One of the greatest casualties of the First World War was information. A devastating H1N1 influenza virus broke out early in 1918. Even though it originated, some now speculate, in Haskell County, Kansas, the virus became known as “Spanish Flu” (the Spanish called it “the French Flu”; Germans, “blitzkatarrh”). Its worldwide havoc resembled the bubonic plague of the high Middle Ages. And yet in 1918, and even today, people failed to take it seriously.

Many sufferers had typical symptoms: three days of fever, drippy nose, achy bones, followed by a slow recovery. Others it struck like poison: knockout fever, bloody sputum, lungs filled with a reddish fluid. Then the body, deprived of oxygen, turned dark blue, the feet black, and people died. During the height of the pandemic, doctors divided incoming cases into two groups: those with pale skin and those with cyanosis, or blue skin. They sent the latter to a death ward. They were already gone.

The virus struck with heretofore unseen swiftness. In November 1918, four women played bridge in a screened sun-porch at Albuquerque, New Mexico, convinced that the fresh air and the six-ply cheesecloth masks they wore would make them safe. The next day, three were dead. The fourth, after a bout with the flu, lived to a ripe old age.

Original estimates ranged between 20 and 40 million people killed worldwide. But since between 17 and 20 million died in India alone, current thinking puts that number between 50 and 100 million. One-third of the world’s population became infected. Unlike any before, but similar to today’s swine flu, the virus was particularly lethal in the 20–40 age group. “They’d be sick one day and gone the next,” wrote poet/M.D. William Carlos Williams, “just like that, fill up and die.”

The Sun, and San Diegans in September 1918, ignored welling statistics on the east coast and in Europe. “San Diego is full of colds, just now,” said the Sun. To avoid infection: steer clear of “secretions of the nose and throat passages, conveyed on handkerchiefs, towels, cups, and mess-gear.” If you come down with the flu, just “treat it as a bad cold,” and be sure to “take Dover’s Powders.” The story, which promised “All the Facts About Spanish Influenza,” was actually an advertisement.

“We simply fail to regard influenza with the degree of seriousness it deserves,” writes Pete Davies in The Devil’s Flu. “We confuse it with the common cold, and we talk about a ‘flu bug going round’ as if it were no more than the viral equivalent of an itch or a scratch. Yet just [90] years ago, it killed maybe two percent of all the people in the world.”

Around the time of the Sun ad, sailors at the Balboa Park naval-training camp and soldiers at Camp Kearny came down with the flu. Medical authorities at Kearny assured San Diegans that the symptoms were “the common garden variety.” They attributed the first deaths to complications from other causes. By early October both facilities, along with Fort Rosecrans and North Island, went under quarantine.

On October 10, Dr. Peter Remondino, 62-year-old president of the health board, wrote an article in the Union pleading with people to take the virus seriously. This disease, he said, “is more virulent and more murderous than any epidemic the nation has yet experienced.”

Remondino urged San Diegans to give doubtful cases “the benefit of the doubt, as if [they] were full of bacilli, as an innocent-looking Picardy retreat may be full of nests of Prussian machine guns.”

Led by Remondino, on October 13, the Board of Health recommended closure of public amusements indefinitely — theaters, churches, dance halls, schools, libraries, movie houses. They also had the fire department set up stations where people could have their throats sprayed with quinine bisulphate. At least some San Diegans heeded the advice: the booth at Horton Plaza ran out of the bitter-tasting “Aunty Flu” remedy almost daily.

On October 18, the Board of Health “insisted” that San Diegans wear gauze masks when going outside. These were easy to make: cut a square of fine mesh, white gauze, 14 1/2 x 14 1/2 inches; fold in four thicknesses; tie the mask snugly around the head; tape down exposed corners. Though many who worked with the public donned them, most San Diegans treated the masks, the Union reported, as a “joke.” The board could only recommend or insist. The power of enforcement lay with the city council.

On October 20, San Diego had 329 total cases of the flu and 11 deaths. Four days later: 488 and 18. During that time, Harry Smelser of Fallbrook went to San Diego for jury duty. He developed flu symptoms. His wife Dot came to care for him. Harry recovered. Dot caught the virus and died.

