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From The Spanish Influenza Pandemic of 1918: An Account of its Ravages in Luzerne County, Pennsylvania, and the Efforts Made to Combat and Subdue It by Oscar Jewell Harvey, 1920.
Early in September, 1918, the United States was invaded by a scourge of highly infectious and fatal disease, which spread with rapidity throughout the country. It was pandemic in its nature, and partook of many of the characteristics of influenza, grip and pneumonia. No one seemed to know much about the disease or its treatment, and medical science and public health agencies were alike unprepared to cope with it.
About all that could be done at the start was to adopt and attempt to enforce drastic regulations to minimize contagion; but even in view of these regulations, and when the plague had burst forth in all its widespread malignity, the country at large seemed slow to awaken to the enormity of the peril which it faced.
It certainly was a disconcerting fact that, at the very time when vast numbers of the people in widely-distributed localities had organized themselves, through the Red Cross and other well-known and efficient mediums, to fight disease and prevent suffering and death, we should be smitten with a visitation which caused more casualties and deaths among the peaceful citizens in the homeland than the deadly missiles and poisonous gases of the enemy effected among the American Expeditionary Forces overseas in the great World War.
From September 9 to November 9, according to reports received by the Federal Census Bureau from forty-six large cities in the United States having a combined population of 23,000,000 souls, there was a total of 82,306 deaths attributed to the scourge. In a similar period of time, in the same communities, the normal number of deaths dues to influenza and pneumonia would have been about 4,000.
In the latter part of September 85,000 cases in Massachusetts alone were reported; and by the first week in October the disease was prevalent in nearly all sections of the United States — twenty-three States, from Massachusetts in the East to California in the West, and from Florida in the South-east to Washington in the North-west, were experiencing the mysterious malady. More than 14,000 cases in the military camps of the country were reported to the office of the Surgeon General of the Army within one period of twenty-four hours.
Up to January 4, 1919, according to the Census Bureau, the mortality due to the fatal disease was 115,258 in forty-six cities of the United States containing one-fifth of the population of the country; while, according to statistics submitted to the Actuarial Society of America in July, 1919, 450,000 deaths occurred in the United States in the Autumn and early Winter of 1918 due to this pandemic disease — which wrought its greatest havoc among infants and persons in adult working life. The mortality of males was greater than that of females, while the highest mortality caused by the disease affected persons of the wage-earning class — especially those situated in the lowest economic range.
The origin or source of the disease was unknown. Some experts looked upon it as simply a variety of a well-known disease prevalent, with occasional outbreaks of violence, for hundreds of years. Others attempted to identify it with a form of pneumonic plague that has raged in parts of China for a number of years past — China and its neighboring lands in Asia forming a vast storehouse of infection from which great epidemics have swept in waves across and around the globe.
It is an historic fact that, in the early part of 1917 about 200,000 coolies, collected from the northern part of China (where the pneumonic plague had raged for six or seven years), were sent to France as laborers, and with them went the germs of the pneumonic plague. Many of these coolies were captured by the Germans in the Spring of 1918— hence the outbreak of the plague, at that time, in the German army, where it is said to have been very serious in its deadly character.
There were some writers of the press who declared that the disease had been brought into this country in German submarine boats; but when it was realized that, like a scourge of the Middle Ages, it was sweeping through Europe— no part of which, civilized or barbarian, was exempt — it was called by many experts a by-product of the World War.
The manner of the pandemic's appearance in different countries indicated that the germs of the disease had been conveyed thither by the currents of the air. Therefore the theory was broached, that the poison gases, with which many sectors of the fighting area in Europe and Asia were drenched, were carried by the winds in every direction, causing the outbreak of the pandemic in England, Germany, France, Spain, Australia, Africa and Asia, as well as in North America and some of the South American countries.
