Victory was eminent for the Allies on the western front in 1918. In January President Wilson announced his Fourteen Points of Peace program signaling to the nation that victory was just around the corner. Grand Rapids had been a strong supporter of the war right from the start. Thousands of young, able-bodied Grand Rapids boys enlisted when the United States entered the war and by the time the draft was called, less than 300 men were called up from Grand Rapids. Besides manpower, Grand Rapids played its part in helping to pay for the war effort by buying Liberty Loan bonds. Parades were held in Grand Rapids and across the country to increase awareness of the public duty to buy more Liberty Loan bonds. Kent County as a whole subscribed for $38,460,400 Liberty bonds during the World War drives for funds and the city of Grand Rapids subscribed for around $30,000,000. The war was a time for great pride and joy in the city of Grand Rapids and the citizens showed it by going above and beyond the call of duty in their support of the Liberty Loan program. In the months and weeks leading up to the end of the war there was cause for much celebration.
All over the country, men returned from combat and were greeted with huge parades and fanfare. Little did they know they were carrying a disease so contagious and so deadly that in little more than a year, estimates as high as 100 million people worldwide (one-fifth of the world’s population) would have to be buried. The disease killed more people than any other disease in history. The disease would leave entire cities decimated, families devastated, and workforces wiped out. It was a disease so horrible and so deadly that history has tried to forget that it ever happened. What scared people the most was that this killer disease was nothing more than the common flu, hardly something to worry about. Many at the time recalled the last outbreak of influenza in 1889-90 but none were prepared for the ferocity of this new strain of flu. They called it Spanish Influenza because at the time of discovery it was very prevalent in Spain but historians today often refer to it as the Purple Plague because of the color it left its victims. Men and women were literally drowned by their own bodies. Spanish flu brought entire continents to their knees. Historians compared the 1918 city scenes to that of European cities during the Black Plague. Carts rode through the cities beckoning citizens to bring out their dead and mass graves were dug wherever there was room. Central Park in New York City was the site of one of the largest of these mass graves. Every town and every city in the world was affected by Spanish flu but there were some that did well to avoid the devastation that influenza was known for. Grand Rapids, Michigan was one such city.
The furniture capital of the nation should have been affected just as badly as its larger neighbors, Chicago and Detroit, but made it through virtually unscathed. Very little has been written about this era of history in Grand Rapids but what little survives gives a very clear picture of how this fair city was able to weather the storm and fight off one of the worst disease pandemics in the history of the world. Rigorous implementation of local and state public health programs such as voluntary and mandatory bans on public gatherings, city and state-wide poster campaigns in theaters and churches, influenza masks, a placard system on homes, voluntary individual quarantines, and the creation of isolation hospitals for influenza patients combined with constructive and positive reporting on the pandemic in the city’s newspapers prevented heavy loss of life in Grand Rapids, Michigan.
Discussion of Influenza
The Great War may have been winding down but a new war on the home front was beginning. Camp Funston, Kansas was where the fighting broke out in March of 1918. Several of the men complained of aching joints, coughing, fever, and general flu symptoms. Military doctors did not think much of the sick men; influenza was common and rarely deadly. Then more men came in complaining of these same symptoms but each was progressively more severe. Three days later, those men were dying. After a month 233 cases had been reported and forty-three had died. A similar outbreak occurred at Fort Riley, another military base in Kansas. The connection between the two bases was a group of soldiers that had enlisted from Haskell County, Kansas. It was in Haskell that many historians now believe the killer flu was born. Medical professionals paid little attention to the outbreak in Kansas because it was such an isolated incident. At the time influenza was not a reported disease so government health officials had no cause for alarm. No one knew that this outbreak was the first wave of what would become a deadly pandemic.
Around the same time a similar outbreak was occurring at Camp Devons near Boston, Mass. Just eighteen days after the first outbreak of the disease that was initially diagnosed as cerebrospinal meningitis, 6,674 soldiers and staff had been infected on the base. By September 23, 12,604 cases of influenza had been reported at Camp Devons alone. It is important to understand that at this point Spanish flu had only killed a handful of soldiers. As rapid as the disease was spreading through the base, the majority of cases of Spanish flu went away after a few days of bed rest. What separated Spanish flu from the common influenza was the frequency of pneumonia onset in influenza victims. While Spanish flu had killed very few of the soldiers, pneumonia had killed sixty-six men, all in peak physical condition by September 23. The virus quickly spread through military bases across the nation. From there it crossed the Atlantic into Europe, Asia, Africa, the pacific islands and South America as well. Spanish influenza thrived in the war torn world, and when all was said and done flu killed estimates of up to 100 million people worldwide.
