By Theodore & Walid Shoebat
During the Spanish flu of 1918, quarantine rules were imposed; businesses, sporting events, religious buildings like churches and synagogues and any place where people gathered together that wasn’t hospital related was shut down. In some places, this lockdown lasted for months. While hundreds of thousands of Americans died — to some extent because there were those who disobeyed quarantine rules — social distancing did work to prevent way more deaths that would have happened otherwise. Like today, churches were ordered to shutdown. In fact, pastors in 1918 demanded that the government shut down the churches for the good of the public’s welfare. In an article published on November 30th by Rocky Mountain News, a publication out of Denver, Colorado, it reads:
“The quarantine regulations were made more stringent. No one but doctors and nurses will be allowed to enter sick rooms, and all houses must be placarded. A committee of ministers appearing for the entire clergy of the city have made representations to the mayor and bureau of health that the contagion is unchecked and that the strictest measures possible are demanded for the sake of public health. The ministers asked that all churches be closed until danger is passed. City officials have not given an answer to the request, but indications are that no further regulations will be imposed.”
Here, the pastors did not say that they were being persecuted, but were willing to keep the churches closed for the good of society.
For another example, on October 15th, 1918, the city of Cleveland’s Department of Public Welfare issued a decree stating:
“1. All places of public congregation including churches, theaters, moving picture houses, dance halls, lodge rooms, assembly rooms, public halls, pool rooms, bowling alleys, cabarets, and all other places used for general meetings whether public or private are hereby closed.
2. Public, parochial, and private schools, including night schools, also public libraries and art museums will close beginning midnight, Tuesday, October 15th 1918.
3. If there is an increase in the number of cases of Spanish Influenza in the city of Cleveland it will be necessary to issue additional restrictions covering all places where persons congregate. In order to avoid necessity for further restrictions to prevent the spread of this disease, it will be imperative for those operating stores, factories, and shops to prevent patrons and employees from loitering or congregating in groups.
4. All public funerals and weddings are prohibited.
5. Under instructions from the State Department of Health, special caution is hereby given to persons operating restaurants, saloons, and cafes that loitering in these places must be strictly prohibited.
6. The crowding of all elevators and all public conveyances must be avoided to the greatest possible degrees. During the prevalence of epidemic influenza all street cars, factories, offices, dining rooms, and rooms or places which must be occupied should be given the greatest amount of ventilation possible.
7. Special permission of the Commissioner of Health must be obtained for all open air meetings.”
From reading these rules, one can see that the current mitigation and quarantine policies that we are going through are not ‘unprecedented’ as we keep hearing, but are actual policies that were imposed when the US was dealing with a dangerous virus over a hundred years ago. When these policies were implemented in 1918 they were, in fact, unpopular. John Grabowski, Case Western Reserve University associate professor of history, editor of the Encyclopedia of Cleveland History and historian at the Western Reserve Historical Society, noted that “They were doing then exactly the same thing we’re doing now … It’s somewhat an eerily similar situation.” Like today, Cleveland’s public health officials in 1918 closed down theaters, dance halls and churches. But, due to people not social distancing, they were still many infections and deaths. In Cleveland, between September and December, 23,600 people got infected and 3,600 people died. In the end, 4,400 people in Cleveland died of the Spanish flu.
Worse than Cleveland was Philadelphia where social distancing measures were not done until two weeks after the first case. Philadelphia allowed public events to go on for those two weeks. The result was that in the last four months of 1918, 13,000 people in Philadelphia died. St. Louis implemented social distancing just two days after its first case and the deaths were a lot less than Philadelphia, having 2,900 deaths.
The initial response to the flu in Cleveland was similar to the general beginning reaction to coronavirus. On September 22, 1918, Cleveland’s Health Commissioner Dr. Harry Rockwood warned Clevelanders of a Spanish flu outbreak. The precautions that he recommended were lax, asking people to simply cover their cough and that sick people stay home. Rockwood was quoted in a news article as pointing out that the Spanish flu was merely a seasonal flu and that it was not a threat.
