More Deadly Than War Itself

January 1, 2001 by Pat Sullivan
 

In 1918—just as World War I was coming to an end—along came a virus, a previously unknown killer that would claim more lives than the war—and in a shorter period of time. In less than two years, the Spanish influenza killed 21 million people worldwide, including 50,000 Canadians. The war, which lasted five years, killed at least 17 million people, including more than 66,000 Canadians. Sadly, many of the victims of the Spanish flu were the very soldiers who had survived long odds in the trenches, because the people at highest risk were aged 20 to 40. “This disease,” notes the Canadian Encyclopedia, “demonstrated a perverse tendency to kill the young and hearty.”

In his WW I memoir, Ghosts Have Warm Hands, Will Bird of East Mapleton, N.S., captured the sense of disbelief that settled in once the flu epidemic took hold. It was early in 1919 and he and his friend Tommy were in London, England. Together, they had survived more than two years of brutal fighting with the 42nd Battalion. Finally, thought Bird, they were safe and at home. “Tommy roused me at noon and said he was feeling feverish. At four in the afternoon, I began trying to locate a doctor. There was no luck on the telephone, so out I went, and after an hour of searching, helped wonderfully by a huge bobby, I contacted a doctor and told him the circumstances. He looked a tired man but he went with me, and in half an hour Tommy was on his way to a hospital…. I had to put on a mask before we went into a long ward. By now Tommy looked wretched, but he managed to grin at my appearance, and then urged me to get out before I caught influenza too….”

The next day Bird went back to the hospital and stayed in the waiting room. Eventually a doctor appeared. “Although he was obviously annoyed with my persistence, he went to see if I could visit the ward. He was back quickly and his message stunned me. Tommy had died that morning.”

The same thing was happening across North America. On Oct. 14, 1918, Joseph Alexander travelled from Saint Georges, Nfld., to St. John’s to enlist in the Royal Newfoundland Regiment. Two days later he went on sick parade and four days after that he died. His military career had lasted six days. In a paper presented to the St. John’s Medical History Society, Dr. David Parsons described the “Spanish lady” that killed him as the “Fourth Horseman of the Apocalypse.”

What he and others were dealing with was a true pandemic—a worldwide epidemic. In the United States, the virus killed 500,000 people. In New York City alone, more than 20,000 people perished.

The Spanish flu, which actually made its first appearance in Canton, China, early in 1918, arrived here with returning servicemen. It worked with incredible speed. In September 1918, three infected soldiers were quarantined at Winnipeg’s train station, but within three days two of them and a railway worker they had met were dead. By January, 800 more Winnipegers had fell victim.

In Toronto, 1,682 people died between Oct. 9 and Nov. 2, 1918. Montreal was hit so hard that it had to adapt a trolley car to carry bodies because the city’s hearses could not meet the demand. By October 1918, influenza was claiming 1,000 Canadian lives a day. During the same period, the country’s battlefield losses averaged about 100 deaths a day. Today, influenza claims about 1,000 Canadian lives a year.

“At the peak we were holding funerals every hour, day and night,” a Toronto undertaker told Maclean’s magazine when it published a retrospective on the epidemic in 1953. “I once went for three days and two nights without sleep. Several times we buried whole families—mother, father and two or three children —within one week.”

Another Toronto undertaker had 23 bodies stacked in his garage because there was no room at the funeral home. “It was almost impossible to get help. As soon as an assistant learned that a person had died of Spanish flu he was out of here like a shot. At the cemetery they had to store bodies in vaults until the gravediggers got caught up.”

The disease also made its way to small-town Canada. In isolated areas like Labrador, entire villages were wiped out. In one, 59 people were left from a population of 266. The Spanish flu tells us a lot about what the country was like in 1918. A look back at the front pages of some Canadian newspapers leaves the distinct impression that the epidemic never arrived here. The only hints in many newspapers were brief mentions in casualty lists, which were still being printed at the end of November 1918, that a growing number of soldiers were “seriously ill.”

It was almost possible to read between the lines. On Jan. 16, 1919, an Ottawa newspaper reported that the body of Private Melville Lynch had been returned to Pembroke, Ont., after a “brief seven-day illness.”

In late 1918 the same newspaper was full of news about men who had been charged under the Ontario Temperance Act and about the fact the war had meant that women “no longer have time to get sore or huffy.” Stores recognized that the returning soldiers would need new clothes, and the paper was full of ads for new suits, $18 and up.

On Dec. 18, 1918, the Ottawa Citizen newspaper published a story that stated “liquor is useless” in fighting the flu. Apparently, many Canadians were buying into a myth making the rounds in the United States that plenty of alcohol “taken internally” was the best way to fight the flu.

Meanwhile, the Regina Morning Leader had reported that the flu was spreading quickly in Saskatchewan. The story described the flu’s symptoms and advised people to wear face masks. Unlike many other parts of the country, public health officials argued against closing schools. However, they said teachers should “immediately exclude a child showing any symptoms of disease whatever.”

In a pre-emptive move, canvassers took to the streets of Regina to track the disease. The Morning Leader newspaper reported that in one house, five of the six residents were ill. “In another instance a man was found trying to nurse his wife and a number of children without cash or coal in the house. In this particular case an advance was made to the householder to enable him to secure supplies on the security of his Victory bond purchased last year.”