The disease took its deadly toll even in lonely Labrador, in the "silent North" of the Western Hemisphere, where ice-floes from farther north fill every harbor of the rock-bound coast; where giant icebergs, miles in length, mountains in height and acres in extent bar the paths of ships and steamers. "A land where railroads are unknown, where streets are never laid nor roads built to connect one settlement with another; a country where horses and cows are less known than are the rhinoceros and zebra to the inhabitants of the United States; a region where even canned milk is a luxury and candy is seldom seen."
On all the desolate coast of Labrador, extending over eight degrees of latitude, not a doctor nor a trained nurse, not a hospital nor a dispensary, not even a health officer, was to be found. Eskimo and Indian, German and Briton, halfbreed and white, hunter and fisherman, fell victims to the dreaded scourge, which traveled with rapidity. Whole settlements were left without a single survivor — the unburied corpses being devoured by half- starved dogs. This is the story that came out of the "silent North" — the most gruesome, most awful, tale of disease and death that the world has heard in many a day!
Following the outbreak of the scourge in Germany it was next heard of in Spain, where it received the name "Spanish influenza". This is really a misnomer, but it has stuck, probably because the disease to which it was applied was the first epidemic of influenza Spain had ever experienced. This name accompanied the disease to the United States, where, by some slangologists, it was early transmogrified into "flu" — by which appellation it has been pretty commonly designated.
The scourge invaded Pennsylvania about the middle of September, 1918, simultaneously attacking widely-separated communities. On October 1 the Department of Health of the Commonwealth issued orders directing the closing of all moving-picture houses, theaters and places of amusement in general; that public assemblages be discontinued; that funerals be privately conducted; that all bar-rooms and wholesale liquor establishments be closed. The matter of closing schools, churches and Sunday-schools was left to the discretion of local authorities. In addition, the Department issued proclamations and appeals for hearty co-operation on the part of the general public in checking the ravages of the scourge.
In Wilkes-Barre on October 3, 4 and 5 the directions and appeals of the State Department of Health were promptly and cheerfully complied with (even clubs and the various fraternal orders and societies observing the mandates, while the sessions of the Courts of Luzerne County for the week beginning October 7 were continued and postponed), although on the first day of the appearance of the disease here only twenty cases were officially reported.
Owing to the absence of many local physicians and trained nurses in the military and naval services of the United States, Wyoming Valley Chapter of the Red Cross issued an appeal on October 3 for trained nurses and for women with some nursing experience to register with the Chapter for service in combating the disease here.
Under the date of October 8 the Commissioner of Health of Pennsylvania issued a circular letter to Department of Health and other physicians "engaged in the State-wide organization against the Influenza Epidemic," in which, among other things, the following information and instructions were set forth:
"From close observation of the progress of the pandemic of influenza which is now sweeping upon us from the Atlantic seaboard, it has been decided by the Governor of this Commonwealth, the Commissioner of Health and the Advisory Board of the Pennsylvania Department of Health to use the organization at hand, and all available organizations that will co-operate to the utmost, in an effort to save the lives of our people. Accordingly, after careful thought, the following [among other] plans have been adopted:
"The State Department of Health to be in absolute control and take full responsibility.
"The formation of nineteen Epidemic Emergency Districts, with a representative of the Department in full charge of each district, taking his orders directly from the Commissioner of Health and transmitting them to those who answer the call.
"Appeals to all Health, Patriotic, Civic, Religious, Business and Social organizations, such as the Red Cross (graduates in elementary hygiene and home care of the sick, or first aid). Associated Charities, Boards of Health, Mayors, Councils, County Commissioners, Directors of the Poor, Boards of Trade, Church Societies, Fraternal Orders, Women's Clubs, Boy Scouts, Motor Messenger Corps, trained nurses, practical attendants, lay workers and volunteer automobilists, to lend all possible assistance under the direction of the Department.
"The Adjutant General has placed the entire State Guard, and all the equipment of his department, at our disposal for the erection of emergency hospitals, furnishing of supplies, safe-guarding of property and the maintenance of discipline.
