In 1918 the Spanish Flu ravaged the United States, particularly in the city of Philadelphia where thousands of people died. This project centers around the collation of texts and images of the 1918 Flu pandemic in the city of Philadelphia during the months of July to December of 1918 with the ongoing coverage of the COVID-19 pandemic in the same city. I argue that through the juxtaposition of a texts that we can elucidate a variety of themes that transcend time including racism, patriotism, and reactions of fear.
Integral to the comparison and analysis of the coverage surrounding historical and present-day events is a clear definition of the word pandemic. According to the Dictionary of Epidemiology, a pandemic is, “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.” Both the 1918 Flu and COVID-19 meet the requirements specified in this definition.
Image: "Electron micrograph of 1918 H1N1 influenza virus particles near a cell" by NIAID.
HIstorical Introduction
In the summer of 1918, while the First World War was raging, the initial cases of the Spanish Flu came to Philadelphia. Similar to many other pandemics and disease outbreaks, the viral infectious disease fostered reactions from fear and trepidation to disbelief and ridicule. The first cases were brought when a British freighter docked in Philadelphia because the crew was acutely ill. While Philadelphians were initially frightened about the illness, most constituent’s worries settled when no cases appeared for weeks. Citizens returned to their daily routines, focusing on furthering the war efforts through liberty bonds and producing supplies.
Background image: Philadelphia Naval Shipyard in 1918. "Philadelphia, PA Naval Shipyard - Building 18 (in March 1918)" by army.archives.
The Liberty Loan parade held on September 28, 1918 garnered the attendance of nearly 200,000 Philadelphians. According to Megan Flynn who wrote, “What happens if parades aren’t canceled during pandemics? Philadelphia found out in 1918, with disastrous results.” in The Washington Post, “Within three days, every bed in the city’s 31 hospitals was filled. There were thousands of influenza patients.” MD Isaac Starr was a third-year medical school student in Philadelphia at the time. Due to the number of medical practitioners abroad for the war effort, the third- and fourth-year students became the first responders to this pernicious pandemic. Starr, who published “Influenza in 1918: Recollections of the Epidemic in Philadelphia,” in Annals of Internal Medicine in 1976, recalls watching patients entering the ward with what appeared to be minor ailments, only to die days later. He said, “Thinking of my function as that of a nurse, I was prepared to carry out the orders given to me. But for most patients there were no orders, and many died without having been seen by any medical attendant but me.” Suddenly, in a matter of weeks the Spanish Flu had devastated the city, leaving thousands dead. In a total of six months, nearly 17,000 Philadelphians died.
Background image depicts several doctors operating on a patient as medical students observe. "This image is taken from History of the Homoeopathic Medical College of Pennsylvania : the Hahnemann Medical College and Hospital of Philadelphia" by Medical Heritage Library, Inc.
News coverage of 1918 Pandemic
The Philadelphia Inquirer first reported about the Spanish Flu as early as July 14, 1918. Much of the coverage surrounding the deadly influenza was overshadowed by a concern for American Troops and the possibility of endangering the strength of the military forces. The unidentified journalist who wrote “Fear New Epidemic May Reach Here” in The Philadelphia Inquirer announced that, “The disease spreads rapidly affecting men chiefly. Women are less frequently affected while children are scarcely ever taken ill with the infection. It is gratifying to know, however, that the diseases is not a very serious one, the death rate being very low.” In general, most of the coverage emphasized the distance of the pandemic, while emphasizing that the war effort was the priority of the moment. Some advertisements at the time, including Wrigley's Gum, emphasized patriotism over concerns about the Spanish Flu stating, "For victory buy liberty bonds. We will win this war- nothing else really matters until we do!"
There was no information published about the British freighter docked in Philadelphia’s harbor in the middle of July. Instead The Philadelphia Inquirer focused its attention on relaying information about the war to readers. The city was, after all, one of the nation’s primary hubs for the creation of ships and steel to be contributed to the war effort. The publication praised the exceedingly large amount of public engagement fostered fourth Liberty Loan parade that took place on the 28th of September—the parade that would eventually lead to a massive spike in cases. The admiration spanned the entire front page, applauding the women, children, and soldiers who participated.
Background image is the front page of The Philadelphia Inquirer on September 29, 1918. Click here for access to that page.
Suddenly the industrial city of Philadelphia was in the grip of a Grippe Espagnole, better known as the Spanish Flu Pandemic. According to an article in The Philadelphia Inquirer published on October 8 (only eleven days after the massive parade) an estimated 75,000 Philadelphians had the Spanish Flu. The article states, “The disease has been raging more fiercely in Philadelphia than in any other city in the state.” Soon the amount of acutely ill individuals overwhelmed the young, often undereducated staff. Due to the war most of the doctors were enlisted abroad, so third- and fourth-year medical students and nurses became the frontline workers of the crisis.