In Rouleau, Sask., the local hotel was transformed into an emergency hospital. Ten deaths had already been reported by Oct. 31, 1918, even though the town’s two doctors had been working night and day in an endeavour to cope. The Morning Leader noted that Rouleau was in much better shape than many other smaller communities. “In many places there are no doctors for miles around or all the doctors and nurses are ill themselves.”

In some places, response to the flu was draconian. In Alberta on Oct. 15, 1918, Edmonton’s City Board of Health ordered the closing of “all schools, churches, theatres, picture shows and all public meetings generally.” A week later, the Provincial Board of Health ordered everyone in the province to wear a face mask when outside the house, “except when necessary to partially remove the mask for the purpose of eating.”

The Canadian Medical Association Journal of January 1919 turned a sneering eye on the latter practice. Despite some “claims to the contrary,” it reported that “the number of cases of the disease continued to increase rapidly for some time after the (face mask) order was enforced, and public confidence in it as a prevention soon gave place to ridicule.”

In Montreal, where an average of 156 people died of the flu every day from Oct. 13-25, 1918, the disease eventually claimed 3,028 lives. The city responded by creating “refuges” for poor patients who couldn’t afford hospital care—one was in the armoury of the Canadian Grenadier Guards and another was set aside “for the Chinese”—and the military released “a number of medical men” to treat civilians. All “places of amusement” were ordered closed and the clergy were asked to “reduce church functions to a minimum.”

In Ontario the Spanish flu claimed at least 3,500 lives, but there were probably many more because the cause of many deaths went unreported. Ontario’s doctor’s decided against quarantining flu patients, arguing that such action would be too difficult to enforce. “In short, the law would, as it has been in many of the states to the south of us, be a dead letter,” wrote Toronto’s medical officer of health.

Indeed, Canada’s roughly 4,000 doctors found the Spanish flu a humbling experience. Edmonton’s medical officer of health, Dr. T.H. Whitelaw, observed in 1919: “The apparent futility of practically all measures of prevention, some of which were acclaimed with great assurance by members of our profession, and the failure of any particular line of treatment, make it incumbent on one attempting to discuss any phase of this subject to approach it with becoming modesty and diffidence.”

Many doctors did their best to cope with the incredible onslaught of work, but unfortunately they knew little about what it was they were dealing with and they had few weapons at their disposal. The penicillin that would eventually be used to fight pneumonia—the killer that followed on the Spanish flu’s coattails—was still more than 20 years from being discovered. At the Canadian Army camp in Bramshott, England, where 2,247 cases of flu were reported and 163 soldiers died, desperate army doctors used everything from “creosote to oil cinnamon” and “none was found to exercise any specific effect.”

Of course anytime there is a health care panic, there are people who will try to make a buck. In the 14th century weird potions were sold to ward off the bubonic plague, and in the 20th century weird claims were made about fending off the Spanish flu. One company recommended a daily glass of purgative water to clean out and keep clean the digestive organs. One ad suggested the flu could be fought “if the bowels are kept clean, allowing the influenza germ to pass through harmlessly.”

What the advertisement didn’t say was that the flu attacked the respiratory system, caused pneumonia and killed people by drowning them in their own fluids. Of course, not everyone knew this at that time.

The flu also kept alive some wartime hatred. In February 1919 Maclean’s magazine published an article that argued the virus should be named after the evil Boche, not the Spanish. “It appears that the Germans, in anticipation that the malady might be justly named the German plague, broadcast a misleading name which they had craftily devised before the infection spread from Germany to other countries.”

So what was the final impact of the Spanish flu epidemic of 1918?

The only lasting change was that Canada was finally given a federal health department in 1919 because the epidemic had shown that the country was totally unprepared to deal with crises like this on a national level. Funds for expanding hospitals became available and public health nursing courses were started at Dalhousie University in Halifax. In 1919 the Department of Health Act was passed. The flu epidemic was also one of the reasons the International Red Cross decided to extend its programs to peacetime activities. And it marked the one time that there were no Stanley Cup playoffs.

The other impacts were much the same as those imposed by the war itself: There was social and economic disruption. Many children were left parentless and many families lost their main wage earner. Businesses lost money because people couldn’t afford to buy their products. Companies, meanwhile, saw sharp reductions in their workforce as more and more people became ill.

Digging For Clues

Why do we have influenza pandemics like the one that struck in 1918? Simply because the viruses that cause the illnesses evolve over time. The situation might be compared with a computer system faced with software that it does not recognize—the computer will not work.

During an influenza pandemic, the body’s immune system faces a virus it does not recognize, and it will no longer work. Of the three influenza pandemics that occurred in the 20th century—1918, 1957 and 1968—only the first one was a mass killer.

The virus that caused the Spanish flu first found a home in wild ducks. It was then passed to pigs and crossed to humans, who had no immunity to it. With the Spanish flu, respiratory failure was almost always the cause of death; in some cases bodies started turning blue or even black from lack of oxygen.

Scientists today are still haunted by the possibility that a virus similar to the Spanish flu could sweep around the world. That’s why researchers recently went to Spitsbergen, Norway, to retrieve tissue samples from six Norwegian miners who died of the flu in 1918. Because the miners were buried in permafrost, their bodies were preserved. During the dig, the researchers wore containment suits in case live virus was discovered, but none was. On the same research front, work is under way to gain a more complete molecular picture of a virus that caused the deaths of so many on the heels of a war that killed so many.

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