In order to understand a pandemic of such magnitude it is important to know the physiology of Spanish influenza. In other words, how the disease was able to spread and kill with such ferocity. In doing so it must first be noted that much of the information about Spanish influenza was not known until many years after the outbreak. The influenza virus differs from other viruses in its ability to mutate and adapt in order to become resistant to anti-bodies. By changing portions of its genetic make-up the influenza virus can waltz into a human body completely undetected. From there, the virus attaches itself to a cell and turns the cell into a virus factory, producing tens of thousands of exact copies of the original virus until the cell bursts. All of that happens in roughly ten hours. It is no wonder soldiers came down with severe cases of the flu so quickly. Influenza was generally a harmless disease associated with fever, sore throat, coughing, aching, and generally feeling ill. A few days feeling downright miserable and the worst was over. With Spanish flu, it struck so hard and so fast that often after three days its victims were dead or had become so weak that their bodies become susceptible to other very deadly diseases such as pneumonia and meningitis. Current Center for Disease Control estimates put influenza deaths at 36,000 people a year on average, so it is safe to say that Spanish flu was far more serious than the common flu. Unfortunately, in the summer of 1918, modern medicine was in its infancy. Little was known about the physiology of disease and how it spread. There was some knowledge of vaccinations but the flu virus was too small for even the most powerful microscopes of the day to see.
The military quickly recognized that there was a serious problem and it was spreading like wildfire through military bases. By September of 1918, Spanish flu had reached the Great Lakes. The Great Lakes Training Station in Illinois was the largest naval training station in the United States with over 45,000 sailors. This was also home to John Phillip Sousa and his fourteen regimental bands. Like many naval bases across the United States of America, when Boston’s naval base sent its healthy sailors away many ended up at the Great Lakes Training Station. The virus slipped past the guards and the quarantines and the Illinois naval base quickly became another Camp Devons, with hundreds dying every day. Nurses recalled that at one point during the peak of the epidemic several living sailors were wrapped and tagged as dead to save time. Another nurse recalled stacking living sailors on top of each other in the morgue because there was simply nowhere else to put the dying sailors. Stories like these were not uncommon and give a better understanding of how truly horrible Spanish influenza was in 1918. It was only a matter of time before this terrible disease exploded into the nation’s population centers and from there to every corner of America and by mid-September influenza had already found its way into Michigan.
Fort Custer in Michigan went to great lengths to try and avoid catching the flu. The Grand Rapids Herald reported on September 25 that, “No man in camp sneezes or coughs without being immediately rushed to the regimental surgeon, who examines the soldier for possible symptoms of Spanish influenza.” Because there was no vaccine to protect soldiers against the flu, this was one of the few methods the army employed to help deter a potential epidemic on base. Unfortunately this was not enough of keep Fort Custer free from the clutches of Spanish influenza. By October, Michigan soldiers were getting sick. As with other military bases, the disease spread slowly at first but quickly increased in ferocity. The first deaths were attributed to pneumonia, as was the case in the rest of the country. From reports in the Grand Rapids Herald and the Grand Rapids Press, Michigan knew that it was only a matter of time before they too would have to cope with this horrible disease. Fort Custer medical officials worked hard to maintain a strict quarantine but the flu was far too contagious to be contained by closed doors.
Influenza in Grand Rapids
The first signs of influenza in Grand Rapids were seen as nothing more than the common flu and having such a disease was hardly seen as hazardous. Doctors and nurses took all of the necessary precautions when influenza reared its ugly head but initially, Grand Rapids physicians took the threat of a citywide epidemic very lightly. They did so for good reason; the spread of disease was much slower in the city that it had been in the military bases and in other parts of the country. Most Grand Rapids physicians felt there was relatively little danger to the majority of the city’s population. Standard treatment for patients presenting influenza was the same as the treatment for the any common flu; prescribing quinine, hot applications and sweating, plenty of bed rest, together with a strong physic. Other treatments reported in the papers were the use of nasal spray and throat spray with any alkaline antiseptic as well as the use of Vicks vapor rub. Both the morning and afternoon newspapers reported very little about the disease in Grand Rapids early on. This was due largely to the fact that very few people had contracted the disease and not a single person in Grand Rapids had died from Spanish flu. Also, the newspapers were the city’s only source of news so writing too much about how deadly Spanish flu could be would have sent the city into a panic.
