Text from Phoenix 1918
Text from Phoenix 1918
http://www.azcentral.com/arizonarepublic/viewpoints/articles/0416nelson0416.html
When a fearful Phoenix wore masks to survive a global pandemic
There was a time not too long ago when people in Phoenix wore surgical masks in public for fear that contact with their neighbor
Gary Nelson
The Arizona Republic
Apr. 16, 2006 12:00 AM
It was as if Louis L'Amour and Stephen King had gone to work on the same story. Dusty Western outposts stalked by a ruthless, seemingly supernatural killer . . . ranches and frontier towns cut off from civilization, struggling to survive . . . cowboys and Indians, lawmen and outlaws, all gripped by the same stifling and unspeakable horror.
But this was no novel. It was real.
In the fall of 1918, the new state of Arizona, home of copper and cattle and boundless dreams, wept with the rest of humanity as the Spanish flu reaped a bumper crop of death.
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In itself, the story is fascinating, if heart-wrenching, history.
Many, however, fear it is more than that.
To read of that haunted autumn is to understand why modern doctors and scientists tremble at the thought of a new pandemic, one they fear even now is being sown around the world on the wings of birds.
Things are different now in many ways, of course. Should the bird flu morph into a bug that can be spread from human to human, the outcome might not be nearly as ghastly.
There is a chance, for example, one that didn't exist in 1918, that a vaccine could stop a mutated virus before it becomes a global monster. Modern communications may mitigate the toll. And we're not in the throes of a vast, mindless war of the sort that helped enable the 1918 scourge.
But 1918 offers a real-world look at what a pandemic can do - and of what might await us if some microscopic tweaking of the bird-flu bug were to let loose an agent of similar lethality today in our teeming, modern state.
It is not especially easy to get the story. Precise numerical records of how the Spanish flu affected Arizona don't seem to exist. Newspapers of that autumn, more concerned with promoting the Great War in Europe, gave the flu only spotty attention. Living memory of the epidemic has all but vanished, its generation swept away by the march of time.
Further, historians have noted a peculiar amnesia with regard to the Spanish flu, an inexplicable, almost willful relegation of the 20th century's greatest national disaster to a black hole of forgetfulness.
What we can extract from the desiccated chronicles is frightening enough.
The Spanish flu seems to have originated not in Spain but not far from here, in the American central Plains, where it appeared in a relatively mild form early in 1918. From there, it is believed to have migrated to Europe aboard packed ships carrying soldiers to the brutal jaws of the Great War.
That summer it mutated, acquiring the attributes that made it so contagious and so deadly. Spain got the rap, it is believed, because that country was neutral in the war, didn't have a great deal of press censorship, and was the first to openly report the effects of the hideous malady.
The first serious American outbreaks occurred in East Coast military camps in late August and early September. Doctors were shocked that most victims were young and healthy. More shocking still were the autopsies on those young men, postmortems that found lungs full of bloody fluid that literally robbed the body of breath.
By the end of September, the killer had Arizona in its sights.
One would expect the state's leading newspaper, The Arizona Republican, to have followed the story closely and in depth. But critics of modern journalism, examining the state of the art as it was practiced nine decades ago, may be forced to admit that newspapers have gotten better over time and that those of 1918 fell sadly short of conveying the true scope of the calamity.
That may have been deliberate, according to David Engelthaler, who currently serves as Arizona state epidemiologist. With all eyes on the war effort, he said, "there was an honest-to-God push . . . not to make it (the flu) a big issue."
"It wasn't until it was causing a large number of illnesses and deaths that it became something the newspapers were reporting," he added.
Be that as it may, a one-column headline on Page 2 of the Oct. 1 Republican reported that more than 20,000 new cases of Spanish flu had been reported in U.S. Army camps the previous two days, causing at least 277 deaths, 64 of them in Camp Dix, N.J.
But as to the effects in Arizona, there was no news other than a report on an inside page that Dr. O.H. Brown, the state health director, had issued a no-kissing order.
"It makes no difference," Brown said, "whether people are engaged to be married and have a perfect right to display affection in this manner. It must not be indulged in, either upon the lips or the hands, unless they are willing to run the risk of contacting the Spanish influenza."
Brown also said people should wash after shaking hands, be careful where they cough or sneeze, carry personal drinking cups, sterilize their dishes and avoid spitting in public places.
As of that Oct. 1, there was one suspected case of the flu in Phoenix.
Beginning with the Oct. 2 edition, the paper regularly carried national stories about the flu on its front page. But curiously, all during that October and November, local flu stories never made the cover, which was devoted mostly to the war in Europe and the sale of war bonds.
Already, though, the disease was hitting Arizona hard: The Northern Arizona Normal School in Flagstaff was closed, with 50 cases of flu reported among its 600 students. In Winslow, four or five suspected cases as of late September had exploded to 200.
Brown could only advise, as he warned of the disease approaching Phoenix, that "if a person is suspicious that a case of influenza is developing, he should go to bed and call as good a physician as he can afford."
