Produced by the University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library

Influenza Encyclopedia

The American Influenza Epidemic of 1918-1919:

A Digital Encyclopedia


Spokane, Washington

50 U.S. Cities & Their Stories

Despite reports of the spread of the new and deadly form of influenza attacking East Coast cities and military camps, Spokane residents initially hoped they might be due to their general remoteness and isolation from major metropolitan areas. Certainly the editor at the Spokesman-Review did. The “imported type” of influenza “is not available, probably because of our distance from the source of supply, the scarcity of bottoms, prohibitive freight rates and the necessity of conserving all transportation facilities and these other little irritations that limit our trade with the Atlantic seaboard,” he jokingly–and somewhat bitterly–wrote on September 24. “At last the East has something the West does not want.”1

A few days later, on September 28, the semi-annual meeting of the state Board of Health convened at the stately Davenport Hotel in downtown Spokane. Influenza had not yet become epidemic in the northwest, but the Board realized that it likely soon would be. Several hundred men at the various Puget Sound naval stations had already been diagnosed with influenza, and sporadic civilian cases were being reported in Seattle, Tacoma, and Spokane. To prepare communities for the impending crisis, the Board of Health issued a statement letting Washington residents know that they should expect six to eight weeks of successive waves of influenza, with widespread closures of public places likely as a result. Residents were called upon to lend their assistance in preventing the spread of the disease. As Dr. T. D. Tuttle, state Commissioner of Health, stated, “The public must be brought to realize that we are facing a serious situation and that it is a patriotic duty to render every aid possible.”2

By the end of the first week of October, approximately one hundred influenza cases had appeared in Spokane. City Health Officer Dr. John B. Anderson expected many more cases to develop, and announced that Spokane would likely face a very serious crisis unless immediate action was taken. The chamber of commerce, understanding that closure orders were inevitable and hoping for a quick end to the crisis, not only pledged its support of the health department, but urged Anderson to take immediate and drastic action. For its own part, it launched a special committee on publicity to educate the public to the dangers of influenza and the personal measures that could be taken to help prevent its spread.3 Anderson did not keep the chamber of commerce waiting; on October 8, the day after the chamber met, he and 18 city physicians met to discuss the situation. The group, having just received a telegram from state Health Commissioner Tuttle urging that local communities close public places (which was a reiteration of United States Surgeon General Rupert Blue’s circular to all state health departments recommending the same), unanimously agreed that a closure order should be issued. Anderson did so immediately. Effective midnight of October 8, all places of public congregation in Spokane were officially closed. This included all theaters, schools, dance halls, poolrooms, churches and Sunday schools, conventions, and other places of public gathering and amusement. Gatherings such as public funerals and weddings were similarly banned. Spokane University was allowed to continue classes for the time being, with the understanding that students were prohibited from leaving campus. In Spokane County, Health Officer Dr. Albert E. Stuht issued a similar closure order, and asked county schoolteachers to close their classrooms immediately.4 County schoolteachers were assured they would be paid for up to three weeks should the closure last that long. Teachers and school directors who failed to comply with the order faced arrest and prosecution.5

Residents generally complied with the order, even if some did not fully believe in the danger influenza posed. As the Spokesman-Review wrote, the streets “looked as sparsely filled as in a blizzard.” Some people did stroll the streets, “but there were no whooping automobiles full of young bloods, or sidewalks filled with short skirted damsels.”6 It was fairly simple for private citizens to comply with the order, and most of them simply stayed at home. The rapidity with which the closure order was handed down left many businesses and organizations unsure of their status, however, and the work of the health department during the first day of the order was given over almost entirely to sorting out the exact details. Most but not all of the schools, for example, closed, the others either uncertain or uninformed of Anderson’s order. Once sorted out, Anderson and his staff turned their attention to related matters. First, the health commissioner ordered physicians to make daily reports of influenza cases, as no one was entirely certain just how many or few cases Spokane actually had. Next, Anderson ordered all streetcars to maintain good ventilation. At the request of the commissioner of public safety, police officers were instructed to arrest all persons caught spitting in public. One violator was unfortunate enough to be caught by Anderson himself, who ordered the man to wipe up the sidewalk or face arrest.7

Anderson stressed to the community that the measures he had just enacted were meant to be precautionary, and that “there is no condition at present to justify a panic.” Early reports indicated a rise in cases across the city, however, most noticeably in the eastern section of the Union Park neighborhood around Sheridan School. Physicians daily reported several dozen new cases, and within a few days Spokane had an estimated 500 total cases, with additional cases being reported throughout the surrounding county.8 With news of the increase in cases, Anderson augmented the closure order. He requested that department stores discontinue special sales so as not to attract large crowds. He closed poolrooms, bowling alleys, and card games in cigar stores after learning that men were congregating in these spots. Anderson did allow churches to hold outdoor services after several clergymen asked the health officer for his thoughts on the subject, but added that they might be just as dangerous as those held indoors.9 A week later he banned outdoor meetings as well.1 The city’s Christian Science Church asked for permission to hold regular indoor services, arguing that it was engaged in the healing of the sick. Anderson denied the request, arguing that, under law, he could not consider the character or the purpose of any individual meetings.11