It was not until October 4th when Rockwood began to take seriously the numbers of those getting infected with influenza across Cleveland and compiled a list of precautions to fight the flu. Those who were infected were isolated in a Ward of the City Hospital. If children showed symptoms they were sent home and employers were urged to permit sick employees to stay home to recover, which was considered an extreme measure given that the US was in the middle of World War One and workers were leaving wartime factories. Today, people are going frantic about how quarantine policy is going to destroy the economy. But, if you open up the factories in the middle of a pandemic, and you have millions of people infected, this will not help the economy either. During the Spanish flu quarantine policy in 1918, people were told not to think that they were helping to serve their country during the war, because if they went to the factories they would only infect more people and thus weaken the workforce. An influenza advisory panel advised against working while ill, stating: “don’t think that by doing so you are helping the country in its war efforts. You may have influenza and spread the disease and thus deprive the nation of many men’s work. It is therefore your patriotic duty to stay at home if you feel indisposed.”
By October 7th it was estimated by officials that Cleveland had 500 cases of flu. The next day, thirty-eight households in the city were quarantined.
Health officials in the city requested saloons and poolrooms to hang up posters with flu precautions that discouraged crowds.Theaters presented public health advisories about how to stop the spread of flu. On October 9th, Rockwood’s concern was expressed when he told reporters, “more radical steps are needed.” The next day, Mayor Harry Davis, in the words of Mary Kilpatrick, “ordered all theaters, movie houses, dance halls, night schools, churches, and Sunday schools to close within days. In short order, so were art museums and libraries, cabarets, poolrooms and bowling alleys. Public funeral and weddings were outlawed.” It was a quarantine, and a massive measure of social distancing.
Schools were allowed to stay open as long as their rate of absent students did not drop below 10% district wide. Children began to ditch school and the schools had to close down. Officials, seeing that youths were simply capitalizing on the situation to skip class, planned to reopen campuses. But, hundreds of students were found to be infected and schools remained closed.
During this time, while all places of worship had to remain closed, some members of the Jewish community began to rebel against the quarantine rule and proceeded with synagogue services. Two Jewish synagogues continued to have services outside of their temples and some were arrested. Today not much has changed. the Orthodox Jewish community in Israel and the US has had many examples of covid-19 infection due to their defiance to quarantine rules. Not much has changed. Just days ago some members of the Orthodox Jewish community in New York City did a funeral procession defying quarantine rule:
Eventually, places of entertainment and churches largely reopened while school closures remained. While some stayed home in fear of infection, Americans by and large left their homes en-masse to enjoy themselves. Chicago was still gradually lifting quarantine restrictions, but metropolitan centers like Kanas City, New Orleans, Cleveland and Seattle saw an inundation of people wanting to enjoy entertainment like boxing matches, theaters and baseball games. The seats were crowded for these spectacles. What made crowds even bigger was the end of the First World War when Americans went to the theaters, the bowling alleys and sporting events to celebrate the end of the war. But, it was not an astute decision to allow such crowding, since there would be eventually a second spike in influenza infection. J. Alexander Navarro, assistant director of the University of Michigan Center for the History of Medicine and the co-editor of the Influenza Encyclopedia, noted:
“The cautionary tale is that these measures have to be kept in place a lot longer than people think. When you think you’re on the other side of that peak, really you’re just still flattening the curve … You haven’t really crested yet. We still have a population that is susceptible until you can get vaccines or until you get enough people who have gotten sick and recovered and have immunity, you still have a population of people who are susceptible to this novel strain.”
What the quarantine rules that were implemented in 1918 teach us is that they worked. According to a 2007 study done by PNAS, “cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates ≈50% lower than those that did not and had less-steep epidemic curves.” Essentially, what these rules did was ‘flatten the curve,’ lowering the rate of infection so as to not overwhelm the medical infrastructure of the country. Philadelphia had a devastatingly hight rate of infection because it did not follow protocol. For example, the city did not cancel a World War One parade on September 28th in which around a quarter of a million people arrived to see the procession and hear the marching bands. Within 72 hours of the parade, all of the beds in Philadelphia’s thirty one hospitals were filled. By October 5th, about 2,600 people in Philadelphia died.
