Schools closed. Synagogues shuttered. Patients in quarantine. Public health officials recommend … gargling?
This is not a description of the 2020 novel coronavirus pandemic, but of the response to the 1918 influenza, also known as Spanish flu or H1N1. The deadly disease killed 50 million people worldwide and 675,000 people in the United States, according to the Centers for Disease Control and Prevention.
Temple University Associate History Professor Hilary Lowe said Philadelphia suffered the most deaths per capita in the nation after the Liberty Loans Parade on Sept. 28 exposed massive crowds to the disease.
“This parade was enormous,” she explained. “Between 200,000 and 500,000 people crowded along Broad Street and into trolley cars. There was a patriotic singalong with multiple marching bands, and the Girl Scouts made a huge tank-shaped float designed to be an exact replica of the ones troops were using overseas.”
According to the Smithsonian Museum, every bed in Philadelphia’s 31 hospitals was full within 72 hours of the parade.
Wilmer Krusen, director of public health and charities of Philadelphia, advised the city to ban all assemblies in public spaces and mandate private funerals. Philadelphia’s Army and Navy bases were also placed under quarantine.
“Epidemics of respiratory diseases are controlled, first, by isolating the sick; secondly, by keeping under observation all those who have been in contact with the sick and, thirdly, by improving the physical resistance of the well,” the Jewish Exponent quoted Krusen in October 1918.
He went on to advise, “Persons who have been in contact with the sick should keep the throat clean by using an appropriate gargle and mouth wash,” and recommended the floors of saloons be scrubbed daily with chloride and lime.
“This flu was uniquely devastating in that young, healthy people suffered high mortality rates,” Lowe said. “Older generations had developed some immunity during an earlier flu pandemic, and healthy bodies had an overproduced response to the virus that killed people in a very violent way.”
The Smithsonian reported that Army physician Roy Grist was stationed at a hospital near Boston and observed victims’ skin turning blue as they suffocated from the fluid in their lungs. According to Lowe, suicide rates rose as people chose to end their own lives rather than suffer from such a gruesome disease.
Teenagers and young adults working in hospitals faced the death of patients and the threat of contracting the disease themselves.
“Young nursing and medical students were pressed into service as early as possible,” Lowe said. “They were encouraged to take ‘fresh air walks’ in Fairmount Park to cope with the mental strain.”
Sixteen-year-old nursing pupil Alice Wolowitz was listed among the Jewish Exponent’s October influenza death notices. Physicians at her workplace, Mt. Sinai Hospital, told the Exponent that she “rendered efficient service during the epidemic and died a martyr to duty.”
Philadelphia’s Jewish community mobilized volunteers and converted hospitals to receive flu patients. “Owing to the shortage of nurses, it is imperative that this hospital receive outside help,” the Jewish Maternity Hospital advertised in a plea for volunteers in the Exponent.
Another article noted, “The wife of one of our rabbis was seen at one of the hospitals daily answering the telephone.”
Jewish Philadelphians also created the Jewish Emergency Society in response to “the great number of children who have become orphans, due to the influenza epidemic, and the great number of women who were left destitute as a result of the terrible disease,” the Exponent wrote.
According to Lowe, more than 12,000 people died in the six weeks following the Liberty Loans parade. Had officials canceled the gathering, the city’s death toll would have been more similar to that of Boston — which suffered 4,794 deaths in the fall of 1918 — based on data in the University of Michigan’s Influenza Encyclopedia.
While all available data provided by the CDC and World Health Organization shows that the 1918 flu pandemic was far deadlier than the COVID-19 pandemic, Philadelphia is still contending with the dangers of crowds and the limitations of health care.
“Philadelphia then was kind of like Philadelphia now in that the health care system was operating at very low capacity,” Lowe said. “We just shut down Hahnemann University Hospital, and back then there was a doctor deficiency because they were stationed overseas. When the flu pandemic hit in 1918, hospitals immediately maxed out.”
St. Louis, by contrast to Philadelphia, opted to cancel its Liberty Loans Parade and faced a flu death toll of only 700. According to CDC, “This deadly example shows the benefit of canceling mass gatherings and employing social distancing measures during pandemics.”
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