By mid-October, Spokane’s limited health care resources were already stretched to the limit. Most of the city’s nurses were serving in the military, leaving precious few to help during the epidemic. On October 13, nurses were so busy that not a single one was available by the afternoon to attend to new cases.12 Medical supplies were also in short supply; the city’s social service bureau’s stock was exhausted, requiring it to appeal to the public for donations of linens, nightgowns, mattresses, and stoves. Hospital bed space was becoming scarce. To alleviate the pressure, the local chapter of the Red Cross met with city and county officials and representatives of the nursing and medical communities to develop a plan for establishing and outfitting an emergency hospital in one of the city’s hotels. The site they chose was the Lion Hotel at the corner of South Lincoln Street and West 1st Avenue. With a central location near Deaconess Hospital, the new emergency facility allowed for more efficient use of nurses, who could care for multiple patients at the same time rather than having to crisscross the city administering care. Some of the rooms were large enough to set up wards.13

The new emergency hospital was first and foremost designed to treat those with fewer financial resources. As a result, the rules and regulations regarding private patients were rather strict. No medicine, prescriptions, or sera were provided for private patients. Likewise, no special meal provisions could be made, and all patients received the same liquid and soft food diet. Private nurses attending to individual patients were not allowed, and physicians were required to make arrangements with the city Superintendent of Hospitals before their patients could be admitted. Once there, private patients were kept under the care of their personal physician, not the other doctors working the rooms and wards. All financially able patients were required to pay $10 in advance. The Lion Hotel management agreed to heat the building and to provide linens, with the city and county to provide jointly for all other necessary equipment and costs.14

Spokane residents were not alone in feeling the effects of influenza. Fort George Wright, a small army installation located within the city limits, was being hammered by the onslaught of cases. Even more patients arrived on October 18, when 58 sick men among a training detachment headed for Spokane’s Modern Automobile School were discovered on a train. They were immediately sent to the Fort’s hospital for care. Local military officials quickly barred civilian visitors from the Fort as well as from all nearby training schools and barracks until the danger of the epidemic had passed. Meanwhile, the Fort was in desperate need of nurses. The hospital there was already full, and one of the barracks was being used for overflow cases. The nursing staff was exhausted, most of them having worked for 48 hours continuously. The local field director of the Red Cross issued an urgent appeal for every available nurse in the city to help at Fort Wright. “The situation is critical,” he said.15 Unfortunately, the situation was no better among the civilian population, where nurses were likewise in short supply.

On October 20, Anderson, worried that some cases of influenza were being diagnosed as common colds and therefore not being reported, issued a lengthy circular to all city doctors. “Doctor,” he wrote, “you may have laudable convictions as to methods of fighting a crisis like the present at variance with the routine established by those now in authority. However, our mutual aim is identical–suppress the flu, save life.” Anderson therefore requested that henceforth doctors treat every case of the common cold as if it were influenza. Patients were to be told to keep themselves isolated at home, to deny visitors, and to remain out of public for at least three days after their temperature returned to normal. Cases, even when the physician believed them to be just a cold, were to be reported as influenza. In the case of pneumonia, case reports required the patient’s name, address, and age. Influenza reports, on the other hand, only required the total daily number of cases.16

Meanwhile, Spokane gained only the briefest appearance of relief as the number of new influenza cases dipped before suddenly rising sharply once again. By late-October, the city was headed into a second peak of influenza. Over 400 cases were reported on October 30 and October 31 alone. Anderson had been hopeful that the worst was over and that the closure order and gathering ban might soon be lifted. Now, as the epidemic continued to roll on, he was much less sanguine. Nurses at the emergency hospital were forced to work 12 to 14 hours per day to keep up with the caseload. At one point the situation became so critical that city officials had to make an appeal to Fort Wright and Camp Lewis to return the nurses that had been sent to those bases at the start of their epidemics. The latter responded by sending ten nurses back home to Spokane, where they were immediately put to work in the emergency hospital.17

With the new spike in cases, Anderson added prohibitions to the list of anti-epidemic measures, including a request that businesses stop displaying war maps in their shops to prevent crowds from gathering around them and a ban on Halloween masks. Anderson believed that costume masks were dangerous because their “promiscuous use”–by which he meant people breathing through their masks and then touching them–could lead to the spreading of germs. He even asked police to enforce the order by stopping masked trick-or-treaters on the streets. Regular gauze face masks, however, were permitted. Apparently, Anderson did not believe that people would be tempted to touch and adjust their gauze masks in the same way they would their Halloween costumes.18

While influenza made its way through Spokane, there were several institutions that, for the time being, were spared. The 285 people at Spokane’s Children’s Home, St. Joseph’s Orphanage, the Church Home for Children, Washington Children’s Home Finding Society, Deaconess Old People’s Home, the local Florence Crittenton Mission, Holy Names Academy, and Edgewood Sanitarium were all influenza free, the result, according to Anderson, of barring visitors once the epidemic began. Administrators at Edgewood Sanitarium went even further, placing their facility in protective sequestration; nurses, for example, were not allowed to leave the premises. The Salvation Army home for women, on the other hand, was not so fortunate. There, visitors were allowed. By the end of October, 43 cases had appeared among the 70 residents.19

Reports for November 4 indicated that it was the deadliest single day in Spokane since the start of the epidemic nearly a month earlier. The next day was Election Day, and Spokane officials were concerned about voters congregating at polling places. Anderson ordered inspectors to guard against overcrowding at the polls, and asked election workers to place voting booths outdoors wherever possible. Where they had to be kept indoors, he asked that no more voters than there were booths be allowed into the room at a time. Whether as a result of the precautions or other factors, inspectors making the rounds of Spokane’s poll locations on Election Day found little of which to complain.20

