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July 24, 2020 Brigitte Ganger

The Spanish Flu of 1918: Remembering a Forgotten Pandemic and its Victims

Honoring the lives of Gustav Klimt, Frederick Trump, Joe Hall, and millions of forgotten victims

The Spanish Flu of 1918: Remembering a Forgotten Pandemic and its Victims
People wait in line to get flu masks to avoid the spread of Spanish influenza on Montgomery Street in San Francisco in 1918. (California State Library/Wikimedia Commons)

The COVID-19 pandemic of 2020 has disrupted nearly every aspect of everyday life in unprecedented ways for people all over the world. However, some living elders may remember the Spanish Flu outbreak of 1918, and its aftermath: a pandemic that infected 500 million, and killed 17 to 50 million — or more.  


This memorial is dedicated to all who died of the deadly H1N1 virus of 1918, as well as those whose lives have been touched by the recent wave of illness caused by COVID-19.


The victims of the Spanish Flu pandemic were generally young and in the prime of their lives; most who died were 18 to 40 years old. As the implications of a new health crisis again ripple throughout the world, it is prudent to reflect on the Spanish influenza, and remember the stories of those who lost their lives. 


Infographic: Spanish Flu The Forgotten Pandemic, Fast Facts. (Beyond the Dash)


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 Why is it called the 'Spanish Flu'?


Family and their cat during the Spanish Flu, 1918. (Unknown Author/Wikimedia Commons)


The Spanish Flu did not originate in Spain, nor was Spain the hardest hit by the pandemic. The 1918 pandemic came to be known as the Spanish Flu for reasons that were mostly political. The outbreak came at a critical moment in the war, when suspicions between warring countries were at an all-time high:



"Spain was one of only a few major European countries to remain neutral during World War I. Unlike in the Allied and Central Powers nations, where wartime censors suppressed news of the flu to avoid affecting morale, the Spanish media was free to report on it in gory detail…Since nations undergoing a media blackout could only read in depth accounts from Spanish news sources, they naturally assumed that the country was the pandemic’s ground zero."


— Evan Andrews, History.com



While the name 'Spanish Flu' is erroneously attributed to the influenza pandemic of 1918, this term stuck. It is the name that is still used most widely by everyday folks when discussing the tragedy. It should more accurately be referred to as the swine flu, or H1N1.


Outbreak and spread


The first cases of the swine flu of 1918 came in February of 1918 in the midst of World War I, though this time frame is debated. No one is certain about the origins of the Spanish Flu virus, but it is believed to have begun as early as 1917 at a British military base in Northern France. Some say it began in Southeast Asia, and others assert some of the earliest cases came from Kansas farm. Wherever the origin, the virus moved quickly through the world. 


Soldiers were mobilizing overseas as the war came to a close, spreading the disease quickly. Conditions in the trenches were miserable and the barracks crowded. In these conditions the flu thrived, infecting and killing wave after wave of people. 


The first wave of flu was relatively mild, killing approximately 75,000 people, which was not significantly higher than flu seasons of years past. But the second wave, in the fall of 1918, was devastating. A third wave came early in 1919, killing more than the first wave, but less than the second wave. 


The second wave of the pandemic was a likely influencing factor in the signing of the Armistice of 11 November 1918, which ended the Great War. 


Symptoms and death


The Spanish Flu transmitted from person to person via respiratory droplets when coughing, sneezing or talking when in close proximity with others. It could also spread by touching surfaces that carried the virus. 


During the first wave, sick people experienced typical flu symptoms: sore throat, fever, chills, and fatigue. However, flu viruses tend to mutate quickly, which is why today there is a different flu vaccine each year. In the second wave of the pandemic, the virus began killing people within days and even hours of developing any symptoms. These patients would suffocate; their lungs filled up with fluid, and their skin turned blue:



"Sometimes within hours, patients succumbed to complete respiratory failure. Autopsies showed hard, red lungs drenched in fluid. A microscopic look at diseased lung tissue revealed that the alveoli, the lungs' normally air-filled cells, were so full of fluid that victims literally drowned. The slow suffocation began when patients presented with a unique symptom: mahogany spots over their cheekbones. Within hours these patients turned a bluish-black hue indicative of cyanosis, or lack of oxygen. When triaging scores of new patients, nurses often looked at the patients' feet first. Those with black feet were considered beyond help and were carted off to die."


