100 years ago, another epidemic terrorized the city

Boston’s reaction to a dangerous virus hasn’t changed much in a century: A narrative of the Spanish flu in the city where it began.

Red Cross workers removing bundles of masks for American soldiers from table where other women are busily engaged in making them, Boston, Massachusetts, 1918. (Photo by PhotoQuest/Getty Images)PhotoQuest/Getty Images

As August 1918 wound to a close in Boston and summer’s dog days gave way to fall, the city was awash in optimism.

The Allies’ great offensive to end the horrific war in Europe was succeeding, meaning the young sons and husbands who’d been fighting overseas might soon be returning home. The Red Sox, led by burly slugger Babe Ruth, would soon be playing for their fifth World Series title. And a new school year was rounding finely into form.

It was “old-time America at its nostalgic best,” says Howard Markel, director of the Center for the History of Medicine at the University of Michigan. “All wonderful, good stuff.”

So when, in late August, a handful of sailors stationed at Commonwealth Pier in what is now the South Boston Seaport fell terribly ill, no one in the city paid much mind.

Beyond the pier, in fact, no one really noticed at all.

Quietly, a few sailors became two dozen. Soon there were scores of sick men at naval installations around the city.

And then, in the span of a few weeks, thousands all over Boston and beyond were infected, with more falling ill each day. Public gatherings were shut down, hospitals overwhelmed. Daily death tolls soared above 100. And even as authorities argued over the seriousness of the outbreak and how to contend with it, the sickness known as Spanish flu turned into a virulent and terrifying wave that would sweep from Boston across the country and ultimately kill millions around the world, casting a shadow of fear that would span a generation.

As the outbreak of the novel coronavirus now unfolds in Boston, sparked by an international business meeting at a waterfront hotel not far from where the first sailors fell ill a century ago, the contours of the Spanish flu outbreak in this city are eerily familiar. The particulars of the two illnesses are different — so far, at least, the 1918 pandemic appears far more lethal — and 102 years of medical advances have improved treatment dramatically. But the public reaction seems barely to have changed.

In both cases, national and local leaders initially diminished the seriousness of the viruses. In both cases, initial attempts to limit the seemingly instantaneous spread proved wildly unsuccessful.

And in both cases, the city was paralyzed with a sudden sense of fear and uncertainty.

In those final, blissful days of August 1918, however, no one yet saw what was coming.

* * *

“The malady appears to be in the nature of old-fashioned grippe. No deaths have occurred. The naval medical authorities who have the matter in charge are doing everything humanely possible to control the outbreak.” — Dr. John S. Hitchcock, head of the Massachusetts Department of Health’s division of communicable diseases, Sept. 5, 1918

“The risk of COVID-19 remains low in Massachusetts. Our health care workers, institutions, and public health partners across the Commonwealth are constantly training for the possible emergency of diseases. Massachusetts is prepared for this potential outbreak.” — Public Health Commissioner Monica Bharel, Feb. 26, 2020

* * *

The new flu arrived quickly at Camp Devens in Ayer that August, which should have been no surprise.

Devens was a bustling barracks of some 45,000 soldiers, many waiting to be shipped overseas. Overcrowded military bases, with units constantly coming and going, had long aided in the spread of illness. Just a few months earlier, the US military had faced a wave of influenza that struck a base in Kansas, now believed to be an early incarnation of the Spanish flu — so-called because of an assumption, at the time, of its country of origin. It had spread rapidly but was mild, resulting in relatively few deaths before petering out.

There would be nothing mild about this second wave as it hit Camp Devens.

A slow trickle of patients started in late August. Within days it became an unimaginable crush, with as many as 1,543 soldiers reporting ill with influenza in a single day, according to the book “The Great Influenza: The Epic Story of the Deadliest Plague in History" by John M. Barry.

In a letter to his family in early September, George Angell, a young soldier from Vermont stationed at Camp Devens, painted a dire picture.

“I was taken sick last Friday with this new sickness that’s having a rage everywhere,” he wrote. “There are 3,000 of the soldiers sick here, 12 have died.”

“And if one is really sick," he continued, "I don’t see how they ever get well.”

The first confirmed civilian case in the United States was reported in Boston in the first week of September, and new cases quickly began appearing in nearby towns, as well as other military installations around the country and abroad.

