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The Spanish Influenza Pandemic in Oklahoma City

Description:

The Setting

The beginning of Fall 1918 was a hopeful time for a United States just coming on to the international scene. American Doughboys had been in the trenches of Western Europe fighting what would become known as the Great War or World War I for about a year. Their exuberance (some would say naivete) and fresh approach had paid off as the Allies began rolling back the German lines all along the front. President Woodrow Wilson had also taken a leadership role in the peace negotiations while back home he had succeeded in total mobilization for the war effort.

Oklahoma City, population 103,000 and not quite thirty years old, had done its part for the war effort, too.  Many city boys had volunteered or been drafted to fight. The women of the city, through the Red Cross, rose up to sew socks, bandages and pajamas for soldiers as well as passing out coffee and doughnuts and kind words of comfort to Doughboys passing through the local train stations.

There was something new and ominous that Fall, though – Spanish influenza. Influenza, of course was not new, but Spanish influenza had ravaged Europe in ways not even the war could have.  This strain of the influenza A virus (later to be called H1N1) likely came from birds and proved to be highly infectious with an infection rate of 20-30% of the population and a mortality rate of 5-10%. All this, of course, was unknown to health officials and researchers. It was not even known that influenza was a virus at the time.

What was known, though, was the severity of this disease. Within hours of being stricken, victims would be incapacitated, unable to walk or even move their arms and legs in some cases.  A fever of 100 to 104 degrees lasting three to four days was common, as was a heavy cough. The skin would turn blue and sometimes black, so much so that sometimes a sufferer’s race could not be determined. In severe cases hemorrhaging would fill the lungs and the stricken person would drown in their own body fluids. The worst cases lead to mental illness and derangement with the victim sometimes taking extreme actions as a result of hallucinations. Even if a victim were to have a mild case of the flu, the likelihood of contracting pneumonia, with its high death rate, was increased.

Throughout late Spring and Summer, the flu spread across the continent, not discriminating Central Power from Allied, French from German. It was called the Spanish influenza because most of the early reports of the pandemic came from Spain which was not a combatant in the war and thus did not suffer from wartime restrictions on the press. But now, in September, people in Boston, New York, and Philadelphia were getting sick. In addition, the hundreds of Army training camps across the country had become incubators for influenza because they had two key ingredients for the spread of disease – dense population and poor sanitation. Initially, though, public health officials were playing it down for fear of causing panic across the country.

 

Influenza Arrives in Oklahoma City

 

Wesley Hospital

On 16 September, an Oklahoma City doctor reported to the Oklahoma County Health Department (OCHD) that he had treated a patient with a ‘heavy cold’, but he was reluctant to call it the flu. Over the next week some similar cases had been seen, but victims were better in three to four days, so no cause for alarm was necessary.  But then on the 26th, Dr. Winnie Sanger reported to the OCHD that Corine Smith, a resident of the Maywood neighborhood had symptoms very similar to what had been seen on the East coast. Officials dismissed it as strong hayfever. In a twist of fate, on the day this first case had been reported in Oklahoma City, ten doctors and dozens of nurses were called into service by the Army and left town for San Antonio, Texas. They would be desperately needed in the weeks to come.

City and county health officials still did not inform the public that Spanish influenza was on the doorstep and maintained the belief that they could control any outbreak of the disease in the city. Such was the feeling on the last weekend in September.  However, on Sunday the 29th, Dr. John Duke, State Health Commissioner published a notice in all the local newspapers under the banner “How To Avoid the Flu”.

 

Confusion Reigns

By Tuesday, October 1, the city was under siege as 5,000 people suddenly fell ill with the flu. At the Emergency Hospital, staff reported that patients began streaming in Sunday night and did not let up all day Monday. Soon all the beds were full and almost all of the nurses had come down with the flu. Doctors initially thought the rapid spread of the flu was due to trains sweeping in from the nine rail lines passing through Oklahoma City, but the Emergency Hospital nurses would not have had time to get sick yet. The head nurse at the hospital provided the answer – her staff had been visited by Army doctors from a camp in Kansas earlier in the week.

