As the first wave of the COVID-19 pandemic crests, without a vaccine, it is an opportune time to briefly revisit and learn from the 1918-19 Spanish Flu.
My earliest recollection came in the 1970s, when infectious disease experts were prophesizing that a pandemic was already overdue. Since then, researchers have sequenced the 1918 virus (2011), and Newfoundland’s Mark Humphries has postulated (2014) that the pandemic originated in northern China in November 1917 and not in the army camps in Kansas, USA, or in France.
In early 1918, 25,000 Chinese laborers crossed Canada in sealed trains heading to the European front. About 3,000 became ill and were quarantined in Canada. More died in Britain and in France before they reached the front. In April 1918, the first wave began with one-in-five soldiers in allied and axis armies developing the flu. The German Field Marshal, Eric Ludendorff, blamed it for blunting his spring offensive. The second wave came in September and was much worse.
The 1918-19 Spanish Flu in Alberta
The government was 13 years old and only partially ready. It had maintained the Northwest Territories public health structure, initiated after the 1870 smallpox epidemic. A board of public health and a medical officer of health were appointed in 1906. The MOH was Dr. William C. Laidlaw (1912-26) but he was overseas in the Canadian Army Medical Corps. His duties were assigned to the 1907 appointed Edmonton MOH, Dr. Thomas H. Whitelaw. The only other full-time MOH, was Calgary’s Dr. Cecil S. Mahood. Part-time MOHs were appointed in some smaller towns.
By the time the infection was over, Alberta would officially record 38,308 cases with 4,380 deaths (cf. 40,000 to 60,000 deaths in Canada) in a population of 500,000. Many felt this under-reported the cases.
The first wave arrived in Calgary on October 2, 1918. It lasted 51 days and was followed by a second wave starting December 11 that lasted 47 days. The third wave lasted a month and ended April 25, 1919. Each wave had fewer cases, but higher death rates. Clinically, the flu cases presented with a temperature of 101-103 degrees F, fatigue, coughing and signs of an upper respiratory infection. Sometimes it came on so rapidly the patient collapsed while out walking. The fatigue lasted up to 14 days. Recovery (or death from pneumonia) usually came in seven days. Most of those affected were 20 to 40 years of age. Houses were quarantined with a placard placed in the window, although not everyone chose to flag their homes.
The first cases likely arrived on a 3 a.m. troop train. Forewarned by a telegram from Regina, Dr. Mahood transferred 15 infected soldiers to Camp Sarcee. Within five days, two registered nurses and a soldier were infected. Ten days later the flu had spread so rapidly, Dr. Mahood banned gatherings at churches, schools, theaters and in public places. The Public Health Act was amended on October 16 to cover the epidemic. Courts were closed on October 18. Masks were required on trains and streetcars before becoming mandatory when outside on October 25. Some were labelled “buy a bond” to support war bond purchases. Medical students rode the rails to ensure compliance and many people were fined for non-compliance.
Then on October 30, all non-essential stores were closed, although some offered telephone-ordered goods for front door pick up. The community response was not unanimous. Some churches circulated pamphlets condemning their closure.
Spirited volunteers organized themselves to check on neighbors, and bring them food and water. Free food kitchens sprang up. Children who had lost their parents and didn’t have relatives were admitted to a shelter, pending an adoption. Hospital emergency departments triaged patients to three schools, the old Calgary General Hospital and a church. Hotels donated beds and sheets; the Red Cross – masks.
On November 4, Dr. Mahood felt obligated to release a “cheer up” message. The same day the business-orientated city council voided Dr. Mahood’s orders, but the board of health intervened and backed Dr. Mahood. Then on November 11, the Armistice ended WWI. A celebratory “solemn thanksgiving” was planned for November 17, but was cancelled by Lieutenant Governor Dr. Robert G. Brett. Many were still held, followed by another round of infections. The first wave ended as abruptly as it began, on November 23, with no new cases being recorded. Stores immediately reopened.