By October, Grand Rapids started to take notice of the disease as the first death was recorded on the third of the month. The man had recently moved to Grand Rapids from Manistee and was only thirty years old. Barely a week later the Governor ordered, “All public gatherings including churches and theaters be abandoned until public safety can be assured.” It was the first time the influenza achieved headline news in Grand Rapids. This action by the governor played a vital role in preventing the spread of the disease through the city of Grand Rapids. The Governor’s main reason for ordering the ban was to prevent the spread of disease but no government action is taken without economic consideration. The paper also reported that, “Men employed in the war industries are incapacititated with the result that work on government materials needed by the American soldiers in France is being impeded.” Governor Albert Sleeper understood that sick men could not produce guns and airplanes and the war industry was a major source of wealth for the state. Still, Grand Rapids had not seen the awesome power of Spanish Influenza. By mid-October the only reported deaths in the city were due to pneumonia.
November and December were the worst months for Grand Rapids where roughly 240 people died from Spanish flu. The disease spread slowly through the city but every day the number of new cases reported increased. The week ending November 23, 473 new cases were reported to the city health department. This was nearly double the report from the previous week and at least four times that of the previous month. The city averaged seventy-four new cases of influenza per day in November. Deaths during this time period were directly related to the flu and not a secondary infection of pneumonia, although deaths of that nature were still prevalent. By December eighty-eight deaths had been reported since influenza arrived in Grand Rapids. City Health Officer Clyde C. Slemons reported that, “18 children under 5 years of age, 9 children aged 5-15, and 61 aged 15 and up have died in the city.” What was so significant about the cases of Spanish influenza at the peak of infection in Grand Rapids was that the disease was taking more than just the young and the old. Typically, influenza kills the young and old of a population creating a U-shaped curve in death rates. In November and December 1918, the curve was a W-shape. Spanish flu was killing the heart of the population. Life expectancy in the city dropped nearly twenty years because of this bizarre pattern of death. This was the trend across the globe. In fact, Spanish influenza killed more men and women aged eighteen to thirty-five than those younger than five or older than sixty-five. December was the worst month for Grand Rapids. On one day, December 12, 1918, 260 new cases of Spanish influenza were reported as well as eleven deaths related to influenza and pneumonia. Two days later another 481 new cases had been reported over the forty-eight hour period. By the end of December influenza was finally starting to taper off in the city and by the end of February Spanish influenza had been virtually eradicated from the city.
The Grand Rapids Herald reported December 15, 1918, “In Grand Rapids we have had 148 deaths from influenza and pneumonia during the period from Oct. 5 to Dec. 7, the lowest number of any city of its size in the United States.” Over the same time period 21,933 had died in New York City and 9,396 had died in Chicago. When all was said and done 309 people had died in Grand Rapids from influenza and pneumonia. This put Grand Rapids in the position of least effected by influenza in cities with 100,000 or more population in 1910. While this was considerably more deaths from influenza than was common in Grand Rapids, the number of deaths due to Spanish Influenza was very little in comparison to the nearest large cities such as Detroit and Chicago. Grand Rapids suffered 187.2 deaths per 100,000 population. Detroit suffered 338.4 deaths per 100,000 population, Chicago suffered 397.9 deaths per 100,000 population and Pittsburgh suffered the worst losses with 1026.6 deaths per 100,000 population. The official population in Grand Rapids was 112,571 in 1910 and 137,634 in 1920 so the estimated population of Grand Rapids in July 1918 was around 135,450. Influenza first hit the United States in March and it wasn’t until October, seven months later, that Spanish Influenza reached the banks of the Grand River. In the first month there were thirty-four deaths from influenza and pneumonia. In November 100 people died and in December, Grand Rapids suffered its worst losses with 142 people dying from influenza and pneumonia. The death rate tapered off by the New Year and by the end of January only thirty-four had died. Statistically Grand Rapids was barely touched by Spanish influenza in 1918 with a total of only 2.8 deaths per 1000. This was a tragedy for Grand Rapids but compared to cities elsewhere in the nation there is no doubt that Grand Rapids survived the epidemic with relatively little harm.
