Kenneth Knoll was 12 years old when the influenza epidemic came to Spokane. This catastrophic event so impressed him that he felt compelled to describe it 70 years later. His essay is based mainly on newspaper accounts, official records and personal recollections and is reprinted from The Pacific Northwesterner, Vol. 33, No. 1, 1989. It is here edited by David Wilma and reprinted by permission of the publisher.
When the Plague Hit Spokane
By Kenneth Knoll
By October 1918, the faltering Allied forces had regrouped to stem the advance of the German Army. After great human sacrifice, the tide was changing in war-ravaged Europe. Young men from Spokane were among those who had been killed or wounded in the fighting. The list of casualties in the Spokesman-Review served as a constant reminder of the toll of war.
Underlying these concerns was another dread. The Spanish Influenza which had been sweeping Europe with severe and fatal effects had leaped the Atlantic Ocean and was now present on the East Coast. The first case of the flu had been reported in Boston on September 5. On October 1, the City Health Department declared that some cases might be in Spokane but saw no need for alarm. The Department recommended covering the mouth and nose while sneezing and using antiseptic sprays and gargles to prevent infection.
As the days passed, newspapers reported a virtual explosion in the number of cases as the disease relentlessly spread across the nation. On the Atlantic Coast, the highest incidence of illness occurred in crowded army cantonments. By October 1, 72,327 cases were reported in Army camps, 20,000 of them occurring in the previous 48 hours. By October 3, there were more than 100,000 cases with over 2,000 deaths in members of the Armed Forces. By the next day, the total number of cases stood at 137,975.
Similar phenomenon was occurring in the civilian population. On October 1, Boston reported 171 deaths from influenza. Philadelphia had 446 new cases and Helena, Montana, 100. By October 3, cases had been reported in 42 states.
The University of Washington in Seattle reported 820 cases among its students on October 4, with one death. On October 5, Chicago had 916 new cases and 78 deaths. Philadelphia had 788 cases and 171 deaths. Officials in Washington, D.C., closed all places of public assembly such as churches, theaters, and dance halls. Seattle did the same and police declared that spitting in the streets would be cause for arrest. By October 7, Washington state was added to the list of states having influenza in epidemic proportions.
The causes and means of transmission of the disease were poorly understood in the early 1900s and as a result, the methods proposed for prevention were often bizarre. Dr. John B. Anderson, Spokane Health Officer, pointed out in the Spokesman-Review for October 10, 1918, that the methods used to fight pestilence in medieval times, such as public bonfires, the burning of mixtures of spices or of salt or vinegar sprinkled on flames were useless. Eye witness accounts tell of the practice in some areas around Spokane of burning sulfur on a kitchen range to protect those entering the home of a flu sufferer. Physicians in the community recommended living in the open, avoiding crowds, ingesting large quantities of water and avoiding fatigue as the best available preventive measures. One City Health Officer stated that the use of aspirin and phenacetin for analgesia was dangerous but that some of the digitalis group would be helpful in sustaining the heart during the illness. Gauze masks were recommended for use by the healthy to prevent exposure to the infection but the protection they afforded was questionable.
Today, we know that Influenza is caused by two types of viruses, that it primarily involves the nose, throat, and bronchial tree, and that it can extend into the lungs in the form of pneumonia, at which time a bacterial infection may be superimposed. What first presents as a simple illness with fever and chills and malaise can progress rapidly to a state in which the patient has shortness of breath, heart failure, and circulatory collapse leading to death. During the flu epidemic of 1918, the infectious agent was particularly virulent, placing the patient in desperate straits. This was particularly true in Europe where malnutrition was prevalent.
By October 8, Dr. Anderson declared that Spokane was in the throes of the influenza epidemic, and ordered that as of midnight, all schools, theaters, places of amusement, dance halls, churches, and Sunday Schools would be closed and that conventions and other public meetings were prohibited. Schools were closed the next day and students who showed up were sent home. I remember that day very well. To us boys, it was an unexpected vacation that allowed us to play war all day long. We had converted one of our friend's backyard into a battlefield with trenches, dug-outs and other trappings of the battlefield. Clods of dirt made very good hand grenades and we got pretty good at lobbing them at each other.
Department stores were forbidden to have special sales as these would draw crowds. Rules regarding ventilation, sanitation, and spitting were strictly enforced. Jury trials were stopped and the Spokane Stock Exchange was closed.