"Requests for aid from stricken communities should be made to the nearest representative of the Department, who will refer them to the physician in charge of the Epidemic Emergency District. This includes calls for doctors, nurses, aids, materials and any other form of relief. The Department will make a supreme effort to satisfy all such needs as rapidly as possible. However, where these are at hand, they should be obtained locally.
"All attendants should wear masks.
"Treatment of Influenza and Pneumonia.”
In furthering the foregoing plans and regulations Dr. Charles H. Miner of Wilkes-Barre, who was at that time, and had been for ten years, County Medical Inspector of the State Department of Health for Luzerne County, was appointed on October 8, by the Acting Commissioner of Health (Dr. B. Franklin Royer), "to take full charge of the organization and co-ordination of all work in District No. 5," composed of Luzerne and Columbia Counties, with headquarters at Wilkes-Barre.
The same day the Acting Commissioner telephoned from Harrisburg to the County Medical Inspector at Wilkes-Barre, informing the latter of his appointment as aforementioned, and asking him to request Maj. Gen. C. B. Dougherty of Wilkes-Barre to aid him in arranging and setting forward plans for the proper handling of the situation in the 5th District.
General Dougherty responded promptly to the call for his services, and he and the County Medical Inspector soon concluded, in view of the fact that the regular and permanent hospitals located in the 5th District were just about "crowded to their limits" with influenza and pneumonic patients, and that the new cases reported each day in the various communities were becoming more numerous, that it would be necessary to establish and equip several emergency hospitals.
It was decided to establish an Emergency Hospital in Wilkes-Barre (where, on October 8, sixty new cases of influenza had been reported to the County Medical Inspector), and the armory of the 9th Regiment, National Guard of Pennsylvania, located on South Main Street, was selected for the purpose.
For some time then the 2d Infantry, Pennsylvania Reserve Militia (Col. S. E. W. Eyer commanding), had occupied the armory as its headquarters. On October 8 Colonel Eyer turned over the armory to the representatives of the Department of Health, and immediately, under the direction and supervision of General Dougherty, the work of thoroughly scrubbing and cleaning the building from top to bottom was begun and was rapidly completed. Then the Shepherd Construction Company of Wilkes-Barre began the erection of four wards on the drill floor of the armory.
Each of these wards was 21x27 feet in area by 10 feet in height, the walls, or partitions, being constructed of hemlock studding covered with beaver board. Each ward had a capacity of fifteen cots, whereby ample air space was allowed for each patient. Considerable plumbing work had to be installed in order to facilitate the efforts of nurses and attendants in giving proper care and attention to the hospital patients. This plumbing work, when completed, represented an outlay of $605.49. Also, the lighting facilities of the armory not being sufficient, it was necessary to install additional wiring and lights throughout the entire building, which was done at an expense of $190.
The basement of the armory was transformed into a commodious and comfortable dining-room; the kitchen was painted white, made sanitary in every respect, and its floor was covered with oil-cloth, while gas ranges were connected and refrigerators were installed. A diet kitchen (separate from the main kitchen) was established convenient to the main floor of the armory.
On the evening of October 9, upon invitation of the County Medical Inspector, [a number of] ladies and gentlemen assembled in the auditorium of the Wilkes-Barre Chamber of Commerce, "for the purpose of taking steps for combating influenza.."
General Dougherty was called upon to preside, and Hayden Williams, Secretary of the Chamber of Commerce, acted as Secretary of the meeting.
The County Medical Inspector spoke at great length with respect to the work already done in the 5th District to combat the pandemic — referring particularly to the emergency hospital which had been established at Wanamie, in Newport Township, Luzerne County, and to the preparations being made for the opening of the Armory Emergency Hospital in Wilkes-Barre. He stated that he had divided the 5th District into five sub-districts, with Dr. S. B. Arment in charge of the work in Columbia County, Dr. J. W. Leckie in charge of the Hazleton sub-district, Dr. W. B. Strieker in charge of a district extending from Nanticoke south to the Columbia County line. Dr. S. L. Underwood in charge of a district extending from the borough of Wyoming to the Lackawanna County line, while he, himself, in addition to a general supervision of affairs in the 5th District, had assumed charge of the work in the territory extending from Wyoming to Nanticoke. He suggested that committees on automobiles, food, drugs and general hospital supplies should be appointed.