Despite medical workers best efforts, the cases kept rising, and the death toll continued to escalate. MD. Isaac Starr described the patients he saw as a third-year medical student-turned head nurse in "Influenza in 1918: Recollections of the Epidemic in Philadelphia,” in Annals of Internal Medicine in 1976. He stated, "Unhappily the clinical features of many soon changed drastically. As their lungs filled with rales the patients became short of breath and increasingly cyanotic. After gasping for several hours they became delirious and incontinent, and many died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth. It was a dreadful business."
In an effort to curb the spread, Dr. B.F. Royer (then-acting state commissioner) forced theaters, saloons, sporting events and other gatherings to close. Some articles commended the government for taking action, while others were still not convinced of the legitimacy of Spanish Influenza.
For example, some editorials invited readers repudiate fear over the pandemic and live as though it was not happening. In an opinion article entitled, "Spanish Influenza and the fear of it" published in The Philadelphia Inquirer, the writer wrote,
“What are they trying to do, scare everybody to death? The fear of influenza is creating a panic … Steer clear of it, therefore and talk of cheerful things – of health, for instance, instead of disease.”
In response a letter to the editor entitled, “Halting the Procession of Fear,” in The Philadelphia Inquirer and signed, “M.” commended the writer and suggested that the biggest problem was the fear, not the ailment. The author also praised the newspaper for not publishing a death toll. Despite the pandemic overwhelming hospitals, and the morgue not being able to keep up with the amount of bodies, the pandemic's devastation of the city was strangely absent in the newspaper. Instead the media outlet focused on how the Penn's game was canceled and the schools were closed because of it.
Image: Cartoon about how the Spanish Flu was ruining the sports world. "An Unwelcome Visitor" by Jim Nasium, published in The Philadelphia Inquirer on October 5, 1918.
However, as cases persisted and the death toll continued to rise, the reportage became more grim. Obituary sections became longer, letters to the editor became more concerned, and the coverage of the Spanish Flu transitioned from skepticism to medical reportage as people recognized the ruthless reality. Around October 21, an article entitled, “Lessons of the Epidemic—A Preventable Disaster Which Demands Official Explanation,” for the The Evening Public Ledger in Philadelphia wrote about the devastation and prodded Americans and the government to take responsibility for the lives lost. It stated, "It is an indisputable fact that, though we had adequate warning, we met the epidemic hands down." The writer goes on to critique the government for making it a partisan issue instead of a human one, reprimands companies for "profiting heartlessly" at the expense of afflicted families, and admonitions individuals who refused to quarantine.
Philadelphia soon found, like many other cities, that the key to stopping the spread was enforcing social distancing and government mandates to wear masks. Unfortunately, the city lost over 12,000 constituents before getting the Spanish Flu under control.
Despite the passage of nearly 100 years, numerous medical advancements, and the invention of digital intermediaries, certain themes remain the same. While it is may be easier to point out the differences between the past and present, it is often more beneficial to discover what ideas, societal expectations, and themes remain unchanged. By looking at the current coverage surrounding COVID-19 and comparing it with the previous pandemic several messages can be uncovered.
Photo of Philadelphia City Hall at night. "Philadelphia City Hall" by michaelrighi
News coverage of the current pandemic
Similarly to the 1918 pandemic, much of the initial information about the disease generated prejudice and suspicion. For example, in an article published in The Philadelphia Inquirer on August 11 of 1918 entitled "It's A Trying Malady" discussed how, "In 1889-90, however, it was the "Russian" Influenza, because in those far-off days Russia was a land of melodramatic mysteries for most of us, and, therefore, the likeliest birthplace of a swift and strange disease."
On February 4, 2020, two days before the first known death as a result of the virus in the United States, an article in The Philly Voice discussed how Asians living in Philadelphia had been unfairly labeled as agents of the disease. Many people afraid of the virus were creating fear of Asians and Asian-American communities and fostering anti-Asian biases because the virus that causes COVID-19 started in Wuhan China in December of 2019.