Meanwhile, on November 4, the Washington state Board of Health issued an order mandating the use of gauze face masks, to measure 5 by 6 inches and to be composed of not less than six layers of gauze sewed and bound together, for all state residents while aboard public conveyances, in public spaces in public buildings, hotels, lodging houses, stores and shops, restaurants, barber shops, and laundries.21 In Spokane, the order did not go into effect for two three days, after it was formally received by the city Board of Health.22 When Anderson formally announced the order, city residents made a run on Spokane’s drugstores and City Hall, where masks were made available for sale. Unfortunately, the majority of residents returned home empty-handed, as the demand far outstripped the short supply. At City Hall, for example, the 300 masks for sale lasted only 30 minutes, and two health inspectors had to control the crowd that had gathered there. Stock at the city’s drug stores lasted a bit longer, but the end result was the same: too few masks for too many people. Given the shortage, the city’s commissioner of public safety announced that police would not start enforcing the order for another day or two, giving Red Cross workers time to make more masks.23

The Red Cross quickly turned out 4,000 additional masks. Unfortunately, these new masks were slightly different from the regulation Red Cross ones (which was the version required by the State Health Department) and hung more loosely at the edges. Health Officer Anderson nevertheless approved their use. He had little choice: with the mask shortage he could either comply with the state order on mask construction or on mask use by the public, but not both simultaneously. Anderson’s decision may have put more masks in the hands–or over the faces, as the case may be–of Spokane’s residents, but it did not alleviate the central issue that masks were uncomfortable and unpopular. In general, masks were worn only so long as necessary. Once outside again, residents tended to stuff them back in their pockets if they bothered to carry or wear one at all. Some of the biggest offenders may have been police officers. The day after the mask order went into effect in Spokane, Anderson received reports that city police, who had been ordered to enforce the mask order, were ignoring it themselves. The health officer immediately notified Commissioner of Public Safety J. H. Tilsley that he would issue arrest warrants if the officers did not comply with the order forthwith. In their defense, officers protested that they had been donning their masks dutifully since the order went into effect. Anderson seemed mollified and did not press the issue any further.24 The next day Tilsley briefly stopped by police headquarters without his mask. None of the officers dared rebuke him, but their stares made him quickly realize his infraction. He slipped out of the building for a few moments to purchase the proper gear before returning with his face appropriately shrouded. Still, according to some, Tilsley’s mask had a tendency to slip below the chin more often than it should have.25

Commissioner Tilsley was undoubtedly pleased, then, by the state Board’s November 11 decision to remove the mask order. In Spokane, news of the decision was reached in the evening and immediately circulated among a population already in the midst of celebrating the end to the war. Anderson was cautiously optimistic that the rest of the restrictions could be removed within a week so long as the Victory Day festivities did not cause another uptick in influenza cases in the coming days. In the meantime, he recommended to the City Commissioners that they consider lifting closure order and gathering ban on Sunday, November 17 if there was no significant increase in the epidemic in the next two days.26

Residents, business groups, members of the clergy, and even some city officials were pleased with the prospect of their city re-opening to business and entertainment as usual. Learning that schools might soon resume classes, the Board of Education unanimously adopted a plant to lengthen school days and extend the school year to make up for the month of lost classroom time. The Superintendent of Schools O. C. Pratt even appeared before the City Commission (sitting as the Board of Health) to argue the case for removing the closure order. So, too, did some representatives of Spokane’s church community and its theater owners. They argued that the main threat had passed, and pointed out the examples of Seattle, which had already re-opened, and New York City, which had never closed.27 Many doctors, teachers, and ministers protested against re-opening the city too soon. The president of the Spokane Medical Society argued for even stricter enforcement of public health measures, including closing all non-essential businesses. Anderson maintained that he needed to gauge the trajectory of the epidemic over the next few days before a final decision could be made. When, on Thursday, November 14, the influenza tally showed 200 new cases–and thus no change from the same day of the previous week–Anderson decided to postpone lifting the bans indefinitely.28

The public did not need to wait long. On November 17, Anderson announced that the closure order and gathering ban would be lifted effective at midnight on Monday, November 18. Some restrictions remained. Theater and movie houses, for example, were required to maintain strict temperature and humidity levels and to deny entry to anyone who appeared ill. They would also have to hire a police officer at their expense to enforce the new rules. Public dances were still prohibited completely. Lastly, schools were to remain closed for an additional week, since, as officials explained it, many parents would not send their children to school again until they felt confident the conditions were safe. In addition, many teachers had been busy volunteering as nurses and caregivers and needed several days rest before returning to the classroom.29

Spokane’s epidemic was not over, and physicians continued to report significant numbers of new cases daily. By the last days of November, the epidemic appeared to be spiking once again. Anderson, concerned that Spokane might experience another shortage of nurses, made an early appeal for volunteers. “In the six weeks of quarantine [closure orders and gathering bans] thousands of people were taken ill and have recovered, practically immunizing them for the time being,” he announced. “Now these people who have had influenza should be willing to come forward and help nurse those stricken.” Already social services were being hit hard with unusually heavy demands for heating stoves, blankets and bedding, and other supplies. On November 29, the emergency hospital received more applications for admission than on any other day during the entire epidemic. Of the 75 patients already there, at least half were seriously ill and a number of them in critical condition.30