Response to Influenza in Grand Rapids
Friday October 11, 1918 Governor Sleeper issued at voluntary ban on public gatherings, which made front-page headlines in the Grand Rapids Press. This would prove to be an extremely effective tool in the fight against influenza in Grand Rapids. The number of cases dropped significantly in the weeks following the ban in the city. The conservative nature of Grand Rapids was the reason this voluntary ban worked so well in the city. Children stayed home from school and most people avoided public gatherings such as theaters, parades, and churches. October 17, 1918 Dr. C.C. Slemons was interviewed by the Grand Rapids Herald and was asked how the city had managed to escape the epidemic to which he responded that it was because of the “realization by the individual of his personal responsibility.” However the state was not satisfied with the results of the voluntary ban and on October 19, 1918 Governor Sleeper issued a mandatory ban on all public gatherings. All theaters, churches, poolrooms, bowling alleys, clubs and lodges were ordered closed at once. Schools were left open at this time because the thought was that children would be safer in the classroom than in crowded downtown shops. This came as quite a shock to the religious community as well as the entertainment industry in Grand Rapids. Sunday sermons were printed in the newspapers along side editorials written by clergymen against the church ban.
Three weeks later the ban was lifted from the city and had left Grand Rapids with very positive results. Wednesday, November 6 only twenty-eight new cases of influenza had been reported. This was a vast improvement from the previous weeks and it proved to the city that the bans, although inconvenient, worked very well. November was a month of great celebration for the city of Grand Rapids. The flu ban was lifted, the census bureau at Washington named Grand Rapids as one of the nation’s healthiest cities, and an armistice was signed with Germany. News from the war was cause for celebration and on November 16, 1918 a Victory Day parade was held in the city. This was a fatal mistake for Grand Rapids. Health officials were unaware of the incubation period for Spanish influenza. People could be infected with the disease and extremely contagious but not show any symptoms. A week after the parade ninety-four new cases of flu were reported. According to city health official Slemons there was little cause for concern but he knew that if something were not done quickly the city would be engulfed once more in Spanish influenza. It took the city a month to decide that another quarantine was needed and on December 14, 1918 all schools, public meetings, dances, and entertainments were ordered closed. Theaters and churches however were not closed. They were given special permission by Dr. Richard M. Olin, secretary of the state board of health, to remain open, which will be discussed shortly. The ban remained in effect until Christmas and again, it reduced the number of reported cases significantly. Only forty-five new cases were reported on Christmas Eve. The bans were by far the most effective tools for fighting Spanish influenza in Grand Rapids. They kept people at home and away from other potentially sick people effectively eliminating Spanish influenza’s means for spreading. While the bans worked the best at controlling the spread of disease in many public places they could not control the spread of influenza in the work place, on streetcars, in stores, and at home.
As stated before, during the second ban in the city theaters and churches were allowed to remain open. This was the result of an agreement reached between general manager of the Consolidated Theaters, Inc. Charles H. Seaman of Grand Rapids and Dr. Olin. Seaman came up with the idea to display movie slides and posters in his theaters and get all theater managers in the state to do the same in order to stay open under the bans. Seaman had already employed this educational campaign in his theaters in Grand Rapids and hoped that co-operation across the sate would decrease the number of cases of influenza. Churches were also asked to join in this educational campaign and were asked to read a statement from Dr. Olin before every service. The campaign was adopted throughout the state and movie slides and posters were ordered and paid for by theater managers. Until the slides and posters were delivered theater managers and clergymen agreed to read the statement from Dr. Olin warning the public of the dangers of influenza, its symptoms and methods of spread. It was one of the few instances in the city where a private business owner took the influenza fight into his own hands and it was a major step in reducing the number of new cases in the city and in the state of Michigan as well as educating the citizens of Grand Rapids about the dangers of Spanish influenza.