General Dougherty gave an account of the serious conditions existing at Minersville and Shamokin in the 3d District, adjoining the 5th District. Dr. Underwood and Miss Tinsley spoke of conditions in Exeter, Luzerne County, where nearly 300 cases then existed. They reported that there were 182 cases in 62 homes; that 98 patients were convalescing; that 10 families were in dire need of help, and that there was a special urgency for women to help in the housework of afflicted families.
Dr. Hughes said that there were 400 cases at Glen Lyon and Wanamie in Newport Township; that sanitary conditions were bad; that there was a lack of nurses, and that the high-school building at Wanamie had just been converted into an emergency hospital.
Dr. G. A. Clark, head of the Wilkes-Barre City Health Department, stated that about 200 cases had been reported in the city, and that the municipality would bear its proper share of the expense incurred in efforts to check the disease.
Dr. Lake stated that there were 36 cases in Kingston and 40 in Edwardsville, and that there had been two or three deaths from the disease. In one home in Edwardsville there were seven cases. He declared that the closing of the schools had helped somewhat in checking the spread of the disease, and that considerable good could be accomplished if Toby's Creek, which had never been cleaned, were placed in a sanitary condition.
Dr. Arment stated that conditions in Catawissa, Columbia County, were bad; that a hospital was needed there, but it was impossible to procure nurses. Six deaths had occurred thus far in that locality, and the disease seemed to be spreading. He suggested that the school-houses in Bloomsburg be converted into emergency hospitals, and reported that the saloons in Centralia were wide open and doing business as usual.
W. H. Conyngham, representing Wyoming Valley Chapter of the American Red Cross, stated that his organization had no funds with which to pay nurses, but that the members of the Chapter stood ready to do anything in their power to combat the disease.
Dr. Mengel, Chief Surgeon of The Lehigh Valley Coal Company, placed the nurses of that organization at the disposal of the community, and suggested that school teachers should be employed to help in the work of caring for the sick.
Mrs. E. Birney Carr reported that the Canteen Service of the Wyoming Valley Chapter of the Red Cross would render all the assistance possible, while Mr. McLaughlin, one of the Commissioners of Luzerne County, gave assurance that the County would render any assistance possible to help stamp out the disease
The Secretary of the Wilkes-Barre Chamber of Commerce volunteered the assistance of the Chamber's staff in handling all details of the work connected with the campaign. Dr. Charles Long suggested that an effort be made to secure financial and other assistance from the Board of Directors of the Central Poor District of Luzerne County.
Anthony C. Campbell, Esq., County Fuel Administrator, told of the serious conditions with respect to the mining industry in the 5th District, and declared that the output of anthracite coal was being seriously affected by the pandemic. On motion of Mr. Campbell it was then unanimously voted: That such emergency hospitals as the County Medical Inspector deemed necessary be established, that those in charge of the work incident to combating the influenza-pneumonia scourge should call upon the Board of Directors of the Central Poor District, County officials and the various municipal officers in the 5th District for financial assistance in defraying such expenses as may be necessarily incurred in carrying on their work, and that the County Medical Inspector be given any and all assistance required.
The meeting then adjourned, and within a day or two therewith the County Medical Inspector announced the appointment of various committees "to cooperate with the State Department of Health in the 5th District with respect to the influenza epidemic..."
Oscar Jewell Harvey. The Spanish Influenza Pandemic of 1918: An Account of its Ravages in Luzerne County, Pennsylvania, and the Efforts Made to Combat and Subdue It. 1920.
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