They called it the Spanish Lady and it was a killer. In March 1918, in the fourth year of a war in which the Allies were in retreat from a German onslaught, a new and horrible disease landed on the shores of eastern North America.
The killer was a new strain of respiratory virus that most likely originated in China and which was brought to war-torn Europe by the Asian labourers recruited by the French and British empires to work on the Western Front. From there it crossed the Atlantic with troop ships landing in Halifax and Montreal and was spread by rail as soldiers travelled west. A particular culprit was the trains carrying the Siberian Expeditionary Force, bound for Vladivostok to help the Allies battle Communist forces in the Russian Civil War. As they journeyed toward the Pacific ports, the trains dropped off infected soldiers who were then carried into urban hospitals, infecting the cities it passed through. In three waves of disease, over the next two years, it would claim 50,000 Canadian dead, a fragment of a global cataclysm that slew between 50 and 1000 million people.
Canada was no stranger to epidemics. In the nineteenth century, the country had suffered from attacks by smallpox, typhus, tuberculosis, and in 1890, the Russian Flu, but the 1918 influenza was far more rapid and deadly. Victims would first complain of a cough or fatigue and then experience a buildup in the lungs that could not be expelled, smothering the sufferer to death in a matter of days. It seemed to target the young and healthy, pregnant mothers, and children.
Our nation’s first line of defence against epidemics had usually been a maritime quarantine: don’t let diseased foreigners land in Canada. But now that the barrier had been breached and the Spanish flu was abroad in the land, authorities found themselves unprepared. The disease was not understood, its causes were unknown, medical facilities and staff were inadequate to deal with the sick, and there were not enough grave-diggers to bury the dead.
As Canada now faces a similar challenge from an influenza strain which we as yet have no weapons against, a look at our experience a century ago might be helpful in predicting what we can look forward to.
There will be massive lock-downs of communities but resistance to isolation will come. In 1918-20 many Canadian towns and cities legislated against public gatherings. Places of entertainment like pool halls, restaurants, and movie theatres were closed, and churches were told to stop holding worship services. Shopping hours were restricted. Weddings and funerals were postponed and sporting events were cancelled. The 1919 Stanley Cup finals which pitted the Montreal Canadiens against the Seattle Metropolitans was brought to a halt before the face-off for the sixth game when it was learned that only three Canadiens were fit to play; defenceman Joe Hall of Montreal would die of the disease. Roads were patrolled to prevent the movement of the sick and families nailed shut their windows lest the disease enter the house through the air.
Though many complied at first, social isolation eventually began to pall, especially when the Great War ended and Canadians wished to celebrate. Despite the bans on public assemblies, hundreds of thousands poured into the streets to mark the victory, inevitably spreading the disease. Businesses started to complain about the economic damage they were suffering; individuals began to flout the regulations. Eventually governments relaxed the restrictions – too early as it turned out, because a second, and more deadly, wave of influenza struck in early 1919.
The efficacy of masks will be debated. In 1918 Alberta it was illegal to appear in public without a mask (over 100 would be fined for ignoring the law) but in British Columbia, medical opinion was divided. Some doctors recommended that those working with the public, such as bank employees, wear a mask at all times, but other physicians believed that the face coverings only collected germs. Wool masks tended to be favoured over those of cheesecloth which quickly became wet and uncomfortable.
The blame game will be played. In the face of catastrophe, it is natural to search for causes and from thence to look for someone to bear responsibility. Just as Democrats in the USA are pointing fingers at the President and Canadian opposition members revile the current Liberal regime for bungling the Wuhan virus, local authorities a century ago blamed the federal government for worsening the situation by allowing sick soldiers to land; the federal officials said that these men were a local concern. Businesses blamed governments for the restrictions that damaged their bottom line. Voters in Winnipeg tossed Mayor Davidson out of office for his actions during the first wave of influenza and the way that the national government handled the flu crisis became an issue in Parliament and helped to defeat the Conservatives at the next general election.