— Sara Francis Fujimura, Perspectives in Health Magazine



With masks over their faces, members of the American Red Cross remove a victim of the Spanish Flu from a house at Etzel and Page Avenues, St. Louis, Missouri. (Uncredited photographer for St. Louis Post Dispatch/Wikimedia Commons)


To die of the Spanish Flu was to die a painful, sudden death. It often took out whole families, and sometimes wiped out communities as it spread rapidly. The tragedy of Spanish influenza, like COVID-19, was the isolation and terror many experienced in the final moments of life.


Notable Deaths


This pandemic was brutal and indiscriminate in its selection and treatment of victims. Among those dead counted influential and well-known individuals, whose untimely deaths may indeed have changed the course of history. Here is a small selection of notable deaths that resulted from the Spanish influenza pandemic. 


Soldiers



"American combat deaths in World War I totaled 53,402. But about 45,000 American Soldiers died of influenza and related pneumonia by the end of 1918."


— Eric Durr, New York National Guard



Medical Department - Influenza Epidemic 1918 - Spanish Influenza in army hospitals. Masks and cubicles used in United States of America General Hospital Number 4, Fort Porter, New York. Patients' beds are reversed, alternately so breath of one patient will not be directed toward the face of another. (National Archives and Records Administration/Wikimedia Commons)


Killing nearly  as many American soldiers as the war, it is largely forgotten that the flu was a major bloody player in the war. It acted as an independent army, wiping out millions of soldiers, health care workers, and civilians.


Soldiers were vectors of the contagion. Trench warfare meant they were living in close quarters, under extremely unsanitary and rough conditions. Here, disease spread rapidly. Soldiers traveled extensively as well, carrying disease from town to town and infecting civilians.  


These soldiers were people too. Loved ones back home missed and wrote them. Many soldiers were young men, with many still in their teen years. They hoped to one day return home and start their adult lives. Even those who expected to die likely imagined a hero's death in the field, not the fevery pneumonia that coldly took them one by one. 


Gustav Klimt


February 6, 1918


Portrait von Gustav Klimt in Jackett, 1908. (Madame d'Ora, Atelier/Wikimedia Commons)


Austrian Symbolist painter Gustav Klimt was among the first to die in the Spanish Flu pandemic. Following a stroke, Klimt was admitted to the hospital. There he contracted, and subsequently died of, Spanish influenza. 


The son of a gold engraver, Gustsav "left the traditional education system to attend the Vienna School of Arts and Crafts on a full scholarship. Klimt’s formal training focused on classical architectural painting." In his life, Gustav Klimt was known as a prominent member of the Vienna Secession movement. His work was decorative, erotic and often controversial. 


At 55, Klimt outlived the age expectancies of the time, which in 1917 was approximately 48 years of age for men, though the average life expectancy for men fell to 36 the following year as a result of flu deaths.  Klimt's life was cut short by the 1918 pandemic, leaving only to the imagination the direction his works could have taken if he had survived. 


"A small square slab, a name, and a hanging birch tree mark the last resting place" of Gustav Klimt, in the Hietzing Cemetery in Vienna.


The Kiss, Gustav Klimt (1907–1908). (Google Art Project/Wikimedia Commons)


Frederick Trump 


May 30, 1918


Photo of Frederick (Friedrich) Trump. (Unknown Author/Wikimedia Commons)


Frederick Trump, German-American businessman and grandfather of the 45th U.S. President Donald Trump, was a victim of the first wave of the 1918 pandemic. 


Born in Bavaria, Trump emigrated to the United States to avoid being conscripted into military service. After his arrival in America, Frederick quickly found work as a barber. Always on the lookout for the next big business opportunity, he bought a restaurant in Seattle with his savings, and later a hotel and brothel that served Yukon miners during the gold rush. He built his fortune, and the foundation for Trump family wealth, through his ingenuity and willingness to take risks. 


Frederick died on May 29, 1918, just a day after he fell ill with one of the early cases of the Spanish influenza. Like thousands around the world, the end of his life came in the form of pneumonia. He was buried in the Lutheran All Faiths Cemetery in Queens, New York.


The Arctic Restaurant and Hotel in Whitehorse, Yukon; co-owned by Fredrick Trump. (Royal BC Museum and Archives Ca. 1899)


Joe Hall 


April 5, 1919


Joe Hall player of the NHL from 1917 to 1919. (Dolan, Edward F./Wikimedia Commons)


Joe Hall was a Canadian hockey player who collapsed on the ice during the Stanley Cup playoffs of 1919. He and several other players came down with the Spanish influenza, and Hall passed away just days later:



"Even as the players recovered one by one, the oldest of them, Hall, 37, continued to deteriorate, developing pneumonia. His widowed mother, who lived in Vancouver’s West End, rushed to his sickbed at Columbia Sanitarium, a hospital in Seattle run by the Missionary Sisters of the Sacred Heart. His wife and their three children left Brandon, Man., by train. Along the way, they received a telegram stating Joseph Henry Hall had died at 3 p.m. on April 5, 1919."


