The Story of a Laboratory, Chapter Three: The Great Pandemic

During the summer of 1918, a ship arrived at the naval base of New London carrying sailors from the Boston Navy Yard who were returning home from service in Europe during the Great War (WWI) (Conn. Health Bulletin, 1919).  They began to fall ill with a set of symptoms that had not been seen before.  A sudden onset of chills, fever and pain led to coughing up copious sputum and blood from hemorrhaging lungs.  Lips and faces turned blue from cyanosis due to oxygen deprivation, a precursor to death (Acari, 2007).  The naval hospital was soon filled, and civilians who worked at the base carried the disease into the community.  This was the beginning of Connecticut’s experience with the great Influenza Pandemic of 1918.

This pandemic (which is a widespread epidemic) was to claim 100 million deaths worldwide, 500,000 in the United States, 8,500 in Connecticut (Acari, 2007), and over 121 in Greenwich (CHB April 1919).  Ten times that number were severely sick. The disease passed through the state from east to west, peaking in early October and then falling off rapidly, although deaths continued into 1919.  The disease rates were higher in the cities than in rural areas, and especially high in the smaller densely populated mill towns (Conn. Health Bulletin, April 1919).  The State Health Bulletin of April 1919 credits the slightly lower rate in the major cities to their policy of restricting openings of public gathering places.  The death rate in Greenwich was 6.4/1000, comparable to the state average of 6.0/1000.  The first deaths in Greenwich were reported in October.  Seventy-one deaths occurred that month, sixteen in November and six in December for a total of 121 deaths from influenza in 1918.  The deaths continued to occur at a lower rate in 1919 (Conn. Health Bulletin, April 1919).  A total of 2,113 cases of influenza were reported to the state in 1919, which includes the fall of 1918.  This is five times the number of all other diseases reported that year (Annual Report, 1919), and represents about 11% of the town’s population.  The State of Connecticut Board of Health set up thirty-five emergency hospitals around the state, and the United States Public Health Service sent one hundred nurses and forty-eight doctors to Connecticut (Winslow, 1920).

The progress of the pandemic can be traced by the weekly reports in the Greenwich newspapers.  On September 19, Acting Health Officer Frank Brooks, MD, issued a warning to the town, not to alarm the community but to prepare it for the epidemic.  He listed the symptoms of influenza and stated that its cause was a bacterium (although viruses were unknown as of yet, most of the deaths were caused by secondary bacterial infections). He described how to care for a patient and steps to take to avoid infection, and commented that known vaccines were not very effective (The Greenwich Press, September 19, 1918).  A week later, the Board of Health issued a statement that cases of influenza were being reported, but it was not a serious problem yet.  The release contained a message from the State Health Department which linked prevention and patriotism:

NOTICE

If you have a cold be fair to others

STAY HOME

Sneezing and coughing may spread grippe and is an unpatriotic act.

BEAR IN MIND

That Influenza is a dangerous as the Hun

And can attack us all though it does not use a gun.

REMEMBER

Should you cough or sneeze and so make others ill

Uncle Sam can call you “slacker” and a “Friend of Kaiser Bill”

World War I, of course, was still in progress (The Greenwich Press, October 3, 1918).  A week later the pandemic had descended upon the town in force.  Over 1,000 cases had been reported, and a decision had been made to close the schools and theaters.  Every empty space in Greenwich Hospital had been converted into an influenza ward, and numerous young women who had received training from the Red Cross for medical duty in France were brought into service as medical aides.  Kitchens were set up to distribute food to families without breadwinners, and the military and community groups donated funds and goods to deal with the patients (The Greenwich Press, October 17, 1918).  The course of the epidemic in town was traced in the report of the January 1919 Board of Health meeting.  The influenza pandemic began about September 23 and lasted until about the 5^th of November, peaking about the 20^th of October.  Prophylactic immunization had proved ineffective (Greenwich News & Graphic, February 17, 1919).

The epidemic spawned some efforts to make money by selling quack medicines, such as Hill’s Bromide Cascara Quinine (Greenwich Press, December 12, 1918) or Cream of Mustard, manufactured in Norwalk, Connecticut (Greenwich Press, October 31, 1918).  The Board of Health also publicized the information that the state laboratory had analyzed samples of Bayer aspirin to dispel rumors that it contained influenza “germs” and slow poisons (Greenwich News & Graphic, January 17, 1919).

C.E.A. Winslow states that the statistics give just a faint picture of the pandemic’s effects on society.  He compared it to bubonic plague; many died without medical care, including whole families.  No one could be found to bury the coffins in New Britain and Waterbury (Winslow, 1920).  Although 90% of the victims recovered, so many people were infected, particularly males between the ages of twenty and forty, that the epidemic removed some of the most productive members of society, leaving a swath of fatherless or vulnerable families across the state.  Social disruption was also caused by the necessity of closing schools and businesses (Acari 2007). 

Oddly, there was not much commentary on the epidemic at the time in the United States as a whole.  Ralph Acari in his 2007 report on the pandemic in Connecticut suggests that it seemed less important to newspaper editors than the war in Europe, or that the large number of deaths simply didn’t seem as shocking then- a time of high mortality- as they would today.  John Barry in his 2004 book “The Great Influenza” claims that active government censorship was practiced to preserve morale and prevent panic.  But the refusal of government officials and newspapers to acknowledge what everybody knew- that something terrible was going on- created an atmosphere of gloom and depression in society.  Apparently, Greenwich was an exception to this pattern, and quite fortunate in that its Board of Health and Health Officer were very open about warning the public of the danger, recommending protective measures, and reporting the progress of the pandemic in the town.

The Greenwich Department of Health Laboratory did not play a role in this drama, as there was no approved test or treatment for influenza.  Larger research laboratories, however, were heavily involved in trying to find the cause and cure for influenza, but they were unable to isolate a causative agent or find an effective antitoxin or vaccine against it (Barry, 2004).  The bacteriological techniques that had proven so successful with other diseases were incapable of dealing with a disease caused by a virus.  This was the first check on the hubris of the 19^th century progressive scientific outlook, that science would soon provide easy answers to all human suffering.  The development of public health in America- and in Greenwich- was to be a convoluted road.