National Review

Medical holocaust 

The deadly 1918 pandemic and its enduring effects 100 years on

With the widespread rollout of a COVID-19 vaccine in The Bahamas and in other nations across the globe still uncertain, and the vaccines guaranteeing no eradication of the infectious coronavirus, our new way of life is likely to persist for some time to come.

Our nation, and indeed the world, have been in this position before, though no one in or lifetime — except those centenarians still with us — was around to experience the much deadlier 1918 flu pandemic, or Spanish Flu, which claimed the lives of millions of people around the world.

Going back in time is often an intriguing undertaking.

The pages of The Nassau Guardian 100 years ago reveal a colony struggling with underdevelopment, scarce financial and other resources, and a pandemic that was lingering more than two years after it begun.

On February 4, 1920, this newspaper observed, “Few households have escaped the sudden onslaught of the influenza germ that is rampant in and about Nassau, and in many cases, whole families have been rendered hors de combat (essentially out of commission).”

The Guardian continued, “Fortunately for us, our climate conditions are such that there is a limit to its aggressiveness and we have to be thankful that so far there are here no known fatalities, such as are occurring in large numbers throughout the States.”

Two weeks later on February 18, this newspaper, which at the time published every Wednesday and Saturday, provided an extensive report on the pandemic:

“The recent epidemic of influenza, which has spread like a wave over the United Sates and Canada and has recently been so prevalent in this island has drawn attention afresh to the origin of this latter-day scourge, which carries death in its tracks and dislocates so completely the machinery of business and, in fact, every phase of life.”

The Guardian extensively reported on a supplement to the Annual Report of the Local Government Board of Great Britain for 1918-19, which was newly issued, and which contained “by far the most comprehensive account of the last great influenza epidemic that has yet appeared and throws some light on the origin of this mysterious disease, which has claimed its victims by the hundred thousand”.

The Guardian noted at the time: “The report suggests that the name ‘Spanish Influenza’, which was originally bestowed upon it, is not correct, as while it was not reported from Spain until May 1918, it was widely prevalent in epidemic form in China and Japan in March of that year.

“During the few preceding years, sporadic outbursts had occurred in America, which attracted more than casual attention, and in the late winter and early spring of 1918, some of the military camps in the States suffered severely from the scourge.

“On the whole, the writer of the report inclines to the view that it originated in China, traveled to the States over the Pacific and thence reached Europe.

“England experienced its ravages as early as 1918 as did Spain, as in April, a large percentage of the crews of the Grand Fleet at Scapa Flow and Rosyth were down with the ‘flu’.

“The army in France suffered severely, and in about a fortnight, over 36,000 cases were admitted to casualty clearing stations, besides thousands of others of a slighter kind.

“Glasgow seems to have been the scene of the first outbreak among the civil population, and by July, the first wave reached its height. This was followed by the terribly severe epidemic of the autumn of 1918, which afflicted practically the whole world and claimed more victims than did the Great War then raging.

“A curious feature of the disease seems to have been that ports and seaside towns suffered less severely than inland cities, possibly owing to the better air by the sea.

“The highest death rate in the States occurred in Philadelphia, where it was considerably more than twice that of London, Boston and San Francisco coming next in the order of severity.

“The number of weeks intervening between the summer and autumn epidemics in varying localities average about 15, and this seems to agree with the periodicity of former outbreaks.

“During the summer wave, persons between the ages of 15 and 45 were most affected, but during the severe winter epidemic, there was evident a shifting towards the extremes of age, particularly towards youth.

“The susceptibility of young children was especially noticeable, the chances of recovering being less than in other age groups.

“Although it would appear now that we may expect an annual visitation of this terrible destructive agency, it is becoming recognized that one attack by no means confers immunity from others.

“In fact, it is suggested that there are several ‘strains’ of the influenza virus, which vary materially in virulence and potency. Each succeeding wave of influenza epidemic seems to have possessed a peculiar dominant ‘strain’ of its own, so marked as to produce a certain wave individually, more strongly marked in some localities than others.

“There seems to be some reason for hoping that succeeding waves are less severe than the first, a conclusion endorsed by local experience in the present epidemic as compared with that of last summer; but so far there has been discovered neither any certain preventative nor any absolute cure, and epidemics take their usual course, inflicting suffering and sorrow until each succeeding wave has spent itself.”

Impact

It is estimated that about 500 million people or one-third of the world’s population became infected with the virus, according to the US Centers for Disease Control and Prevention (CDC). The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. Mortality was high in people younger than five years old, 20-40 years old, and 65 years and older.

The CDC notes, “With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.”

In a column on October 19, 2005, well-known Bahamian columnist the late Larry Smith noted that little information was available on the impact the 1918 flu had on The Bahamas or the region, but estimates put the death toll throughout the Caribbean at about 100,000 between October 1918 and March 1919, with nearly 30,000 deaths in British territories.

Jamaica, Belize and Guyana suffered most, with heavy mortality among the poor. No flu deaths were officially reported here, but researchers say 60 people may have died. The total Bahamian population at the time was only 53,000, Smith noted.

The Nassau Guardian reported on February 4, 1920 that then-governor, Sir William Lamond Allardyce, fell ill to influenza:

“The 1920 session of The Bahamas Legislature was opened yesterday by the Hon. F. C. Wells Durrant, attorney general of the colony. It became generally known on Monday that His Excellency the Governor had fallen a temporary victim to the prevailing epidemic of influenza — which is fortunately, according to the doctors, of a milder form than that last experienced — and acting on medical advice, the governor has wisely decided on a rest and has taken a few days’ sick leave,” the paper noted.

