The flu epidemic wasn’t yet over in Connecticut when the state Health Department looked back with a sad and sharp post-mortem in its monthly Health Bulletin.
The edition of April, 1919 cut to the heart of the difference between that viral crisis and the one that grips us today, even as the deaths continued. That difference, starkly: The pandemic of 1918 took young adults — not elderly, not children and youths.
“Its sinister characteristic was that it took the strong and able,” the Bulletin said in an article titled, “The Visible and the Invisible Toll of Influenza.”
“It took the potential fathers and mothers,” the article reported. “Passing lightly the very young and almost ignoring the old, it aimed straight at the very flower of the flock, selecting the ones on whom the race depends for its present economic strength and its future replacement.”
A frightful spike formed another huge difference. In one month, October, 1918, the Spanish influenza took 5,116 Connecticut residents, a stunning leap from 323 the month before.
That was in a state with 1,410,000 residents. It would be the equivalent of 13,000 Connecticut deaths today, or 225 deaths in both Fairfield and Greenwich — in a single month.
That’s exactly ten times the death rate New York City has seen over the last month.
That same fiscal year, 1918-19, the state Department of Health doubled its budget to the equivalent of $2 million in today’s dollars. It hired its first epidemiologist — the position now occupied by Dr. Matthew Cartter, one of the most visible people in the coronavirus crisis.
Today the department spends $122 million a year. So in some ways, a lot has changed. In others, not so much.
Connecticut’s monthly Health Bulletins delivered tips on social distancing without those catchwords. “Don’t inhale anyone’s breath...Don’t visit close, poorly ventilated places.”
“Don’t use drinking cups or towels that other people have used....Clean your teeth and mouth frequently.”
“You could take those instructions and pretty much post them now and they work,” said Leith Johnson, archivist at the Wood Memorial Library and Museum in South Windsor, a retired Wesleyan University archivist, who sent out the entire collection of Health Bulletins from 1918 and 1919 to the Wood community.
Missing was the reminder to wash our hands a lot, though it admonished “spitting on the floor.” And it urged, cover your mouth when you cough or sneeze — perhaps with your hand, a no-no in the 21st century.
Then as now, social distancing appeared to work. The three largest cities, New Haven, Bridgeport and Hartford, didn’t shut down. But they did place restrictions on theaters and schools — and they all suffered losses in the range of 850 to 975 that fall, or 60 to 70 deaths for every 10,000 people. (New York City is now at about 4 deaths per 10,000.)
The smaller cities and towns that didn’t enforce restrictions suffered worse. Seymour and Derby lost residents at a rate of 110 to 130 per 10,000 people.
The raw number of deaths stood as the headline calamity, of course. Worldwide, at least 50 million people would die. And yet, as the state’s monthly Health Bulletin saw it, the biggest tragedy was in who died, as much as how many.
“The vast army of the unborn must be accounted the great invisible toll of the epidemic,” penned a forward-looking writer, perhaps Health Commissioner John T. Black, a Hartford physician. “The sum of the dead, ghastly as it is in a human way and devastating as it is in an economic way, is negligible in the life of the state compared to the effect of influenza on our future birth rate.”
That comment came six months after the end of World War I, then simply called the war or the Great War. For many countries the flu pandemic not only took more lives than the fighting, it took more young men.
Consider: Between Sept. 14, 1918 and Dec. 28 of that same year, 8,488 Connecticut residents perished from the flu, or from pneumonia, mostly related to the flu. Of those, 4,807, or 57 percent, were between 20 and 39 years old.
Just 401 were 60 and over. And it’s not like those oldsters didn’t exist. That group, the year before, accounted for 35 percent of all Connecticut deaths. In the flu spike, their share of deaths plummeted even as they continued to die in the same numbers as always.
Today, by contrast, we’ve all seen the charts that show the vast majority of deaths hitting the elderly.
Back then, the science that predicts the flattening of the curve was still not spelled out. And yet the Bulletin pointed out that in cities with restrictions, “the course of the epidemic was less explosive and more extended.”
One page in a 1918 bulletin urged parents to give every child a full quart of milk a day, clearly reflecting the dairy farm economy of the times. Another called for stricter punishment for anyone who spreads syphilis, the scourge of the day after they managed to control tuberculosis. “There is no reason why a crime so heinous should not be placed in the same category with rape,” an August, 1919 editorial read.
There’s no indication anyone predicted the spike. And likewise, our forecasts are more art and politics than science. We can only hope and pray for the best, and stay home as the death count rises.
Their optimism, like ours at our best, shone through. The final Bulletin article of that year was titled “Cancer – A Curable Disease.”
It opened with the line, “What knowledge has done for tuberculosis, knowledge will do for cancer.” A century later, the anguished fight continues.