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What New York Looked Like During the 1918 Flu Pandemic What New York Looked Like During the 1918 Flu Pandemic
(about 16 hours later)
The wire arrived in New York City from an incoming ship at sea, announcing that 10 of its passengers and 11 crew members were ill. So a team of doctors and officials waited at a Brooklyn pier to greet the Norwegian vessel Bergensfjord and, with it, the first cases in the city of the deadliest pandemic in modern human history.The wire arrived in New York City from an incoming ship at sea, announcing that 10 of its passengers and 11 crew members were ill. So a team of doctors and officials waited at a Brooklyn pier to greet the Norwegian vessel Bergensfjord and, with it, the first cases in the city of the deadliest pandemic in modern human history.
It was Aug. 11, 1918. The ship docked, the sick were rushed to nearby hospitals, and the pier was placed under quarantine. Everything appeared to be under control. Then more sick arrived.It was Aug. 11, 1918. The ship docked, the sick were rushed to nearby hospitals, and the pier was placed under quarantine. Everything appeared to be under control. Then more sick arrived.
The illness spread, racing through crowded neighborhoods and tenements. The numbers rose slowly at first, then soared as if swept in on a huge wave — a pattern eerily familiar 102 years later.The illness spread, racing through crowded neighborhoods and tenements. The numbers rose slowly at first, then soared as if swept in on a huge wave — a pattern eerily familiar 102 years later.
It was the Spanish flu, and it would kill tens of millions of people worldwide, including 675,000 people in the United States. In New York City, more than 20,000 died, at a rate of 400 to 500 a day at its apex. It was a bracing death toll — and yet city leaders saw it as a sign of a job well done after the fact. It could have been much worse.It was the Spanish flu, and it would kill tens of millions of people worldwide, including 675,000 people in the United States. In New York City, more than 20,000 died, at a rate of 400 to 500 a day at its apex. It was a bracing death toll — and yet city leaders saw it as a sign of a job well done after the fact. It could have been much worse.
Today, looking back at the response to the pandemic of a century ago from the street-level vantage of shelter-in-place apartments is to watch, in many ways, our own current experience with a sepia tint. City leaders struggled with the same decisions then as today.Today, looking back at the response to the pandemic of a century ago from the street-level vantage of shelter-in-place apartments is to watch, in many ways, our own current experience with a sepia tint. City leaders struggled with the same decisions then as today.
“Do you close the schools? Do you close the subways?” said Sarah Henry, chief curator at the Museum of the City of New York. “Do you quarantine people?”“Do you close the schools? Do you close the subways?” said Sarah Henry, chief curator at the Museum of the City of New York. “Do you quarantine people?”
But in other ways, the experience of 1918 was altogether its own: a different flu, a different city. The first death in New York City was recorded about a month after the Bergensfjord arrived, and the numbers rose rapidly.But in other ways, the experience of 1918 was altogether its own: a different flu, a different city. The first death in New York City was recorded about a month after the Bergensfjord arrived, and the numbers rose rapidly.
“And they were hard deaths,” wrote Mike Wallace, a historian, in “Greater Gotham: A History of New York City from 1898 to 1919.” He described “patients gasping for breath as their lungs filled with bloody frothy fluid.”“And they were hard deaths,” wrote Mike Wallace, a historian, in “Greater Gotham: A History of New York City from 1898 to 1919.” He described “patients gasping for breath as their lungs filled with bloody frothy fluid.”
The city had a new mayor, John Francis Hylan, a former laborer for the transit system who earned a law degree before entering politics. He had only just appointed a new health commissioner, Royal S. Copeland, whose credentials were questionable to some (“dean of a homeopathic medical school,” wrote John M. Barry in “The Great Influenza,” and “not even an M.D.”).The city had a new mayor, John Francis Hylan, a former laborer for the transit system who earned a law degree before entering politics. He had only just appointed a new health commissioner, Royal S. Copeland, whose credentials were questionable to some (“dean of a homeopathic medical school,” wrote John M. Barry in “The Great Influenza,” and “not even an M.D.”).
Now, Mr. Copeland suddenly faced an almost unimaginable crisis.Now, Mr. Copeland suddenly faced an almost unimaginable crisis.
