Blue lips. Blackened skin. Blood leaking from noses and mouths. Coughing fits so intense they ripped muscles. Crippling headaches and body pains that felt like torture. These were the symptoms of a disease that was first recorded in Haskell County, Kansas, one hundred years ago this week, in January 1918. From Kansas the illness spread quickly: not only throughout the U.S. but across the world. Eventually (if misleadingly) it became known as Spanish flu. And while its effects on the body were awful, the mortality rate was truly terrifying.
During a pandemic that lasted two years from its outbreak in the U.S., between 50 million and 100 million people across the globe died. Spanish flu killed more people than any pandemic disease before or since, including the sixth-century Plague of Justinian, the medieval Black Death, the AIDS epidemic or Ebola.
The First World War, which was ending just as the flu took hold, killed barely a third as many people with bullets and bombs as the H1N1 strain of influenza did with coughs and shivers.
This photograph, from the archives of Oakland Public Library in California, shows nurses of the American Red Cross preparing surgical dressings for use on flu patients during the winter of 1918-19. Colorizing the photograph reveals that they are wearing a variety of uniforms. The dark-veiled women standing to the top-right of the frame are wearing the blue headdresses that had been brought in for use by the Red Cross Supply Corps in regulations issued in 1917. Others, however, are still wearing uniforms dating to before these new rules were issued. Color paint-portraits of Red Cross nurses tell us that veils had previously been white. During the emergency conditions of the pandemic, presumably there were better things to worry about.
The virus had first appeared in Oakland in early October, and within a fortnight of its arrival thousands of people were sick. The city hospital was quickly overwhelmed, so the mayor ordered the recently opened civic auditorium (now the Kaiser Convention Center) to be converted into an overflow ward with 80 beds. All were quickly filled by seriously ill Oaklanders.
The image here was one of several taken during a visit to the auditorium by the renowned local newspaper photographer Edward A. ‘Doc’ Rogers. Doc was no stranger to calamity, having covered major Bay Area disasters including the 1906 San Francisco earthquake. The nurses he photographed were volunteers working for the American Red Cross. The gauze across their mouths was a precious commodity, since literally every person in the city required it: citizens had been compelled by law to wear a face-mask in public, under pain of an $100 fine and 10 days in prison.
In Oakland, swift action by the city authorities to shut schools and churches and enforce public hygiene measures meant that the local flu epidemic was under control by February 1919. Nevertheless, 1,300 citizens had died, out of 675,000 American deaths in total: more than were killed during the entire Civil War. The pandemic, combined with mortality during the First World War, caused United States life expectancy to drop by 12 years.
Today flu can still be lethal, but a tragedy on the scale of 1918 has, mercifully, not been repeated.