STATEN ISLAND, N.Y. – The 1918 Spanish influenza epidemic was one of the deadliest disease outbreaks in human history, killing as many as 50 million people across the globe, including around 675,000 in the United States.
But thanks to the unconventional thinking of one public servant, New York City fared better than many other American cities in managing the illness.
NO VACCINES. OR CLOSURES
One important factor makes 1918 different than what the world has faced during the COVID-19 pandemic: Flu vaccines wouldn’t be developed until the 1940s, so people fearful of influenza couldn’t protect themselves that way. And the city couldn’t mandate that residents and municipal workers get vaccinated, as Mayor Bill de Blasio has done with COVID vaccines.
Dr. Royal S. Copeland, the commissioner of the city Department of Health, was New York’s top general on the influenza battlefield.
Much of what Copeland did went against what many other U.S. cities did to contain the outbreak.
The book “Greater Gotham,” which covers New York City history from 1898 to 1919, describes how Copeland chose to keep schools, theaters and entertainment venues open while other cities decided to close them.
Copeland reasoned that schools were often more sanitary than housing in the city, particularly the jam-packed slums that blighted the urban landscape at the turn of the 20th century.
City schools also had an established system of child health monitoring and care, and there was of course no option for computer-driven remote learning at the time.
So kids were examined by doctors at school each day, with sick children sent home. Few children fell victim to the flu.
New York City kept schools and entertainment venues open during the 1918 influenza pandemic. (Photos courtesy of the U.S. National Archives)
Copeland also decided to keep theaters and other entertainment spots open, reasoning that most of the venues were clean and well ventilated. Patrons could not cough, sneeze or smoke.
The doctor also thought that movie houses and performances stages could be used to spread the word to New Yorkers about flu prevention measures. Venues that didn’t live up to Copeland’s cleanliness and ventilation standards were closed.
THE BIG WORRY
Crowded city subways and elevated train lines, potentially packed with infected passengers who couldn’t afford to miss work and stay home, worried Copeland the most.
But instead of shuttering the transit system, Copeland worked with city businesses to stagger their opening times so that there wouldn’t be the usual crush of people during the normal morning and evening rush hours.
As New York City officials have done during the COVID-19 pandemic, Copeland instituted a mass public awareness campaign about the flu, with 10,000 posters placed at rail stations, ferry landings, stores, police stations and elsewhere explaining how the flu spread and telling the public to cover their coughs and sneezes and to refrain from spitting.
This full-page ad from the Oct. 23, 1918 Syracuse Herald was placed by many of the city's liquor dealers. There was a notable spike in the sale of whiskey during the 1918 Influenza Epidemic, many believing the drink could prevent the disease. (Heritage Microfilm image)
An army of Boy Scouts helped the city enforce the no-spitting rule, handing out cards that said “You are in violation of the Sanitary Code” to offenders. On one October day, 134 men were fined a dollar each at the Jefferson Market Court for spitting, according to “Greater Gotham.”
NO MASK MANDATE
Mask-wearing mandates were common in Western states, but were not instituted in New York City, though officials did recommend people wear facial coverings. Many city dwellers voluntarily chose to mask up, with newspapers giving tips on how to make masks at home, according to History.com.
New York City fared better than other major American cities during the 1918 influenza pandemic. (Composite by Tom Wrobleski/Staten Island Advance)
Many masks were made of gauze or even more porous material, however, and did little to stop the spread of germs. And some New Yorkers poked holes in their masks so they’d be able to smoke while wearing them.
And as with today, some Americans felt that wearing a mask was a violation of their civil liberties.
NYC BEATS THE ODDS
Unfortunately, little could be done to help the flu patients themselves. The city set up health centers and visiting nurses tended to the afflicted with soups, baths, blankets and fresh air until the flu subsided or the patient perished.
Around 20,000 New Yorkers died during the worst of the flu, which was seen from September to November of 1918. But the city death rate of 4.7 people per 100,000 was better than that seen in Boston (6.5) and especially Philadelphia (7.3).
Though counter-intuitive, Copeland’s anti-shutdown strategy helped New York City dodge the worst of the 1918 influenza pandemic.
MORE ON THE DEADLY 1918 SPANISH INFLUENZA PANDEMIC
Why the 1918 flu was so deadly.
How Staten Island battled City Hall during the 1918 influenza pandemic.
A deep look at how NYC kept its public schools open during the 1918 influenza pandemic.