Faced with a rising tide of cases, Anderson announced that all homes with known cases of influenza would be placarded immediately. The measure was not meant as a full quarantine, however, only as a warning to potential visitors, and occupants were not confined to their homes. The new policy was in keeping with Anderson’s belief that the recent spate of cases was the result of the public’s disregard for safety. “People have let themselves loose and gathered in crowds wherever they found something to see,” he told reporters. “Crowds are breeders of influenza and so long as we have influenza and people mass together it will spread.” Yet, despite some pressure to issue more sweeping measures, Anderson did not feel it was necessary to order the closure of Spokane’s entertainment venues again. He did recommend to the Board of Education, however, that the schools be closed. School officials disagreed, arguing that they could handle the situation and suggesting that doses of anti-influenza serum be given free to children with parental permission. Anderson was temporarily mollified.31

Unfortunately for school officials, parents were not. The Board of Education office was besieged with phone calls from concerned parents questioning the decision to keep schools open in the wake of another peak in the epidemic. Many of these parents kept their children home, which, when combined with children who were ill, resulted in an absentee rate of nearly a third of the school district’s student body. Facing mounting pressure to act, on December 2 school officials asked Anderson to issue an order closing Spokane’s schools. Anderson wanted to wait another day or two so that he could study the latest flu tallies, but made it clear to all that a school closure would likely include prohibitions on children going downtown, walking the streets, or attending movie theaters.32

When reports showed nearly 300 new influenza cases for December 3, the Board of Health issued the order closing all public schools. Most of the city’s parochial schools decided to close as well. Children under 13 were barred from all places of public assemblage, including Sunday schools. The school board was not entirely pleased with the decision, with many members arguing that if the situation was severe enough to warrant closing schools then it was also severe enough to warrant closing entertainment venues and gathering spots, or at least to keep children over 13 from visiting them. As one member put it, “Already today the older pupils are running into danger by going to theaters and other places, which we hoped to prevent, but which the action of the Board of Health encouraged.” Essentially, high school students had received an unexpected vacation.33

That changed somewhat on December 6, when Anderson and the Board of Health announced a modified plan designed to end the spread of Spokane’s epidemic without resorting to another closure order. Most of the measures were aimed at allowing for ventilation and at preventing crowding. Thus, theaters were required to close alternate rows of seating (effectively halving their capacity) and to shut down daily between 5:00 pm and 7:00 pm to allow for ventilation of the building. Churches were allowed to hold devotional services, but likewise had to seat congregants in every other pew. Stores could not announce special sales. Streetcars were allowed to carry only as many passengers as there were seats, and “straphanging” was not permitted. Business colleges, art schools, academies, and private schools could remain open provided they had at least 1,000 cubic feet of air space per pupil. Elevators could only carry half their passenger capacity at any time. Conventions and special assemblies were not permitted without prior consent of the city health office. Anderson made it clear to all that if these measures did not work within a few days to a week, he would order a sweeping closure order that would effectively shut down the entire city.34

Spokane bore the new restrictions with some grumbling. The business community, looking forward to the end of the epidemic and of all restrictions on their livelihood, was particularly upset. Some theater managers were not entirely pleased with having to reduce their seating capacity by half, but others reported that attendance was already so drastically reduced by the epidemic that it mattered little. Whether the reduced revenue theaters were seeing was due to the epidemic or to the restrictions, most found it difficult to make enough to cover their operating expenses. To help theaters a bit, Health Officer Anderson shortened their mandatory closing hours by half and hour, giving managers a chance to hold two nightly performances. Poolroom and soft drink parlor owners complained that it was not fair to cut their card games while private poker and bridge games continued to thrive. Anderson told them that private games were likewise prohibited, although he must have known full well that enforcing such a restriction was nigh impossible.35 Restaurant owners received bad news on December 11, when Anderson announced they could not hold Christmas or New Year’s celebrations. As the health officer told the public, “This ban is on and will not be raised until school opens in January. There is no hope for an earlier lifting of it, even if no cases at all are reported.” He added that residents should make their holiday purchases now and not wait until later, as the situation could change for the worse, requiring further tightening of the restrictions.36

As the holidays approached, Spokane’s influenza situation slowly improved. The flu tallies for December 20 were the lightest in several weeks, a pattern that continued over the remaining days of the year. Nurses, physicians, and staff at the Lion Hotel emergency hospital were thrilled to enjoy a quiet Christmas, a drastic change from the hectic Thanksgiving they recently faced. Anderson was now convinced that the worst was over. On December 30, he announced that the epidemic restrictions would be lifted effective at noon on New Year’s Day, with schools to open on January 2.37 Anderson told the public to expect influenza to linger in Spokane until June, but assured the community that the current danger was over and the situation well under control. To help ensure that it continued to abate, he admonished residents to practice self-isolation and quarantine if feeling ill, calling it “a question of individual integrity.”38

Spokane now had the task of piecing together life as normal. Theater and movie house owners were among some of the most adversely affected by the public health measures, and they had not been shy about expressing their disagreement with the prolonged restrictions on their business. On January 10, a group of theater owners asked the City Council for a refund for the 40 days they were closed and an allowance for the time they were allowed to run at half capacity. The Council was divided on the issue, with one commissioner strongly opposed and three in favor. Tilsley, the public safety commissioner, recommended that theaters be compensated through a one-month’s rebate on their license fee. The next day, on January 11, the City Council passed Commissioner Tilsley’s recommendation, granting theaters a $21 rebate–the 40-day prorated amount of their $200 annual license fee.39

Perhaps more than any other event, it was the closing of the Lion Hotel emergency hospital on January 13 that truly signaled the end of Spokane’s epidemic. In its 89 days of operation, the hospital treated 617 patients and saw 68 deaths. The high mortality rate was to be expected given how sick most of the hospital’s patients were upon admittance. At the height of the first peak of the pandemic, the number of patients at the hospital reached as high as 140; during the second peak it got as high as 132. On average, patients remained in the hospital for nine days before doctors deemed them well enough to be released.

