THE PANDEMIC BEGINS
On March 4, 1918, Pvt. Albert Gitchell, a cook at Camp Funston in the Fort Riley, Kansas military reservation, was admitted to sick bay, the diagnosis: flu. His was the first recorded military case of what would come to be called the Spanish flu, one that, when it had run its course, would infect hundreds of millions of people worldwide and kill more than 50 million.
Though contagious, because the cases were mild – and with the French and British armies in desperate need of fresh troops from their new ally the United States in order to finally bring to an end the Great War (World War I) – Fort Riley’s commander ordered the flow of men entering and leaving for Army bases throughout the country to continue uninterrupted. Only flu victims requiring hospitalization were exempt.
Wherever they went, from Army camps to points of departure, to naval bases and elsewhere, infected soldiers passed on the disease, leaving in their wake an evergrowing number of victims to this new strain of flu. Once in Europe, infected soldiers soon spread the virus across France. From there, it was carried into England, over the trenches into Germany, and throughout Europe.
Ironically, because so many of the nation’s top medical professionals had either enlisted or were drafted when America declared war against Germany, soldiers, Marines, and sailors were able to receive the best medical care. But with flu vaccines yet to be invented, the only effective weapon doctors had against the spread of infectious diseases was the quarantine. Unfortunately, with the nation on war footing and having to fasttrack training and deployment of troops, medical professionals in the military, from Army Surgeon General Maj. Gen.
William Gorgas – the conqueror of malaria in Panama – to Surgeon General of the Navy Rear Adm. William C. Braisted, were helpless to stem what they knew would be a tidal wave of flu cases.
Yet only the most senior political and military leaders on both sides knew of the threat posed by the epidemic. Because they were afraid such news would devastate civilian morale and abet the enemy, the Allies and Central Powers both maintained strict censorship of the media. Such news of the virus that existed consisted of local newspaper reports, giving the impression that the problem was isolated or regional. The exception was Spain, a neutral country. When infected migrant workers returned home from France, the Spanish press’ extensive reporting caused the virus to get the mis-applied nickname that would be forever associated with the pandemic: Spanish flu.
By early summer 1918, when it appeared that the Spanish flu had run its course, top military authorities on both sides felt confident the problem was well in hand, if not over, and they could focus attention on their new offensives that would, one way or another, win the war.
The news that they were wrong was contained in the opening lines of a weekly status letter dated Sept. 7, 1918, from Navy Surgeon General Braisted to Secretary of the Navy Josephus Daniels. Braisted’s message began with an optimistic opening sentence: “The health of the Navy continues excellent in that admission rates for all causes continue lower than average peace time rates.” This optimism was undercut by the next sentence, which ominously stated, “However, the incidence of influenza is increasing.” By the end of the month, the U.S. Navy Bureau of Medicine and Surgery (BUMED) would face the greatest challenge of its existence, one that when it was over would see seven of its members – Superintendent Lenah H. Sutcliffe Higbee, Lt. Cmdr. Lee McGuire, Lt. William Redden, Nurse Marie Louise Hidell, Nurse Lillian Murphy, Nurse Edna Place, and Hospital Apprentice 1st Class Carey Miller – receive the Navy Cross for their heroic efforts fighting the Spanish flu.
NAVY NURSES STEP UP
In 1918, the U.S. Navy Nurse Corps celebrated its 10th birthday. Superintendent Lenah Higbee, a plankowner – one of the “Sacred Twenty” as the original 20 nurses were called – had 160 nurses ready for duty when America entered the war in April 1917. Fifteen months later, the Nurse Corps had 1,082 nurses, and none too soon. In late August-early September 1918, the flu’s violent, deadly second wave struck. In naval hospitals across the nation and overseas, Navy nurses found themselves on the medical front lines, working under appalling and dangerous conditions to save the lives of their patients, with many falling victim as well and some paying the ultimate price.
Because it received men from all over the nation, the sprawling Great Lakes Naval Training Base located north of Chicago became an epicenter of this second wave. When nursing school graduate Josie Brown reported for duty there, she was stunned by the flu’s effect on patients. She recalled that many victims suffered projectile nosebleeds. “Sometimes the blood would just shoot across the room,” she said. “You had to get out of the way, or someone’s nose would bleed all over you.”
