The 1918 Flu Pandemic – Fighting the Ghost – Extra History – #4

September 28th Philadelphia The liberty loan parade
is in full swing. Thousands march in the streets. Hundreds of thousands watch. Few know that health officials have pressured
the mayor to cancel the event. Women wave flags. A child sits
on his father’s shoulders. The crowd falls silent
for a simulated bombing run. Airplanes buzz overhead, anti-aircraft guns fire
blanks into the sky. The crowd, necks craned, tries to imagine
what it’s like to be in mortal peril. Little do they know… they already are. [Music] “Birth of The People” The flu was already
burning in Philadelphia, but after
the Liberty Loan parade, it explodes. Three days later, the hospitals start to fill. With the war sapping
medical professionals, there aren’t enough
doctors or nurses. And the hospital staff starts to die. Though colleagues
fall around them, doctors and nurses
stay at their posts. Some in private practice
make 60 house calls a day. Over a thousand died
that 1st week, and in 3 weeks
the death toll approaches 5,000. The dead quickly begin
to overwhelm Philadelphia. Morticians post staff at hospitals
to free up beds the moment victims expire. If a patient
starts turning blue, nurses tagged them
for the morgue. It saves time. But the morgue is out of space
and refuses to accept more bodies. Workers keep doors and windows open
to dissipate the stench, and fluid runs out the door
and into the gutter. The Catholic Church gets involved, mobilizing clergy
to help clear the backlog. When the priests enter the morgue,
they find 400 bodies. They’re everywhere, lying on desks
and stacked in corners. The building is at 12 times
its maximum capacity. Things are no better
at graveyards. Pre-burial vaults are full. The city has run out of coffins
and wood to build coffins. People use wheelbarrows
and potato sacks to bring loved ones
to the cemetery, then leave them there. Once again,
the church steps in, hiring a construction crew
to dig trenches with steam shovels. They stack the coffins two deep while recording
exactly where each person is buried. At night, citizens hear them reciting
Latin prayers over the mass grave. But that took
time to organize, and for weeks, thousands
are not buried at all. With hospitals, morgues,
and cemeteries refusing to accept corpses, people have to live
with the dead in their homes. And many families are so ill
that they can’t move a corpse at all and simply sleep, eat, and live next to the deceased. Weeks in, Philadelphia leaders finally rent
a warehouse as an overflow morgue. Organized teams
of policemen and priests circle the city, collecting the dead
in horse-drawn carts. Philadelphia would be
the worst-hit city in America, with half a million cases. By the end of October, the city government almost
ceased to function, and private citizens stepped
in to run the response. People volunteered cars as ambulances
and worked as dispatchers at medical phone banks, a primitive “911.” But just up the coast,
it was a different story. While the head of New York’s board of health
had been slow to respond, the city had experience fighting epidemics,
like polio and tuberculosis. The Public Health Service
had a major presence, and experienced screening and quarantining people
at the Port of New York. In fact, the port had started quarantining ships the moment reports of the flu arose on the western front. But the war made
full quarantine impossible. The city instituted laws
criminalizing spitters and people who failed to cover
their mouths when they coughed or sneezed. They posted notices urging the sick
to stay home under voluntary quarantine, report illnesses to a doctor, and they called for people
to wear gauze masks. The Board of Health surveyed neighborhoods
to track the spread, they set up medical centers that dispatched
doctors and nurses on house calls, and most importantly, they convinced businesses
to stagger working hours and shopping times, reducing crowds on public transit. But even in New York, the press continued to minimize
the outbreak in order to “protect morale.” And it was the same in cities
and towns across America, even as the disease spread west. Newspapers would claim there was
nothing to worry about one day, and then the next announced
that all public gathering places were closed. The result was uncertainty and fear. Everyone knew newspapers
were covering it up; people could see the obituaries. They saw the Red Cross ads
begging for nurses. Families tracked the flu coming down the rail line or highway via letters and articles buried in the back pages. It was in the next state, the next county, the next town, and finally next door. In this climate of mistrust, rumours grew. One conspiracy theory claimed
the flu was a bioweapon, released from German u-boats off
the Atlantic coast. Another said that the German-owned Bayer Corporation had poisoned its aspirin with the disease. A rumor ran around Phoenix
