Worried About a Pandemic? Consider the Spanish Influenza of 1918-1919

Lessons Learned

Society Ladies serving Tea
Figure 1: Even society women, like those pictured above, volunteered to nurse victims of the Spanish Flu epidemic. These women are preparing the table at the Emergency Hospital and Girls Club in Philadelphia. (National Archives, 32-M-F-6-220)

In reviewing what worked during the pandemic, many present-day health authorities point the importance of city authorities quickly instituting “social distancing.” Those municipal health authorities that acted early and instituted quarantines, public closings and banned public gatherings had lower infection and death rates. In addition, good nursing was held to be the main factor in determining whether a patient would survive the disease. When faced with a disease that the medical world had no drug or vaccine to fight it, the importance of having nurses to keep the patient fed and comfortable became paramount to survival.[1] It is interesting that a pandemic that killed so many people was quickly forgotten by those who lived through it. Some historians believe that is because it didn’t kill a major world leader or a famous individual. Woodrow Wilson came down with the virus at the Paris Peace Conference, but survived. Perhaps if he had died from the illness, the pandemic would have figured more heavily in history books.

Red Cross equipment
Figure 2: The Middlesex Chapter of the Red Cross inspects equipment that is to be sent to Wesleyan University at the beginning of the epidemic. Middletown, Connecticut. (National Archives, 165-WW-269165-WW-269 B-57)

Another theory why many forgot the Spanish Influenza so quickly is that people died of many epidemics during the 19th and early 20th century. In addition, most victims of epidemics died at home, not in hospitals so it was not as unusual to see family members die of disease in 1918 as it would seem today. Finally, many saw the Spanish Influenza as one more byproduct of a senseless war that had killed a whole generation of young men. It was the war that loomed large in people’s memories, not a disease that seemed to accompany it. Interest in the Spanish Influenza of 1918 only spiked again during the H5N1 virus outbreak. Suddenly many health organizations were studying the epidemic to determine what lessons might be learned to help in the eventuality of another flu virus pandemic. Officials noted that government health organizations are far more organized to fight pandemics today. Vaccines and antivirals help diminish the onslaught of secondary bacterial infections, such as pneumonia. A better educated public exists today and knows how to institute “social distancing.”

Red Cross fundraising quilt
Figure 3: When southern Ohio closed businesses, schools and public meetings they also put a stop to the Red Cross work meetings for 5 weeks. Many Red Cross workers kept busy at home creating quilt squares that were assembled into quilts for the soldiers. The swastika on the quilt in the lower left-hand corner was still just a decorative element in 1918 and would not be adopted by the German Nazi Party until 1920. (National Archives, 165-WW-269-B-56)

One factor that was discussed during a workshop on the 1918 Pandemic was the fact that health authorities were not always completely honest with the public. In 1918 health officials and newspaper editors downplayed the actual threat to the public’s health in an effort to stave off panic. Certainly all would agree that it is important that Government Health officials and the media should report the truth to the public, but after watching modern media outlets become almost hysterical over each new epidemic, perhaps they could borrow a warning from the 1918 Dallas Morning News, that “being scared is, itself, a disease.”[2]


All photographs are from the Still Picture Reference, Special Media Archives Services Division, National Archives at College Park and are part of the Photo Set: Spanish Flu Epidemic, 1918. Author has restored and enhanced images.

1. Laden, Lisa. "We Heard the Bells: The Influenza of 1918." Flu.Gov. December 4, 2009. http://www.flu.gov/pandemic/history/weheardthebells/script_120709.html (accessed September 24, 2014).
2.Morrisey, Influenza Epidemic, 1-2; Hatchett, “Effects on Infrastructure,” 11-15; Barry, “Effects on Society,” 5-11; "Toxic Traces: What Made the 1918 Influenza Virus So Deadly?" National Institute of Allergy and Infectious Diseases. August 12, 2010. http://www.niaid.nih.gov/topics/Flu/Research/Pandemic/Pages/ToxicTraces.aspx (accessed September 24, 2014); "The Effects on the Individual and the Family." Pandemic Influenza Past, Present, Future. Washington, D.C.: Department of Health and Human Services Center for Disease Control and Prevention, 2006. 16-22; Dallas Morning News, "Being Scared is Not a Precaution," 8.