What I Learned by Following the 1918-19 ‘Spanish’ Flu Pandemic in (Almost) Real Time

Fresno’s influenza outbreak finally came to a close in February 1919—four months after it had begun. On February 6, three days following the reopening of all Fresno schools and the suspension of the mask mandate, city health officer Dr. Mathewson reported to the Board of Health that just a handful of new cases had been reported over the past few days. Although cities such as Boston had suffered from three waves of the deadly virus, Mathewson was confident that Fresno would not. He was correct, at least for a time. The city did experience another flu flare-up, but that wasn’t until January 1920.

The 1918-19 flu pandemic was indeed over in Fresno.  

All told, 258 residents died from flu or flu-related pneumonia during the fall and winter of 1918-19, a startlingly high number for a city of just 45,000 residents. Adjusting for population growth, a virus this lethal would kill roughly 3,000 Fresnans today.

Yet because of Fresno authorities’ relatively swift and stringent response to the viral outbreak, especially in its first wave, the flu was less deadly here than it was many American cities. During the first 10 weeks of the epidemic, San Francisco had 470 deaths per 100,000 residents and Boston had 570 deaths per 100,000. America’s hardest hit city, Philadelphia—where authorities downplayed the threat of the virus for weeks—suffered 740 deaths per 100,000 its population. In the same time span, Fresno’s mortality rate was 308 per 100,000, which compared favorably to 25 of the 36 largest American cities in 1918.*

Once the epidemic ended, life in Fresno and surrounding Central Valley communities quickly returned to normal. Churches that had been voluntarily refraining from holding any public meetings, such as the First English Lutheran and the First Congregational churches, resumed services. Fraternal orders, ladies’ clubs, boy scout troops, and other community groups got back to their regular schedules. On February 20, the Hanford Board of Heath revoked its prohibition on dancing, allowing the town’s fire department to begin preparing for its annual ball, which had been postponed because of the epidemic.

Judging by stories in the Fresno Morning Republican, the city and its residents swiftly put the pandemic behind them. There were occasional reminders of the deadly outbreak. On April 9, the paper noted that the Fresno County Board of Supervisors had spent $2260 to buy a lot adjoining the Mountain View Cemetery to provide “an indigent burial ground.” “So many deaths occurred during the influenza epidemic,” explained the story, “that all the lots in the county section of the cemetery property were filled and it became necessary to secure additional grounds in which to bury the county poor.”

But the flu was just as likely to come up as a joke in the pages of the Republican, when it came up at all. On February 23, for instance, an advertisement for Henry Dermer’s $15 Suit House warned of “another epidemic” that was looming: “New Clothes Fever.” The ease with which advertisers could make light of the deadly pandemic, combined with the infrequency of stories about it that spring and summer, suggest that Fresnans did not linger of their tragic event, despite its magnitude.

This Henry Dermer’s $15 Suit House advertisement, which appeared in the Fresno Morning Republican on Feb. 23, 1919, predicted a new epidemic: “New Clothes Fever.”

The same can be said of Americans as whole. Although the 1918-19 pandemic inflected about one-third of the world’s population and killed 675,000 Americans, it does not loom large in American collective memory.  Unlike other deadly episodes in the nation’s history, including the Civil War, World War I, or World War II, the United States did not erect monuments to the deceased or enact holidays to mourn their loss. Just five years after the pandemic the Encyclopedia Britannica published a massive history of the 20th century called These Eventful Years: The Twentieth Century in the Making as Told by Many of Its Makers. Yet this 1,300-page, two-volume book entirely ignored the 1918-19 influenza pandemic. 

There are many explanations for the mass amnesia about this health crisis, not least of which is the fact that it was overshadowed by the memory of World War I. But another reason is that is that people at the time were used to death—especially death from disease—in a way that we are not today.

Take this graph, from a recent working paper published by the National Bureau of Economic Research:

As it makes clear, deadly epidemics were not unusual for residents in New York City, who in the nineteenth century experienced multiple cholera and smallpox outbreaks that killed more residents per capita than the 1918-19 flu epidemic. People living New York City in 1918, in other words, had gone through this sort of thing before. That same, of course, can be said about people across the rest of the country and the globe, including here in Fresno.

