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Philadelphia 1918: It Started With a Cough

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  • Philadelphia 1918: It Started With a Cough

    A long article here: http://www.upenn.edu/gazette/1198/lynch.html

    In Pennsylvania, the influenza epidemic began almost unnoticed in the middle of September. First a few cases, and then the numbers began to rise rapidly. Worried state health authorities decided to add influenza to the list of reportable diseases. Their concern increased when 75,000 cases were reported statewide. The worst was still ahead.
    Philadelphia was about to become the American city with the highest death toll in one of the three worst epidemics in recorded history.

    Philadelphia, October 4: 636 new cases, 139 deaths.
    Dr. A.A. Cairns, acting president of the Philadelphia Board of Health, is frantic: more new cases every day, and the city's death toll is mounting. The state has already closed all the vaudeville and picture houses, theaters, and saloons in Pennsylvania. Cairns decides to close all schools and churches in the city...
    Weeping women in West Manayunk block the car of Dr. Joseph Schlotterer, who is making a house call, and permit him to leave only after he treats 57 neighborhood children.
    Frantic shoppers strip pharmacy shelves bare. The press of customers is so great that the Philadelphia College of Pharmacy and Temple University suspend classes so that pharmacy students can help fill prescriptions. Most are for whiskey, which, now that saloons are closed, is available only in drugstores. Rather than wait to become a statistic, people turn to home remedies: goose-grease poultices, sulfur fumes, onion syrup, chloride of lime.
    The Hospital of the University of Pennsylvania is quarantined, and no visitors are permitted. Due to the shortage of physicians, third- and fourth-year Penn medical students volunteer to take care of the patients.
    Panic is beginning the grip the city.

    Philadelphia, October 8: 1,481 new cases, 250 deaths.
    The director of the Philadelphia Hospital pleads for volunteers to relieve nurses who have collapsed from overwork.
    In many families, both parents are ill and unable to care for their children. Their cries for help often go unheeded, as many neighbors fear entering a house where there is influenza. Others, without thought of their own safety, tend the ill, care for the children, and comfort the dying.

    Philadelphia, October 10: 5,531 new cases, 361 deaths.
    Philadelphia hospitals are filled to overflowing. Hospital beds are set up in the Armory. The University of Pennsylvania, together with Jefferson College and Hahnemann Medical College, recruits 300 fourth-year medical students to aid overworked physicians.
    Besieged by outraged residents, the Bureau of Street Cleaning agrees to sprinkle the streets with disinfectant.
    After 12 Penn dental students are stricken, the University closes the Dental School, noting that "working over patients' mouths subjects the men to the danger of contracting the disease."

    Philadelphia, October 14: 4,302 new cases, 557 deaths.
    A new health menace threatens: the dead are not being buried fast enough.
    More than 500 corpses are awaiting burial, some for more than a week. The Office of the Coroner cannot keep up with the demand for death certificates. Cold-storage plants are used as temporary morgues, and the J.G. Brill Company, manufacturers of trolley cars, donates 200 packing crates to be used as coffins. Prisoners from the House of Correction team up with seminarians from St. Charles Seminary to dig graves, as the cemeteries cannot keep up with the demand. Fifty students from Penn's Dental School volunteer to work in city hospitals to relieve exhausted medical staffs.

    Philadelphia, October 16: 2,280 new cases, 650 deaths.
    The heavy death toll attracts human vultures. Some cemeteries raise burial fees to $15 and tell families they will have to dig the graves themselves. Several undertakers increase the price of their services by 500 percent.
    Unscrupulous pharmacists inflate the price of cheap whiskey -- usually the only treatment prescribed for influenza -- to $52 a gallon. Enterprising barkeeps defy the Board of Health ban on saloons with back-door sales. One saloon owner argues with the Vice Squad that he is only looking after the health of his regular customers.
    The ferries are jammed with people anxious to get to Camden, where the bars are still open. The daily mass exodus causes Dr. Henry Davis, chief of the Camden Board of Health, to close the city's saloons "in the interest of public health. Thousands of the lowest people of Philadelphia came over the river and created great disorder. They were the vilest men and women that have visited Camden."

