WE
SURVIVED IN 1918; WE WILL SURVIVE IN 2020
How the Spanish Flu Pandemic Affected
Georgia, Part Two
After Mayor Asa Candler had a meeting with Dr. J.P. Kennedy and the Board
of Health about the reopening of the public gathering spaces, the board met
again in mid-October.
After that meeting the board was not yet ready.
On October 24th, Kennedy stated that he thought the schools
should remain closed but he was in favor of other places opening.
School officials took his word and voted to keep the schools closed until
at least November 4th. Kennedy
anticipated the Board of Health would accept his recommendation for allowing
theaters and other public entertainment venues to reopen. At the meeting of the
Board the next day, the suggestion was struck down.
Board members argued the influenza situation was more precarious than
official figures would suggest, citing as evidence the dozens of unreported
cases they had each seen in their private practice over the last several days.
Mayor Candler, eager to reopen his city, jumped at the chance to go on
the attack. “Do you mean to admit that you have violated an order that you
yourself helped to pass?” he asked of one Board member.
The Board then considered removing the closure order effective November
2. However, Mayor Candler
voted against the measure, arguing the Board had no way of predicting what
conditions would be over the period of a week.
He wanted Atlanta reopened immediately.
With backing from Candler and several of the Board members, the
resolution failed. Upset over the
Board’s decision, Candler announced a special session of the city council,
which decided to overrule the Board of Health and allow Atlanta’s places of
public gatherings to reopen on October 26th.
The epidemic may have improved enough for theaters to reopen but the same
could not be said for the weather or the war situation. Because of the war and
the need to keep vital industries running, Atlanta was under power consumption
restrictions. Non-essential users
had their power curtailed, a situation exacerbated by dry weather that left the
Tallulah River, the source of Atlanta’s hydroelectric power, lower than usual.
Even with the all –clear from city council for theaters to reopen
again, Captain G. K. Miltenberger of the War Industries Board announced that he
would only allow them to open for a
maximum of six hours a day. It was
better than nothing; Miltenberger had previously announced the theaters would be
kept closed entirely, regardless of the city council’s decision.
However, on Monday, October 28th, Miltenberger relaxed the
power curtailment enough to allow theaters to return to their normal opening
hours. The Atlanta, Lyric and Grand
Theaters reported high attendance as did the city’s various movie houses.
As one reporter for the Atlanta Constitution said, “After being closed
for several weeks, it seemed that every theatrical performance and every movie
was just a little better than it was before the ban and everybody was in the
best of humor.”
November arrived and the number of new influenza cases continued to
decline. Kennedy cheerfully
announced he felt the epidemic had run its course in Atlanta.
Another reporter for the Atlanta Constitution wrote that “”the
influenza was no longer an interesting topic of conversation.” He went on to
say there had been enough victims in Atlanta to prevent any of them from having
that exclusive feeling and yet there have not been enough to make much of a
boast in years to come when those now present say, “how back in 1918 when the
Spanish Influenza was raging!” Atlanta’s death rate was the lowest in
the South. By the end of November, the Census Bureau reported Atlanta’s was
still amongst the mildest in the country.
However, by Thanksgiving, Atlanta’s cases began to surge again.
Kennedy reassured residents the increase in cases did not indicate a
recurrence of the epidemic. One
physician complained that most of these supposed cases were actually bad colds,
but people assumed they had the influenza and called him to confirm it.
He believed people simply
needed to keep their windows open in order to avoid influenza.
The school officials decided to take no chances and Acting School
Superintendent Charles Culver announced that any child exhibiting symptoms of a
cold would immediately be excluded from school.
As Christmas approached, Atlanta found itself in growing need of nurses
and aides to care for the many ill. The Central Council of Social Agencies, the
local chapter of the American Red Cross, the Anti-Tuberculosis Society and the
Associated Charities met to coordinate relief work and to issue calls for
volunteers. A central office was
formed at the Red Cross headquarters which served to route calls for help in
order to reduce the likelihood of several nurses being sent to the same
household. The Red Cross also
embarked on a citywide survey to ensure all residents were receiving the care
they required to better allocate nurses and physicians.