Overall, over 11,000 Spokane residents fell ill with influenza between October 1918 and February 1919, representing nearly 11% of the city’s population. Some 562 people died of influenza or pneumonia during that period. The result was an excess death rate of 482 out of 100,000, higher than Seattle’s 414 per 100,000, but lower than average for all Western cities combined (529 per 100,000). In that regard, Spokane’s experience was like that of many American cities–not altogether good, but not terribly bad either.

What makes Spokane’s epidemic interesting, however, is the shape of its epidemic curve. Most American cities outside of the East Coast experienced two distinct peaks of influenza deaths during the fall of 1918 and early winter of 1919. In contrast, Spokane experienced three sharp peaks. The first occurred around October 20, and led Anderson to declare that the worst was over. The number of deaths decreased for a week before suddenly cresting again, this time at nearly double the height of the first peak. Deaths abated over the course of the following two weeks before increasing sharply for a third and final time, peaking in early-December and then steadily declining over the course of the next month.

Notes

1 “The Spanish Influenza-less West,” Spokane Spokesman-Review, 24 Sept. 1918, 4.

2 “Influenza Here; Public Warned,” Spokane Spokesman-Review, 29 Sept. 1918, 1.

3 “Plan to Head Off Influenza,” Spokane Spokesman-Review, 8 Oct. 1918, 10.

4 “City Acts to Stop Spread of Influenza,” Spokane Daily Chronicle, 9 Oct. 1918; “Close All Theaters and Theaters in County,” Spokane Spokesman-Review, 9 Oct. 1918, 1.

5 “Epidemic Grows, Girl Succumbs,” Spokane Spokesman-Review, 10 Oct. 1918, 1.

6 “Influenza Edict Aids Home Life,” Spokane Spokesman-Review, 11 Oct. 1918, 5.

7 “Epidemic Grows, Girl Succumbs,” Spokane Spokesman-Review, 10 Oct. 1918, 1.

8 “Report 19 New Influenza Cases,” Spokane Spokesman-Review 11 Oct. 1918, 1; “Report 95 New Influenza Cases,” Spokane Spokesman-Review, 12 Oct. 1918, 6; “Report 60 More Influenza Cases,” Spokane Spokesman-Review, 13 Oct. 1918, 6.

9 “Bargain Sales Under Flu Ban, Is City Mandate,” Spokane Daily Chronicle, 12 Oct. 1918.

10 “Nine More Die of Pneumonia,” Spokane Spokesman-Review, 19 Oct. 1918, 6.

11 “One Death, 53 New Flu Cases,” Spokane Spokesman-Review, 17 Oct. 1918, 6.

12 “Nurse Famine Is Spokane Menace,” Spokane Spokesman-Review, 14 Oct. 1918, 5.

13 “Another Death from Influenza,” Spokane Spokesman-Review, 16 Oct. 1918, 6; “Lion Hotel Will House Patients with Influenza,” Spokane Daily Chronicle, 16 Oct. 1918; “New Influenza Hospital,” Spokane Spokesman-Review, 17 Oct. 1918, 6.

14 “’Don’t Kick! Help!’ Says Health Man,” Spokane Spokesman-Review, 21 Oct. 1918, 6; “Another Death from Influenza,” Spokane Spokesman-Review, 16 Oct. 1918, 6; “New Influenza Hospital,” Spokane Spokesman-Review, 17 Oct. 1918, 6.

15 “58 Californians Have Influenza,” Spokane Spokesman-Review, 19 Oct. 1918, 2.

16 “Epidemic New in Name Only,” Spokane Spokesman-Review, 20 Oct. 1918, 9.

17 “Twelve Deaths from Influenza,” Spokane Spokesman-Review, 3 Nov. 1918, 6; “Influenza Takes 10 More Lives,” Spokane Spokesman-Review, 4 Nov. 1918, 6.

18 “No Diminution in Influenza Shown,” Spokane Spokesman-Review, 30 Oct. 1918, 6; “More Influenza, Less Pneumonia,” Spokane Spokesman-Review, 31 Oct. 1918, 6.

19 “Flu Passes Old Folk, Children,” Spokane Spokesman-Review, 30 Oct. 1918, 6.

20 “Health Warning is Given Voters,” Spokane Spokesman-Review, 5 Nov. 1918, 6; “Fewer Flu Cases than Week Ago,” Spokane Spokesman-Review, 6 Nov. 1918, 6.

21 “Every One Must Wear Gauze Masks,” Spokane Spokesman-Review, 4 Nov. 1918, 1.

22 “Epidemic Death List 13 in Day,” Spokane Spokesman-Review, 5 Nov. 1918, 6; “Fewer Flu Cases Than Week Ago,” Spokane Spokesman-Review, 6 Nov. 1918, 6.

