The Great Influenza (31 page)

Even Tammany's use of power in New York was haphazard compared to that of the Philadelphia machine, which had returned to power in 1916 after a reformer's single term in office. Philadelphia's boss was Republican state senator Edwin Vare. He had bested and mocked people who considered themselves his betters, people who despised him, people with such names as Wharton, Biddle, and Wanamaker.

A short, thick-chested, and thick-bellied man (his nickname was 'the little fellow') Vare had his base in South Philadelphia. He had grown up there before the incursion of immigrants, on a pig farm in a then-rural area called 'the Neck.' He still lived there despite enormous wealth. The wealth came from politics.

All city workers kicked back a portion of their salary to Vare's machine. To make sure none ever missed a payment, city workers received their salary not where they worked or in City Hall (a classic and magnificent Victorian building, with curved shoulders and windows reminiscent of weeping willow trees) but across the street from City Hall in Republican Party headquarters. The mayor himself kicked back $1,000 from his pay.

Vare was also the city's biggest contractor, and his biggest contract was for street cleaning, a contract he had held for almost twenty years. At a time when a family could live in comfort on $3,000 a year, in 1917 he had received over $5 million for the job. Not all of that money stayed in Vare's pockets, but even the part that left passed through them and paid a toll. Yet the streets were notoriously filthy, especially in South Philadelphia - where the need was greatest, where everything but raw sewage, and sometimes even that, ran through the gutters, and where the machine was strongest.

Ironically, the very lack of city services strengthened the machine since it provided what the city did not: food baskets to the poor, help with jobs and favors, and help with the police - the commissioner and many magistrates were in Vare's pocket. People paid for the favors with votes which, like a medieval alchemist, he transmuted into money.

The machine proved so lucrative that Edwin Vare and his brother William, a congressman, became philanthropists, giving so much to their church at Moyamensing Avenue and Morris Street that it was renamed the Abigail Vare Memorial Methodist Episcopal Church, after their mother. Not many churches are named after mere mortals, but this one was.

Yet nothing about the machine was saintly. On primary election day in 1917, several Vare workers blackjacked two leaders of an opposing faction, then beat to death a policeman who intervened. The incident outraged the city. Vare's chief lieutenant in 1918 was Mayor Thomas B. Smith. In his one term in office he would be indicted, although acquitted, on three entirely unrelated charges, including conspiracy to murder that policeman. That same election, however, gave Vare absolute control over both the Select and Common Councils, the city's legislature, and broad influence in the state legislature.

Director of the Philadelphia Department of Public Health and Charities was Dr. Wilmer Krusen, a political appointee who served at the mayor's pleasure and whose term automatically expired with the mayor's. Krusen, a decent man whose son would become a surgeon at the Mayo Clinic, was as good an appointment as the machine made. But he lacked background in, commitment to, or understanding of public health issues. And he was by nature someone who thought most problems disappeared on their own. He was not someone to rush into a thing.

He certainly would exert no pressure whatsoever on the machine to advance the public health. Although a gynecologist, he refused even to help the military in its massive national campaign against prostitution. Even New Orleans had succumbed to pressure to close Storyville, where prostitution was legal, but no pressure could make Philadelphia, where prostitution remained illegal, in any way hinder its flesh industry. So, according to a military report, the navy 'actually took control of police affairs' outside its installations.

The city government was choking on corruption, with lines of authority split among Vare, precinct captains-turned-entrepreneurs, and the mayor. It did not wish to act, nor could it if it chose to.

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Four days after the arrival of the sailors from Boston at the Navy Yard, nineteen sailors reported ill with symptoms of influenza.

Lieutenant Commander R. W. Plummer, a physician and chief health officer for the Philadelphia naval district, was well aware of the epidemic's rage on Commonwealth Pier and at Devens and its spread to the civilian population in Massachusetts. Determined to contain the outbreak, he ordered the immediate quarantine of the men's barracks and the meticulous disinfecting of everything the men had touched.

In fact, the virus had already escaped, and not only into the city. One day earlier 334 sailors had left Philadelphia for Puget Sound; many would arrive there desperately ill.

