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Spanish Influenza and Its Control - 1918

The epidemic of Spanish influenza continues to be appalling, and communities and states continue to take their isolated measures to control it. Unfortunately, the actual severity of the epidemic cannot be gauged, since this disease has only lately been made reportable in a number of states.

The figures available are certainly bad enough: 100,000 cases reported in Boston; 20,000 cases in Philadelphia; over 8,000 cases already reported in New York city; 15 per cent of the population down with influenza in Oswego, N. Y.; thousands of cases reported daily in Pennsylvania.

In the eastern and southern parts of Connecticut influenza appears to be increasing about 2,000 cases having been reported in New London and vicinity on September 23. According to the latest reports of the United States Public Health Service, complete data on the prevalence of the disease among civilians are impossible, but cases have been reported in California, Colorado, Louisiana, South Carolina, South Dakota, Tennessee, Texas and many other states.

The mortality from influenza and from its frequent complication or sequel, pneumonia, is considerable. Out of 2.073 new cases reported on Sunday, October 6, 185 were cases of pneumonia; 142 deaths from influenza and pneumonia were reported in one day in Manhattan and Brooklyn boroughs in New York City alone.

The methods of control in cities and localities where the epidemic is raging vary greatly. In Philadelphia, courts were adjourned, the sale of liquor for hidden, Liberty Loan meetings abandoned, public assemblies of all kinds stopped, and theater performances and church services held no longer.

In parts of New Jersey the public schools have been closed. Similar action has been taken in Omaha and other western States. In New York city a novel experiment by the Health Department has been to order industrial concerns in certain sections of the city to close their Plants at varying hours from 4 to 6 P. M., so as to allow the working population to leave for their homes gradually without too much overcrowding.

An order has also been issued to the theaters, dividing them into zones—those of one zone beginning and ending performances a half hour earlier than the others so as to avoid the letting out of all theaters at one time.

Department stores have been ordered to close earlier and a strong educational propaganda has been begun to prevent overcrowding and to control the spread of the disease by attention to personal hygiene. The project of closing the schools, with their 800,000-child population, is being seriously debated.

In spite of the severity and extent of the epidemic, many health authorities are still quite optimistic that the disease will soon be controlled, and that no other means are needed than those undertaken by municipalities and states.

Officials holding this opinion contend that the only factor making for the inefficacy of these means is the shortage of physicians and nurses in many localities.

On the other hand, there are many public health administrators who claim that this is a time when it becomes obvious that peace, not less than war, it needs its unified command, and that the difficulty of a local control of the spread and prevalence of the present epidemic distinctly shows the need of a central, unified, federal control of all disease prevention activities in the country.

That this opinion is gaining ground is partly shown by the recent act of Congress, appropriating one million dollars for the control of influenza by the United States Public Health Service, and also by the very comprehensive and far-reaching war program of the public health service, intended especially for extra cantonment areas and war industrial centers, which has been recently announced by Surgeon-General Rupert Blue.

Common Welfare: Spanish Influenza and Its Control," in The Survey: The War Brought Home to New Jersey, New York: Survey Associates, Inc., Vol. 41, No. 2, 12 October 1918, p.44.

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