The influx and turnover of patients was so great that hospital staff was forced to organize them into queues going from beds to stretchers on the floor beside the beds, with more continuing down the hall. In the morning, the staff removed those who had died the night before, replacing them with the next-closest patient.
Another area that became an epicenter was Philadelphia. Despite second-wave cases recorded as early as August, city leaders allowed a Liberty Loan Drive war bond parade to proceed as scheduled on Sept. 28. More than 200,000 attended, raising $600 million. Three days later, the flu’s second wave exploded in the city and nearby Navy Yard with such violence that within days, and in a move reminiscent of the Black Death plague of the Middle Ages, men in horse-drawn wagons traveled the streets calling for citizens to bring out their dead for burial.
Marie Louise Hidell and Edna Place were stationed at the naval hospital in Philadelphia. Like the rest of the staff, they worked grueling shifts. One night alone, Hidell admitted 188 patients. Brushing off warnings about how they were putting their lives at risk, they contracted the virus and within hours of each other died on Sept. 29, the first two Navy nurses to succumb to the flu.
Navy nurse Lillian Murphy was stationed at the hospital in Naval Operating Base Hampton Roads, Virginia, another hard-hit second-wave epicenter because it was a dispatch location for soldiers going to France. By Oct. 8, the base hospital had treated more than 3,500 cases. Like her sister nurses elsewhere, Murphy worked tirelessly day and night treating her patients. She contracted the disease and died on Oct. 10.
On the second anniversary of Armistice Day, Nov. 11, 1920, the Navy officially recognized the courage and sacrifice of these nurses. Higbee became the first woman to be awarded the Navy Cross “for distinguished service in the line of her profession and unusual and conspicuous devotion to duty.” Place, Hidell, and Murphy received Navy Crosses posthumously for “distinguished service and devotion to duty.” These four are the only women to date to receive the Navy’s highest decoration.
THE TRAGEDY OF THE USS PITTSBURGH
The autumn outbreak of the Spanish flu’s second wave struck just as convoys of troops from America to Europe were reaching their peak. Ultimately, more than 12,000 troops died on transports before reaching France. So devastating was that second wave that it forced a temporary suspension of troop convoys. Of all the Navy ships to suffer from the outbreak, none equaled that of the USS Pittsburgh, the only major Navy warship to be put out of action by the disease.
The Pittsburgh entered the history books on Jan. 18, 1911, when, as the USS Pennsylvania, Eugene Ely conducted the first complete landing and take-off cycle from the armored cruiser’s makeshift flight deck. Re-named the Pittsburgh in 1912 to make available the state’s name for the lead ship in a new battleship class, in 1917 Pittsburgh became the flagship of Commander in Chief, Pacific Fleet, Adm. William Caperton. In late 1917, Caperton was ordered to form the South Atlantic Squadron and conduct anti-submarine warfare patrols off the coast of eastern South America. Because of the large Royal Navy presence already patrolling those waters, Caperton’s stated military mission was a cover for his unstated one: “showing the flag” diplomatic events with local dignitaries to keep Brazil, Uruguay, and Argentina in the Allies’ camp. By summer 1918, his squadron had shrunk from four armored cruisers to just the Pittsburgh, making the military mission moot.
Experience in handling the mild first wave of Spanish flu had made local health officials complacent when the Pittsburgh arrived at Rio de Janeiro in the beginning of October, where the ship prepared to enter a floating dry dock for scheduled repairs and maintenance. On Oct. 4, the passenger ship SS Dannemara arrived and discharged its passengers. Though some were infected with the flu, the city’s health authorities did not impose a quarantine. Nor did the Pittsburgh’s skipper, Capt. George Bradshaw, suspend shore liberty for the crew as a precautionary measure. By Oct. 7, the flu’s second wave began cutting a familiar deadly swath through citizens and sailors. When the Pittsburgh entered dry dock on Oct. 10, more than 90 sailors had fallen ill. The next day the case count had skyrocketed to 418. On Oct. 13, Seaman E.L. Williams became the first flu fatality.
