.’”

While this is only a brief summary, anyone wanting to do research on the 1918-1919 influenza pandemic will find government documents to be of use and interest with Public Health Reports probably the most useful publication of all.