23 “City to Enforce Order on Masks,” Spokane Spokesman-Review, 8 Nov. 1918, 1; “Crowds Rush to Buy Flu Masks,” Spokane Spokesman-Review, 9 Nov. 1918, 6.

24 “Red Cross Heeds Flu Mask Call,” Spokane Spokesman-Review, 9 Nov. 1918, 7; “Health Officer Warns Police,” Spokane Spokesman-Review, 10 Nov. 1918, 1.

25 “Artistry in Flu Masks Is Shown,” Spokane Spokesman-Review, 11 Nov. 1918, 6.

26 “Abolish Flu Mask Rule; May Open Theaters, Churches Sunday,” Spokane Spokesman-Review, 12 Nov. 1918, 7.

27 “Fewer Flu Cases, But More Deaths,” Spokane Spokesman-Review, 13 Nov. 1918, 6.

28 “Anderson Favors Continuing Ban,” Spokane Spokesman-Review, 14 Nov. 1918, 6.

29 “Flu Conditions Growing Better,” Spokane Spokesman-Review, 19 Nov. 1918, 6.

30 “Epidemic Shows Sharp Increase,” Spokane Spokesman-Review, 30 Nov. 1918, 6; “Make New Record in Flu,” Spokane Spokesman-Review, 30 Nov. 1918, 7.

31 “Tack Up Epidemic Cards on Homes,” Spokane Spokesman-Review, 1 Dec. 1918, 6.

32 “Close Schools Probably Today,” Spokane Spokesman-Review, 3 Dec. 1918, 6.

33 “Report of 292 More New Flu Cases,” Spokane Spokesman-Review, 4 Dec. 1918, 7.

34 “Modified Flu Ban is Ordered,” Spokane Spokesman-Review, 7 Dec. 1918, 1.

35 “Health Officer Visits Theaters,” Spokane Spokesman-Review, 8 Dec. 1918, 6; “Theater Owners Would Lift Ban,” Spokane Spokesman-Review, 17 Dec. 1918, 7.

36 “New Flu Cases Show Decrease,” Spokane Spokesman-Review, 12 Dec. 1918, 6.

37 “Flu Inspectors in Stores, Plan,” Spokane Spokesman-Review, 20 Dec. 1918, 8; “Schools Reopen Thursday, Jan. 2,” Spokane Spokesman-Review, 31 Dec. 1918, 7.

38 “Flu Is under Control,” Spokane Spokesman-Review, 3 Jan. 1919, 6.

39 “Theaters Given Some Cash Back,” Spokane Daily Chronicle, 11 Jan. 1919.

Riverside Avenue looking west, Spokane. Click on image for gallery. Riverside Avenue looking west, Spokane.
A view of the Oregon-Washington Railroad and Navigation Company bridge and the Monroe Street Bridge crossing the Spokane River, with the city in the background. Click on image for gallery. A view of the Oregon-Washington Railroad and Navigation Company bridge and the Monroe Street Bridge crossing the Spokane River, with the city in the background.

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Spokane, Washington

Timeline of Events

Excess Death Rate (per 100,000) Daily EventsClick day to view details. Selected Event
graphNational
200Excess Death Rate (per 100,000)
180 
160 
140 
120 
100 
80 
60 
40 
20 
0 
Total Excess Death Rate 482
Total Deaths per 100,000 population over duration of epidemic (roughly 1918 September 14 through 1919 February 22).
 19181919
 AugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchApril
Sa273101724317142128512192629162330714212841118251815221815222951219
Fr2629162330613202741118251815222961320273101724317142128714212841118
Th2518152229512192631017243171421285121926291623306132027613202731017
We243171421284111825291623306132027411182518152229512192651219262916
Tu2330613202731017241815222951219263101724317142128411182541118251815
Mo2229512192629162330714212841118252916233061320273101724310162431714
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September 29, 1918

At a State Board of Health meeting in Spokane today, Dr. H. H. McCarthy, Commissioner of the State Board of Health, asks the public to help prevent the spread of cases of influenza already present in Spokane. It is predicted that successive waves of influenza will appear over the next six weeks, and it may be necessary to close theaters, churches, and public schools.

September 30, 1918

Dr. John B. Anderson, City Health Officer, says that he is ready and willing to close public places if it becomes necessary. Health Officer Anderson asks the public to seek immediate medical treatment at the onset of a cold, and issues a warning against coughing and sneezing in public. A local theater asks patrons to use handkerchiefs when sneezing.

October 7, 1918

According to Health Officer Anderson, “The authorities will not wait for an epidemic of the disease to take action.”

October 8, 1918

Health Officer Anderson says Spokane is facing a serious crisis unless immediate measures are taken.

October 9, 1918

Health Officer Anderson issues closing orders for all public places of assembly including schools, dance halls, churches, and conventions. Jury trials are also postponed while the closing orders are in effect. All reading rooms of public libraries are closed. The Spokane Stock Exchange closes until the Health Department sanctions its reopening.

October 10, 1918

As long as people do not congregate, public funerals are allowed. Spokane University is allowed to continue classes, providing students remain on campus. Every hospital in the city is filled to capacity, and Dr. J. E. Drake, Spokane School Physician, is in charge of locating a building to serve as a temporary emergency hospital. The Health Department has received reports of 110 cases to date. According to Health Officer Anderson quarantine has not been effective in other cities, and will not be used in Spokane.