Plummer also immediately called in Paul Lewis.

Lewis had been expecting such a call.

He loved the laboratory more than he loved anyone or anything, and he had the full confidence of Welch, Theobald Smith, and Flexner. Lewis had won their confidence by his extraordinary performance as a young scientist under each of them in turn. He had already achieved much, and he held the promise of much more. He also knew his own worth, not in the sense that it made him smug but in that it gave him responsibility, making his promise at least as much burden as ambition. Only an offer to become the founding head of the new Henry Phipps Institute (Phipps had made millions at U.S. Steel with Andrew Carnegie, then, like Carnegie, had become a prominent philanthropist) which was associated with the University of Pennsylvania, had lured him to Philadelphia from the Rockefeller Institute. He was modeling Phipps after the institute, although Phipps would focus much more narrowly on lung disease, particularly tuberculosis.

No one needed to tell Lewis the urgency of the situation. He knew the details of the British sailors who had died in early July, and he had very likely tried to culture bacteria from them and prepare a serum. Soon after learning that influenza had appeared in the Navy Yard, Lewis arrived there.

It was up to him to take charge of what would normally be the step-by-step, deliberate process of tracking down the pathogen and trying to develop a serum or vaccine. And there was no time for normal scientific procedures.

The next day eighty-seven sailors reported ill. By September 15, while Lewis and his assistants worked in labs at Penn and at the navy hospital, the virus had made six hundred sailors and marines sick enough to require hospitalization, and more men were reporting ill every few minutes. The navy hospital ran out of beds. The navy began sending ill sailors to the Pennsylvania Hospital at Eighth and Spruce.

On September 17, five doctors and fourteen nurses in that civilian hospital suddenly collapsed. None had exhibited any prior symptoms whatsoever. One moment they felt normal; the next, they were being carried in agony to hospital beds.

* 

Navy personnel from Boston had been transferred elsewhere as well. As Philadelphia was erupting, so was the Great Lakes Naval Training Station, thirty-two miles above Chicago. Teddy Roosevelt had created the base in 1905, declaring that it would become the largest and best naval training station in the world. With forty-five thousand sailors it was the largest, and it had begun to generate a proud history. The 'Seabees' naval construction battalions were born there, and during the war Lieutenant John Philip Sousa created fourteen regimental bands there; sometimes all fifteen hundred musicians played en masse on Ross Field, spectacle for tens of thousands who flocked to hear them. As the influenza virus swept through the base, there would be no massing of anyone, musicians or otherwise. At this base, influenza ripped through the barracks very much like an explosion.

Robert St. John had just been inducted into the navy there when he became one of the early victims. Given a cot in a drill hall where soon thousands of men (in that one hall) would lie unattended, he later recalled, 'No one ever took our temperatures and I never even saw a doctor.' He did make his first friend in the navy, a boy on the next cot who was too ill to reach for water. St. John himself barely had the strength to help him drink from his canteen. The next morning an orderly pulled the blanket over his friend's head, and two sailors put the body on a stretcher and carried it away. By then the medical department had already reported that '33 caskets to Naval Medical Supply Depot required.' They would soon require far more than that.

One nurse at Great Lakes would later be haunted by nightmares. The wards had forty-two beds; boys lying on the floor on stretchers waited for the boy on the bed to die. Every morning the ambulances arrived and stretcher bearers carried sick sailors in and bodies out. She remembered that at the peak of the epidemic the nurses wrapped more than one living patient in winding sheets and put toe tags on the boys' left big toe. It saved time, and the nurses were utterly exhausted. The toe tags were shipping tags, listing the sailor's name, rank, and hometown. She remembered bodies 'stacked in the morgue from floor to ceiling like cord wood.' In her nightmares she wondered 'what it would feel like to be that boy who was at the bottom of the cord wood in the morgue.'

* 

The epidemic was sweeping through the Philadelphia naval installations with comparable violence, as it had in Boston. Yet in Philadelphia, despite the news out of Boston, despite the Great Lakes situation, despite events at its own Navy Yard, Philadelphia public health director Wilmer Krusen had done absolutely nothing.

