The Great Influenza (51 page)

Fear, that was the enemy. Yes, fear. And the more officials tried to control it with half-truths and outright lies, the more the terror spread.

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The Los Angeles public health director said, 'If ordinary precautions are observed there is no cause for alarm.' Forty-eight hours later he closed all places of public gatherings, including schools, churches, and theaters.

The Illinois superintendent of public health had (privately, in a confidential meeting with other Illinois public health officials and Chicago politicians) suggested they close all places of business to save lives. Chicago Public Health Commissioner John Dill Robertson violently rejected that suggestion as unwarranted and very damaging to morale. In his official report on the epidemic, he bragged, 'Nothing was done to interfere with the morale of the community.' Later he explained to other public health professionals, 'It is our duty to keep the people from fear. Worry kills more people than the epidemic.'

The mortality rate at Cook County Hospital for all influenza cases (not just those who developed pneumonia) was 39.8 percent.

Literary Digest,
one of the largest-circulation periodicals in the country, advised, 'Fear is our first enemy.'

'Don't Get Scared!' was the advice printed in virtually every newspaper in the country, in large, blocked-off parts of pages labeled 'Advice on How to Avoid Influenza.'

The
Albuquerque Morning Journal
issued instructions on 'How to Dodge 'Flu.'' The most prominent advice was the usual: 'Don't Get Scared.' Almost daily it repeated, 'Don't Let Flu Frighten You to Death,' 'Don't Panic.'

In Phoenix the
Arizona Republican
monitored influenza from a distance. On September 22 it declared 'Dr. W. C. Woodward of the Boston Health Department assumed an optimistic attitude tonight' . Dr. Woodward said the increase in cases today was not alarming.' At Camp Dix 'the camp medical authorities asserted they have the epidemic under control.' And the paper noted the first influenza deaths in New Orleans two days before the New Orleans daily newspaper the
Item
mentioned any death in the city.

But after the first case appeared in Phoenix itself, the
Republican
fell silent, utterly silent, saying nothing about influenza anyplace in the country until the news was such that it could no longer keep silent. Its competitor the
Gazette
competed in reassurances, quoting local physician Herman Randall saying, 'Ten people sit in the same draught, are exposed to the same microbes. Some will suffer and perhaps die, while the others go scot free' . The people during an epidemic who are most fearful are usually, on the testimony of physicians, the first ones to succumb to the disease.' And in Phoenix, even after the war ended, the 'Citizens' Committee' that had taken over the city during the emergency continued to impose silence, ordering that 'merchants of the city refrain from mentioning the influenza epidemic directly or indirectly in their advertising.'

Meanwhile, Vicks VapoRub advertisements in hundreds of papers danced down the delicate line of reassurance while promising relief, calling the epidemic, 'Simply the Old-Fashioned Grip Masquerading Under a New Name.'

Some papers experimented in controlling fear by printing almost nothing at all. In Goldsboro, North Carolina, recalls a survivor, 'The papers didn't even want to publish the lists of names [of the dead]' . The information about who was dying had to come up through the grapevine, verbally, from one person to the other.'

A historian studying Buffalo County, Nebraska, expressed puzzlement that '[t]he county newspapers manifested a curious reticence regarding the effects of influenza, perhaps most evident in the The
Kearney Hub
. It may be surmised that the editors played down the severity of the problem to discourage the onset of general panic in the face of what was a thoroughly frightening situation.' As late as December 14 that paper was telling people not to 'get panicky,' telling them city officials were 'not inclined to be as panicky as a great many citizens.'

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How could one not get panicky? Even before people's neighbors began to die, before bodies began to pile up in each new community, every piece of information except the newspapers told the truth. Even while Blue recited his mantra (
There is no cause for alarm if proper precautions are taken
) he was calling upon local authorities to 'close all public gathering places, if their community is threatened with the epidemic. This will do much toward checking the spread of the disease.' Even if Colonel Doane had said
Influenza is nothing more or less than old fashioned grippe,
newspapers also quoted him saying, 'Every person who spits is helping the Kaiser.'