— Tom Hawthorne, The Tyee



He was already a three-time Stanley Cup winner at the time of his death, having won in 1907 with the Kenora Thistles, and then in 1912 and 1913 with the Quebec Bulldogs. Coming from the "infamously rough International Hockey League," Joe earned the most penalty minutes in the league. "Known for his hard hitting, violent outbursts and sometimes less than clean play" before physical play had been normalized in professional hockey, Hall earned the moniker 'Bad Joe Hall'. 


Just four days before his death, Hall was planning to play in the Stanley Cup Playoffs. Spanish influenza quickly took the 37-year-old athlete's life along with millions of others it had already taken during the second wave. Though his career was marked by a mix of accolades and scandal, his time in professional hockey was cut tragically short. Joe Hall was inducted into the Hockey Hall of Fame in 1962. 


Hall's image was somewhat rehabilitated by his sudden death, with many remembering him as a feisty, but ultimately good-hearted player:



"Years ago Joe Hall was styled 'Bad' Joe Hall, but this was uncalled for," wrote Calgary sportswriter Harry Scott. "Hall has played some rough hockey in his day, but only after another player started it. He took his bumps and handed them out after being provoked."


Tyee



His body rests at the Mountain View Cemetery in Vancouver, Canada. 


Postcard of Joe Hall, between 1910 and 1911. (Sweet Caporal/Wikimedia Commons)


Memorial Archives


The lives of everyday people accounted for most Spanish Flu deaths. Their stories, documented in the Centers for Disease Control and Prevention In Memorial archives, help paint portraits of the harrowing deaths victims of influenza faced.


The Forgotten


The Spanish Flu killed millions, but the exact number of fatalities can never be truly known. Most put the number around 17 – 50 million, while some say the number far exceeds the 50 million mark. From oral and written accounts of the virus and its spread, it's clear that the Spanish influenza forced people away from their loved ones in the final moments of life and in the first moments of death. 


Medical Department - Influenza Epidemic 1918 - Spanish influenza in army hospitals. Medical and quartermaster corps men in connection with the United States Army Hospital Number 4, Fort Porter, New York wore masks while at work around the hospital. (National Archives and Records Administration/Wikimedia Commons)


People were terrified of catching the virus, including health care workers and loved ones. The social isolation made for very lonely, painful deaths. With the body count climbing ever higher, there are accounts of the dead being buried in mass graves. Record keeping standards of the time were overwhelmed by the sheer number of dead, which is why the total global death count ranges by millions. In some areas, the death toll grew so high that staticians stopped counting


Thousands, if not millions, of victims are now forgotten. These people may have perished alone, or in mass, only to have their stories go untold and the memory of them forgotten. Most likely received no final rites or comfort before passing away. In honoring the memories of those who died due to Spanish influenza, it's important to pay tribute to those whose stories died with them.


Their bodies rest all over the world, in graves marked and unmarked. Some lay in mass graves, hastily dug and filled by those who hoped to prevent further spread of disease. 


Spanish Flu Vs. COVID-19


There are obvious comparisons between the Spanish Flu and COVID-19, but also many differences. This chart highlights the key similarities and differences between the two greatest pandemics in living memory. 


Infographic: 1918 Flu Vs. COVID-19. (Beyond the Dash) 


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'The Forgotten Pandemic'


Perhaps the most chilling impact of the Spanish Flu pandemic is the "cultural amnesia" that has persisted in the aftermath. Despite one-third of the global population contracting the illness, 50 million casualties, and years of uncertainty, people quickly forgot about the flu — so much so that it is now known as 'The Forgotten Pandemic'. 


The photograph depicts volunteer nurses from the American Red Cross tending influenza sufferers in the Oakland Auditorium, Oakland, California, during the influenza pandemic of 1918. Oakland Public (Library/Wikimedia Commons)


The interwar years brought the Roaring 20s, renewed optimism, prosperity, and technology. People gained access to telephones, commercial flights, movies, media, and new styles of art and music. Connection with others was at an all-time high, but no one wanted to remember the recent years of sickness and death. 


Perhaps in an effort to move on quickly, talk of the war's casualties centered around battle. The wearing of masks did not become mainstream in the west, despite the enormous number of flu casualties that devastated the United States and Canada. The flu was keenly felt, and then mostly forgotten. 


This cultural amnesia is relevant today, as the world faces a similar crisis in the form of COVID-19. The sheer scale of death, the volume of suffering, and the panic of overcrowded hospitals and funeral homes remain foreign to many people living in North America. Many now wonder, "How many need to die before this new crisis is taken seriously?"


