Lessons of 1918-19 Spanish flu epidemic
Eekhof, Special to This Week -
The old newspaper
clippings spread out before Dr. Garry Humphreys tell a story that still
packs a punch five years into the new millennium.
The tale that's documented in The Evening
Examiner articles dates back to the fall of 1918 when an outbreak of
Spanish influenza caused havoc and health concerns around the globe.
As many as 50 million people worldwide died from
the Spanish influenza epidemic.
Peterborough wasn't spared as several local residents died due to
Spanish influenza or complications associated with it, such as
pneumonia. From mid October to early November 1918, local health
authorities ordered theatres, schools, churches and other public places
in the city closed so people couldn't gather and possibly spread the
disease. For many citizens, the closing battles of the First World War
were temporarily forgotten as they tried to keep their homes free from
Spanish influenza or cared for loved ones affected by the virus.
"It's fascinating to look at these articles,"
says Dr. Humphreys, the local medical officer of health who heads the
Peterborough County-City Health Unit.
"I think it's important to pay attention to
history because history teaches you a lot."
The lesson for Dr. Humphreys and other public
health officials is to be prepared for the worst. As he casts one eye on
the past, Dr. Humphreys has the other focused on the future for the next
big influenza outbreak, or pandemic, which public health experts say
isn't a matter of if but when.
"A pandemic is not like a plane crash, which is
an isolated, one-time incident," Dr. Humphreys explains.
"An (influenza pandemic) will be ongoing for
several weeks...and could make up to 30 per cent of people ill."
Influenza, or the flu, commonly hits in the
winter months, affecting different people differently. Some get fevers,
the sniffles, nausea or other mild
symptoms. For some, especially young infants and frail older adults,
influenza can be more serious and even lead to death. Many people get
immunized with a flu shot every fall to reduce their risk of getting
Every 20 or 30 years, a new strain of influenza
comes along that morphs into a potential killer. An influenza pandemic
ensues as the new strain sweeps across
continents and ravages people who are highly susceptible to getting sick
or dying from it and for whom there is not a vaccine readily available
to protect them.
In the 20th century, pandemics occurred in 1957,
1968 and 1976 but none took the toll that the Spanish influenza pandemic
of 1918-19 did.
In many ways, the world in 1918 was not ready
for such a pandemic. Modern medicine was still in its infancy and the
resources of most Western countries were
focused on winning the Great War raging in Europe. As a result of
fighting, soldiers were moved around constantly or squeezed together
into trenches and barracks, thus creating ideal conditions for the
Spanish influenza to spread. It was akin to a perfect storm.
There are different theories on where the
Spanish influenza pandemic originated. Many believe it started in Europe
but author John M. Barry, in his recent book The Great Influenza: The
Epic Story of the Deadliest Plague in History, speculates the pandemic
began at a U.S. army base in Kansas and was spread
by American soldiers sent to fight overseas.
The term "Spanish influenza" is a bit of a
misnomer, according to Mr. Barry, since Spain experienced few cases of
the disease early on. Spain was neutral in
the war, so its newspapers were not censored
like those in Britain, France and Germany. As a result, Spanish media
were the only ones reporting regularly on
the spread of the influenza virus, especially when the Spanish king
became sick from it. Mr. Brooks surmises the name "Spanish influenza"
stuck as Spanish news accounts were picked up in other countries.
Whatever the origin of its location and name, by
the fall of 1918, the spread of Spanish influenza was leaving places
like Peterborough bracing for the worst.
An ad placed by Bell Canada in the Oct. 10, 1918
edition of The Evening Examiner gives a hint of the trouble that was
brewing. The ad, entitled "Telephone Service & Spanish Flu," notes that
many of Bell's operating staff were off sick, and the remaining staff
were stretched thin handling the large increase in calls from more
people being at home ill themselves and using the telephone.
"Use your telephone only when absolutely
necessary," the Bell ad implored.
"You will thus be helping to keep the service
intact to meet the urgent needs of the
community in the present emergency."