that dogs carried the disease, and as a result, Arizonians killed thousands
of strays and pets. And in San Francisco, a policeman shot a man who refused to comply with
new flu-mask laws. Evangelist Billy Sunday claimed
the disease was “A punishment visited
upon a sinful nation,” and held a mass prayer meeting
to end the epidemic. Several in the crowd collapsed
of flu while praying for deliverance. Whole towns isolated themselves, hiring armed guards. The flu got in anyway, arriving with mailmen
and milk trucks. Shops began asking customers
to shout their orders, then leave the money
on the doorstep. The owner would take the money and leave the goods. Children distilled this paranoia
into a jump rope rhyme, one that captured the sense
of an unwanted visitor invading the home: ♪ “I had a little bird
and her name was Enza ♪ ♪ I opened up the window
and In-Flew-Enza” ♪ The country needs something to stop this nightmare. At the Rockefeller Institute, they isolate Pfeiffer’s bacillus
in mid-October, and the Army Medical School begins
the process of injecting it into horses, drawing their blood, and isolating the antibodies
for a vaccine. By October 25th, the vaccine is ready. Express trains rush deliveries to the west coast
to protect troops and shipbuilders there. They’ve made enough to vaccinate
the entire US Army and its civilian employees. But only enough for the Army. For the duration of the war, the Rockefeller Institute
was a military organization, and therefore their work focused
on the military. No matter how much mayors
and governors begged for vaccine, They wouldn’t receive
a single vial. It took a parallel civilian effort
to provide relief to the public. At the New York hygienic lab, Williams labors over lung samples
from hospitals and orphanages, trying to find whether Pfeiffer’s exists
in a majority of victims… and she finds it! Everywhere. She isolates a sample
and proves antibodies can bind to it, further confirming it was the culprit. That done, she cultures
vast quantities of Pfeiffer’s, liter upon liter, then hands them off to Park, who rushes upstate
to mass-produce vaccine at his farm. Deep down researchers knew
this was not good science. The process had been too fast. No one really knew
whether Pfeiffer’s caused the flu. And if, as some suspected, the culprit
was a virus invisible to microscopes, these vaccines would do nothing. It was, one researcher said, “Like fighting a ghost.” Still, it was worth trying. There was a possibility they’d accidentally snared
the disease-causing agent in their sample, and the horses
would make antibodies for it. That was how the first rabies
vaccine happened, after all. In fact, one Rockefeller researcher
counted on this, producing a vaccine that contained antibodies
for every bacteria he could find, all mixed together, hoping that one would
stop the disease. Even as they rolled out the vaccine, Surgeon General Gorgas cautioned
it was experimental and no one knew
if it would work. And… it didn’t. Labs across the country
produced dozens of vaccines, and none of them prevented flu, because flu was, as some feared, an invisible virus. Yet despite that failure, medical science was not helpless. They could do little for patients
killed directly by the flu (the ones that turned blue), but they could fight
the opportunistic pneumonias that followed it. The anti-pneumonia vaccine
and serum Avery had worked on during the earlier
measles epidemic was effective, and likely saved some people. Thousands of troops took it. On the surgical side, doctors developed
a new procedure to enter the lungs and drain the sacs of pus
that drowned patients. Others used oxygen, X-rays,
and cardiac stimulants to support ailing victims. But nurses provided
the most valuable care. There were too few doctors, too many patients, not enough medicine, and what treatments they had often
took too long to administer en masse. Nurses, on the other hand, could keep patients hydrated, warm,
and breathing comfortably. They could ease coughs
and lower temperatures. And that kind of long-term care probably affected a patient’s survival
more than anything a doctor could do in the few minutes they had
at each bedside. Added to that, the Red Cross developed a system
that predicted the flu cycle of infection, when it would die down in one area
and spring up in another, letting them deploy
emergency teams of nurses before they were needed. But as everyone from city officials
and the Red Cross responded to the crisis, there was one man who refused
to do anything… President Wilson. When briefed about
the deadly influenza outbreak, the one question on his mind was whether he should order the troop ships
to continue ferrying soldiers to France. He did, and the flu kept killing. [Music] “The Cytokine Storm”

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