A week later, the number shot up to over 4,500 deaths. Many of the city’s health professionals were serving in the war, and Philadelphia’s medical infrastructure did not have the capacity for such a level of infection and death. On October 3rd, the city’s officials essentially shutdown Philadelphia, forcing almost all public places, including schools, churches, theaters and pool halls, to close down. The death rate was so high that morgues were not able to keep up with the numbers of bodies. It got so bad that families had to bury their dead on their own. The prices of caskets surged.
The phrase “bodies stacked like cordwood” became a common saying. Just as some today have been saying that covid-19 is a Chinese bio-weapon, there were even news reports about how influenza was a biological weapon of the Germans. But the real cause of the problem was the initial carelessness of the city. Philadelphia’s health director, Wilmer Krusen, publicly affirmed that influenza was not a threat, and belittled it as “old-fashioned influenza or grip.” Basically, Krusen was saying that it was ‘just a flu’, which is what many have said and have been saying about covid-19. It was Krusen’s trivializing of the threat that led to the parade being allowed and, in turn, the deaths of thousands.
Krusen belittled the situation knowing fully well that the country’s monthly draft call-up had been cancelled because army camps, such as the nearby Camp Dix in New Jersey and Camp Meade in Maryland, were full of infections from the deadly influenza. Krusen did not want to tell the truth of the virus supposedly in fear that it would cause panic. He was also pressured by corporate interests as he was under extreme pressure to meet bond quotas for the war. As the contagion devastated the city, Krusen tried to implement proper measures, according to Smithsonian Magazine:
“After his initial failure to prevent the epidemic from exploding, Wilmer Krusen had attempted to address the crisis, largely in vain. He asked the U.S. army to stop drafting local doctors, appropriated funds to hire more medical workers, mobilized the sanitation department to clean the city, and perhaps most important, clear bodies from the street. It was too little too late. On a single October day, 759 people died in the city and more than 12,000 Philadelphians would die in a matter of weeks.”
When Philadelphia finally did shutdown, the city’s publication, the Inquirer, complained on March 5th: “The authorities seem to be going daft. What are they trying to do, scare everybody to death?” Sailers in Boston who were infected were sent to the Philadelphia Naval Yard because ‘there was a war to fight’, and within days of their arrival 600 men were in the hospital infected and two of them died. The next day, 14 were infected, and the next day it was 20 infections. Sailers, infected with influenza, were sent to New Orleans, Puget Sound Naval Yard in Washington State, the Great Lakes Training Station near Chicago, and to Quebec. The virus traveled from base to base, from fleet to trains, and the war helped spread the disease that would kill 100 million people.
Howard Markel, director of the University of Michigan’s Center for the History of Medicine, did a study on the role that quarantining had in containing 1918 influenza and showed how when St. Louis loosened up its social distancing measures flu deaths started to rise once again. The study demonstrated how the second spike of deaths only appeared when cities got rid of their social distancing measures. Markel stated: “Among the 43 cities, we found no example of a city that had a second peak of influenza while the first set of nonpharmaceutical interventions were still in effect.” The 2007 study by PNAS concluded that “no city in our analysis experienced a second wave while its main battery of [nonpharmaceutical interventions] was in place. Second waves occurred only after the relaxation of interventions.”
Many Americans complied with social distancing laws for weeks and, in some places in the country, for months. According to Markel, a potential explanation as to why Americans complied easily was because they were used to diseases, and pretty much everyone had a relative, be it parents, aunts and uncles, who died of a disease. People, in the words of Markel, “were all used to living through epidemics all the time. There was a flu epidemic in the 1890s. There was a bad polio epidemic in 1916. There were diphtheria, pertussis (whooping cough), measles, chicken pox, and smallpox epidemics during that period … Contagious diseases and their deadly effects were part of people’s lives. So they understood when the doctor quarantined them what that meant.”
Quarantine works. And no, its not ‘unprecedented,’ but was done before and is part of anti-pandemic policy.