Image: The deserted streets of Wuhan, China amidst the pandemic. "After the K.O." by Go-tea 郭天
On Wednesday, March 4 the state announces its first known case of COVID-19. Despite the state closing 63 schools and limiting gatherings to less than 250 people cases of coronavirus spread quickly throughout the city. In an effort to preemptively prepare for the surge in cases, Philadelphia Mayor, Jim Kenney starts trying to figure out locations to situate tent hospitals. An article by Inga Saffron entitled,"Philadelphia brings in tent hospitals and extra staff for the coming coronavirus surge" published on April 1, 2020 by The Philadelphia Inquirer discusses the preparation, and why it is so needed. "During the flu epidemic of 1918, a victim, wrapped in a blanket, is escorted by a policeman. The epidemic killed an estimated 675,000 in the U.S. Health officials — while nervously eyeing New York City’s soaring casualties — say they hope never to have to use the emergency facilities. But the efforts are grim echoes of 1918, when the so-called Spanish Flu ravaged the city."
Image: "Sample of test tubes. A healthcare provider donning a pair of green latex gloves in order to protect herself during her subsequent interaction her next patient." Original image sourced from US Government department: Public Health Image Library, Centers for Disease Control and Prevention, 2282599
As cases came to Philadelphia, the city found itself prepared to handle certain historical problems, like logistics, but unwilling to confront others, like racism. Similarly to the 1918 Spanish Flu pandemic, COVID-19 has disproportionately affected BIPOC communities. In 1918, due to the Jim Crow laws in place, black Americans could not be treated for influenza in most hospitals. This meant that African American health care workers were the primary (and often only) means of providing care to race members struck by influenza. Despite some progress, race inequalities exist today, especially in the health care system. On June 11, The Philly Voice discussed how many black Philadelphian residents lacked access to testing sites and faced other forms of barriers in the medical industry. The article voiced how deeply black communities in Philadelphia, and across the nation, have been affected.
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Tension over the murders of several black Americans including George Floyd and Breonna Taylor also sparked protests and marches across Philadelphia. On June 23, The Philadelphia Inquirer covered a Black Lives Matter march that took place on Broad Street of Philadelphia, the same street that had attracted so many visitor in the summer of 1918. Unlike the Liberty Loan Parade though, only hundreds attended the event as opposed to thousands. Also, as the image depicts, most protestors wore masks. As seen in the image below, protestors also did caravans so as to maintain social distancing measures.
Background Image: "Human Rights Advocates, Hunger Strikers, Gather to Tell Wolf: “Free People Now!”" by joepiette2.
Despite the large amount of participants in the BLM protests an article in the Philadelphia Inquirer on June 27, 2020, stated that there had not been a substantial increase in COVID-19 cases. They noted that the city was not doing a lot of contact tracing at the time, and that the protests may have prompted an overall increase in people staying home, which may have offset the impact of coronavirus cases among protestors.
Similarly to the 1918 Pandemic, many Philadelphians felt that the government's cavalier attitude towards COVID-19 led to unnecessary loss. On October 16, 2020 The Philadelphia Inquirer published an article about how President Trump's indifference toward this pandemic is particularly offensive to Philadelphian's fighting for their lives. Like the 1918 article in the same publication, the author emphasized that the United States knew the coronavirus was coming, but did little to protect its people from it.
The coronavirus continues to affect people across the nation, especially Philadelphia. On November 6, 2020 and article in The Philadelphia Inquirer wrote that, the city was in possibly the worst period of the pandemic. According to The City of Philadelphia COVID-19 Overview, updated on December 6, the cases are starting to lower; however, it will be a long time before Philadelphia, or any US city for the matter, is recovered from this pandemic.
Image: "Coronavirus" by Muenocchio.
Conclusion
Through juxtaposing The Philadelphia Inquirer’s coverage of both the 1918 Pandemic and the novel coronavirus, I have discovered themes of racism, patriotism, and reactions of fear. According to Vanessa Northington Gamble in an article entitled, "There Wasn’t a Lot of Comforts in Those Days: African Americans, Public Health, and the 1918 Influenza Epidemic" for the 2010 April edition of Emerging Viral Epidemics and Pandemics, mainstream newspapers rarely discussed the black population. Gamble states, "In 1918, mainstream newspapers rarely covered black life and when they did, they frequently reinforced racist stereotypes about black people. It was left for black newspapers to provide African Americans with visibility and a voice. These newspapers dispensed news about events in black communities, chronicled the achievements of African Americans, articulated black concerns, and attacked racial inequities." None of the 1918 coverage in The Philadelphia Inquirer acknowledged the mortality rate of Black communities, or their valiant efforts to slow the spread of influenza in the city.