A placard system was also implemented in early December in the city of Grand Rapids by city manager Locke. This campaign called for all homes afflicted by influenza to place a placard on their home issued by the city with an inscription forbidding all persons from entering the home except immediate family. The placard system was part of an effort to increase awareness of the disease in the city. Combined with the placard system were individual voluntary quarantines and flu masks for individuals going out in public. All three parts of this campaign were Locke’s contribution to the fight against flu and they worked very well. Advertisements for the masks were placed throughout the city with the well-known slogan, “Cover Up” and the Red Cross was employed to help sell masks in public places and churches for ten cents. Locke urged Grand Rapids’ citizens to wear masks on streetcars, in crowded stores and by persons who visit or work in public and crowded places. The citizens responded and everyone wore masks when they went out in public, placards were placed on homes all over the city and sick people were staying at home. The most important development that arose from these campaigns was that people were informing their physicians much quicker when any of influenza’s symptoms were detected. Education on the disease was improving and it was bringing the number of new cases reported down in the city. The only problem was where was the city going to put all of the sick people.
In October, before the worst of the epidemic was known, city manager Locke recommended that the city provide isolation hospitals for persons living in hotels, lodging houses or other places where adequate care could not be given. The city commission acquired two sites; the DeVore Hospital and a private hospital on Eastern Ave. The space would also serve as a place for overflow from Butterworth and St. Mary’s Hospitals. At the time there was no need for the extra space as Butterworth and St. Mary’s had plenty of room to accommodate influenza patients but by December 1918 even the extra isolation hospitals were not enough to manage all of Grand Rapids’ sick. Furthermore, on December 12, 1918 the Kent County Medical Society recommended that, “all hospitals in Grand Rapids set aside one floor or its equivalent for isolation and treatment of influenza patients.” Individual quarantines were only so effective and physicians could not make every house call, so hospital space was extremely important for those who needed immediate attention. The extra isolation hospitals Locke acquired in October made caring for influenza patients much easier and contributed to the city’s overall success against the disease.
The newspapers were by far the most effective public announcement system in 1918 and they served as a very effective early warning system for the city of Grand Rapids. In the months leading up to the Spanish flu outbreak in the city there were weekly reports on influenza on the east coast and across the country. Most printed material prior to September gave tips on how to avoid the flu, advertised various drugs that were said to be the most effective at keeping one healthy, and informed the public about the disease itself. A recurring advertisement informed the city on how bad the disease could be but focused more on how rare it was that anyone died from influenza. It recommended plenty of fluids and bed rest if anyone felt they were coming down with the flu and that anyone suspected of having the flu should report immediately to their doctor or physician. These early reports helped to decrease initial infection in the late summer and early fall of 1918 in Grand Rapids. Newspapers were equally effective in the peak months of the pandemic in Grand Rapids. Daily disease reports were printed in the Herald in November and December along with informational advertisements concerning the symptoms of Spanish flu as well as ways to combat the disease and prevent its spread. In December the Red Cross ran advertisements advocating joining the organization for only a dollar. After just two days 4,000 Grand Rapids citizens had joined the Red Cross. This was crucial for a city that desperately needed volunteers to care for influenza patients all over the city. The Red Cross created another successful newspaper ad campaign that asked citizens of Grand Rapids to volunteer their cars to nurses combating Spanish influenza in poor neighborhoods. Again there was record support for the Red Cross campaign as people all over the city volunteered their cars to nurses. It was an important development for the city as well because physicians could only make so many house calls. By providing nurses with a means for making house calls Grand Rapids was able to reach every citizen in need of care.
Newspapers also played an important role in how they reported on Spanish flu. Aside from simply not reporting on all of the outbreaks across the nation, newspapers tried hard to put a positive spin on the news they did report. In the months leading up to the outbreak in Grand Rapids not one single influenza story made the front page of either Grand Rapids newspaper. Readers were forced to search deep within their newspaper to read about influenza in the nation, often finding less than fifty words in the middle of page thirteen, as was the case of the first report of influenza related death in Grand Rapids. This was done to subdue panics in the city and portray influenza an ignorable problem in Grand Rapids. By printing articles deep within the newspaper the editors were ensuring that the casual reader would not read about the flu. In November and December nearly every article in the Herald on Spanish influenza in Grand Rapids was printed on page three. Only when a major event such as a statewide ban would either the Press or the Herald print the story on the front page. Nearly everyone who could read bought the newspaper but most people read only the first few pages where the good news was located. The Great War was coming to a close and people in Grand Rapids cared more about the young men fighting the Germans than the young men fighting influenza. The front page was reserved for war headlines almost exclusively. As the flu became more widespread in the city it was impossible for the newspapers to ignore the disease and national reports were frequently printed on the front page.