When the number of dead reached 16, Caperton contacted city authorities to arrange burial arrangements. On Oct. 21, he led ashore a funeral party. Upon reaching their destination, Caperton later wrote, “Conditions in [Sao Francisco Xavier Cemetery] beggared description. Eight hundred bodies in all states of decomposition, and lying about in the cemetery, were awaiting burial. Thousands of buzzards swarmed overhead.” Graves dug for the dead sailors had been taken over by others, forcing shipmates to dig new graves. Simple wooden crosses with their names were affixed over them. Ultimately, the Pittsburgh suffered 663 cases (80 percent of the crew) on the sick list, with 58 fatalities. Forty-one were buried ashore, with all eventually returned for re-burial in the United States. In their memory, a 20-foot-high white granite obelisk carved with the names and ratings of the sailors was erected. On it was the inscription: “Erected by the crew of the USS Pittsburgh, in memory of their shipmates who died from the influenza, October- November 1918.”
AMERICAN SAMOA DODGES A BULLET
American Samoa is an unincorporated territory in the South Pacific about 2,500 miles southwest of Hawaii and 2,000 miles north-northeast of New Zealand. During World War I, U.S. Navy Cmdr. John Poyer was naval governor of American Samoa. His counterpart in Western Samoa, a British colony administered by New Zealand and located 40 miles west, was Lt. Col. Robert Logan. Logan had led the force that captured Western Samoa from the German occupiers, and with the victory became the military governor, a post he held throughout the war. He was, however, apparently an easily offended martinet. In November 1918, the Spanish flu pandemic would test to the utmost the administrative skills of the two men, with one rising to the challenge and becoming a hero, and the other failing, with tragic consequences.
Contact with the outside world for these remote island territories was through radio and ship. The SS Talune regularly worked the route between Auckland and the Samoas and nearby islands.
The second wave of the Spanish flu arrived in New Zealand from infected British Commonwealth ships in early October 1918, and rapidly spread, with devastating consequences. As the Talune prepared for its scheduled run at the end of the month, despite two of its crew hospitalized with the flu, local health authorities cleared the ship for travel on Oct. 30.
Meanwhile, in American Samoa, Poyer had read about the pandemic through a radio bulletin from the news syndicate Press Wireless. Deciding not to await instructions, Poyer seized the initiative. He summoned the Samoan matais (chiefs) to a council and together they worked out a quarantine for the territory. Any ship arriving had to either discharge passengers, crew, and cargo on Goat Island in the inner harbor near the capital, Pago Pago, or enter the hospital for a two-week quarantine. The matais organized native patrols to watch the beaches and intercept any vessel, even those carrying relatives from other islands.
The Talune arrived at Apia, Western Samoa’s capital, on Nov. 7, with some crewmembers and passengers already exhibiting flu symptoms. Their condition downplayed by the ship’s captain, the quarantine officer allowed infected passengers to disembark. Only after the Talune had departed and he was reading newspapers brought by the ship did Logan discover the flu’s severity. By then it was too late. Meanwhile, at American Samoa, the Talune’s captain found in Poyer an informed official not to be fooled, resolute with his quarantine.
In late November, with the flu raging out of control in Western Samoa, Logan dispatched a mail boat to rendezvous with a mail steamer at American Samoa. Poyer intercepted the vessel at the harbor’s entrance and ordered it to quarantine or turn back. The steamer’s captain requested permission to put his mail cargo directly on the mail boat. Poyer refused. The ship turned away, its cargo still on board.
When informed of what had taken place, Logan took umbrage and cut off all contact with American Samoa. Later, when Poyer offered medical assistance from the first graduates of a nursing school established for natives, Logan refused. Thanks to Logan’s incompetence, 90 percent of Western Samoa’s population became sick, with about 8,500 fatalities.
Poyer, meanwhile, received the Navy Cross “for the extraordinarily successful measures by which American Samoa was kept absolutely immune.” The grateful natives whose lives he saved honored him as well. In 1919, they built a high school and named it Poyer School, and composed a song. Set to the tune of “The Star-Spangled Banner,” it contrasted what happened between Western and American Samoa. It ended with the line: “God in heaven bless the American governor and flag.”
Two more waves of the Spanish flu would occur before the pandemic ended in 1920. When it was over, the Navy recorded 5,027 deaths and more than 106,000 hospitalized, out of a roster of 600,000 sailors – an undercount, as mild cases were not recorded. Braisted estimated a sickness rate in the Navy of 40 percent. Though the Navy’s primary responsibility was treating infected sailors, medical staff stepped up in local communities, in some cases taking full control from overwhelmed officials. Yet despite its devastating impact, for the general public, the horror of trench warfare soon came to overshadow the fact that more American soldiers, sailors, and Marines died of the flu than were killed in action in the war.
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