While the same publication during the COVID-19 is more willing to discuss the prejudice surrounding BIPOC communities, the high mortality rate indicates structural racism. The presence of this theme even after the passage of 100 years indicates the pervasive nature of racism in our country both historically and presently. Racism is so prevalent in the city of Philadelphia that individuals felt that it was more important to protest and risk getting sick than do nothing and stay safe. These actions speak volumes about how significant this issue is.
Patriotism
Another theme discovered through the course of research is patriotism. The 1918 Pandemic began amidst World War I. One of the reasons the Spanish Flu ravaged the city of Philadelphia particularly is because of a Liberty Loan parade held on September 29, 1918 which tried to increase public financing for the end of the war. In retrospect, many historians believe that thousands of deaths could have been avoided had the city officials intervened earlier and stopped mass gatherings. City officials were aware of the dangers of the Spanish Influenza, yet determined that patriotism should be prioritized. Newspapers supported this belief by emphasizing their war coverage and burying articles about the Spanish Flu. As a consequence, influenza gripped the city, eventually killing thousands of people. While the United States’ is not at war, people continue to engage in acts of patriotism, take the Black Lives Matter protests for example. These marches are a demonstration of democratic engagement. I can think of nothing more patriotic than exercising one's First Amendment rights. Another example of patriotism took place on November 7, 2020 when thousands of Philadelphians thronged Independence Hall in a display of joy over the newly-elected President Joe Biden. However, unlike 1918 there has not been a rapid increase in cases because of these acts of patriotism. It is important to note though, the strength of one's convictions. These displays show that certain beliefs are more important to some individuals than their own health, or the health of others.
Reactions of Fear
Finally, reactions of fear have persisted throughout the Spanish Influenza and Covid-19. This theme is connected to the first theme specified because many people have manifested their fear through racism and scapegoating. Both coverage of the 1918 Spanish Flu and Covid-19 have expressed scorn towards people in other countries and BIPOC Americans. The Philadelphia Inquirer was one of many US publications that published articles accusing Germany of intentionally spreading the pandemic as a weapon of war. This does not seem very different from conspiracy theories and fake news today that argue that the coronavirus is a man-made biological weapon. Also, there have been reactions of fear towards citizens of our country. In 1918 many black Americans were blamed for spreading the disease because of writings by Frederick L. Hoffman who claimed that African Americans were biologically inferior. These notions seem ridiculous by today's standards; however, present-day coverage discusses reactions of fear and anger toward Asian-Americans. Another aspect of fear found in my research was the expression of anxiety and concern over the future. Coverage surrounding both of these pandemics have expressed dismay and horror over the amount of mortalities. Many of them, after the fact. In reflecting on the pandemics, articles from The Philadelphia Inquirer, published nearly 100 years apart both express concern that people knew about the illness and did nothing. These expressions of fear, patriotism, and racism indicate how American’s both disassemble and unite together during times of peril.
It is true that the past does not predict the future, but it can be a successful tool in helping us analyze what is important. The past is not told by passive and objective observers, but rather through biased perspectives. In analyzing the past, it is easy to point out the errors people have made. It is much more difficult to do this in the present. Through observing information we require ourselves to confront our prejudices and think deeply about ideas and notions we readily accepted as true. Through the comparative value of analyzing the past with the present we have the opportunity to uncover buried truths. These persistent themes and truths can guide us to make better decisions as we proceed.
Bibliography
Primary Sources
Spanish Influenza is Due to Hunger,” The Philadelphia Inquirer, July 14, 1918
“Fear New Epidemic May Reach Here,” The Philadelphia Inquirer, July 22, 1918.
“It’s A Trying Malady,” The Philadelphia Inquirer, August 11, 1918
Yanks are coming! Times 20,000 feet in Liberty Pageant,” The Philadelphia Inquirer, September 29, 1918
“Theatres, Saloons In Penna. Closed to Halt Influenza,” The Philadelphia Inquirer, October 4, 1918.
“Penn’s Opening Game Prevented By Influenza,” The Philadelphia Inquirer, October 5, 1918.
“Spanish Influenza and the fear of it,” The Philadelphia Inquirer, October 5, 1918
“178 Deaths, 788 Influenza Cases,” The Philadelphia Inquirer, October, 5, 1918
“Medical Sciences Newest Discoveries About the Spanish Influenza,” The Philadelphia Inquirer, October, 6, 1918
Advertisement for Wrigley’s Gum, The Evening Public Ledger, October 8,1918.
“Halting the procession of fear,” The Philadelphia Inquirer, October 8, 1918.
“Stop the senseless influenza pandemic” The Philadelphia Inquirer, October 8, 1918.
“Dirty Streets And the Spread Of Disease,” The Philadelphia Inquirer, October 10, 1918.