On the same day the Bell ad ran, the newspaper
carried a report that the city's medical officer of health at the time,
Dr. Charles Hewitt Amys, had ordered schools, theatres, churches and
other public places closed until further notice to reduce the spread of
Spanish influenza. Dr. Amys also urged local factories to send home
workers who may even be mildly sick so that other workers were protected
and "Peterborough may escape the serious degree with which the epidemic
has crippled many of the communities in this province, causing
widespread distress and many deaths."
Dr. Amys went further, and by the end of October
1918, had arranged with city officials, other doctors and the local
Board of Health to have an isolation
hospital set up at the old Oriental Hotel to handle people suspected of
having the virus. It was intended to take the strain off the regular
hospitals in Peterborough and lessen the
risk of influenza spreading to patients of these facilities.
By early November 1918, a news story appeared
detailing the 'Many Cases of Hardship Throughout City as Result of
Influenza Epidemic.' The anecdotal cases
included the following:
* A family of five on Elm Street who were all
sick with the flu but where the father, who could hardly get up, still
kept the fire going and got hot drinks
for his wife and kids. Unable to work, he received no pay and "his job
hangs on the generosity of his employer," the newspaper article noted.
* A home in south-end Peterborough where
everyone was sick except a young girl who cared for her family. Days
passed and the mother gradually got better. Meantime, the little girl
who has been acting as the family's nurse developed pneumonia and within
two days was dead. "She practically killed herself," the attending
physician was quoted as saying.
Conditions with the Spanish influenza gradually
improved in Peterborough, so that by Nov. 11, 1918, people had even more
reason to celebrate the signing of an armistice that ended the First
World War. A day later, schools re-opened and life began to get back to
normal. That same day, Dr. Amys reported to the Board of Health that the
city had got through the crisis and that the "death rate had been very
low considering the gravity of the situation."
To this day, Dr. Amys' actions are credited for
saving lives and reducing the toll taken by Spanish influenza in
Peterborough. But as Dr. Amys noted at the
time, the experience for him and others in the
medical community was challenging and "had taken the heart and soul out
Fast forward to the present and Dr. Humphreys
and others in public health ready to wage war with their own version of
the 1918 Spanish influenza epidemic. In 2005, the World Health
Organization has identified a lethal strain of avian influenza, known as
H5N1, as the likely source of the next pandemic. H5N1 is now mainly
spread to humans from sick chickens and has jumped around Southeast Asia
for the last two years. There are fears it could go global as it moves
westward to Europe.
The main fear of health authorities is the avian
influenza could mutate and be spread directly from person to person. If
that happens, a highly-contagious,
ever-changing virus could spread in waves and infect many people. It
would take several weeks or even a couple of months before the mass
production of an effective vaccine could be made available to people.
According to its numbers, the local health unit
estimates anywhere from 18,500 to 47,000 people in Peterborough city and
county could become clinically ill from
avian influenza. Not only would hospitals and doctors' clinics be
overwhelmed, upwards of 21,000 local residents would require outpatient
Projections also show that avian influenza would
cause 14 to 52 additional deaths per week in the Peterborough region.
Currently, there are an average of 23 deaths per week locally.
Amid these forecasts, there is good news, says
Dr. Humphreys. Unlike 1918, pandemic plans are in place at the local,
provincial and federal levels to protect the health of residents. And
there is also much greater awareness and co-operation among health
officials worldwide to control any global epidemic.
In Peterborough, Dr. Humphreys notes the health
unit is working with the Peterborough Regional Health Centre, city and
county officials, and others for a co-ordinated
response to a pandemic. Among other things, the contingency plan calls
for creating a command centre to supervise the local response to a
pandemic, close monitoring of avian influenza
activity in the area, a mass immunization of all local residents within
10 days of a vaccine being made
available, the distribution of anti-viral drugs to the sick to help
fight the flu, and establishing an assessment centre to arrange for the
care of people who are sick with influenza, be it recuperating at home
An alternative site for influenza care is also
foreseen should the hospital become overwhelmed with cases.
"An outbreak never occurs the way it is
planned," Dr. Humphreys notes.
"But I think people should be aware that the
Board of Health has developed plans (for a pandemic)...and we're as
prepared as we will be."
The lessons of 1918 have been well learned.