Lasting impact


Despite the fleeting cultural acknowledgement of the Spanish influenza tragedy, the flu of 1918 contributed to several advancements to public health, women's rights, and the brief period of peace between the wars.


Women's suffrage


Demonstration at the Red Cross Emergency Ambulance Station in Washington, D.C., during the influenza pandemic of 1918. (Library of Congress/Wikimedia Commons)


Women won the right to vote nationally in the United States in 1920. Many factors contributed to this turn of events, but their success in both aiding war efforts and the emerging health crisis are noted as among the most critical:



Although they wouldn’t have labelled their actions as “social distancing” at the time, suffragists aligned themselves with the message of the health authorities. They postponed campaigns, wore masks and focused on petitions instead of large-scale public events. Local women’s organizations signed up to volunteer with the Red Cross and a key part of their work was to help discharged soldiers recover from the flu, as several outbreaks were at military camps.


— Suyin Haynes, TIME



Public health policies


Some regions managed to beat down cases of the flu, only to ease restrictions and face subsequent surges and deadly waves. Early social distancing efforts were effective in reducing spread; however, like today, it was difficult to keep people apart. 


Trolley car windows were kept open to prevent the spread of Spanish Influenza which did much to slow up war progress in this country. This photo was taken in Cincinnati. The practice of keeping windows open was nationwide. (National Archives and Records Administration/Wikimedia Commons)


It was a critical moment. Folks were forced to either accept or reject public health guidelines. In some parts of the United States, it was illegal not to wear a mask. There was resistance to masks and the advice of health officials then, as there is again today


In San Francisco, authorities came up with a plan to avoid the worst of the flu and implemented strict guidelines early in the second wave. They distributed thousands of face masks, and required they be worn in public. Police forced people to wear masks at gunpoint, and in some cases even shot those who refused. 


Public health policy has advanced exponentially in the century since the Spanish Flu outbreak. However, the 1918 flu pandemic gives today's health policy makers a terrible example for  modeling new findings:



"Influenza and coronavirus share basic similarities in the way they’re transmitted via respiratory droplets and the surfaces they land on. Descriptions of H1N1 influenza patients in 1918-19 echo the respiratory failure of COVID-19 sufferers a century later. Lessons from efforts to mitigate the spread of flu in 1918-19 have justifiably guided this pandemic’s policies promoting nonpharmaceutical interventions, such as physical distancing and school closures."


— Mari Webel, Megan Culler Freeman, The Conversation



The data that informs much of the modern pandemic response comes from the real events of 1918-19. Globally, we owe a debt of gratitude to the doctors, nurses, researchers, and record keepers of the time for our ability to respond today to COVID-19. Many of these trailblazing heroes died themselves while battling the 1918 flu pandemic. 


Infographic: History of Masks, Then and Now. (Beyond the Dash)


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The end of the war


The flu was a possible factor in the ending of the war. Troops were already downtrodden and depleted when the first wave began to spread, but the second wave put the nail in the coffin of many regiments faster and more effectively than the previous three years of battle. 


Spanish Influenza sign at Navy Yard in 1918. (U.S. Navy/Wikimedia Commons)


Peace came on November 11, 1918, following the deadliest month of the pandemic. Some dispute that the war ended due to the pandemic, but its impact on those on the front lines, as well as those left at home during that miserable time, is undeniable. 


COVID-19: A new pandemic


While the vast majority of citizens have heeded the warnings of the past, the health and policy blueprints left by those who faced the Spanish influenza have been tested by a new culture of defiance against medical authority. 


Pay your respects to those affected by the pandemic by signing the COVID-19 Community Wall.


The Spanish influenza killed more people than WWI, WWII, Vietnam, Korea, Iraq, and Afghanistan wars combined. Despite the extreme death count and the trauma of the first world war, the interwar years brought respite, a renewed sense of optimism, and the Roaring Twenties. In the post-war jubilation, the terror of the purple death was mostly forgotten or attributed to combat. The pandemic was largely forgotten until COVID-19 broke out and began affecting the everyday lives of regular people early in 2020. 


Regular people again hold the fate of the world in their hands, as flu viruses can only be contained by communal diligence in personal hygiene, physical distancing and barriers, such as masks. It remains unclear how the new pandemic will play out, but reflecting on the Spanish Flu and its millions of victims has never been more relevant. We invite you to remember the stories of those who lost their lives, and honor their sacrifices by continuing to be vigilant and cautious during COVID-19, any subsequent waves, and beyond.

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