“Flu Nearly Wiped Out,” The Philadelphia Inquirer, October 20, 1918.
“Lessons of the Epidemic—A Preventable Disaster Which Demands Official Explanation,” The Evening Public Ledger, October 21, 1918
“Need Day Nurseries for “Flu” Victims’ Kin,” The Philadelphia Inquirer, November 11, 1918.
John B. Mitchell and William H. Davis, “Special tables of mortality from influenza and pneumonia: in Indiana, Kansas, and Philadelphia, Pa., September 1 to December 31, 1918” United States Bureau of Census, 1920.
Jeff Gammage and Justin McDaniel, “Coronavirus hasn’t reached Philly. But fear and racism are spreading,” The Philadelphia Inquirer, February 4, 2020, https://fusion.inquirer.com/news/coronavirus-china-chinese-racism-fear-wuhan-philly-20200204.html
Inga Saffron, Jason Laughlin, and Audrey Whelan, “Philadelphia brings in tent hospitals and extra staff for the coming coronavirus surge,” The Philadelphia Inquirer, April 1, 2020, https://fusion.inquirer.com/health/coronavirus/field-hospital-surge-preparations-philadelphia-covid-19-coronavirus-20200401.html
Samantha Melamed, “Why an ‘infodemic’ of fake coronavirus news is putting Philadelphia mask-makers into Facebook jail,” The Philadelphia Inquirer, April 13, 2020, https://fusion.inquirer.com/news/coronavirus-fake-news-philadelphia-face-mask-facebook-jail-20200413.html
Queen Muse, “Philly’s Black Community Has Been Disproportionately Affected By COVID-19. Why Is the City Just Now Doing Something About It?,” Philadelphia Magazine, June 11, 2020, https://www.phillymag.com/healthcare-news/2020/06/11/black-community-covid-19-philadelphia/
Marie McCullough,"COVID-19 has not surged in cities with big protests, but it has in states that reopened early. Here are some possible reasons." The Philadelphia Inquirer, June 27, 2020 https://www.inquirer.com/health/coronavirus/coronavirus-no-spike-cities-despite-protests-big-surge-in-states-that-reopened-20200627.html
Aubrey Whelan, “‘He Makes it into a joke’: For Philly COVID-19 patients, Trump’s cavalier attitude stings,” The Philadelphia Inquirer. October, 16, 2020, https://fusion.inquirer.com/health/coronavirus/trump-coronavirus-treatment-healthcare-access-philadelphia-20201016.html
Oona Goodin-Smith, "‘We’re not going to disappear’," The Philadelphia Inquirer. October 21, 2020. https://www.inquirer.com/news/philadelphia/a/philadelphia-defund-police-black-lives-matter-20201021.html
Ellie Silverman, “Philly is in ‘possibly the worst period of the entire epidemic’,” The Philadelphia Inquirer, November 6, 2020, https://fusion.inquirer.com/health/coronavirus/newsletter/covid19-coronavirus-philadelphia-case-high-surge-positivity-pennsylvania-farley-20201106.html
Justine McDaniel, Oona Goodin-Smith, Anna Orso, Ellie Rushing, and Laura McCrystal, “Philadelphians cheer in the streets as Joe Biden wins the presidency,” The Philadelphia Inquirer, November 7, 20 https://fusion.inquirer.com/politics/election/philadelphia-joe-biden-celebration-election-2020-results-20201107.html
“Covid-19 Data for Pennsylvania,” Department of Health, December 6, 2020,https://www.health.pa.gov/topics/disease/coronavirus/Pages/Cases.aspx
Secondary Sources
Isaac Starr, “Influenza in 1918: Reflections of the Epidemic in Philadelphia,” Annals of Internal Medicine, 10, no. 4 (May 1976): 97-103.
Vanessa Northington Gamble, “There Wasn't a Lot of Comforts in Those Days: African Americans, Public Health, and the 1918 Influenza Epidemic,” Emerging Viral Epidemics and Pandemics 125, no. 3 (April 2010): 113-122.
American Journal of Epidemiology: Oxford Academic." OUP Academic. Ed. Miquel Porta. Oxford University Press, 01 Jan. 2014. Web.
Christina M. Stetler, “The 1918 Spanish Influenza: Three Months of Horror in Philadelphia,” Pennsylvania History: A Journal of Mid-Atlantic Studies 84, no. 4 (Autumn 2017): 462-481.
Meagan Flynn, “What happens if parades aren’t canceled during pandemics? Philadelphia found out in 1918, with disastrous results,” The Washington Post, March 12, 2020.
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