Bad Days in American History: October 31, 1918

Some things are hard to date. Disease epidemics are one of them. Ultimately, in discussing them, you are often placing an arbitrary date upon a long-term epidemic. You don't usually know when it starts so you are kind of winging it.

That's what we are going to do today. By Halloween of 1918, death was not just something to mock and imitate. The nation was in a full bore epidemic of influenza. The dreaded Spanish flu had reached the United States in full force.

That year, an extra strong strain of flu was circling the globe. It's believed it started in China, but that is very difficult to pin down. In an era before rapid transportation (something that would contribute mightily to the rapid spread of AIDS), perhaps this plague might have remained in Europe and Asia. But this same year also saw the end of World War I. Soldiers were living in trenches in France, often in damp, horrid conditions. They caught this flu while fighting against the Germans. Ships were crossing the Atlantic almost daily, so long as they avoided German submarines. The flu quickly spread to the United States.

Today, we fear disease epidemics, but we don't really know what they are like. Swine flu (which I will perennially call it after that Israeli minister protested that this was offensive to his people, something that is so ridiculous as to be mocked for eternity) has the potential to reach epidemic proportions, but a true epidemic is a mass killer. This flu is an unusual killer only in the 24 hour news cycle. Pre-World War II America saw real epidemics--yellow fever, smallpox, influenza, cholera--and we have nothing to compare it to today except for AIDS, and that really only for those of us who remember the 1980s. Modern medicine is so far advanced that we can contain most potential epidemics; even HIV is not quite preventable, and we also developed high-quality medications to give those who contract it a fighting chance to live a long life.

The 1918 flu epidemic changed the world. An estimated 675,000 Americans died of the disease. Life expectancy in this country dropped by 10 years. The death rate from flu for those aged 15-34 rose by 20 times in one year. The war experience made everything worse--we already found our physicians and hospital facilities seriously overtaxed dealing with the thousands coming home with mustard gas lung burns and other war wounds. And we simply did not have the medical facilities we do today. People died all the time in 1918 of preventable illnesses anyway; to add a worldwide epidemic on top of it was a recipe for disaster. 1/4 of Americans and 1/5 of the world's population came down with the flu that year, including President Woodrow Wilson while he was in France trying to dictate to everyone what the post-war world should look like, selling out colonized peoples, and the like.

The lesson from the 1918 flu epidemic is that preventive medicine and technology can do a lot to help us. But it can't do anything. The technologies we have used to fight illness have had unintended consequences, particularly the development of drug-resistant super strains of illness. Eventually, we will deal with a real epidemic again. To our credit, I think we know this, thus the real worries every time we see a West Nile or SARS or swine flu. Less to our credit is the panic that results with each of these. It'd be nice to see rational policy-based responses to these problems and I think the government has generally done a good job handling these situations (with Reagan's handling of AIDS being a huge exception and arguably the worst thing he ever did, though union members and Central Americans would have something to say about that). But the 24 hour news cycle has acted with tremendous irresponsibility in covering these issues, whipping up a foaming panic with each death and creating a feeding frenzy of fear.

A lot of the details in this post came from this Stanford based website, which also has a lot of great links that you can check out if you want to read more.