In 1918, Louisville came together when faced with flu pandemic

Louisville City Hospital, photo from University of Michigan history of medicine project.

I was paging back through some old newspapers, looking at what generally is agreed to be the worst influenza outbreak in Louisville’s history, and was struck by something. They didn’t know as much back in 1918 when the so-called “Spanish Flu” hit, but they knew more than you probably think. Today, our technology is better, and communications, and we have more advanced medical care. But several things they did back then were actually better than today.

When it comes to viral infections, the best remedy, for individuals and communities, is to try to avoid them. And the best measure for containment is limiting large gatherings. In 1918, Louisvillians, by all appearances, had a healthy respect for this.

Today’s 10 thoughts are all from the 1918 flu that hit Louisville and the nation. Maybe from looking at what happened then, we can get some insight for today.

1). THE FLU OUTBREAK began with soldiers at Camp Zachary Taylor, which at the time was the largest military training grounds in the nation for soldiers headed into World War I. The flu quickly spread through that population, overwhelming the medical facilities there, forcing barracks to be converted to medical use. Within three days of the first flu reports, strict measures were taken to bar soldiers from the rest of the city. No more than 15 were allowed to congregate. Guards were posted to assure they didn’t venture off base.

2). TWO DAYS AFTER the first reports from Camp Taylor, city officials took some decisive action. They ordered public gathering places to ensure better ventilation. They ordered streetcars to run with open windows, and what we would now call “social distancing” for riders. They also prohibited public funerals as a measure to limit large gatherings. Within a week after those actions, the state ordered that flu patients be quarantined in their homes, which were to be placarded with warnings not to enter.

3). ONE THING THAT may have saved lives in those days was that nurses – who did much of the caring for flu patients – went home to home to check on patients, rather than the patients traveling to hospitals and spreading the flu. Now, that wasn’t a better setup for those who needed more intensive care and sanitary conditions. There were people in hospitals – and the beds in fact filled quickly and makeshift hospital facilities had to be created — but I can’t help but believe that people having access to home care helped things from being worse than they were, which was pretty bad, as you’ll see. Not being an expert in this, I’ll stand corrected if necessary.

4). ON DAY 13, city health officials began planning in earnest for a larger outbreak. The state closed all churches, schools, and places of amusement or assembly until further notice. Louisville mayor George Smith met with local merchants and persuaded them to stagger their employees’ hours so that the streetcars wouldn’t be overcrowded. For comparison purposes, today, and we can debate timelines, but we’re on Day 8 since the first case in Kentucky was discovered. The first school closures will begin on Day 9.

5). STILL, THE SPREAD WAS ON. I’m impressed at how different elements and groups in the city began to jump into the crisis. Private citizens donated their cars to be used so that nurses and volunteers could check on the sick. School nurses and other volunteers joined the cause to care for the sick. The Louisville Advertising Club made sure that safety notices were placed in the papers every day. Public and private groups came together in a seamless way. As the cases increased, so did the cooperation. In times like this, many of us find ourselves asking not, “What do I want to do?” Instead, the question is, “What do I need to do for the common good?” I hope that’s the attitude we’ll have as we go through this together.

6). BY DAY 24, THE NUMBERS WERE IMPROVING. State and city leaders met at the Seelbach Hotel. But instead of lifting the clamps on some of the restrictions, they actually tightened them. They ordered saloons and soda fountains to close at 6:30 p.m. Churches were, however, allowed to open for individual prayer.

7). NOT UNTIL DAY 47 WERE THE BANS LIFTED. Churches were allowed to have services again on Nov. 10, 1918. A day later, students returned to school. Restrictions on stores, restaurants and bars stayed in place. And the city mandated social distancing measures at places like bowling alleys, theaters and other public gathering spots. The problem was, having been cooped up for so long, people flocked out, and stood in lines, and gathered.

8). WITHIN A MONTH, IT HAD STARTED ALL OVER AGAIN. On Day 81, having seen another spike in flu cases, especially among young people, city health officials closed schools again, and barred everyone under 14 from theaters and other gathering places. One interesting note: Through the Christmas holiday, store owners took care in their advertising to stay away from promotions that would send people flocking to their shelves. This, to me, typifies the community spirit you read a great deal about from that crisis. The second school closure was lifted on Dec. 30, and though there was a milder spike in February, no further closures were needed.

9). IN ALL, MORE THAN 14,000 died in Kentucky in the 1918-19 outbreak. In Louisville, more than 1,500 died at Camp Taylor, and 577 died in September and November in city (the population of Louisville was in that time around 230,000). More died outside the city limits in Jefferson County.

10). BY MOST ACCOUNTS, the current virus threat is not as deadly, but perhaps more contagious. More cases are expected. The number, health experts continues to say, will be determined by the public willingness to avoid large gatherings in common areas. If we can’t, government will be forced to take action that will make that happen.

Most of these points were gleaned from research done by the University of Michigan Center for the History of Medicine, which drew heavily on material from The Courier-Journal and The Louisville Times, and from reports from the city board of health. You can read a full summary of its findings on Louisville and the 1918 epidemic here.

Stewart Sanders of the Kentucky Historical Society wrote a prescient piece on the 100th anniversary of the flu outbreak for the Lexington Herald-Leader in 2018. You can read his piece here

Charles Hartley of Shepherdsville wrote a reflection of the period in Bullitt County for The Courier-Journal in 2014. That piece is available here.