Guest Columnist

Lessons for Iowa from the Spanish Flu pandemic of 1918

Influenza patients during the 1918 flu pandemic in Iowa (Credit: Office of the Public Health Service Historian) No furth
Influenza patients during the 1918 flu pandemic in Iowa (Credit: Office of the Public Health Service Historian) No further info available as to location & date.

As we race to understand and deal with the COVID-19, it’s interesting and sobering to remember that we had a flu virus crisis in Iowa once before.

The 1918 flu, known as the Spanish influenza, killed as many as 50,000,000 (that’s million!) people worldwide between 1918-1919. Surprisingly, that infamous flu infected and killed healthy young people with almost half of deaths among those 20-40 years old. The influenza caused victims to cough up blood and many had what was described as a blue tint to their skin. Deaths were caused when patients’ lungs filled with blood actually causing them to “drown.”

Spanish newspapers first reported the illness because Spain was a neutral country in WWI and their newspapers were not censored, as were countries declared adversaries in the war. Freedom of the press and media is a precious commodity and crucial for intelligent and scientific decision-making. Influenza killed ten times more American soldiers than World War I.

Iowa was not spared from this terrible scourge. In reviewing history, we find that in the fall of 1918 the Iowa Board of Health “quarantined” the entire state. The power of the Board was so robust that they ordered all “public gathering places to close.” The order closed all churches, schools and other places of congregation. Iowans were required to wear face masks when interacting with others in public spaces.

We know that the faster quarantine was put in place, the lower the casualties. Philadelphia delayed and went ahead with a huge Liberty Loan parade while St. Louis health Commissioner Dr. Max Starkloff implemented this prophylaxis, promptly closing schools, pool halls and other public gatherings. As a result of this wise decision, the mortality in St. Louis was one-eighth of Philadelphia’s death rate.

Oddly quarantine is the same response we are using 102 years later.

The 1918 influenza was daunting because no one understood the menace, fear and panic dominated. Since there was no cure, folk treatments including whiskey, lemon juice and “turpentine rub” were advertised. Not surprisingly none of these worked.

It’s important to remember that the deadly pandemic sent the grim reaper to harvest innocent Americans in different proportions depending on the government actions taken. I emphasize government because as we are discovering today, it is only the public sector that can assume leadership and either exacerbate or improve the end results of major disasters such as this, hurricanes, tornadoes, earthquakes, tsunamis or other massive assaults on the public. For the detractors of “big government” or, in current lingo, the “deep state” this may not be good news.

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In those days, there was little understanding of viruses and medicine was at best rudimentary. Hospitals and medical facilities would be barely recognizable today. Doctors had a “black bag” with a stethoscope, bone saws, sulfur, a bottle of whiskey, some bandages, a tourniquet, ether and precious few other medical tools.

Between 1918-1919 over 6,000 people died in Iowa and this powerful virus infected at least 93,000 people. At the University of Iowa, 38 staff and students died from the flu or from pneumonia brought on by the disease and at least fifty-one died at the Iowa State College (now Iowa State University). At the military facility Camp Dodge an astonishing 10,000 soldiers were treated for influenza and more than 700 died.

Influenza is a pernicious illness because viruses mutate quickly and it therefore is virtually impossible to anticipate the next pandemic even in 2020 with all the science we have. Iowa’s governor has moved quickly and repeatedly to implement policies that hopefully will encourage a St. Louis not a Philadelphia response to this new twenty first century viral threat.

It’s discouraging that 102 years after the devastating Spanish Influenza pandemic we are still so vulnerable. Our medical facilities (ICU units, respirators, haz-mat suits, and trained medical personnel) apparently are once again not robust enough. And too many political leaders today have acted more like the fateful Philadelphia city health commissioner, Wilmer Krusen, who did not implement timely quarantines in 1918.

Steffen Schmidt is the Lucken Professor of Political Science at Iowa State University

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