But it can’t be said about most of us today. We not used to infectious diseases disrupting our daily lives, destroying our economy, or killing hundreds of thousands of our fellow citizens. And this reality points to an important lesson that it is worth pondering: once the coronavirus crisis is over, it may take us quite some time to process and psychologically recover from this tragedy. It is not likely to be forgotten as easily as the 1918-19 flu outbreak.

What else can we learn from these dispatches on Fresno’s 1918-19 influenza pandemic?

Not long after I began this project six (long!) months ago, I published some preliminary lessons from the pandemic in the pages of the Fresno Bee, lessons that are worth rehearsing.**

The first lesson was that early action makes a difference. Fresno moved comparatively quickly in response to the health crisis and, as outlined above, this paid dividends.

The second lesson was that we should expect greater resistance the longer the coronavirus crisis drags on. During the first wave of the pandemic, most Fresnans seem to have followed city regulations, though some flouted the mask rule. During the second wave, however, resistance became more overt. Pool halls and other places of amusement refused to close their doors, and business owners threatened lawsuits unless they were permitted to operate unfettered. Public health officials, meanwhile, increasingly struggled to convince residents to put aside their individual interests for the good of the community.

In the past week, Fresno has seen signs of growing resistance to the current emergency health restrictions, including a rally in which local business owners claimed that on October 1 they would open up their gyms, restaurants, and stores regardless of state directives to the contrary. One local restauranteur says he will file a lawsuit against the city and state for discrimination. If, as many health experts predict, we see a second wave of the virus this winter, such resistance will only grow.

The third lesson I offered in April was that if the current outbreak stretches into the fall, then the United States must make preparations to avoid a significant decline in turnout in the 2020 general election. As I explained in Dispatch VII, the 1918 flu depressed turnout for the midterm election by almost 20% in the Seventh Congressional district, which represented Fresno. Nationwide, the decline was about the same—40% in 1918 as compared to 50% in the 1914 midterm.

We cannot afford to let the coronavirus keep 20% of Americans from the polls in November. Fortunately, we have much better solutions to the challenges of voting in a pandemic than existed in 1918, when the only thing that authorities could do was move polls outdoors. The safest solution, of course, is a vote-by-mail system. Unfortunately, although F.B.I. director Christopher Wray says there is no evidence of a “coordinated national voter fraud effort,” President Donald Trump continues to cast doubt on the security of mail-in ballots.

The final—and most important—lesson I highlighted was that Fresno, like countless other communities across the country and beyond, has survived deadly pandemics before.

As I hope these dispatches have illustrated, this is not the first time we’ve upended our lives in the face of a deadly virus. It’s not the first time we’ve closed churches, schools, and businesses, taught our children by remote learning, or donned masks each and every time we go out in public.

We’ve done this before, and if we pull together and make the necessary personal and collective sacrifices, we will survive this pandemic, too.

* These figures are drawn from Sean Hannon Clark thesis, “The Impact of the 1918-1919 Influenza Pandemic on Fresno, California” (M.A. history, California State University, Fresno, 1991), which used Fresno County’s Record of Deaths to calculate the costs of the epidemic in the city.

** I aimed to chronicle the 1918-19 pandemic in real time, allowing readers to follow the course of that health crisis as our own pandemic unfolds, week by week. But I failed to keep pace. As a result, it took me six months to cover the four month arc of the 1918-19 pandemic, a fact that highlights both the challenges of such a real-time project as well as the longevity of the COVID-19 outbreak. We are six months in with no end in sight.

Ethan J. Kytle is a professor of history at California State University, Fresno. His latest book, coauthored with Blain Roberts, is Denmark Vesey’s Garden: Slavery and Memory in the Cradle of the Confederacy, which was published by The New Press in 2018. Ethan’s work has also appeared in the New York Times, the Atlantic, the Washington Post, the Oxford American, the Chronicle of Higher Education, the Civil War Monitor, and the Fresno BeeHis next book, also coauthored with Blain Roberts, will be a narrative history of the 1960 school desegregation fight in New Orleans. For more installments in our Dispatches from Fresno series, click here.