Not all the city's public health figures remained oblivious to the threat. The day after the first sailor fell ill, Dr. Howard Anders, a prominent public health expert who despised and had no faith in the Vare machine, wrote Navy Surgeon General William Braisted to ask would 'the navy (federal) authorities directly come in, under this threat of influenza invasion, and insist upon safeguarding its men and collaterally the whole population of Philadelphia' ?' (Braisted declined.)

Krusen publicly denied that influenza posed any threat to the city. He seemed to believe that, for he made no contingency plans in case of emergency, stockpiled no supplies, and compiled no lists of medical personnel who would be available in an emergency, even though 26 percent of Philadelphia's doctors and even a higher percentage of nurses were in the military. Indeed, despite building pressure from Lewis, from Anders, from physicians all over the city, from faculty at Penn and Thomas Jefferson Medical College (which refused to release six doctors who wanted to volunteer for military service just as the epidemic erupted) not until September 18, a full week after the disease appeared in the city, did Krusen even schedule a meeting with Plummer, Lewis, and several others.

In Krusen's fifth-floor office at City Hall they acquainted each other with the facts. In Massachusetts nearly one thousand had already died, with tens of thousands ill, and the Massachusetts governor had just issued a plea for doctors and nurses from neighboring regions. In Philadelphia hundreds of sailors were hospitalized. Few signs of disease had surfaced among civilians, but Lewis reported that as yet his research had not found an answer.

Even if Lewis succeeded in making a vaccine, it would take weeks to produce in sufficient quantities. Thus, only drastic action could prevent the spread of influenza throughout the city. Banning public meetings, closing businesses and schools, imposing an absolute quarantine on the Navy Yard and on civilian cases - all these things made sense. A recent precedent existed. Only three years earlier Krusen's predecessor (during the single term of the reform mayor) had imposed and enforced a strict quarantine when a polio epidemic had erupted, a disease Lewis knew more about than anyone in the world. Lewis certainly wanted a quarantine.

But Plummer was Lewis's commanding officer. He and Krusen wanted to wait. Both feared that taking any such steps might cause panic and interfere with the war effort. Keeping the public calm was their goal. Those polio restrictions had been imposed when the country wasn't fighting a war.

The meeting ended with nothing decided except to monitor developments. Krusen did promise to start a mass publicity campaign against coughing, spitting, and sneezing. Even that would take days to organize. And it would conflict with the downplaying of danger by Krusen and navy officials.

In Washington, Gorgas, who likely had heard from Lewis, was unsatisfied with these developments. By then influenza had erupted in two more cantonments, Camp Dix in New Jersey and Camp Meade in Maryland, that sandwiched the city. Lewis was in very close contact with the Philadelphia Tuberculosis Society, and Gorgas asked it to print and distribute twenty thousand large posters warning of influenza and stating a simple precaution that might help in at least a small way: 'When obliged to cough or sneeze, always place a handkerchief, paper napkin, or fabric of some kind before the face.'

Meanwhile the
Evening Bulletin
assured its readers that influenza posed no danger, was as old as history, and was usually accompanied by a great miasma, foul air, and plagues of insects, none of which were occurring in Philadelphia. Plummer assured reporters that he and Krusen would 'confine this disease to its present limits, and in this we are sure to be successful. No fatalities have been recorded among Navy men. No concern whatever is felt by either the military and naval physicians or by the civil authorities.'

The next day two sailors died of influenza. Krusen opened the Municipal Hospital for Contagious Diseases to the navy, and Plummer declared, 'The disease has about reached its crest. We believe the situation is well in hand. From now on the disease will decrease.'

Krusen insisted to reporters that the dead were not victims of an epidemic; he said that they had died of influenza but insisted it was only 'old-fashioned influenza or grip.' The next day fourteen sailors died. So did the first civilian, 'an unidentified Italian' at Philadelphia General Hospital at South Thirty-fourth and Pine.

The following day more than twenty victims of the virus went to a morgue. One was Emma Snyder. She was a nurse who had cared for the first sailors to come to Pennsylvania Hospital. She was twenty-three years old.