There will be economic damage. Our ancestors a century ago discovered the cost of losing income during a mandated closure as well as the effects of ill and dying labourers leaving the workforce. A poolroom owner in Victoria claimed that he had lost $2500 because of the ban on public gatherings. Business groups, feeling the pinch, petitioned the government to relax their precautions while left-wing activists demanded that the government mitigate the harm suffered by the working class. If the experience of 1918-20 is anything to go by, the economic expenditures made by the government to some citizens will be seen as unfair and profiteering by those who do not receive such payments.
Desperate times call for desperate measures and a pandemic will surely produce unfounded claims of a cure. In 1918 people thought that the strong smell of onions would ward off disease while others advised of the value of enemas and vegetarianism. Entrepreneurs will attempt to take advantage. Drug stores sold chili paste that could be slathered on the chests of flu victims and the price of lemons shot up as rumour spread of citrus cures. Hudson’s Bay Company stores advertised the health virtues of Boral Throat Gargle, Listerine, Paraformic Throat Ease Tablets, Harry Lauder Vocalets, Cascara Bromide Quinine, Evans Famous Pastilles, Syrup of White Pine and Tar, and Norway Pine Syrup. Cigar store owners claimed that tobacco kept the influenza at bay while “Eat more candy, have less flu” was the advice of sweet shops. Thousand swore by the therapeutic uses of alcohol and opioids. In the twenty-first century crisis we can already see bogus cures being offered at a price as well as the helpful ingenuity of those with 3-D printers trying to fill the need for respirators.
Volunteers are essential. Pandemics will eventually overwhelm the capacity of the state to deal with the care of the ill, the disposal of the dead, and the filling of jobs held by those who can no longer work. This is where an army of volunteer help, particularly women, stepped in to assist at hospitals, tend to orphans, visit shut-ins and keep essential services open. In British Columbia, the Rotary Club organized a volunteer taxi service among its members to ferry doctors, nurses, and clergy to emergency hospitals while a garage offered free repairs to all cars being used in the shuttle service. Canada today has a more extensive government apparatus but a century ago our country had a more developed civil society of churches, fraternities, and service organizations that could respond to the call for voluntary help.
Churches will adapt. Today churches, shuttered for a time by their denominations, are holding services online, live streaming their sermons and liturgies. A century ago pastors published their sermons in the local newspaper. On the day the First World War ended, Reverend Edward Diamond of Kenora, Ont. immediately organized a service of thanksgiving at the city’s Anglican cathedral. Since public gatherings were forbidden Diamond reported that he “alone thanked God” for the victory by singing hymns and reading psalms to an empty church
Ethical issues will arise. Inevitably in a hard-pressed medical system, triage will become necessary. Doctors and nurses must decide who among the ill can be saved and those on whom medical intervention would be useless. Among the Health Canada guidelines which our current government is presumably acting upon is a section which deals with “a code of ethics that is distinct from traditional clinical ethics”. The document states: “Whereas clinical ethics focuses on the health and interests of individuals, public health ethics focuses on the health and interests of a population. When a health risk like a pandemic affects a population, public health ethics predominates, and a higher value is placed on collective interests.”
Government intervention in our lives will grow. The confusion of responsibility and glaring gaps in responses to the crisis a century led to the creation of a federal department of health (though that is an area constitutionally given to the provinces). It also prompted calls for a comprehensive policy health care which were heeded decades later. In 2020 we can already see government given emergency powers that would prove irksome if long-continued and we can hear activists crying for a universal basic income.
Historians, I am the first to confess, make terrible prophets. Reactions to a crisis a century ago may not be mirrored today, and the only iron law among human actions is the Law of Unintended Consequences. Stay calm and be kind is the best advice.
Gerry Bowler is a Canadian historian and a Senior Fellow with the Frontier Centre for Public Policy.