Disease and Response Across the Nation
Public gathering bans, movie slide and poster campaigns, placards, masks, and other programs used in Grand Rapids were all very effective but it was not the only city that had success with these programs. Bans on public gatherings were in widespread use in all cities and states affected by Spanish influenza. Sometimes however, influenza struck so hard and fast that there was no one to police the streets, put out fires, remove trash, operate telephones, operate theaters or supervise shops and other public gatherings so everything was closed before an official ban could be issued. Theaters across the nation lost $400,000 a week in revenues and stores struggled as well. Masks were widely used across the country along with movie slide and poster campaigns. Almost every photograph taken during the epidemic depicts an individual wearing a flu mask.
Quarantines were very common long before Spanish flu took over the country so it was no surprise that they were the first forms of disease containment to be used. The military used them when Spanish influenza first showed up but they had not acted quickly enough and did not confine all soldiers to the base, only those who were presenting flu symptoms. When influenza made its way into American cities many major cities were hit so hard and so fast that they had no time to set aside space to accommodate the massive influx of Spanish influenza patients. Cities like San Francisco and Philadelphia were forced to use any large, empty and dry space they could find to house the sick and even those places were not enough to house all of the sick and dying. There was no time to discuss plans of action against the disease. The dead piled up in Philadelphia where, in one week, over 4,000 of its citizens died from influenza and pneumonia. The only hope most large cities in the United States had was to wait out the disease and try to contain it as much as possible. Grand Rapids was extremely lucky not to be hit with the ferocity that places like New York, Philadelphia, San Francisco and the like were hit.
What hurt cities elsewhere in the United States more than insufficient hospital space and the speed at which the disease spread was how it effected important public services in major cities. Police and fire departments were crippled by influenza in Philadelphia. During the epidemic 487 police officers were absent from duty because of influenza in the city. Other services vital to the city were hit equally hard. Garbage piled up on the streets as there were no garbage collectors well enough to pick up trash. Telephone operators, which were imperative to the city’s fight against the disease, were unable to do their job because so many were sick, and the city’s mortuary industry became the biggest problem. City morgues filled up so fast in Philadelphia that by the end of the epidemic the city had taken over five cold storage facilities to use as supplementary morgues. The lack of coffins and gravediggers only compounded the problem and it took the city several weeks to obtain just a small number of coffins, most of which were pine boxes. Far more common was for the city to dig trenches, which Philadelphia dug in Potter’s Field for those that could not afford proper burial. As bad as the situation was in Grand Rapids, it could have been much worse.
More Recent Influenza Epidemics
The influenza epidemic of 1918 taught Michigan as well as the rest of the country a great deal about how to prepare for a disease outbreak of any magnitude. The epidemic also jumpstarted the research side of medicine, which helped create Johns Hopkins University and other medical schools around the country. June Osborn labeled the period between 1918 and 1976 the “golden years for microbiology and preventative medicine.” In that time period major advances in the effectiveness of vaccines were made because of an important discovery made in 1930. It was found that viruses could be grown in hens’ eggs allowing medical scientists to test vaccines in the lab instead of volunteer test subjects. This was an extremely important discovery because until that time, almost nothing was known about viruses. Diseases such as influenza and yellow fever could be studied, tackled and defeated. In 1957 the United States was afflicted with another influenza epidemic but because of better-prepared public health departments and medical advances America was able to avoid serious casualties to Asian flu. It, however was labeled as a failure because doctors and medical professionals still did not fully understand how a vaccine worked and as a result 70,000 Americans died of Asian flu. A similar outcome came just eleven years later with the outbreak of the Hong Kong flu. Vaccines were not distributed in time and 33,000 Americans lost their lives. Along with the loss of life, the 1968 epidemic cost the United States over $3,000,000,000. To put this amount into perspective the 1918 Spanish influenza pandemic cost (in 1968 dollars) $100,000,000,000.