An editorial in the Union on October 21 said that while masks were okay for Greek tragedy, today “only highwaymen, burglars, and holdup men wear them professionally.

“We sincerely regret,” the editorial concluded, “that some of the young women in public employment are compelled to wear these masks. We miss their pretty faces.”

On November 17, the virus — at the time restricted to downtown and the waterfront — began to wane, and the Board of Health lifted the restrictions against public amusements. Twelve days later, 100 new cases appeared, including eight deaths in two days. Dr. Remondino, known to all as “Rem,” came out of retirement. He turned the Old Mission Brewery, at the foot of Washington Street, into an emergency isolation hospital. According to historian Jerry MacMullen, who was one of them, “Rem proudly related that he did not lose a single patient.”

Throughout 1918, the flu pandemic competed with the “War to End All Wars” for attention. Headlines with three-inch letters — five, for the Armistice on November 11 — elbowed influenza statistics onto the second page. Even though, as John M. Barry writes, the flu “killed more people in 24 weeks than AIDS has killed in 24 years,” and even though the most common victims were often the healthiest, including pregnant women, the virus never shook its status as la grippe, three achy days and home free.

The city council’s reticence to enforce regulations struck the health board like a virus. Coroner Schuyler Kelley and Dr. W.W. Crawford resigned out of frustration. “This is not the time to stand from under,” Dr. Ernest Chartres-Martin scolded Crawford. “This is the time to see the city through. I’ll see the council damned before I resign.”

On Saturday, November 30, Chartres-Martin and Remondino, both of whom were recovering from the flu, met with fellow members John Buerkle and newly appointed Senator Leroy A. Wright at Remondino’s home. They wrote a two-pronged emergency resolution: quarantine schools, churches, and public amusements; give the Board of Health the power to enforce the edict. On Monday, they brought their proposal to the city council.

The meeting, scheduled for 10:00 a.m., didn’t begin until almost 11:00, since council members were attending the funeral of William Dougherty. The son of Councilman James Dougherty had died of the flu.

“We are unable to cope with the situation as we ought,” Dr. Chartres-Martin told the assemblage. Therefore, the board wanted to make the quarantine official.

After reading the proposal, Councilman Walter P. Moore moved its adoption. This was a surprise, since Moore boasted that if he had to wear a mask, he’d burn a hole for his cigars. No one seconded the motion. They tabled the resolution by unanimous vote.

“There was not a word of comment by health authorities or members of the council,” wrote the Union. “The crowd departed, leaving the council to its regular business.”

That afternoon, Dr. Chartres-Martin telegrammed the State Health Board demanding the authority to enforce — not merely “authorize” — closing public places. When Chartres-Martin received no answer, he sent another.

Prominent San Diegans weighed in. “We should back the health board,” wrote George Marston. “A quarantine would do no good,” countered James H. Holmes, manager of the U.S. Grant Hotel, adding that the previously closed schools, churches, theaters, and “unnecessary” public gatherings had suffered enough.

Mayor Louis Wilde: “There is a class of people blind and indifferent to the death and sick rate, apparently unconcerned about everything else but nickel nursing and sight-seeing. If we cannot put life and health above dollars and pleasure for a few days, we had better abolish the Bible and the Constitution.”

On December 4, Dr. F.F. Gundru, vice president of the State Board of Health went over the city council’s head and authorized a quarantine in San Diego. But what kind? The specifics were unclear.

On December 5, at 10:00 a.m., the city council, health board, and local businessmen held a meeting. A crowd packed not only the third-floor chambers, but also the lobby and down the long hallway, where coughs and sneezes echoed. Councilman Thomas J. Fisher ordered anyone not involved in the “flu question” to leave immediately. Such an assemblage, he said, constituted a health hazard. No one moved.

Two attorneys, representing business interests, advocated wearing masks “under certain conditions” and opposed a general quarantine. Speaking for the Board of Health, Dr. Chartres-Martin argued for enforcement of the partial quarantine, and the wearing of masks, but opposed a general closing of all businesses.

Councilman Will Palmer advocated all or nothing. Partial enforcement was “discriminatory legislation.” The day before, he said, theater managers in Los Angeles filed a class action suit against the state.