Tuesday and Wednesday each saw about 500 new cases added to the total and health officials assumed this meant that the infection rate had slowed from the initial burst. On Wednesday, Jesse W. Hill and then Lillie Browning succumbed to the disease. These first two deaths were travelers who had been staying at the Lee-Huckins Hotel when they fell ill. An enquiry there proved that the disease was far from contained - the management reported that half of the staff of the hotel was out with Spanish influenza.

Unfortunately at this critical period in the crisis, the medical community was in disarray. Doctors in the field were so busy treating patients, they were unable to accurately report on the situation – a case of not seeing the forest for the trees. At the same time administrative doctors were unsure of what action to take because they were likewise unable to assess the severity of the local epidemic and because there were overlapping areas of authority. Dr. J. R. Black, president of the County Medical Society suggested closing the public schools; he was seconded by Dr. LeRoy Long of the University Hospital – neither had the authority, however – and there were still those who said it would pass in a day or two. To further compound the confusion, Mark Kesler, Oklahoma City Commissioner of Public Safety (similar to a modern emeregency management director) – the one man who had ultimate authority to act in crisis situations – left the city to visit his mother in Kansas City.

A City Under Siege

 

 Library Day at University Hospital

Over the next few days the city would be brought to its knees. Something was different about Spanish influenza. Most strains of the influenza virus attacked weak bodies – the very young and the very old – and only mildly affected strong, healthy young and middle-aged people. This new strain seemed to operate in an opposite manner. Just as it struck hard at the virile young soldiers, it seemed to target the healthy hard-working citizens of Oklahoma City. All around the city the economy began to disintegrate. Doctors and nurses, of course were hit hard, but soon the motormen and conductors of the Oklahoma Railway (street car line) were struck and people were unable to get to and from work. President John Shartel promised to run the lines as long as he could if he had to do it himself. Often one man acted as motorman, conductor and ticket taker on the same car. Soon almost the entire staff of Alexander Drug Company, the city’s largest distributor of medicine for the flu, was ill. It made little difference, though, because most delivery drivers were sick, too. Western Union reoprted that they were receiving 400-500 messages a day, but they only had four people willing or able to deliver them. Finally, in one of the more dire announcements to come out during the early days of the crisis, Pioneer Telephone reported that 174 of their operators (nearly all of them) had fallen victim to Spanish influenza at a time when communication was most critical. One business profited quite well, however. With medicine in short supply, doctors were signing prescriptions for dram bottles of whiskey to be filled at the police station from confiscated supplies. When word got out that whiskey helped flu sufferers, moonshiners and bootleggers did a brisk trade in whiskey at $18.00 a quart ($234.00 after adjusting for inflation).

By the end of this first week of the crisis, city medical and health officials tried to take stock of the situation. Most doctors reported that they were seeing fewer and fewer cases each day. Dr. George Hunter, the City Physician, and the County Board of Health believed that the dropoff in cases was proof the worst was over. Dr. Leila E. Andrews dissented saying that the people who know how bad the situation is are too busy working to protest. In the end the Board ruled that Oklahoma Cityans were unduly alarmed because of newspaper reports of the national pandemic and what was seen in the city were just strong colds, not Spanish influenza. They not only ruled that a quarantine was unnecessary, but likewise closing the schools – after all schoolchildren were not getting ill. 

On Monday morning of the following week, word came that Mayor Ed Overholser was ill; by the end of the day only one city commissioner  - finance chief Mike Donnelly – was able to show up for work. With city government decapitated, hospitals filled to capacity, doctors and nurses working 48 hour shifts, communication and transportation systems on life support and the working life in the city a shambles, it was shaping up to be one of the most dire periods in Oklahoma City’s history.

