Today’s shortage of flu vaccine seems almost small in comparison

A major shortage of flu vaccine this year has people around the country scrambling to find shots – even traveling to Canada to get immunized against the nasty respiratory bug.

But nearly 90 years ago, when still-experimental vaccines were all but useless, the world battled a flu outbreak unlike anything seen in modern times.

Conservative estimates say the 1918 influenza pandemic killed 25 million people around the globe; it may have felled twice that many, or even more.

“The estimate is about a fifth of the human species got sick,” says Alfred Crosby, a one-time Washington State University professor and noted flu historian who wrote “America’s Forgotten Pandemic: The Influenza of 1918.”

As it did in every other corner of the planet, the 1918 flu hit Spokane and the rest of the Inland Northwest hard.

In Spokane alone, more than 10,000 people got sick and nearly 450 people died, according to newspaper reports and other documents from the era.

Tales of the flu striking elsewhere had been swirling for several weeks when, on Oct. 8, 1918, Spokane’s Health Officer Dr. John B. Anderson ordered that “all public places where people assemble are officially closed.”

That meant that all schools, movie houses, dance clubs, pool halls and similar venues were shuttered. Church services, chamber of commerce luncheons and wedding parties were forbidden.

Even a clairvoyant holding a séance was arrested and jailed for violating the public meetings ban. Martha Guder was “about to give a demonstration of spirit rapping” to 10 people in her home when investigators busted her.

But residents were assured that there was “no occasion for alarm.” At that time, 100 people in Spokane had contracted the flu.

Ten days later, more than 1,000 people had fallen ill and 15 had died.

Unlike the flu we know today, which is most deadly for the very old and the very young, the 1918 strain of Spanish flu was particularly lethal for the young and otherwise healthy. As the illness spread, death reports would be filled with people in their 20s, 30s and 40s who succumbed to the disease.

By Oct. 15, Spokane’s hospitals were so packed with flu patients, officials looked for a new place to house them. They chose the Lion Hotel building, 112 ½ S. Lincoln St. But that did not make the building’s owners very happy, and they filed a complaint with the city against turning the property into an emergency hospital. It was not a winning battle.

“We don’t care a rap what the owners of the building think about it or about us,” Anderson, the health officer, said. “This is a very serious emergency and if the owners of the Lion Hotel think they can put a dollar on one side of the scale and a human life on the other and get away with it they are very, very badly mistaken.”

In another 10 days or so, the emergency flu hospital would be filled to capacity, and officials began struggling with a growing shortage of nurses.

Many of the city’s nurses were unavailable because they were overseas during World War I. And still more nurses found themselves in bed with the flu after caring for so many patients.

Officials became desperate, pleading: “Married women who have had experience in nursing, even as undergraduates, are asked to respond, if only a few days at a time.”

Soon, guarding against the flu became a common pastime.

Employees at Exchange National Bank started wearing masks while on duty, and other bankers soon followed suit. All soldiers on duty in the city also were ordered to wear masks, along with Western Union messenger boys, barbers, YMCA employees and telephone operators.

Drug stores were nearly picked clean of “gargles, germicides, atomizers, inhalers, pills, cough drops, detergents, preventatives and alleviatives of all sorts.”

Particularly popular were “kerolene inhalers,” which looked like a tin whistle stuffed with medicated cotton. The inhalers had a mouthpiece and a horn to insert in the nose. Another top-selling item was a pocket-sized glass tube filled with wool saturated with “methol, phenol, methyl salicylate and eucalyptol.”

Oil of eucalyptus was believed to keep flu germs at bay.

Spokane citizens apparently kept their flu phobia in check, at least according to one Spokesman-Review article.

“Drug stores report almost no demand for gas masks as yet,” the story noted.

The flu took a huge toll on families. Children were orphaned. Parents lost their new babies.

In Spokane, a 6-year-old boy, the oldest of four children, found his mother slumped across two kitchen chairs. She apparently died of pneumonia brought on by the flu while trying to start a fire on the stove.

By Oct. 26, Spokane had seen 1,760 flu cases and 30 deaths.

Reports from North Idaho and other eastern Washington towns are sketchier, but the flu was apparently widespread throughout the region.

By the end of October, more than half the residents of Ritzville had been infected. There had been nearly 100 deaths in one month in North Idaho and residents in at least one county were ordered to wear masks, or face a fine of “not less than $5 nor more than $100.”

Dr. William Wood, 91, who lives in Coeur d’Alene, was just 5 years old during the flu epidemic. He never got sick. But his 8-year-old sister, Dorothy, and outgoing girl with an easy laugh, died of the flu.

“It was a very terrible thing, that flu epidemic,” Wood says. “My sister, kind of unexpectedly, she just died suddenly. I know my folks took a long time to get over it.”

In Spokane, the flu crisis peaked on Nov. 12. On that day alone, a dozen people died.

Less than a week later it appeared the disease was on its way out.

The public cheered when the city-wide quarantine ended on Nov. 18.

“Spokane is back to normal,” the Spokane Daily Chronicle enthused. “Street cars are carrying full loads. Theaters are busy. Churches are announcing the regular Wednesday evening prayer meetings and Sunday services.”

Schools, however, remained closed. And all dance halls and public and private dances were still forbidden from operating.

But city officials may have lifted the ban too soon.

In the midst of the epidemic, World War I came to an end. With the signing of the armistice, “people in Spokane, as elsewhere, went wild,” according to the Health District’s annual report for 1918.

“The sudden release from the tension of war and the more recent tension of suspension of liberties by reason of the ban, created the enthusiastic desire on the part of everyone to celebrate, and this they proceeded to do for three days,” the report says. “There was an influx of people from the country; community singing was indulged in.”

On Nov. 30, Spokane’s emergency flu hospital set a new record: 26 new patients admitted in one day.

And on Dec. 7, city officials reinstated the ban on public gatherings.

Movie theaters were allowed to stay open, as long as every other row of seats was kept empty.

The epidemic had swept through Spokane by early 1919.

In the end, 10,477 people in the city contracted the illness and 424 people died.

“From the point of fatalities the influenza epidemic has exceeded anything that has ever visited Spokane,” The Spokesman-Review noted.

Much has changed in the years since the 1918 influenza pandemic. And, yet, little has changed.

We now have flu vaccines, but both the supply and the effectiveness are often not reliable.

As for the “vaccines” available in 1918, Crosby, the historian, says, “None of them were worth a damn.”

Crosby says he once asked someone what was in the old vaccine:

“He smiled and said, ‘Soup’.”

Sanitation has improved over the years, as has our understanding of disease transmission.

But we’re much more interconnected today than we were in 1918. Hop on a plane in the morning and you can be across the world in time for dinner.

“We don’t live in isolation,” says Dr. Paul Stepak, epidemiologist for the Spokane Regional Health District. “We don’t protect ourselves by ignoring problems outside of our borders.”

The Health District has begun planning for a major flu outbreak, in conjunction with preparing for other disasters, Stepak says.

“I think it’s extraordinarily likely another influenza pandemic will occur,” he says. “There’s always a lot of work to be done. You’re never sitting pretty because you never know where it’s coming from. What you can do is improve your capacity to respond.”