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How Chicago Dealt With the 1918 Spanish Flu

The Health Commissioner didn’t close schools or churches, but he did ask police to arrest anyone who coughed or sneezed on the street.

Workers prepare bandages in 1918 at Red Cross headquarters in Chicago.   Photo: Chicago Tribune/UPI

The coronavirus pandemic is a once-in-a-century event — literally.

It’s been almost exactly 100 years since a different virus stopped the entire world. That would be the Spanish Influenza, which in 1918 killed 50 million people, including 8,500 Chicagoans.

Obviously, the world of 2020 has numerous advantages over the world of 1918 in halting a viral outbreak. We have anti-viral medications. We have automation, which means fewer people have to venture outside their homes to perform vital physical labor. We have the internet, which allows many workers to complete their tasks remotely, including the staff of Chicago magazine. And we have electronic mass communications, which allows authorities to instantly issue orders and warnings to the public. Our world is easier to shut down.

In 1918, the city waited until infections spiked — nearly a month after the first outbreak — to close most public gathering places. The first local cases were diagnosed at the Great Lakes Naval Training Center in North Chicago. Even though all leaves were canceled for enlisted men, the flu hit Chicago two weeks later, possibly because visitors were still allowed on the base.

At first, the authorities simply asked Chicagoans to be considerate and cover their mouths. On September 24th, a day when only one influenza diagnosis was recorded, “[p]lacards warning against danger of sneezing, coughing and spitting [were] placed in all street and elevated cars,” according to a timeline of preventive measures later published in the American Journal of Public Health by Chicago’s Health Commissioner, Dr. John Dill Robertson (second from left, below).

D. H. Heide, Dr. John Dill Robertson, C. A. Alling, and Lucius Tetar in Dill Robertson’s health department office. On the back wall is the 1916 organizational chart for the newly formed Association for the Prevention of Infantile Paralysis (Polio). Photo: Chicago Tribune

By the beginning of October, hundreds of new influenza cases were reported every day. Robertson insisted on the disinfection of ‘L’ cars and streetcars every day, and on fining landlords who didn’t heat their buildings.

The city didn’t close the schools, because children didn’t seem to be bearing the brunt of the outbreak. They figured it was better to keep the kids indoors, where they could be watched for symptoms, than allow them to run the streets. (In fact, children would end up dying of the flu at a higher rate than their parents.) Any student who coughed or sneezed was “sent home at once,” on Robertson’s orders. He also asked police to arrest anyone who coughed or sneezed on the street. Eventually, Robertson insisted that all influenza patients be quarantined.

Still, the epidemic raged. By the middle of October, there were more than 2,000 diagnoses and 500 deaths a day from pneumonia and influenza. Only then was an Emergency Commission created to deal with the crisis. On the 12th, it ordered a halt to public dancing.

“The commission determined the step was necessary because of the close contact between dancers, the exercise of the dance and the frequent chilling of the body that is to follow,” the Tribune reported.

On the 15th, according to Robertson’s report, “theaters, skating rinks, moving picture shows, night schools and lodge halls closed.” Then, on the 18th, the day after the worst day of the outbreak, the commission ordered “[a]ll public gatherings not essential to the war, such as banquets, conventions, lectures, social affairs, athletic contests, of a public nature stopped. Music, cabarets and other entertainments stopped in restaurants and cafes. Crowding prohibited in poolrooms, saloons, etc.”

Churches were allowed to continue holding services, because they were believed important to the public morale. The bars and restaurants weren’t closed, either. How could they be? Not everyone had an icebox to keep food fresh, or a kitchen in which to prepare it.

The restrictions remained in place through early November, by which time the Spanish flu had raged through the population and receded. Robertson reported on the distribution of an “immune human serum,” but this is believed to have been ineffective. At the time, scientists had not yet discovered that influenza is caused by a virus. 

One ban that wasn’t lifted: smoking on public transportation.

“Why should we go back to the old days, even when the present menace of influenza has disappeared?” Robertson asked. “Resume smoking on the cars and elevated and spitting and coughing recommences, spreading disease germs.”

The modern response to the coronavirus has been far more thorough. In the early stages of this pandemic, with less than 100 cases reported in Illinois, Gov. J.B. Pritzker closed all schools, bars and restaurants – institutions that weren’t shut down at any stage of the Spanish flu. Today, we’re better able to adjust our lives to social distancing — and we have an example of what happens when we don’t do it quickly enough.

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