The 1918 trip around the world taken by the influenza virus as it moved from body to body on the wings of sneeze and cough left a trail of 50 to 100 million bodies. In the United States, the pandemic took more people in a single year than AIDS has killed in 40 years.
In the light of those numbers, 33,000 flu deaths in New York City has long been considered a relative if very macabre success. The city's death rate from the disease — 4.5 per thousand — was lowest among large cities on the east coast, and on the low end nationwide. By comparison, Boston's death rate was 6.5 and Philadelphia's was a whopping 7.3.
High marks for crisis management have historically been given to Royal S. Copeland, the president of what was then called the city's Board of Health. He's generally seen to have stumbled at first by underplaying the seriousness of the outbreak. "There is no cause for alarm," he told the public even as violently ill passengers were being removed to hospitals from ocean liners and naval vessels at anchor in the harbor. But, ultimately, it's Copeland's innovations that are credited with helping to slow the virus.
A clever public information campaign spread health tips through newsreels at theaters; posters reading "Spit Spreads Death" were hung all over town; and Boy Scouts accosted people heedlessly coughing in public with cards that read, "Stop! You're in violation of the sanitary code." Hundreds of nurses were told not to wait for patients to arrive at hospitals but go to tenement-packed slums and bring healing, along with the application of selective quarantine, to the infected, their family, and neighbors.
And crucially, Copeland took advice from a brilliant health official named S. Josephine Baker on the question of whether to close the schools. She strongly supported keeping school doors open so children could be monitored and treated early if they showed signs of infection.
Was it enough?
John Barry, author of The Great Influenza, a definitive history of the plague, said, no. "In most disasters, people come together and help each other," he told WNYC. "That was not the case in 1918 in most places. I think a lot of that was because of the politics of it and the public health response, or lack thereof."
Barry said the city's low death rate from influenza might have resulted from natural immunization among part of the population when a milder form of the virus moved through the city several months before the lethal strain showed up. In other words, luck.
But Copeland has his defenders, among them Allan Kraut, professor of history at American University, and Jessica Cole, a planner at the city's Department of Health and Mental Hygiene. We interviewed both, along with James Colgrove, professor of public health at Columbia University. They discussed how the disease was handled a century ago — as well as lessons we might apply when doing battle with future pandemics.