Even as the flu rapidly spread, it got little attention. Boston’s newspaper headlines through the first two weeks of September were dominated by news about the war and the ongoing World Series. It wasn’t until Sept. 15, roughly three weeks after the first soldiers reported ill, that the influenza epidemic reached the front page of The Boston Post.

“Spanish Grip Claims Nine,” read the headline of the small story.

Still, residents had slowly began to take note.

The local electrical workers’ union canceled forthcoming meetings, citing a dozen or so members who’d contracted the virus. In Milford, a grade school was closed out of caution, despite no serious cases of the flu. At Simmons College, students were instructed to exercise outside rather than indoors, and to avoid public transportation.

And fear of gathering in large crowds was clearly beginning to spread.

On the night of Sept. 11, 1918, the Red Sox took on the Chicago Cubs in Game 6 of the 1918 World Series. The game was held at Fenway Park, where Games 4 and 5 drew 22,183 and 24,694 fans, respectively.

The total attendance for Game 6, in which Boston would prevail to win the franchise’s fifth World Series title?

Just 15,238.

* * *

“Avoidance of crowded cars, elevators, or buildings is recommended. Common drinking cups or towels should be taboo. Care should be taken against spreading of the disease through sneezing or coughing by infected persons: the handkerchief should be used in these emergencies.” — The Boston Globe, Sept. 11, 1918

“I encourage everyone to follow steps to prevent the spread of infection. Wash your hands often with soap and water for at least 20 seconds, stay home if you’re feeling sick, and cough or sneeze into a tissue or your elbow.” — Boston Mayor Marty Walsh, Twitter, March 9, 2020

* * *

Any hopes that the flu might pass quickly had been extinguished by mid-September.

Though some communities had remained relatively unscathed — Marlborough, which was surrounded by a number of towns greatly affected by the flu, saw very few cases — such places were increasingly rare.

Cases from around the state piled up: 1,500 in Brockton, 1,000 in Salem. More were being reported each day.

“You didn’t need the newspaper to tell you that your grandmother had pneumonia — you could walk next door and see it,” says Markel. “The case tally was so high that it really, really panicked and frightened people to the core."

The flu ripped through workplaces, particularly large businesses. At one point, the New England Telephone and Telegraph Company reported that 800 of its 4,000 employees were out sick, nearly all with the flu. Many businesses locked their doors, either out of precaution or, later, mandate — as daily life in Boston took on a suddenly grim feel.

“Most depressing day after bad news from Eugene," wrote Edith Coffin (Colby) Mahoney, a mother of two from Salem, in a journal entry dated Sept. 26. “He died at 6:40am. Several thousand cases in the city.”

Wrote Barbara Hillard Smith of Newton, in her own journal: "In bed. Felt rotten. School closed till Monday.”

Almost from the start, hospitals struggled to keep up.

Though Boston would ordinarily have been comparatively well-positioned to handle an outbreak — then, as now, it was a national leader in the medical world — the city’s medical personnel had been depleted due to the war efforts.

When the Red Cross announced it would be making free gauze masks available to those caring for the sick, hundreds of people lined up at locations across the city to get them. Advertisements for so-called influenza remedies soon began appearing. (“If you find yourself tired or weak as a result of the epidemic,” read one ad for an elixir that appeared in The Boston Post, “the commonsense preventative is to begin taking Father John’s Medicine at once.”)

No drugstore remedy, however, was going to stop an outbreak that, by now, had left the state’s top medical officials aghast.

“Previous theories with respect to the nature of the disease were soon found to be practically valueless,” Eugene Kelley, commissioner of the Massachusetts Department of Health, would write a few months later, in the department’s bimonthly bulletin.

And it would only grow worse.

By Sept. 18, even as some officials continued to downplay the seriousness of the epidemic, death tallies were becoming a daily occurrence in the pages of the Globe.

* * *

“The Converse Rubber Shoe Company closed down on all except government work yesterday until next Monday.” — The Boston Post, Sept. 27, 1918

“Takeda Pharmaceutical Co. urged its 50,000 global employees on Sunday, including the roughly 5,000 in Massachusetts who make up the largest head count of any drugmaker in the state, to work from home if possible until further notice to avoid spreading the new coronavirus.” — The Boston Globe, March 8, 2020

* * *

Entering the final week of September, public officials began taking steps to effectively close down the city.

On Sept. 26, almost a month to the day after the first case surfaced, Boston’s newly appointed health commissioner, William Woodward, a Georgetown-educated physician who’d been instrumental in the fight against typhoid fever a decade earlier, imposed a so-called “gathering ban," closing down all theaters, soda shops, and saloons until the epidemic could be controlled. Many schools had already been shuttered, and most churches, if they hadn’t already, soon followed suit.