Especially hard-hit was East Atlanta, a section of town only recently
incorporated into Atlanta and without the same infrastructure and municipal aid
that the rest of the city received. Neither
Kennedy nor the Public Safety Committee believed the epidemic severe enough to
take further action. The Committee
issued a statement saying, “The influenza situation in Atlanta is up to the
people themselves,” and regarding Kennedy’s opinion, “closing public
places again would be useless.”
Kennedy maintained his position throughout the rest of the winter, as the
epidemic continued to gain strength. At the end of January, 1919, the situation
had become severe enough where the Fulton County Medical Society invited members
of the state, county and local health boards along with military medical
officers to confer about what should be done to bring the epidemic to an end
once and for all. A greater
proportion of influenza cases were developing
pneumonia than had been the case in the last days of 1918, resulting in an
increased number of deaths. An
estimated six to eight patients were dying in the hospitals each day.
Nurses were severely overworked trying to handle the caseloads.
In the end, the conferees decided the best course of action was to
isolate cases, quarantine households, and to impress upon the public the need to
practice proper cough etiquette and to avoid crowds.
The committee also suggested that serious cases of influenza and
pneumonia not be transferred to hospital so that would not infect other
patients. Reports seemed to think Kennedy, the Board of Health or the City
Council would not have taken any stronger action in any event.
Throughout the rest of February, Atlanta’s death rate remained
elevated. In mid-March Dr. Kennedy
reported the city’s death rate appeared to be returning to normal and it was
his opinion Atlanta’s second wave of influenza had ended.
Atlanta had closed its public gathering places for just over two weeks
total, which was a relatively short period in comparison to many other American
cities that issued closure orders. Part
of this may have been due to the fact Atlanta was under strict power consumption
restrictions in the fall of 1918. Under
Captain Miltenberger, all elevators were closed, rolling blackouts kept the city
dark two nights a week and stores were required to close by 6:00 pm on
Saturdays. These wartime measures
undoubtedly led to an increase in social distancing and may have had an impact
on the shape of Atlanta’s epidemic curve.
Also, the number of streetcars in service was significantly reduced in
order to save power. This could have
led people to walk or take alternate transportation, thus keeping them off the
crowded streetcars. And it may have contributed to additional crowding as
residents waited and jockeyed for a place on fewer cars.
The Census Bureau released figures which reported Atlanta lost a total of
829 residents to the epidemic through the end of February 1919.
With a population of just over 200,000 that equated to an epidemic death
rate of approximately 414 per 100,000 people.
The average for cities in the South and Midwest combined was 413 per
100,000, landing Atlanta right in the middle of these cities.
Records show a difficulty in ascertaining just how severe or mild
Atlanta’s epidemic was. Case
reporting in the early days of the epidemic were sporadic and it was found that
many physicians, including members of the Board of Health, did not submit
regular case reports to Dr. Kennedy’s office.
Because of the requirement to issue death certificates, mortality data is
more reliable. Kennedy frequently
cited US Census Bureau statistics to bolster his claim that Atlanta’s epidemic
was one of the mildest in the nation, however upon examining these records
indicates a significant gap in reporting of influenza deaths. Atlanta only
reported influenza deaths to the US Census Bureau for three weeks during the
epidemic (the weeks ending October 12, 19 & 26).
For the rest of the epidemic period, the city only reported pneumonia
deaths. It is quite possible that
the Atlanta physicians automatically attributed all influenza-related deaths to
pneumonia, or that Kennedy did so before forwarding the data to the Census
Bureau. Sadly it is not known whether Atlanta only reported pneumonia deaths and
omitted those caused by influenza.
American History textbooks from 40 & 50 years ago only reported the
basic minimum of facts which were presented to students by their teachers. Some
teachers relayed only the facts while others dug deeper give a more concise
meaning to the lessons. Over the years history texts have grown larger and
thicker adding tremendous amounts of new material which has been uncovered
through diligent research. It will
be interesting to see just how our future American History textbooks treat this
modern pandemic, so much worse than in 1918 but equally as devastating over the
great number of lives taken. Modern
medicine has made great strides from 100 years ago and cures which seemed
unthinkable then are at our fingertips now.
As it is touted over and over on news reports today, “We will get
through this together,” just like we did 102 years ago.