Red Cross a White Knight

The day after city government was crippled, the American Red Cross came to the rescue. Already mobilized for the war effort, the national headquarters authorized all local chapters to use their supplies and manpower to fight the influenza pandemic. There were many women already active in the Red Cross efforts, but it was Alberta F. Daugherty, holding the unlikely position of Education Director, who stepped up and became the leader in the fight against the deadly virus. She believed that there were hundreds, maybe thousands, more ill in the city who had gone untreated because the transportation and communication systems were down; doctors only knew about the cases that came to them. Mrs. Daugherty quickly began recruiting women who would be willing to go into the homes of sick people and care for them. This appeal went out in many of the newspapers in the city:

“Every strong, competent woman who knows how to take the temperature of a patient, who can give a bath, make a bed, who can bring order to a chaotic house and who can cheer the members of a family is needed in the present crisis. It takes a brave woman, a self-forgetful woman to answer this call, a woman whose love for humanity is deep and genuine, whose patriotism is flawless. The spirit of the men who face the enemy without flinching is not unlike the spirit of the good women of this country who are performing extraordinary labors, who are braving the hazards of contagion, who are unafraid to do battle with death.”

Mrs. Daugherty worked eighteen hour days and some said they believed she had worked 48 hours without sleeping at times. When the Red Cross sewing rooms were unable to keep up with the demand for pajamas or hospitals asked for baby beds, Mrs. Daugherty would grab the phonebook and begin calling people asking for donations. She would visit homes where she heard there was flu and bring food, clean the home and do the laundry and then be gone as quickly as she arrived. On many occasions she used her own car as an ambulance to transport the worst cases to a hospital.

The Red Cross already had sewing rooms setup to make bandages and socks for soldiers and these quickly converted to making flu masks, pneumonia jackets and pajamas for influenza victims. But the central headquarters for fighting the Spanish influenza was the Carnegie Library. The library became the place where calls for help were received, donations were dropped off and delivered and volunteers were organized and assigned. It was already a public gathering place and storehouse for information, so it fell into this role naturally and effectively.

A Ban on Public Gatherings

Meanwhile, Dr. John W. Duke, state health commissioner took the official step of placing Spanish influenza on the quarantinable list of diseases. This meant that local health officials now had martial law powers in their jurisdictions. Almost immediately authorities in Oklahoma City closed all places of public gathering - schools, churches, concert halls, theaters and bars. The Columbus Day parade was cancelled as was a concert by world-renowned Irish tenor Michael McCormack. Newsies were also regulated so that no more than one per block could operate lest a crowd should gather to buy newspapers. Police had to break up a throng which had gathered around Rosenthal’s store window – Mr. Rosenthal had posted a large map showing the last Allied push on the faltering German army. Officers were also ordered to place people who spit in public under arrest or issue them fines.  Enforcement was proving difficult, though, as the police department was hit hard by the flu and there were hardly any officers available. For the first time in years, the police resorted to deputizing citizens to enforce the new ordinances.

Businesses were still struggling, too. Undertakers and funeral directors were beginning to struggle with 15-40 deaths a day. Florists had run out of flowers for the grieving. Adjustments were being made as quickly as possible, though. Packingtown had been hit hard, so the great meat processing firms from Kansas City and Chicago began shipping workers by the hundreds from plants up north to work at the plants in Oklahoma City. Closing the schools had an immediate benefit - with 14,000 children at home several hundred teachers were now available to enter the workforce in other capacities. They quickly volunteered to work in homes with sick people, some became telephone operators, others worked for the Red Cross and other duties.

As the second week of the crisis drew to a close, the weekend brought warm temperatures and blue skies. Spurred on by health officials recommending fresh air and exercise as a way to ward off the flu, many people went for Sunday drives in the country, played rounds of golf or simply frolicked in the city’s parks. Despite this fair weather, storm clouds were brewing over city hall.

