Learning lessons from the 1918 flu pandemic
By STUART W. SANDERS
One afternoon in May 1918, my 12-year-old grandfather was walking home from school in Louisville when he encountered a man from his neighborhood.
Run home fast, the man said, your father’s dead.
With this abrupt message, my grandfather sprinted home, tears streaming down his face. His father had died from “edema of the lungs,” which was brought about by complications from influenza.
Four years later, my grandfather’s mother passed away from pneumonia, also said to be a complication from the flu.
The loss of both parents broke up the family. Their home and many belongings were auctioned off. My grandfather and his brother moved in with their minister. Their sister was sent to live with a relative in Florida.
They were just one of thousands of Kentucky families affected by the flu pandemic that struck the United States 100 years ago. In fact, tens of millions of people across the world died between 1918 and 1920 from influenza and related complications.
In Kentucky, more than 14,000 people perished. As historian Nancy Baird writes, “Kentucky suffered severely from the Spanish influenza — more severely than she had suffered from the war in Europe. The impact of the disease on the state was immeasurable … Six times as many of the state’s citizens died of Spanish influenza as gave their lives while serving their country.”
World War I hastened the spread of the illness, which included the dreaded strain called the “Spanish flu.” Because of massive troop movements across international lines, the disease spread quickly.
At Camp Zachary Taylor in Louisville, for example, 11,000 people became sick and an estimated 1,500 died.
Losses also occurred at other military bases in Kentucky. At what is now Fort Knox, civilian worker Luke Gordon, a former streetcar conductor from Frankfort, died from the Spanish flu.
Kentuckians were also left mourning friends and family who perished out of state.
In September 1918, for example, Dr. William Argo, a Danville native who graduated from Harvard medical school, died of influenza while serving in the military in Boston.
That same month, Leslie Link, a soldier from Bourbon County, died of influenza at the Great Lakes Naval Training Station near Chicago. His obituary noted that, “He was a young man of good habits and a good constitution, but even that could not resist the inroads of such an insidious disease as influenza.”
To prevent the spread of the flu, church and social gatherings were cancelled and businesses, coal mines and schools closed. The state board of health asked “all patriotic people who show symptoms of this disease” to “promptly isolate themselves in their homes, for the protection of the public, and in their rooms for the protection of their families.”
The board also banned public funerals for those who died from the flu. Sadly, there were many funerals caused by the pandemic.
Influenza also caused serious economic consequences. In addition to businesses closing, one Kentucky Red Cross worker wrote, “A large number of cases were reported where the mother was left with a large family of children without any means of support: left really to the mercy of the meager assistance that sympathetic neighbors might give.”
Now, 100 years later, influenza is widespread across the nation. We are fortunate, however, that today’s flu activity is not a pandemic outbreak.
In the last century, the United States has experienced at least four influenza pandemics: in 1918, 1957, 1968 and 2009. According to the Kentucky Cabinet for Health and Family Services, “Scientists predict that another pandemic will happen, although they cannot say exactly when.”
Pandemics are caused when a new flu strain crosses from animals to people. Because humans have no pre-existing immunity to the new strain, it spreads swiftly. Moreover, international flights and improved travel will allow a 21st-century pandemic to cross the globe at rapid speed. This will lead to a large number of deaths, overcrowded hospitals, a lack of anti-viral medications and a massive disruption of our healthcare infrastructure.
When preparing for the next pandemic, authorities should take heed of the words of an official with the Kentucky Red Cross, who worked during the 1918-1920 pandemic:
“Let us organize our forces so perfectly that a recurrence of this, or any other epidemic, will never find us so unprepared,” she wrote in 1919. “The only solution to the problem . . . is to organize our health forces better and to teach the people to care for themselves and their families.”
It is not if we will be stricken with another flu pandemic, but when. While a state pandemic flu emergency plan is in place, educating and preparing all aspects of society — from public health departments, transportation officials, schools and beyond — is essential to ensure the minimum possible impact when another pandemic strikes. This includes ongoing efforts to educate Kentuckians about how the virus spreads as well as the critical importance of flu vaccines and “social distancing” — allowing telecommuting, canceling events, closing schools — to slow the spread of disease.
According to Dr. Anna Goodman Hoover, Deputy Director of the National Health Security Preparedness Index Program Office at the University of Kentucky, vaccination rates in Kentucky have declined since 2013 among seniors over the age of 65 as well as among children between the ages of 6 months and 4 years old. With these declining rates, it is evident that continuing education about the ways to prevent influenza is necessary.
Simply put, we need to remember the lessons learned from 100 years ago. And, to paraphrase the Red Cross worker from 1919, authorities should use this time of widespread flu activity to prepare and educate Kentuckians about what can happen when influenza reaches pandemic proportions.
One draft of the state Pandemic Influenza Preparedness and Response Plan notes that, “The devastation that could accompany an influenza pandemic is not reflected in the public’s perception of the annual flu season, despite the fact that influenza causes significant morbidity and mortality each year.”
In other words, most Kentuckians do not realize the devastation that a flu pandemic will wreak upon the state. Studying what transpired in Kentucky from 1918 to 1920 can help us better understand what to expect and can help us prepare for future pandemics. Historical knowledge is power, especially when it comes to public health.
Stuart W. Sanders is the Kentucky Historical Society’s History Advocate. He lives in Danville.