July 1, 2020
E. Rosalie Li, interdisciplinary public health Johns Hopkins Bloomberg School of Public Health
The chief message from 1918, uttered through anguish and brokenheartedness, teaches a simple yet perilous if forgotten lesson: Tell the truth. Do **that — and you just might live.
The world held just 1.7 billion people back then. No less than 675 thousand Americans and 50 million people worldwide perished as a virus prowled through one-third of the entire human population. Outbreaks often catch humanity unaware, bringing societies to their knees. They require us to respond with a multipronged offense and defense that must happen at breakneck speed.
Not preparing is gambling with your continued existence. If you get lucky and make it through, you will probably lose many more people than if you had planned. Perhaps that made mass death so shocking; history had told us to expect an outbreak with war. We had prepared for that.
That was the case in 1918. The brittle relationship between the public and its leadership fractured entirely under the strain of outbreak and war. It was not their lack of preparation that damned their response so much as the complete absence of truth by any definition.
The press and health officials addressed the issue with “either reassurance or silence.” President Woodrow Wilson never issued a statement on influenza throughout the pandemic.
Spain had the distinction of remaining neutral in the First World War. When word of it reached Americans, long after their President knew of it, they called it the “Spanish flu.” Contrary to what the name suggests, which also created confusion back then, the virus originated somewhere closer to home.
Unlike the US and other countries, the Spanish press remained free and honestly reported a bewildering epidemic that some mistook for the bubonic plague. The victims often developed blue skin before they died. Juxtaposed with silence about it elsewhere, Spain's horrifying coverage led Americans to believe that Spain had been ground zero. Still, the Spanish press called it the “French flu,” suspecting it had come from France.
The misleading monikers show precisely why we avoid locations when naming unknown diseases today. We later learned the actual origin was likely the United States. It is just as well; we probably would not have admitted it back then.
The index patient, sometimes called patient zero in popular culture and cinema, Private Albert Gitchell of the US Army, fell ill on March 4, 1918. By day’s end, over one hundred soldiers died of the same sickness.
The American President, Woodrow Wilson, had a tight lid on the media, so the public would not be privy to this information. He believed in the necessity of keeping morale high for the war effort. This belief led him to exert authoritarian control over the press. The outbreak inconvenienced his focus on the war, reflecting the federal response.