On Oct. 4, The Republican's front-page headline read, "Disease and death stalk hand in hand through land." By the time the epidemic abated, the newspaper's headline writers would have all but exhausted their vocabularies trying to say the same thing day after day. The flu had now reached every state in the Union, and Arizona was beginning to reel, with the University of Arizona in Tucson under quarantine.
By Oct. 8, Dr. Brown himself was attending to matters in Winslow, where 500 cases were now reported.
On that same day, Phoenix closed theaters and prohibited public gatherings of all kinds - a virtual suspension of civic life that, astonishingly, was not reported until the seventh paragraph of a story on Page 8 of The Republican. It also was reported that authorities would begin to arrest bar and restaurant owners who did not sterilize glasses and dishes.
Tucson's acting mayor closed all theaters, schools, churches, pool halls and other public places on Oct. 9, even though at that point Tucson was reporting no flu deaths.
Bisbee reported 500 cases by mid-October. Holbrook was hit hard. Winslow reported 21 deaths as of Oct. 13. By Oct. 16, half of the doctors in Phoenix were reported out of town, fighting the disease in Arizona's ravaged rural areas, and some of those doctors themselves were to succumb to the disease.
Although the paper kept no running totals of cases or deaths, obituaries began to hint at the vast human toll.
It was reported on Oct. 19, for example, that Ralph Dickinson, newlywed son of a prominent Flagstaff family, had died. His young widow, the former Blanche Mumford of Mesa, also was mourning a sister, who herself had been married only two years. And the young women's mother had just received word that the flu had killed her brother in Colorado.
"Mesa people are stunned at the sad tragedy that has thus fallen upon this home," The Republican reported. "At times death strikes with even more cruel blows than ordinary humanity seems able to endure."
About that time the Influenza Committee in Phoenix set up a telephone hotline for sick people to call for help. The number was 1,477.
All through October and November, the disease ravaged Arizona. Formation of the Phoenix Philharmonic Orchestra was delayed. Auxiliary hospitals in Phoenix and every other sizable Valley town were choked with the sick and dying.
Authorities in Flagstaff declared the disease under control and then promptly reported 54 deaths. A doctor there reported that every pregnant woman afflicted with the flu died. Nineteen died in Globe-Miami in just one day. No one was allowed in or out of Jerome. Superior, Winkelman and Hayden were quarantined.
Flu tore through the Apache Reservation; in fact, Native Americans, without benefit of modern health care or sanitation, died at four times the rate of White Americans. Towns in northern Mexico resorted to digging mass graves.
The Red Cross in Phoenix appealed for volunteer nurses: "Fearless men and women only. Cowards not wanted."
On Nov. 3, a man named Panco Morino was occupying a bed where two patients had previously died in the Phoenix auxiliary hospital. When he saw another man die, Morino, clad only in a nightgown, jumped up and fled despite having a high fever. Guards fired several shots at him and chased him for two blocks before losing him in an alley.
By Nov. 17, the government reported more Americans - at that time, 82,306 - had died of Spanish flu than had died in the just-ended war in Europe. But the nightmare was not over; later that month, Phoenix ordered everyone to wear a gauze mask in public and began arresting violators.
By then, however, the disease appeared to be abating in the Valley, and in December, public gatherings were once again allowed.
That may have been a mistake.
Engelthaler said the flu made a comeback in Phoenix in January 1919. Tucson, he said, avoided a second outbreak, possibly because it was not as hasty as Phoenix in trying restore normalcy to public life.
He said he has no precise numbers on the Spanish flu epidemic in Arizona. There were, Engelthaler said, several thousand cases in Phoenix, out of a population of about 28,000. Extrapolated onto Arizona's current population, he said, that would mean three-quarters to a million cases, which would be staggering. State historian Marshall Trimble has said Phoenix lost perhaps a tenth of its population because of the disease.
Engelthaler said the flu was so deadly that during its height, the average American life expectancy dropped by half. The national toll, which never will be precisely known, has been conservatively estimated at 500,000 - greater by 100,000 than the number of Americans who died in World War II.
Worldwide, estimates vary wildly, from 20 million dead on the conservative side to perhaps 100 million, a disaster unmatched by any other in history.
Which brings us to the question of whether it could happen again.
The spread of bird flu into the human population, with human-to-human transmission, is possible, Engelthaler said.
The good news, he said, is that "a bird-flu mutation would probably make it less virulent," transforming the disease into one more akin to the Hong Kong or Asian flus that periodically circle the globe as opposed to one of the Spanish flu's virulence.
Further, we're getting faster at making new vaccines. Right now, Engelthaler said, it could take six months to create a vaccine for the bird flu. In another five years, we could reduce that time to six weeks.
But six weeks was about all the time the 1918 bug needed to do most of its dirty work, and there would still be the question of how to get billions of doses of vaccine to susceptible populations in remote and poor parts of the world.
"It's a fool's game," Engelthaler said, "to try to predict what would happen."