    Philadelphia, October 17: 1,686 new cases, 711 deaths.
    The city's hospitals are placed under police supervision, with patrol cars serving as ambulances. The Red Cross Home Service, besieged by servicemen overseas for information about their families, frequently sends no reply. The families do not wish them to know their loved ones have died.
    Countless deeds of charity help rescue the forgotten members of society --the destitute, the orphaned, the retarded, and the friendless. Sisters of the Holy Child comfort and care for youngsters in a West Philadelphia home for "backward children" after all the staff have fled. Emergency Aid members visit shabby boarding houses where hundreds lie ill with no one to assist them and arrange for their care.
    A man who sneezed is forcibly ejected from a trolley by his fellow passengers.

    Philadelphia, October 20: 1,334 new cases, 606 deaths.
    As quickly as the epidemic had come, it left.
    Churches reopened on October 27 in Philadelphia. Schools, theaters, vaudeville houses, and bars followed in quick succession.
    The passage of the "Spanish Lady" through the streets of Philadelphia left in its wake 12,191 reported deaths and 47,094 reported cases in four weeks and a business community crippled by revenue-losses in the millions.
    One question still haunts medical science: Where did the virus come from and where did it go after 1918? Some believe that a mild hog flu virus combined with an equally mild Pfeiffer bacillus in a synergetic process, producing a killer that injured human lungs beyond their capacity to recover --but no one knows for certain.
    The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

  • #2
    Re: Philadelphia 1918: It Started With a Cough

    Below is a chart based on the data listed in the post above. The cumulative total of new reported cases in Philadelphia between Oct 4 and Oct 20, 1918, is 17,250. The cumulative death total during this period (as noted in the article) is 3274. That would represent a CFR of almost 19 percent, with a final CFR of almost 26% for the the town for the single month of October based on the totals noted in the final paragraph.

    The passage of the "Spanish Lady" through the streets of Philadelphia left in its wake 12,191 reported deaths and 47,094 reported cases in four weeks and a business community crippled by revenue-losses in the millions.
    Click image for larger version

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    • #3
      Re: Philadelphia 1918: It Started With a Cough

      many cases were unreported.
      With 1.7M population and 25% CAR you would have more
      than 400000 cases
      I'm interested in expert panflu damage estimates
      my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

      Comment


      • #4
        Re: Philadelphia 1918: It Started With a Cough

        Barry has 2 chapters about Philadelphia : 17 and 19.

        His main culprit is the Liberty-Loans Parade on Sept.28,
        then the early introduction, overcrowding, the bad management,
        bad health equipment.
        He traces the outbreak back to 300 sailors arriving from Boston
        on Sept.7, 19 of which reported ill on Sept.11

        But in total Philadelphia with 12100 deaths = 0.71% did not so much
        worse than the US-average with 0.5% dead.

        How many deaths in Philadelphia if the parade had been cancelled ?
        my estimate: 11000
        I'm interested in expert panflu damage estimates
        my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

        Comment


        • #5
          Re: Philadelphia 1918: It Started With a Cough

          There was also a stigma attached to anything influenza related. An older family member lived thru the 1918 pandemic and had a young child die of pneumonia in about 1919 or 1920. She was adamant that the child had died of pneumonia and not Influenza. She would not consider the possibility. She would have been about 17 at the time of the pandemic and would not discuss it in any detail. It was more important to look forward and get on with life.

          I would not be surprised if many doctors at the time were urged by surviving family members to declare a cause of death other than the dreaded influenza. This was an era when neighbors and communities were much closer and less anonymous than they are today. Word of mouth would quickly spread which doctors strictly followed rules and regulations for reporting cause of death. Since the doctors future income may depend on the good will and patronage of the surviving relatives I wonder how many deaths caused by Influenza were reported as maybe: pneumonia or heart failure?
          We were put on this earth to help and take care of one another.

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          • #6
            Re: Philadelphia 1918: It Started With a Cough

            influenza and pneumonia deaths are often added together and considered
            as a whole.
            Even for declared deaths from heart disease you would recognize
            influenza in the statistics by seasonality.
            That's how they arrive at the figure of 36000(40000 meanwhile ?)
            per year in USA from influenza, while the reported deaths from influenza
            are only a few thousand.
            I'm interested in expert panflu damage estimates
            my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

            Comment

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