By that point, the situation had grown so dire that local officials discussed — and later implemented — a restriction on visitors at the funerals of those who’d died of Spanish flu.

Meanwhile, city and state officials were offering near-daily appeals for anyone able to aid the sick.

Many answered the call. A Worcester doctor named Peter Shea gave up his private practice to help those afflicted. Malden’s mayor, who was also a physician, made arrangements to hand off governmental duties to his staff so he could tend to the crisis.

Soon, the reinforcements, too, were falling ill.

In Canton, the town’s only two physicians both contracted the flu. In Boston, 80 nurses and five attendants were ill at one point. At Camp Devens, where the outbreak was still roiling, 12 nurses arrived from the Red Cross, Barry wrote. Eight of the 12 quickly caught the flu. Two died.

Some hospitals, filled far beyond capacity, simply declined to take any new patients, no matter how sick they were; in the absence of sufficient medical care, sick residents were being left to care for themselves, with sometimes tragic consequences.

Late in September, a man named Irving Tuttle of Lexington decided he could no longer take it.

“He had been confined with illness for some time,” read a small story on his suicide that appeared in the Post, “and it is believed his sickness deranged his mind.”

In a desperate attempt to supplement the medical personnel increasingly taking ill, Judge Michael J. Sullivan, one of five people appointed to a city effort to deal with the epidemic, suggested having Boston schools’ 3,000 teachers serve as volunteer nurses to help with treatment.

Eventually, thousands of teachers and nursing students would be brought in to help care for patients, many bused in from across the country.

Pleas for help grew increasingly urgent.

In Washington, D.C., Senator John Weeks of Massachusetts asked Congress for $1,000,000 to help stop the flu’s spread. “Tens of thousands of people in New England are affected, with hospitals full to overrunning, no nurses available, and doctors worked as near 24 hours a day as is humanly possible,” Weeks pleaded.

The funds were awarded the following day.

And still, the death count continued to rise.

On Sept. 25, the Boston Health Department reported 105 deaths.

On Sept. 28, there were 152.

On Sept. 30, 171.

By the time September wound to a merciful close, the virus had proven so deadly, taking 700 lives in the final week of the month alone, that it was being discussed much in the same way as an enemy army.

Wrote the Globe, “Day by day, the doctors, nurses and bacteriologists have been feeling out the enemy’s weak points, tirelessly searching for the point in his line where science can break through."

* * *

“Governor McCall decided to abandon his contemplated trip to Halifax, N.S. Accordingly, he returned to his home in Winchester yesterday and will remain in close touch with the influenza situation until the epidemic is checked.” — The Boston Post, Sept. 30, 1918

“Massachusetts Governor Charlie Baker cut short his family’s Utah ski vacation and flew home Monday night as the fallout from coronavirus deepened, raising questions about Baker’s handling of what has become a global crisis.” — The Boston Globe, March 9, 2020

* * *

The end came gradually.

In the first two weeks of October, there would be daily death totals of 202, 191, and 183.

But by mid-way through the month, for reasons not entirely clear, the numbers suddenly began to drop.

On October 15, there were 98 reported deaths; the next day, 71; a day after that, 53.

Slowly, the fear that had gripped the city began to subside.

For weeks, residents had been relegated to their homes, watching helplessly as the flu ravaged their communities — striking friends and neighbors, draining hope, and, for many, life from family members.

So on Oct. 21, when the city announced it would officially emerge from its self-quarantine with the reopening of saloons, soda shops, and schools, residents could barely contain their glee.

The news in that day’s Globe trumpeted the city’s grand reopening.

“It is anticipated that today and tonight will be just like a happy holiday in Boston,” the story said, “with great crowds of residents and visitors abroad.”

The excitement would prove premature; a few weeks later, a jubilant gathering of thousands celebrating the end of the war would spark another round of illness. Hundreds more would die, pushing the toll in Boston to more than 6,000 by midway through the next year, and some 675,000 nationwide. Across the world, an estimated 50 to 100 million people would die from the Spanish flu or resulting pneumonia.

But on this night, at least, hope had the upper hand.

“A mighty effort will be made everywhere and by everybody today," the Globe story continued, "to lift and set aside the sadness which the epidemic brought to Boston.”