A look back at the Spanish Flu Epidemic.
On December 21, 1918, the Ohio State Journal published a warning about the lingering flu pandemic from the state’s acting health commissioner: “Beware the mistletoe.” Not only should readers resist the temptation of a holiday kiss, but they shouldn’t even be at a social gathering where it might come up.
“You will show your love for dad and mother, brother, sister and the rest of ‘em best this year by sticking to your own home instead of paying annual Christmas visits, holding family reunions, and parties generally,” the commissioner said.
Christmas 1918 was not Christmas 2020. The pandemic had already peaked in the U.S. in the fall of 1918 as part of the disease’s second wave. Meanwhile, this week the deaths attributed to Covid-19 in the U.S. are the highest they’ve ever been, showing no signs of waning as the holiday approaches. But the flu also killed far more people (675,000) than Covid-19 has to date, in a country that was much smaller, population-wise, at the time. And it wasn’t over by any means. In some cities, a third wave was already starting as Christmas approached, says Kenneth C. Davis, author of More Deadly than War, a history of the pandemic and World War I aimed at young readers.
“There was an uptick, and it was a serious uptick in some,” he says.
A century ago, the federal government held much less authority and power than it does today; the CDC, for instance, wouldn’t get its start until 1946. Decisions about how seriously to take the disease fell to states and, especially, municipalities.
Davis says San Francisco took it quite seriously, implementing a strong mask mandate in the fall as well as measures that’d be described today as social distancing. After cases rose sharply in mid-October, the city locked down harshly; the measures worked to keep the flu at bay and, a month later, the city reopened and dropped the mask mandate. But the flu was not done with the city yet. Come Christmastime, Davis says, the cases were again on the rise, and residents, having finally escaped from the pandemic shutdown, were not eager to go back.
“San Francisco wanted to institute the mask rule again but people resisted,” he says.
Davis said some anti-maskers of the day felt their rights were infringed on. Some Christian Scientists cited religious objections. And other people simply found masks too much trouble. It didn’t help that masks at the time were generally homemade, using several layers of cheesecloth and were supposed to be boiled for ten minutes every day to keep them clean.
While it’s hard to tease out whether Christmas gatherings or shopping contributed, influenza case numbers did indeed rise again in San Francisco in early January.
Lendol Calder, a historian at Augustana College in Illinois and author of Financing the American Dream: A Cultural History of Consumer Credit, says it wasn’t just the debate over masks that seems familiar today. In some places, residents complained that officials shut down churches but left saloons open. The closing of churches was a major issue in Milwaukee, a city that took the pandemic especially seriously—and that was also home to deeply observant German and Norwegian immigrant communities.
“To have churches closed during the Advent-Christmas season was huge,” Calder says. “That was people’s social media, to go to church.”
But, Calder adds, even Milwaukee allowed churches to hold services on Christmas Day.
Of course, Christmas is also a shopping season, and that was already true in 1918. The Macy’s Thanksgiving Day Parade wouldn’t start until 1924, and Black Friday mania was decades away, but retailers were beginning to realize that the holiday shopping season could make or break their year.
“They pushed hard in November and December with advertising to get people to come shop,” Calder says. He says retailers were concerned about potential supply chain issues and urged shoppers to come in early in case items ran out. They also made sure to let potential customers know that they could deliver goods to those who were afraid to go out in public.
Davis says store-owners’ desire for a strong Christmas season also figured in anti-mask sentiment.
“They don’t want people to wear masks in the stores because they thought it was frightening,” he says.
Despite the anti-maskers, Howard Markel, director of the Center for the History of Medicine at the University of Michigan Medical School, says the question of how to guard against the flu was not politicized in the way that anti-Covid measures are today.
“Most people did comply because they had greater faith in their public officials, and they had greater faith in the science of medicine, even though it was much more rudimentary than today,” he says.
Markel notes that epidemic disease was very familiar to the early 20th century public. Families, many of which had lost a child to diphtheria or watched a loved one suffer from polio, were generally willing to comply with some limitations on their activities. Most public health departments wore badges and had police powers, and this was generally uncontroversial.
“They could forcibly quarantine you or put you on a quarantine station on an island,” Markel says.
As municipalities determined what public activities should or shouldn’t be permitted, Calder says people were puzzling through their own choices about how to celebrate the holidays.
“When you’re reading people’s diaries, they are fatigued obviously but also measured,” he says. “You don’t find people freaking out about this. They mourn the loss of traditional ways of celebrating the holidays, and they want to see relatives and are wondering whether they can or not.”
Markel, who is also editor of the Influenza Encyclopedia, a digital archive of materials from the pandemic, says one advantage people of 1918 had in terms of making holiday plans is that family gatherings were generally not the treasured once- or twice-a-year events they are for many people now.
“Extended families often lived together or right near each other, next door or upstairs,” he says. “Getting together for a holiday meal was much less of an event than it is today, when many people don’t live in their hometown.”
At the same time, Americans longed to see each other during the holiday season of 1918 for a reasons beyond the Christmas spirit: Young men were returning from the battlefields of Europe and military bases following the official end of the First World War on November 11.
“Many people had the sense that they had just lived through one of the most historic years in history,” Calder says. “[The war was a] victory for democracy over authoritarianism. Just 11 months earlier, it hadn’t looked so good. It was just a huge shock and relief to see the Armistice signed.”
For the families of more than 100,000 men lost in the war, many dying from the flu, in the course of less than a year—and for those who had lost someone to the flu at home—it must have been a somber Christmas. But, for many others, the relief of the war’s end and the apparent decline of the pandemic encouraged many Americans to come together.
“The mood was absolutely euphoric for most of the country,” Davis says. “There’s a pent-up desire to get out—that existed back then as well. The mood of the country was, ‘We’ve come through something terrible. We have something to be thankful for.’”
To whatever extent that joy encouraged people to gather in public or hold Christmas parties at home, it certainly contributed to some of the infections and deaths in the third wave of the flu. In light of the current high rate of infections, that’s something worth taking seriously today. Much like Ohio’s health commissioner in 1918, Markel says we must go against the instincts that drive us to gather together in order to protect the people we love.
“It goes against everything we love to do to not celebrate the holiday season,” he says. “And we must nevertheless not do it. It makes me sad to say it.”