And even while Blue and Doane, governors and mayors, and nearly all the newspapers insisted that this was influenza, only influenza, the Public Health Service was making a massive effort to distribute advice - nearly useless advice. It prepared ready-to-print plates and sent them to ten thousand newspapers, most of which did print them. It prepared (the Red Cross paid for printing and distribution) posters and pamphlets, including six million copies of a single circular. Teachers handed them out in schools; bosses stacked them in stores, post offices, and factories; Boy Scouts stuffed them into tens of thousands of doorways; ministers referred to them on Sundays; mailmen carried them to rural free delivery boxes; city workers pasted posters to walls.

But a Public Health Service warning to avoid crowds came too late to do much good, and the only advice of any real use remained the same: that those who felt sick should go to bed immediately and stay there several days after all symptoms disappeared. Everything else in Blue's circulars was so general as to be pointless. Yet all over the country, newspapers printed again and again: 'Remember the 3 Cs, clean mouth, clean skin, and clean clothes' . Keep the bowels open' . Food will win the war' . [H]elp by choosing and chewing your food well.'

The
Journal of the American Medical Association
knew better. It dismissed the public reassurances and warned, 'The danger to life from influenza in this epidemic is so grave that it is imperative to secure from the individual patient the most complete isolation.' And it attacked 'current advice and instructions to the public from the official and other sources' (Blue's advice, the advice from local public-health officials downplaying everything) as useless and dangerous.

'Don't Get Scared!' said the newspapers.

Meanwhile people read (those in the West seeing it before the virus reached them) the Red Cross appeals published in newspapers, often in half-page advertisements that said; 'The safety of this country demands that all patriotic available nurses, nurses' aids [
sic
] or anyone with experience in nursing place themselves at once under the disposal of the Government' . Physicians are urgently requested to release from attendance on chronic cases and all other cases which are not critically ill every nurse working under their direction who can possibly be spared for such duty. Graduate nurses, undergraduates, nurses' aids, and volunteers are urged to telegraph collect at once' to their local Red Cross chapter or Red Cross headquarters, Washington, D.C.'

'Don't Get Scared!' said the papers.

Be not afraid
.

But not everyone was ready to trust in God.

* 

In 2001 a terrorist attack with anthrax killed five people and transfixed America. In 2002 an outbreak of West Nile virus killed 284 people nationally in six months and sparked headlines for weeks, along with enough fear to change people's behavior. In 2003 SARS killed over eight hundred people around the world, froze Asian economies, and frightened millions of people in Hong Kong, Singapore, and elsewhere into wearing masks on the streets.

In 1918 fear moved ahead of the virus like the bow wave before a ship. Fear drove the people, and the government and the press could not control it. They could not control it because every true report had been diluted with lies. And the more the officials and newspapers reassured, the more they said,
There is no cause for alarm if proper precautions are taken,
or
Influenza is nothing more or less than old-fashioned grippe,
the more people believed themselves cast adrift, adrift with no one to trust, adrift on an ocean of death.

So people watched the virus approach, and feared, feeling as impotent as it moved toward them as if it were an inexorable oncoming cloud of poison gas. It was a thousand miles away, five hundred miles away, fifty miles away, twenty miles away.

In late September they saw published reports, reports buried in back pages, reports in tiny paragraphs, but reports nonetheless: eight hundred cases among midshipmen at Annapolis' in New York State coughing or sneezing without covering the face was now punishable by a year in jail and a $500 fine' thirty cases of influenza among students at the University of Colorado - but, of course, the Associated Press reassured, 'None of the cases, it was said, is serious.'

But then it
was
serious: four hundred dead in a day in Philadelphia' twenty dead in Colorado and New Mexico' four hundred now dead in Chicago' all social and amusement activities suspended in El Paso, where seven funerals for soldiers occurred in a single day (it would get much worse)' a terrible outbreak in Winslow, Arizona.

It was like being bracketed by artillery, the barrage edging closer and closer.