October 11, 1918

Health Officer Anderson closes all poolrooms and bowling alleys today due to violations of anti-congregation orders. There are now 256 reported cases in the city. Anderson issues a list of suggestions for staying healthy, including washing hands before meals, using handkerchiefs, getting plenty of fresh air and good food, and avoiding those who are ill.

October 12, 1918

Health Officer Anderson estimates there are 300 mild cases of influenza in the city. All card games in cigar stores are now included in the closing order.

October 14, 1918

There is a shortage of nurses in the city. The Social Services Bureau runs low on linens, beddings, mattresses, and stoves and appeals to the public for donations. Officers and officials decide that a public hospital is now a necessity, and a plan is proposed to outfit a hotel with hospital equipment.

October 16, 1918

A delegation representing city, county, and school medical departments, representatives of the Red Cross, the nurses association, and the City Commissioners receive a promise of $2,000. from the County Commissioners to fight influenza. The City will also receive $2,000. The Lion Hotel is to be used as a temporary hospital for influenza patients, and is expected to open tomorrow. Health officers visit department store managers today to solicit cooperation with quarantine policy.

October 17, 1918

Health Officer Anderson meets with a delegation of theater men who wish to know when the quarantine will be lifted, as business is suffering. Crowding is no longer allowed on streetcars.

October 18, 1918

All open-air gatherings are included in the closing bans today, on the recommendation of Health Officer Anderson. Anderson appeals to nurses to answer the demand for nursing services in Spokane. The City Health Office reports a shortage of nurses due to the number of Spokane nurses engaged by the Army.

October 19, 1918

The Lion Hotel temporary hospital is in need of supplies, including sheets and pillowcases. The Red Cross urges all women with nursing experience to register. According to Health Officer Anderson the epidemic will not crest for a few days yet.

October 21, 1918

Health Officer Anderson says conditions are better today than at any previous point in the epidemic. Anderson publishes a list of rules for the temporary hospital run by the City.

October 22, 1918

256 new cases are reported today. According to Health Officer Anderson anti-influenza masks will not be used in Spokane. He believes there is no need for this drastic measure.

October 23, 1918

Health Officer Anderson announces that any society functions given in defiance of the closing ban will result in arrest and prosecution. This announcement comes after Anderson discovers social gatherings have been held at several prominent homes. More nurses are needed at the temporary hospital. Anderson issues an order prohibiting visitors at hospitals. Surgical patients are beginning to contract influenza, and it is believed that hospital visitors are the source.

October 24, 1918

According to Health Officer Anderson, due to the nature of reporting, estimating the situation is currently impossible. The temporary hospital is in need of bedding and “table delicacies” for patients. Schoolteachers are volunteering at the Red Cross and the temporary hospital.

October 25, 1918

School vacations this year will be brief in light of the influenza epidemic, and educators believe the school year may be extended but will need a special act of the State legislature. To prevent congestion at City Hall, Health Officer Anderson orders local draft boards to stop sending questionnaires to registrants under the age of 19 and over the age of 36. Anderson distributes signs listing health regulations and deputizes every physician in the city as health officers. Upon the request of physicians a conference is held to discuss the epidemic.

October 26, 1918

The Empire State Building canning sugar office is ordered closed by Health Officer Anderson due to crowding. The War Department notifies Fort Wright and the Modern Automobile schools that all soldiers on duty in the city are to wear masks. As a preventive measure, all cigar-clipping machines in cigar stores and drink parlors are ordered removed by Health Officer Anderson.

October 27, 1918

City health officials believe the situation is improving. The temporary hospital continues to experience a shortage of nurses. Health Officer Anderson suspends dancing classes, music lessons, and any other small classes.

October 28, 1918

Health Officer Anderson warns against improper use of masks, reminding mask users to refrain from touching the mask and to remember to change the mask every few days. Anderson issues an order to halve the number of elevator passengers to prevent crowding. Nurses at the temporary hospital are working double shifts, with little to no relief or sleep. More nurses are needed.

October 29, 1918

The Health Department prohibits all public meetings and gatherings. The City Health Office receives over 200 reports of influenza and pneumonia today. All stores in the city, with the exception of grocery stores, are to be closed until next Monday (11/4).

October 30, 1918

Nurses at the temporary hospital say people have been violating the no visitors order given by Health Officer Anderson. Businesses displaying war maps are asked to remove them due to crowding.

October 31, 1918

According to Health Officer Anderson the public has improved their compliance with influenza regulations. A ban on Halloween masks goes into effect tonight and will be enforced by health inspectors. The public is reminded that influenza masks are not included in this order.

November 1, 1918

According to Health Officer Anderson, the crest of the epidemic has been reached in Spokane. However, Anderson reminds the public to continue to take precautions. Cabaret entertainment and music in restaurants is placed under the ban today. Two soft drink establishments, which violated City Health Office orders, are closed and their proprietors are arrested.

November 2, 1918

A shortage of nurses at the temporary hospital today results in appeals to Fort Wright and Fort Lewis. Nurses at the temporary hospital have been working 12 to 14 hour days.

November 3, 1918

According to Health Officer Anderson the epidemic has not improved to any appreciable extent.

November 4, 1918

Health Officer Anderson prohibits dice shaking in cigar stores as it causes congestion. According to Anderson conflicting reports from physicians are making it difficult to accurately assess the situation. After conferring, judges and City and County health officials decide to close the courts for three weeks. The State Board of Health asks citizens wear anti-influenza masks.