By 1976 the United States had well-established plans to combat another epidemic. Virology and become a reputable science and national public health departments had been created such as the Center for Disease Control (CDC) and the National Institute of Health. When word that a new flu virus had found its way on to U.S. soil these organizations were quickly mobilized, hiring vaccine companies to mass produce a vaccine to be distributed nationally and writing containment strategies to combat a possible rematch with the 1918 Spanish influenza. Millions of dollars were spent on immunizing Americans but there was a major problem, no one was coming down with influenza. What had been a heroic effort to defeat an impending epidemic turned into a litigation nightmare. Millions of dollars were spent on a vaccine for a disease that never spread. Even worse, the vaccines were said to have caused countless medical problems in patients who received the drug.
Today it seems that America has finally figured out how to deal with a potential epidemic. With the discovery of the Avian flu in China, Americans were thrown into another flu scare. Standard flu vaccines had been distributed nationally for several years and given to the young and the old before flu season. When news of this new flu hit television sets everyone in America wanted the flu shot and hospitals around the country ran out of the flu vaccine. This prompted the government to change their historical plan of attack. The pains from the 1976 disaster were still around so the CDC and the Department of Public Health, Education, and Welfare knew not to mass-produce and distribute a vaccine that had not been fully tested. They also knew that it was better to wait and see just how bad the disease could be. State governments created standard plans for combating pandemics, mapping out exactly what makes a disease outbreak a pandemic and how the state should respond. The Pandemic Influenza Plan for the state of Michigan is available for download on their website and the report gives an extremely detailed plan of attack if Michigan is infected with a pandemic influenza. It outlines what actions must be taken by the state and local governments as well as the state and local health departments for each stage of the pandemic; inter-pandemic period, pandemic alert period, pandemic period, and post-pandemic period. This is an extremely effective tool for fighting any type of pandemic disease and something that would have completely changed the face of the 1918 influenza epidemic had this kind of plan existed.
Conclusion
The fall of 1918 was a time of great joy and great tragedy. The nation was celebrating peace on the warfront and mourning those lost to influenza on the home front. Grand Rapids was hit head on with this conflict and arose victorious amidst many failures around the globe. In a world where millions were dying or had died from influenza and a nation where hundreds were dying daily in some of its largest cultural and industrial centers, Grand Rapids was incredibly lucky. Some would say it is better to be lucky than good but in the case of Grand Rapids they were both lucky and good. They were lucky that they had a conservative and well educated population. They were lucky that they didn’t have a military base near the city. They were lucky that influenza spread slowly through the city instead of exploding as it did in Philadelphia. They were lucky that only 309 people died. But there were some things that luck had nothing to do with.
Grand Rapids city health officer Dr. Clyde C. Slemons was very good at his job. His colleague Dr. Richard M. Olin, secretary of the state board of health was also very good at his job. Both men recognized the threat that influenza posed to their city and their state. Dr. Olin was quick to ensure that Fort Custer maintained a strict quarantine until the base was no longer contagious. When that failed he was quick to inform the public of the eminent danger of an influenza epidemic. Both public gathering bans resulted in a drop in the number of new cases reported and every public health program implemented by the state was very effective in Grand Rapids. Dr. Slemons also had some very bright ideas such as the placard system and the voluntary quarantine that greatly reduced the number of new cases of Spanish influenza in Grand Rapids. His city was extremely well informed about the dangers of influenza due to poster and movie slide campaigns. The city was also very well prepared for the massive influx of influenza patients requiring isolation hospital space thanks to city manager Locke. Were it not for these programs Grand Rapids would have had to rely solely on its luck and from the looks of New York City and Philadelphia in October 1918 it is safe to say that luck would not have lasted.
Grand Rapids survived the worst disease pandemic in history with only minor casualties. Any loss of life is terrible but when compared to the incredible loss of life in New York City over the same time period, Grand Rapids’ deaths were miniscule. It was effective implementation of isolation tactics such as bans, quarantines and influenza hospitals, superior education of the city’s population on flu symptoms, methods of its spread and proper care of those afflicted, and an understanding of personal responsibility that prevented a disaster in Grand Rapids.
Bibliography
Barry, John M. The Great Influenza. New York: Penguin Group, 2004.