“The quarantine has been of no value,” said Roland Dowell, representing the motion-picture operators. “And perhaps some of the doctors are rather glad to have an epidemic, as I’ve heard they’re charging ‘flu’ patients $5 a visit, and other patients only $3.”

“That’s a low down, diabolical lie!” shouted Chartres-Martin, leaping to his feet. “If this man will meet me on the street and repeat his statement, he’ll be in the hospital, or I will!”

When others grabbed him, Chartres-Martin shook free, took a deep breath, and said: “In the last seven days, we have had over 600 new cases and 42 deaths. We’re doing our best to cope. It’s time the council did its share!”

Councilman Fisher: “We would jeopardize our bonds in supporting a partial ordinance. I say we go the full limit with a quarantine.”

The health board’s newest member, Senator Leroy A. Wright, rose to speak.

Councilman Moore objected. Wright was not a physician, he said: only MD’s should be on the board. Sensing a stall tactic from the liquor lobby’s number one advocate, City Attorney Cosgrove acknowledged that the appointment of a “layman is legal.”

Wright demanded urgency. A partial quarantine wasn’t enough. “People are dying every day…I beseech you, then, to go farther. Unless you act at once, you are not doing your duty. You should do something.”

Dr. Chartres-Martin suggested drawing up a different resolution, limiting the quarantine to specific sites.

When the council rejected the proposal, Chartres-Martin vented: “The council will do nothing not approved by the theater managers! If such is the case, there’s no use in the health board trying to do anything.”

Councilman Fisher proposed a complete quarantine, with full legal enforcement, effective at midnight. “Slam the lid,” he said, pounding the table with his fist. The council adopted the proposal unanimously. Fisher ordered a call to the State Board of Health for complete instructions.

Dr. W.W. Kellogg, secretary of the State Board, sent them. Kellogg confessed he found the situation in San Diego, where the city council blocked recommendations of health authorities, “unusual.”

On December 6, 1918, an “absolute quarantine” went into effect. Except for stores providing “the necessities of life” — foodstuffs or drugs — all other places of “public or private gatherings of any kind” were closed.

That morning, San Diego looked like a ghost town: no streetcars, few autos parked at curbs, fewer pedestrians. Forty people who refused to wear masks received five-dollar fines, laid down by the police’s “flu squad.” The newspapers printed every offender’s name.

On December 9, the health board lifted the quarantine, but ordered San Diegans to wear gauze masks outside their homes until Christmas Eve.

Between October 8, when Dr. Remondino wrote his warning in the Union, and December 9, 3337 San Diegans came down with the flu; 202 died.

QUOTATIONS
1. Gina Kolata: “It came when the world was weary of war. It swept the globe in months, ending when the war did. It went away as mysteriously as it appeared.”

1. Alfred W. Crosby: “The important and most incomprehensible fact: nothing else — no infection, no war, no famine — has ever killed so many as short a period, and yet [the pandemic] has never inspired awe, not in 1918 and not since.”

2. Richard H. Peterson: “Throughout 1918, there were 4392 cases and 324 deaths in San Diego. For 1919, the city reported 648 cases and 44 deaths.”

SOURCES
Barry, John M., The Great Influenza: The Epic Story of the Deadliest Plague in History, New York, 2004.

Crosby Alfred W., America’s Forgotten Pandemic: The Influenza of 1918, New York, 1989.

Davies, Pete, The Devil’s Flu, New York, 2000.

Kolata, Gina, Flu: The Story of the Great Influenza Pandemic and the Search for the Virus That Caused It, New York, 1999.

Peterson, Richard H., “The Spanish Influenza Epidemic in San Diego, 1918-1919,” Historical Society of Southern California, January 1989, vol. 71.

Porter, Katherine Anne, Pale Horse, Pale Rider, New York, 1939.

Taunbenberger, Jeffery K., and David M. Morens, “Influenza: the Mother of All Pandemics,” Centers for Disease Control, cdc.gov/eid, January 2006, vol. 12, no. 1.

…articles from the San Diego Union, the San Diego Sun, and the Los Angeles Times.
— Jeff Smith