New York City was a perfect breeding ground for a flu. Rush hour had just been created with the installation and expansion of the subway and elevated trains. The earliest commuters packed the cars. Water fountains that featured a single community cup had only recently been done away with by a “Ban the Cup” campaign.New York City was a perfect breeding ground for a flu. Rush hour had just been created with the installation and expansion of the subway and elevated trains. The earliest commuters packed the cars. Water fountains that featured a single community cup had only recently been done away with by a “Ban the Cup” campaign.
“It was believed, at the time, that that was safe because the cup was always being washed by the water,” Ms. Henry said.“It was believed, at the time, that that was safe because the cup was always being washed by the water,” Ms. Henry said.
There were calls to shut down the city’s theaters, but Mr. Copeland saw them as a chance to educate and kept them open.There were calls to shut down the city’s theaters, but Mr. Copeland saw them as a chance to educate and kept them open.
“In every theater, before the entertainment began, someone appeared before the curtain and explained the danger of infection from coughing and sneezing,” Mr. Copeland told The New York Times that year. “The audience was told how influenza spreads and how to protect themselves and others.”“In every theater, before the entertainment began, someone appeared before the curtain and explained the danger of infection from coughing and sneezing,” Mr. Copeland told The New York Times that year. “The audience was told how influenza spreads and how to protect themselves and others.”
Public-service campaigns flourished, in the form of pre-internet, pre-radio and pre-television media, such as leaflets and posters. They sought to curb all manner of bad habits, from unprotected sneezing and coughing to spitting in the streets. The city’s Boy Scouts walked the streets, patrolling for spitters.Public-service campaigns flourished, in the form of pre-internet, pre-radio and pre-television media, such as leaflets and posters. They sought to curb all manner of bad habits, from unprotected sneezing and coughing to spitting in the streets. The city’s Boy Scouts walked the streets, patrolling for spitters.
“If they spotted someone spitting publicly, they would hand out a card to teach them they were endangering the city,” Ms. Henry said.“If they spotted someone spitting publicly, they would hand out a card to teach them they were endangering the city,” Ms. Henry said.
Then there were the schools.Then there were the schools.
“The first thing that was done almost everywhere but New York was to close the schools,” Mr. Copeland explained that year. “They may have been just the right things to do in those places; I don’t know their conditions. But I do know the conditions in New York, and I know that in our city one of the most important methods of disease control is the public school system.”“The first thing that was done almost everywhere but New York was to close the schools,” Mr. Copeland explained that year. “They may have been just the right things to do in those places; I don’t know their conditions. But I do know the conditions in New York, and I know that in our city one of the most important methods of disease control is the public school system.”
Most school children lived in tenements, “frequently unsanitary and crowded,” with parents “occupied by the manifold duties involved in keeping the wolf from the door,” the health commissioner explained. Left unwatched, they’d be running in the streets, so schools were seen as not just preferable, but vital for children.Most school children lived in tenements, “frequently unsanitary and crowded,” with parents “occupied by the manifold duties involved in keeping the wolf from the door,” the health commissioner explained. Left unwatched, they’d be running in the streets, so schools were seen as not just preferable, but vital for children.
“They leave their often unsanitary homes for large, clean, airy school buildings, where there is always a system of inspection and examination enforced,” Mr. Copeland said.“They leave their often unsanitary homes for large, clean, airy school buildings, where there is always a system of inspection and examination enforced,” Mr. Copeland said.
The city allowed businesses to stay open, too, staggering their hours of operation to prevent crowded trains and commutes. “White-collar offices would open at 8:40 and close at 4:30,” Mr. Wallace wrote. “Wholesalers would start their days earlier, non-textile manufacturers would start later.”The city allowed businesses to stay open, too, staggering their hours of operation to prevent crowded trains and commutes. “White-collar offices would open at 8:40 and close at 4:30,” Mr. Wallace wrote. “Wholesalers would start their days earlier, non-textile manufacturers would start later.”
Mr. Copeland had his detractors, to whom he found time to respond. When the mayor passed along a letter from a New Yorker suggesting he was not taking the outbreak seriously, Mr. Copeland shot back: “Your Health Commissioner does consider this a serious matter, and so very serious that he has been devoting about twenty-one hours a day to its consideration and dreaming about it the other three hours.”Mr. Copeland had his detractors, to whom he found time to respond. When the mayor passed along a letter from a New Yorker suggesting he was not taking the outbreak seriously, Mr. Copeland shot back: “Your Health Commissioner does consider this a serious matter, and so very serious that he has been devoting about twenty-one hours a day to its consideration and dreaming about it the other three hours.”
