Washington D.C. and the influenza outbreak of 1918

Abstract

Kenneth Crotty, who was only eleven years old at the time of the influenza pandemic of 1918, recalled the terror and uncertainty that had spread across the country as a result of what at the time was known as the “Spanish flu.” Crotty, like millions of others across the world, experienced the effects of the flu firsthand: he was the church’s altar boy for over thirty masses for those who had died from the disease. Recalling those funerals, Crotty stated: “They’d have those monstrous big candles on the first six aisles+and I remember the heartbreak I felt when I saw that person lugged down the center aisle, down the steps, [and] packed into a small truck.” Crotty also had personal connections to the flu; both of his sisters became ill and were separated from him in an attempt to contain the illness.2 Crotty’s experience was not uncommon during the late Summer and Fall of 1918, as 500 million people, or onethird of the world’s population, became infected with influenza in what would become known as the most severe flu pandemic in modern history. In the United States, the flu first presented in military camps and then spread to almost every city in the country. One of these was the nation’s capital, Washington, D.C.3 The first death in Washington, D.C., was reported to be that of a thirty-year-old man named John Clore who died on September 21, 1918, at Sibley Hospital. More deaths were reported daily and by October 5, the average number of deaths was hovering around thirty each day.4 As the political and military center of the United States, the nation’s capital should have been prepared to contain the spread of a pandemic such as this one, at least in theory. After all, in addition to government officials, many of the country’s most talented military and civilian medical experts had offices there. The city was also home to the national headquarters of the American Red Cross—a place where public health officials, physicians, and nurses gathered to address issues related to the health needs of a nation at war. Indeed, the well-being of the entire country rested on the shoulders of those in the capital. But the situation was complicated, particularly because of the war in Europe. In 1918, Washington, D.C., was teaming with military personnel, clerical workers, and all manner of federal support staff. Boarding houses, offices, and hotels were overcrowded. Additionally, many of the workers were young and had little immunity to any flu virus; however, their robust immune systems, when activated, reacted violently to the disease when it attacked.5 Meanwhile, many physicians and nurses had volunteered to serve their country in the war, depleting the city of medical and nursing personnel. When the pandemic reached Washington in the late summer of 1918, health officials simply could not keep up with the rate at which the virus spread. The combination of the aggressive nature of the disease along with little knowledge about its etiology and treatment further added to the gravity of the situation. Finally, with the entire country affected by the flu, government officials were simply overwhelmed.6 Trying to address the outbreak at the national as well as the local level proved difficult; too much chaos existed to make effective decisions for both. In the end, Washington, D.C., was considered a “harvest field” for the flu.7 Over 33,000 of the city’s citizens fell ill; nearly 3,000 died.8 Aware that the flu had devastated military camps in Boston, Washington’s Health Officer, William C. Fowler, and US Surgeon General, Rupert Blue, were alert to the possibility of an outbreak in Washington, D.C. However,