Mrs. Daugherty Rides to the Rescue

Making her rounds throughout the crisis, Mrs. Daugherty had witnessed many tragic scenes in the city. At the home of the Harding family the mother and father had become ill with influenza. Mrs. Harding soon died and left Mr. Harding with a months-old infant and a two year old. He was so ill he couldn’t care for the children and the infant died. Neighbors phoned the police to send for help to bury the mother and baby and find someone to care for the two year old. Many soldiers had become worried about their families and the Red Cross sent Nettie  Wiesman to visit every soldier’s family to try and ease their worries. In one soldier’s home she found a family of six children all sick for a week with no care or medicine. In another, a family which had given four sons to the military had three children sick with influenza.  One of the saddest cases reported was that of a young mother who had been unable to nurse or feed her weeks-old infant and was too weak to even close the baby’s eyes after its death. When Red Cross volunteers found her she was suffering from mental trauma after staring into the baby’s dead eyes for several days.

Though exhausted, Mrs. Daugherty was undaunted.  She found conditions in the city, especially among the poor and working classes to be deplorable and she was very frustrated by the lack of care, concern and heart displayed by city leaders, both at city hall and in the medical profession. After filling the hallways and closets with beds and pulling every medical student out of class to administer care, the hospitals had long since stopped taking new patients, especially those who could not pay.  For some reason, though, authorities refused to open the city’s Detention Hospital, normally reserved for patients with highly contagious diseases such as tuberculosis, but recently closed due to staff shortages. There were also stories of the sick not getting medication because they could not pay for it. These problems infuriated Mrs. Daugherty and she appealed to Mr. Kesler and Dr. Hunter to do something about the problems. Initially they balked, but then Dr. Hunter agreed to open the Detention Hospital, on the condition that he personally approve each case. This opened up 100 new beds, but because Hunter was so busy with other duties, he was not admitting very many patients.

Mrs. Daugherty did not stop there. She also complained to city commissioner Donnelly and he quickly arranged for the city to commandeer rooming houses downtown to board patients at the city’s expense. The city also agreed to pay a pre-determined amount for each influenza patient admitted to a local hospital.

Mrs. Daugherty continued to plead with anyone who would listen to her description of how perilous conditions were in the city.  One person who was not at all pleased with Mrs. Daugherty’s efforts was Mark Kesler.  He had been out of town visiting his mother throughout the crisis and had begun to take criticism for shirking his duty. He felt Mrs. Daugherty was the source and phoned her at her home one evening and accused her of playing politics and trying to oust him from his post.

Prominent local attorney and chair of the Red Cross committee David I. Johnston was one of those who had heeded Mrs. Daugherty’s call to action. When he heard that Mark Kesler had attacked her, Johnston led a group of forty citizens who marched unannounced into the mayor’s office seeking Kesler’s resignation. The next day, October 17,  Mayor Overholser and commissioner Jack Walton, still ailing from influenza, were brought from their sick beds to attend a special meeting with Commissioner Donnelly presiding. Also present were Mr. Kesler, Dr. Hunter, Mr. Johnston and Mrs. Daugherty.

Almost immediately, Mr. Johnston rose and demanded Mark Kesler resign as public safety commissioner. He felt Kesler’s absence and mishandling of the crisis was cause for his removal. Johnston further recounted to the commission the work the Red Cross had done to help the city during the crisis and considered it an injustice that Kesler had accused Mrs. Daugherty of playing politics. The commissioners asked Mrs. Daugherty to tell her side of the affair and she closed by saying, “The business of combatting this epidemic, in plain English, means that sick people shall not be left to die simply because they are poor. Mr. Kesler can call it ‘politics’ if he wants to, but those of us who are not politicians regard it as simple Christian duty and humanitarian decency.”  Johnston, shouting angrily, turned to Kesler and told him if he didn’t resign, “the blood of these dead people will be on you! It’s a damnable thing! Less than a dozen cases have been admitted to the Emergency Hospital and people are dying like rats! Six or seven babies died only this morning!” Johnston closed by saying that if the city commission did not act against Kesler, a posse would keep the Detention Hospital open by force. He finished by turning to Kesler, “and I don’t know what will happen…” Although reluctant to do so, Kesler finally tendered his resigination. Perhaps seeing the writing on the wall, Dr. Hunter the City Physican also resigned. Commissioner Donnelly then decided to give control of all city health facilities to the Red Cross committee and offered all the financial help the city could muster.