The ban on public meetings brought some unforeseen results. The rule included funerals and weddings. One man's funeral was scheduled for October 11. His wife hired a brass band to play at the service but was told that attendance would have to be limited. By arrangement with the City Health Officer, the services were held in the Gonzaga Chapel with only six mourners and six pallbearers present. The brass band and a large gathering of friends stayed outside in the open air.
A minister asked the City Health Department to determine if a wedding with 30 guests would be considered a public gathering. He was told that it was, and therefore, the wedding could not be held. The bride solved the problem by reducing the guest list and got married anyhow.
A clairvoyant was arrested for holding a séance for spirit-rapping. She claimed that it was not a public meeting but rather a gathering of friends. Her plea was of no avail and she was jailed. The proprietor of the Pastime Pool Room was arrested for continuing to hold card games. Then there was the case of the owner of a soft drink establishment who was arrested for having too large a crowd in his place. He weighed 350 pounds. When the police officers tried to put him into the patrol wagon, they discovered the door was too narrow for him to pass through, so to add to his indignity, he had to walk behind the paddy wagon to the station.
Bowling alleys were closed on October 11. As a result, toy and game departments of stores were flourishing as people looked for entertainment at home. Some theater managers made use of the closure of their establishments to redecorate the interiors. Two theater musicians, now without jobs, used the time to get married.
On October 14, Spokane experienced 59 new cases and three deaths. The City Council discussed the need for a public hospital for flu cases. A rapid solution consisted of using a downtown hotel for this purpose.
The municipal hospital for influenza patients opened at noon on October 17. It replaced the Lion Hotel at 1121/2 South Lincoln. Miss Ethel Butts of the Deaconess Hospital nursing staff was the hospital manager. The hotel furnished heat, linens, and maintenance.
The First Church of Christ Scientist asked the Health Department for permission to resume church services in the belief that their meetings would be effective in preventing the epidemic. Dr. Anderson replied that he could not waive the rules against indoor assemblies for one group only.
On October 30, the Red Cross summoned the women of Spokane to a sewing bee at the Old National Bank Building to sew flu masks for the Army Training Corps at Moscow, Idaho. The masks were made of six plies of surgical gauze, six by eight inches in size, gathered slightly at the narrow end with strings attached at each corner to tie around the head and neck.
By morning of October 22, the epidemic appeared to be lessening, but by the following day, there were 209 new cases and a total death toll of 35. Among these was a young woman who had given birth to a baby girl five days earlier. Her husband followed her in death the next day.
The sense of fear and helplessness bred by the situation led to feelings of anger and frustration. As part of the war effort, restaurants were required to conserve fats, and were limited to serving one pat of butter, weighing no more than half an ounce, to each customer. One jeweler in Spokane believed that the pat of butter he received was less than the allowed amount. When he could not get his grievance satisfied by his waiter, he announced that the next time he came for lunch, he was bringing his jeweler's balance with him and his pat of butter better be a full half ounce.
Drug stores reported sales of large amounts of gargles, germicides, and inhalers. The clerks at the Exchange National Bank started wearing flu masks on the job. The bank president was already wearing his.
The Spokesman-Review for October 27 carried a large advertisement by the Davenport Hotel stressing the freshness of the air in the hotel. The public was told that the air was taken from above street level and then passed through "marvelous devices" to warm and humidify it. Two days later, the Kemp and Herbert Department Stores ran a similar advertisement saying that there was a constant change of air on every floor. Flu masks were now being worn by store clerks, messenger boys, and paper boys.
Seven people died in Spokane on October 28. There were 300 new cases and the flu hospital was filled to capacity. On November 3, the State Board of Health ordered that flu masks be worn throughout the state in all public conveyances, corridors, lobbies, and other public buildings. Stores were ordered to keep their doors wide open. The next day, the Superior Court closed for three weeks in response to the epidemic.
At midnight, November 10, 1918, the Armistice agreement was signed, ending World War I. This was an occasion for much celebration. Dr. Anderson said that if there was no marked increase in flu cases after the crowded celebrations, he would feel that the danger was past. At this time, the State Board of Health withdrew the mask regulation and stated that the quarantine might be lifted the following Sunday, after which theaters, schools, and churches could open.