Today, the restrictions of 1918 look relaxed compared with the reaction to the coronavirus outbreak, especially the clampdown on nonessential business, schools, theaters and gatherings in general. The difference speaks to an essential difference between today’s virus and the 1918 epidemic: In 1918, there were no known asymptomatic cases; you felt sick — very sick — within about 24 hours of encountering the flu, or you very likely did not have it at all. Healthy people, unlike today, were not considered a threat to one another.
Because of its quick onset, the sick overwhelmed hospitals immediately. “Bellevue patients were laid out on cots, jammed together in every nook and cranny,” Mr. Wallace wrote. “Children were packed three to a bed.”
So, instead, the hospitals came to them. Teams of nurses were spread out over some 150 health centers throughout the five boroughs, set up “in settlements, church houses, babies’ milk stations and, in some cases, schools,” Mr. Copeland explained.
Updated June 22, 2020Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Today, the restrictions of 1918 look relaxed compared with the reaction to the coronavirus outbreak, especially the clampdown on nonessential business, schools, theaters and gatherings in general. The difference speaks to an essential difference between today’s virus and the 1918 epidemic: In 1918, there were no known asymptomatic cases; you felt sick — very sick — within about 24 hours of encountering the flu, or you very likely did not have it at all. Healthy people, unlike today, were not considered a threat to one another.
Because of its quick onset, the sick overwhelmed hospitals immediately. “Bellevue patients were laid out on cots, jammed together in every nook and cranny,” Mr. Wallace wrote. “Children were packed three to a bed.”
So, instead, the hospitals came to them. Teams of nurses were spread out over some 150 health centers throughout the five boroughs, set up “in settlements, church houses, babies’ milk stations and, in some cases, schools,” Mr. Copeland explained.
In the centers, nurses, nurse aides and volunteers answered calls from a clearinghouse where new reports of infection were directed, and then hurried to the homes in question. A “large army of women” volunteered to visit the sick, carrying fresh linens, supplies and quarts of soup.In the centers, nurses, nurse aides and volunteers answered calls from a clearinghouse where new reports of infection were directed, and then hurried to the homes in question. A “large army of women” volunteered to visit the sick, carrying fresh linens, supplies and quarts of soup.
The sick were quarantined in their rooms, with signs posted on their front doors warning the milkman to stay away. Those who became ill in boardinghouses or crowded homes were taken to hospitals.The sick were quarantined in their rooms, with signs posted on their front doors warning the milkman to stay away. Those who became ill in boardinghouses or crowded homes were taken to hospitals.
The influenza orphaned scores of children. “It wasn’t particularly affecting children and it wasn’t particularly affecting older people,” Ms. Henry said. “It was affecting healthy young adults. People in the prime of their life.”The influenza orphaned scores of children. “It wasn’t particularly affecting children and it wasn’t particularly affecting older people,” Ms. Henry said. “It was affecting healthy young adults. People in the prime of their life.”
In the end, 4.7 of every 1,000 New Yorkers died of the 1918 influenza, a lower rate than those of other cities on the East Coast: 6.5 in Boston and 7.4 in Philadelphia, Mr. Wallace wrote.In the end, 4.7 of every 1,000 New Yorkers died of the 1918 influenza, a lower rate than those of other cities on the East Coast: 6.5 in Boston and 7.4 in Philadelphia, Mr. Wallace wrote.
“New York did not suffer as badly as some other cities,” said Paul Theerman, the library director at the New York Academy of Medicine. “It’s always had a vigorous public health movement,” he said. “And luck.”“New York did not suffer as badly as some other cities,” said Paul Theerman, the library director at the New York Academy of Medicine. “It’s always had a vigorous public health movement,” he said. “And luck.”
Mr. Copeland went on to defend his own “unconventional” approach to the outbreak at every opportunity, including in a letter to the Staten Island borough president shortly after it had passed.Mr. Copeland went on to defend his own “unconventional” approach to the outbreak at every opportunity, including in a letter to the Staten Island borough president shortly after it had passed.
“When the history of the influenza epidemic in America is written,” he wrote, “you will not be ashamed of the chapter devoted to the care afforded to this metropolis.”“When the history of the influenza epidemic in America is written,” he wrote, “you will not be ashamed of the chapter devoted to the care afforded to this metropolis.”