In Lincoln, Illinois, a small town thirty miles from Springfield, William Maxwell sensed it: 'My first intimations about the epidemic was that it was something happening to the troops. There didn't seem to be any reason to think it would ever have anything to do with us. And yet in a gradual remorseless way it kept moving closer and closer. Rumors of the alarming situation reached this very small town in the midwest' . It was like, almost like an entity moving closer.'

In Meadow, Utah, one hundred miles from Provo, Lee Reay recalled, 'We were very concerned in our town because it was moving south down the highway, and we were next.' They watched it kill in Payson, then Santaguin, then Nephi, Levan, and Mills. They watched it come closer and closer. They put up a huge sign on the road that ordered people to keep going, not to stop in Meadow. But the mailman stopped anyway.

Wherever one was in the country, it crept closer - it was in the next town, the next neighborhood, the next block, the next room. In Tucson the
Arizona Daily Star
warned readers not to catch 'Spanish hysteria!' 'Don't worry!' was the official and final piece of advice on how to avoid the disease from the Arizona Board of Health.

Don't get scared!
said the newspapers everywhere.
Don't get scared!
they said in Denver, in Seattle, in Detroit; in Burlington, Vermont, and Burlington, Iowa, and Burlington, North Carolina; in Greenville. Rhode Island, and Greenville, South Carolina, and Greenville, Mississippi. And every time the newspapers said,
Don't get scared!
they frightened.

The virus had moved west and south from the East Coast by water and rail. It rose up in great crests to flood cities, rolled in great waves through the towns, broke into wild rivers to rage through villages, poured in swollen creeks through settlements, flowed in tiny rivulets into isolated homes. And as in a great flood it covered everything, varying in depth but covering everything, settling over the land in a great leveling.

* 

Albert Camus wrote, 'What's true of all the evils in the world is true of plague as well. It helps men to rise above themselves.'

One who rose was Dr. Ralph Marshall Ward, who had abandoned medicine for cattle ranching. Leaving medicine had not been a business decision.

An intellectual, particularly interested in pharmacology, he was a prominent physician in Kansas City with an office and pharmacy in the Stockyard Exchange Building down by the bottoms. But Kansas City was a major railhead, with the yards near his office. Most of his practice involved treating railroad workers injured in accidents. He performed huge numbers of amputations, and seemed always to work on mangled men, men ripped into pieces by steel. To have a practice with so much human agony ripped him into pieces as well.

He had too much of doctoring, and, from treating cowboys hurt on cattle drives north to Kansas City, he had learned enough about the cattle business that he decided shortly before the war to buy a small ranch more than a thousand miles away, near San Benito, Texas, close to the Mexican border. On the long trip south, he and his wife made a pact never to utter a word that he had been a doctor. But in October 1918, influenza reached him. Some ranch hands got ill. He began treating them. Word spread.

A few days later his wife woke up to a disturbing and unrecognizable sound. She went outside and saw out there in the gloaming people, hundreds of people, on the horizon. They seemed to cover that horizon, and as they came closer, it was clear they were Mexicans, a few of them on mules, most on foot, women carrying babies, men carrying women, bedraggled, beaten down, a mass of humanity, a mass of horror and suffering. She yelled for her husband, and he came out and stood on the porch. 'Oh my God!' he said.

The people had come with nothing. But they knew he was a doctor so they had come. The Wards later told their granddaughter it was like the hospital scene in
Gone With the Wind,
with rows of wounded and dying laid out on the ground in agony. These people had come with nothing, had nothing, and they were dying. The Wards took huge pots outside to boil water, used all their resources to feed them, treated them. Out on the empty harsh range near the Mexican border, they had no Red Cross to turn to for help, no Council of National Defense. They did what they could, and it ruined them. He went back to Kansas City; he had already gone back to being a doctor.

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There were other men and women like the Wards. Physicians, nurses, scientists - did their jobs, and the virus killed them, killed them in such numbers that each week
JAMA
was filled with literally page after page after page after page after page of nothing but brief obituaries in tiny compressed type. Hundreds of doctors dying. Hundreds. Others helped too.