“As senior member of the Executive Council, the duty of administering then devolved upon Mr. Wells Durrant, and it was in the capacity of His Excellency the Administrator that he opened the session yesterday and read the speech, which the governor had prepared for the occasion.

“We feel sure that the members of the legislature and the community generally are thoroughly in accord with the regret for the governor’s indisposition, which the administrator gracefully expressed, that they unite in the hope that his recovery will be speedy and complete and that he will soon be enabled to resume the duties of his office.”

In that speech, read on the governor’s behalf, the governor announced that among the bills to be presented to the legislature would be a Bill to Amend the Health Act.

Days later, on February 11, 1920, The Guardian reported the governor’s recovery: “We are glad to learn that His Excellency the Governor is recovering from his attack of influenza. We hope that his improvement will continue so that he will be up and about in a short time.”

On March 3, The Guardian reported the Board of Health by virtue of and under the authority of the Quarantine Act, 1905, ordered the health officers of the several ports of the colony to visit all ships arriving from foreign ports before they are admitted to pratique. The order continued in force for a period of two months from February 21, 1920.

The Guardian also reported similar notices relating to other jurisdictions.

It advised in its March 3 publication: “After February 24, 1920, the new quarantine regulations as promulgated in the Moniteur of December 17, 1919, will be in full force. A quarantine anchorage has been established in the harbor of Port-au-Prince and is marked by a yellow buoy, at which place all incoming ships subject to quarantine must stop. The buoy is located 500 yards north of the range, in 60 feet of water…” 

Months later, on October 2, the pandemic’s third year, The Nassau Guardian carried a telegraph from The New York Times, stating the world saw Great Britain organized for war in 1918, “now little by little the nation is being organized for purpose of national health.” 

“While seeking to avoid the dislocation of commerce, which is apt to result from quarantine, efforts are [being made] to increase international understanding with a view to improving the health of the world. None can forget that 6,000,000 lives were lost in India from the plague in the first 10 years of this century, and that nearly 6,000,000 died from influenza in India in 1918,” the article stated. 

BBC noted in an article on March 2, 2020, titled “Coronavirus: What can we learn from the Spanish Flu?” that the flu spurred the development of public health systems across the developed world, as scientists and governments realized pandemics would spread more quickly.

“The Spanish Flu broke out in a world, which had just come out of a global war, with vital public resources diverted to military efforts,” the BBC said. “The idea of a public health system was in its infancy – in many places, only the middle class or the rich could afford to visit a doctor. The flu killed many in slums and other poor, urban areas, among populations with poor nutrition and sanitation, and often those with underlying health conditions.”

On August 11, 1920, The Nassau Guardian reported the establishment of an International Health Office after a war on disease was declared. 

An agency formed “to bring administrative health authorities in different countries into closer relationship with each other; to organize means of more rapid interchange of information on matters where immediate precaution against disease may be required (e.g. epidemics) and to simplify methods for acting rapidly on such information where it affects more than one country”. 

The goal was also to “provide a ready organization for securing or revising necessary international agreements for administrative action in matters of health, and more particularly, for examining those subjects which it is proposed to bring before the executive and general committees with a view to the conclusion of international conventions….” 

The concern was beyond just the Spanish Flu.

On June 26, 1920, The Nassau Guardian reported that cases of Bubonic Plague — the disease that caused the “Black Death” in the mid-1300s — had been reported at Pensacola “which is about as near to The Bahamas as the plague has appeared”.

This newspaper advised, “Every precaution is being taken by the health authorities in Florida and even in Miami, we note that rat poison is being freely distributed. We suggest an anti-rat campaign should be instituted in The Bahamas at once. It is time that more vigorous measures should be taken in the interests of the public health for the destruction of rats and also of flies, which are disease carriers whose presence we see encouraged on every hand in this city.

“The reputation of this island as a health resort is at stake. Let our people begin reform in their own homes by waging war on rats, cockroaches and flies.” 

Enduring effects

The CDC noted that since 1918, the world experienced pandemics in 1957, 1968, and in 2009. These subsequent pandemics were less severe and caused considerably lower mortality rates than the 1918 pandemic.

“When considering the potential for a modern era high severity pandemic, it is important, however, to reflect on the considerable medical, scientific and societal advancements that have occurred since 1918, while recognizing that there are a number of ways that global preparations for the next pandemic still warrant improvement,” the CDC said in an article that preceded the COVID-19 pandemic.

In its piece nearly a year ago on the Spanish Flu and lessons for the COVID-19 pandemic response, BBC observed: “The public health measures we see being enacted today across the world as efforts to contain the spread of coronavirus are one of the Spanish Flu’s most enduring effects.”

An October 18, 1918 ad in the Illustrated Current News in New Haven, CT, advised readers: Do not take any person’s breath. Keep the mouth and teeth clean. Avoid those that cough and sneeze. Don’t visit poorly ventilated places. Keep warm, get fresh air and sunshine. Don’t use common drinking cups, towels, etc. Cover your mouth when you cough and sneeze. Avoid worry, fear and fatigue. Stay at home if you have a cold. Walk to your work or office. In sick rooms, wear a gauze mask like in illustration. 

To date, COVID-19 has claimed the lives of more than two million people worldwide; 175 of those deaths have been reported in The Bahamas.

Globally, 100 million cases have been confirmed.

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Candia Dames

Candia Dames is the executive editor of The Nassau Guardian.

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