On November 14, one Spokane citizen urged that the officials release confiscated whiskey to the flu sufferers to help their recovery. The Volstead Act prohibiting the sale of alcoholic beverages had become law on October 28. On November 15, the Judge of the Superior Court ruled that the whiskey could not be released, so the flu victims had to suffer soberly.
Spokane Public schools opened on November 25, but the Superintendent warned that one sneeze and the pupil would be sent home. If any member of a family had the flu, none of the children in that family were permitted to attend school.
On November 30, there was a dramatic rise in the number of flu cases 242 new ones; the next day there were 250. On December 2, several churches held memorial services for the victims and there were 603 new cases with 118 in the municipal hospital. Twenty-nine percent of the students were absent from school that day, and at an emergency meeting, the School Board asked the Health Department to close the schools again. The next day, the schools were closed indefinitely.
By December 5, 300,000 to 350,000 people had died in the United States since September 15. Walla Walla and Yakima reported that their hospitals were full of flu patients. In Spokane, the Health Department re-instituted a modified flu ban. Theaters were required to close and air out between 5 and 7 p.m. and to use only alternate rows of seats. Churches were allowed to have services only if they used alternate row seating and did not allow singing. Street cars could carry only as many passengers as could be seated. All homes with flu patients posted warning placards.
By December 13, the total reported cases in the city stood at 10,024. Western Union Life Insurance Company reported policy sales had doubled since the start of the epidemic and that their losses had increased. The total paid by Spokane County for widows' pensions was the largest in its history. The disease reached its peak on the week ending December 7, with 2,210 cases and 52 deaths. The next week the number of cases was half that but the number of deaths was 76. By December 19, there were only 32 patients in the flu hospital and two deaths that day. Yakima reported that for the first time in six weeks, a day had passed without a death from the flu. The City Health Department ruled that Christmas church services could be held but would not allow any congregational singing.
On December 22, there were no deaths and only 23 patients in the flu hospital. On December 24, the patient count was down to 16. Dr. Anderson said that restrictions would be lifted after the first of the year and that theaters having modern systems of ventilation would be the first to be allowed to open.
Christmas arrived on this hopeful note. On December 31, the papers announced that schools would reopen on January 2 and that churches and theaters could also reopen. Dance halls had to stay closed. The two Spokane high schools reported only 10 to 15 percent absenteeism, although grade schools showed 30 to 50 percent absent. To recover lost time, school hours were lengthened.
Life was starting to return to normal. On January 13, 1919, the flu hospital closed its doors. It had been open for 89 days and had cared for 617 patients, 68 of whom had died. Miss Ethel Butts was in charge the entire time, and she served without pay.
During the epidemic, the four visiting nurses of the Social Service Bureau were of great help. Many times they found entire families ill with no one to take care of them. The nurses carried a supply of broth with them for those who were unable to prepare their own food. Physicians who had not been called into military service had provided care and reassurance to the multitude of patients whom they had visited day and night at their homes and at the hospital. Morticians worked overtime to remove the dead and maintain burial services.
The incidence of illness gradually tapered off and after the middle of January, news items regarding the epidemic dropped from 12 or more column inches a day to one or two. On January 23, 12 cases were reported, with no deaths. Except for a brief resurgence during the first three months of 1920, the epidemic was over. For the entire period in Spokane, out of a total of 16,985 patients with influenza and its complications, 1,045 had succumbed. Compared to many other cities, Spokane had suffered lightly.
The citizenry reacted well toward the problems produced by the epidemic even though this was a period disrupted by the demands of an all out war in Europe and the adjustments needed for the establishment of peace. The annual report of the City Health Department for 1918 makes special mention of how the people rallied with volunteer efforts to relieve suffering, by transporting and assisting stricken families and aiding doctors and nurses in their labors, particularly at the influenza hospital.
Farmers in the surrounding areas freely donated food supplies such as eggs and milk; stores donated fruit and vegetables to the hospital; the city and county governments furnished money and supplies to the needy. A sense of personal responsibility for helping in an emergency was evident.
Today there is little by which to remember the event. There are few who can recall it. The hotel which housed the flu hospital has been torn down and the site is now a downtown motel. The only remaining physical evidences of the Influenza Epidemic of 1918 are the newspaper reports, the official health records and some tombstones in the cemeteries.