Sweeping Changes

As usual, the Red Cross was prepared. A plan of action had already been drawn up and was immediately put into action. Mrs. Daugherty and the Red Cross Relief Committee designed a multi-pronged attack on the Spanish influenza. They separated the problem into three separate issues. First, the worst cases needed to be identified and admitted to a hospital. Second, milder cases and those recovering, needed better food, clean clothes and clean homes. Third, to help prevent relapses and the possibilty of other communicable diseases like cholera or tuberculosis, the city would need to be literally scrubbed down.  To organize their efforts, the Relief Committee drew up a large map of the city and divided it into eight districts, each with a Red Cross worker and a local citizen as a district captains. This broke the work into manageable units and provided better communication and coordination because the captains were familiar with the neighborhoods they were working in.

The morning after the Kesler meeting, the Red Cross plan was put into action. If the plan was to work, they would need more people. Immediately, a new and more aggressive call for more volunteers went out. The response was dramatic as hundreds of people stepped up either individually or through civic clubs. Many said they had been willing to help, but had not known how.

The Relief Committee sent volunteers to visit every single household in the city to find victims and to distribute 20,000 pamphlets explaining what Spanish infulenza was and how it could be treated and prevented. The worst cases were to be sent to hospitals and anyone who refused to go was to be forcibly removed by the police and taken to the hospital. The canvass found that the Packingtown area was hit the hardest. In this neighborhood populated by immigrants and some of the poorest families in the city, volunteers found that every single house had a least one case of the flu and some had as many as five cases. To insure that there were enough beds for these ‘new’ cases, Mrs. Daugherty arranged for temporary hospital wards to be set up in First Presbyterian Church, Oklahoma City Country Club, and the Community Center.

The Liberty Kitchen, which had been providing coffee, doughnuts and soup for troops in passing trains, shifted from feeding soldiers to feeding Spanish influenza patients. Dietary guidelines were drawn up for patients suffering from influenza and a separate diet for those recovering from it . Commissioner Donnelly authorized the purchase of groceries at city expense and ordered the police to assist in the delivery of meals. Many civic clubs whose members owned cars also volunteered.  One civic club, the Provident Association, set up a facility to wash laundry for the whole city, free of charge. They also opened a childcare center and nursery to care for the healthy children of influenza victims until their parents were back on their feet.

The final thrust of the attack was carried out by Commissioner Donnelly and the city’s Public Works Department. City workers rounded up as many able-bodied men as they could find to clean up the city. Trash was collected from every boulevard, side street and back alley. Those streets paved with brick were hosed down and scrubbed with soap, dirt streets were raked, and rats and bugs were chased out of dark corners and sent packing. Rooming houses were also inspected and either condemned or cleaned up.

The Tide Turns

The tide in the battle against Spanish influenza turned almost overnight. Doctors had begun to see increasing numbers of children develop the flu and several relapses began to occur as well, but once the Red Cross began removing infected people from homes and getting them early care, the number of new cases dropped dramatically. Doctors, nurses, and the early volunteers could now get some rest after two weeks of round-the-clock shifts.

The next two weeks were still critical. One dangerous situation developed involving energy. Because of war production natural gas prices had risen, so most consumers intended on using coal for the winter of 1918-19 to heat their homes. Accordingly, distributors such as Oklahoma Gas and Electric Company did not lay in large winter reserves. However, the coal miners in southeastern Oklahoma were hit terribly hard by Spanish influenza and coal production took a steep dive at the same time the weather turned cold.  Doctors were concerned that it would be hard to fight off the flu if people were shivering in their homes. 