This was an invaluable book for gaining a better understanding of the scope of the pandemic in the U.S. Barry wrote about the horrors of influenza in military bases. It also gave a very detailed description of the physiology of influenza and a history of the understanding of viruses in the U.S.
Crosby, Alfred W. America’s Forgotten Pandemic. Cambridge: Cambridge University Press, 1989.
This book was the most essential book for obtaining the big picture of the influenza pandemic. I found this book in nearly every bibliography on the pandemic. This book provided me with much of the statistical information on disease and death rates in Grand Rapids. It also gave a narration and discussion about the pandemic and why it was so severe. Crosby argued that the pandemic was forgotten despite the incredible death rate.
Forstall, Richard L. Population of Counties by Decennial Census: 1900 to 1990. Washington D.C.: U.S. Census Bureau, 1995 <http://www.census.gov/population/cencounts/mi190090.txt> (November 22, 2006).
This document supplied me with basic census data in Grand Rapids from 1910 and 1920 so that the reader would have a better understanding of how large Grand Rapids was at the time of the pandemic.
Kolata, Gina. Flu: The Story of the Great Influenza Pandemic of 1918 and the Search For the Virus That Caused It. New York: Farrar, Straus and Giroux, 1999.
This book gave me information on the Swine flu epidemic that never was in 1976 and also touched on the previous epidemics in the U.S. I used Kolata’s discussion of the mistakes made in 1976 and compared it to current policy on pandemic disease.
Michigan Department of Community Health. Pandemic Influenza Plan. N.p.: 2006 <http://www.michigan.gov/documents/Pandemic_v2_146401_7.2_0.19_.pdf> (November 5, 2006).
I found this document on Michigan’s website along with a great deal of literature on influenza. This document gives an extremely detailed strategy for the state should another pandemic find its way back to Michigan.
Miller, J. Donald, June E. Osborn. “Precursors of the Scientific Decision-Making Process Leading to the 1976 National Immunization Campaign,” in Influenza In America: 1918-1976, ed. June E. Osborn New York: Prodist, 1977.
This article gave me a general understanding of the more recent flu epidemics in American history including the 1957 Asian flu, the 1968 Hong Kong flu, and the 1976 Swine flu.
Puisis, Tena. “First Draft Army (WWI) Grand Rapids, MI” N.d. http://www.lithuaniangenealogy.org/databases/mi/GrandRapids/FirstDraft.html?letter=G (November 22, 2006).
This website gave me a very some very basic World War I facts including number of Grand Rapids enlistments and draft requirements. It also has images from the Grand Rapids Press with the same information printed.
Grand Rapids Herald.
The Herald was an incredible source of information that made up the bulk of my research. There was very little local information on the pandemic so the Herald was where I was able to get information on public health programs, disease and death statistics, and local reactions to the pandemic.
Grand Rapids Press.
Here again was an invaluable resource. The Press did not report as often on influenza as the Herald so I only used this newspaper for the end of September 1918 and all of October 1918. It gave information on the first ban as well as information on the isolation hospitals.
Tena Puisis, “First Draft Army (WWI) Grand Rapids, MI” N.d., http://www.lithuaniangenealogy.org/databases/mi/GrandRapids/FirstDraft.html?letter=G (November 22, 2006)
Corresponding death rates from 1915 were around 130 deaths in the months from September to March, Crosby, 60-61.
Richard L. Forstall, Population of Counties by Decennial Census: 1900 to 1990 (Washington D.C.: U.S. Census Bureau, 1995) http://www.census.gov/population/cencounts/mi190090.txt (November 22, 2006)
Ibid, “Governor Sleeper Issues Proclamation Closing State Because of Influenza Spread” Oct. 19, 1918, 1
J. Donald Miller, June E. Osborn, “Precursors of the Scientific Decision-Making Process Leading to the 1976 National Immunization Campaign,” in Influenza In America: 1918-1976, ed. June E. Osborn (New York: Prodist, 1977) 16
Gina Kolata, Flu: The Story of the Great Influenza Pandemic of 1918 and the Search For the Virus That Caused It (New York: Farrar, Straus and Giroux, 1999) 185
Michigan Department of Community Health, Pandemic Influenza Plan (March 2006) 8 http://www.michigan.gov/documents/Pandemic_v2_146401_7.2_0.19_.pdf (November 5, 2006)