There was also an election pending the first week in November. Politicians were calling it the “year without a campaign” since they were unable to hold rallies and meetings because of the ban on public gatherings. Newspaper advertisements and stories by symapthetic editors were the best most candidates could do for a campaign. Judge J. B. A. Robertson, running for governor on the Democratic ticket, managed to get a story in the Oklahoma News in which he suggested that since people had been unable to hear from all the candidates it was better that they simply vote to keep the Democrats in office for continuity and security. He would win the election on November 5.

By Wednesday, October 23, the pandemic was definitely under control. Health officials had already seen a decrease in new cases and by this time began to see crowded hospital conditions ease. There was still human tragedy as in the case of Mrs. Coldiron. A widow, her daughter died of Spanish influenza and she returned home from the funeral to find a Red Cross worker waiting to inform her that her soldier son had been killed in France. Overall, though, spirits began to rise across the city as news spread of the peace negotiations in Europe and children began to prepare for Halloween. Officials would not lift the ban on public gathering, but felt that if the children did not bunch up too much and infected people did not participate, then ‘ghost walking’ would be permitted. 

Finally, on November 9, the ban on public gathering was lifted. It was a Saturday night and the whole city seemed to rejoice. Theaters were packed as owners struggled to put together shows on short notice, but theatergoers didn’t seem to notice and cheered for encore after encore. Their spirits and energy were bolstered by news that Germany had surrendered - the Great War had ended. They would play and cheer and shout this night and come together for rejoicing and thanksgiving the next day, when churches would open for the first time in over a month. The people of Oklahoma City had weathered their most trying times. They battled hand-to-hand with war, death, and disease and emerged victorious.

Epilogue

Spanish influenza attacked young and old, rich and poor alike and although all the deaths were mourned with sadness, there were some high profile deaths which bore heavy on many across the city. One of the earliest such victims was Duke Sweatt. Sweatt was allowed to join the Navy in 1916 at the age of 14 (the youngest person in the military at the time) and had served two tours with the Navy during the war when he fell ill and died of Spanish influenza at the age of 17.  Fifteen year old John Douglas, the grandson of the Carnegie Library founder Julia Douglas, and his mother, Grace both died within days of each other. He had just won a national contest for a Liberty Loan poster he had created. Finally, city engineer Guy V. McClure, who had been overseeing the contruction of the dam for the water supply lake west of the city, also died of Spanish influenza. He was so beloved that many citizens wanted to name the project Lake McClure in his honor. However, before the name became official, revered Mayor Ed Overholser resigned his post because of lasting complications from his bout with influenza. City commissioners decided to name the project Lake Overholser instead to honor the man who did so much for the city. 

In the Spring of 1919, state health officials made an attempt to quantify the effects Spanish influenza had on Oklahoma. Nationally, it is believed that 28% of the population of the United States contracted the disease and 500,000 to 675,000 people died. We may never know the total number of those infected because many people in rural areas did not have access to medical care and statistics were based on cases reported by doctors. Officials estimate there were 100,000 cases of Spanish influenza or about 5% of Oklahoma’s population of two million; there were 7,500 deaths making a 7.5% mortality rate; the average length of illness was eight days.  Dr. J. W. Duke, head of the State Health Department, also believed that scarring and other long-term effects of flu survivors would soon shorten the lives of about 9,000 more people through increased susceptibility to pneumonia, tuberculosis, and heart damage. Exact numbers for Oklahoma City are not known, but in a later report, state officials estimated that from September 1918 to April 1919, Oklahoma City represented about 20% of the state totals.  Attempts were also made at assessing the economic cost of the pandemic. Using insurance company valuations and industry averages for wages, it was estimated that the loss of life, loss of 400,000 production days, and loss of wages cost the state $15,100,000 (adjusted for inflation the total would be about $196,000,000) without taking into account the amount spent for treatment and medicine.

Copyright Metropolitan Library System.