November 5, 1918

Health Officer Anderson declares that the influenza situation is graver than the general public realizes. He appeals to volunteers to help doctors and nurses who are overtaxed. Due to uncertainty as to the scope of the State Board of Health’s anti-mask order, it has not yet been enforced in Spokane. Inspectors at polling places are asked to mitigate crowding.

November 6, 1918

The temporary influenza hospital currently has 142 patients. Cook County hospital in Chicago sends influenza serum to Health Officer Anderson. The serum is to be used for the most severe cases.

November 7, 1918

Health Officer Anderson says local authorities will enforce the State Board of Health anti-influenza mask order. The Red Cross and the Health Department are working together to make masks, which will be sold in public places for 5 cents each. Masks must be worn in all public places. The order also dictates that all proprietors of stores and restaurants must keep their establishments well ventilated.

November 8, 1918

Masks are available for purchase every half hour and demand is high. In less than thirty minutes 500 masks are sold at City Hall, and two City Health Inspectors are required to control crowds. Dr. D. H. Ransom, Assistant Health Officer, begins administering the anti-influenza serum today, free of charge. Health Officer Anderson is his first patient.

November 9, 1918

Police officers are issuing warnings to those not wearing masks today. Beginning Monday (11/11) police will begin to make arrests. A health officer is stationed at the temporary influenza hospital today to prevent visitors from entering. The Red Cross makes 2,812 masks today.

November 10, 1918

Spokane citizens circulate a petition asking City Commissioners to refrain from arresting individuals who are not wearing anti-influenza masks.

November 11, 1918

A group of businessmen ask the City Council to appeal to the State Board of Health regarding the anti-influenza mask order. The State Board of Health abolishes the anti-influenza mask order. Upon receipt of the order in Spokane, masks are removed.

November 12, 1918

An appeal to the City Council to end the ban meets with failure today. According to Health Officer Anderson if no marked increase in cases occurs by Thursday, he will recommend City Council lift the ban. To make up lost time, schools plan to begin at 8:30, and the school year will be extended by one week.

November 13, 1918

The City Council discusses an immediate lifting of the ban, but postpones their decision until tomorrow. Health Officer Anderson argues against an immediate lifting of the ban. Theater managers prepare for Sunday shows in the hopes that the quarantine will be raised tomorrow.

November 14, 1918

The Board of Health decides the ban will not be lifted yet, and will remain in place for at least another 7-10 days. The total number of influenza cases in the city is now 5,040.

November 15, 1918

City influenza hospital nurses are overtaxed and need helpers for non-specialized nursing tasks.

November 18, 1918

The ban is lifted at midnight this evening. Public meetings and gatherings will once again be allowed. Public schools will open Monday (11/25). Schools will open earlier and close later and no vacations will be given in an effort to make up time lost. Dance halls will remain closed indefinitely.

November 19, 1918

According to Health Officer Anderson the death list is decreasing by the day and the influenza is on the wane. The sixty-one patients who reported to the emergency hospital is the smallest number since the week it opened. Health officials stationed at theaters today will ask individuals who are coughing and sneezing to leave the theater.

November 20, 1918

Health Officer Anderson says the influenza situation is good, with the influenza hospital discharging more patients than it receives. After visiting theaters, Anderson says conditions in theaters are satisfactory. Restaurant owners ask that the ban on dancing be removed, but health officials reject the request.

November 21, 1918

Health Officer Anderson confers with car companies today regarding the enforcement of the order for open windows in streetcars. At the request of his members, School Board Commissioner J. C. Argall requests that Anderson issue an order to open schools tomorrow. However, the request could not be granted as County Health Officer Dr. A. E. Stuht is out of town.

November 22, 1918

The emergency influenza hospital continues to need volunteer help.

November 23, 1918

According to Health Officer Anderson the epidemic is becoming less of a serious health risk to the public. Fewer calls from families in distress from influenza have been made to the social service bureau in the last few days.

November 24, 1918

Health officers stationed at area theaters are removed this evening. Spokane churches are crowded today after being closed since 10/8.

November 25, 1918

According to Health Officer Anderson and County Health Officer Stuht the ban on dancing will be removed next Tuesday (12/3). All public dance halls, restaurants, and private parties are included in this removal. It is expected that after 12/15 the temporary influenza hospital in the Lion Hotel will be closed and patients will be treated at regular hospitals.

November 26, 1918

County Health Officer Stuht says the ban on dancing will be lifted at midnight tonight. Spokane Health Officer Anderson reminds the public to take necessary precautions to avoid the disease.

November 27, 1918

City health authorities are surprised by a sharp increase in influenza cases.

November 29, 1918

Health Officer Anderson reminds the public to take care if they fall ill and to return to bed rather than attempting to go about their usual business.

November 30, 1918

The supply of nurses in the emergency hospital is running very low and graduate and retired nurses are needed. With parental consent all Spokane schoolchildren are to be vaccinated against influenza. The School Board will administer the serum free of charge. Health Officer Anderson reminds the public to avoid crowds, but says he will not reinstate the ban unless conditions warrant such an action. Slides warning against coughing, sneezing and spitting are shown at theaters today.

December 1, 1918

The City Health Office announces its intention of putting up placards on all residences where influenza is present. Women with practical experience in home nursing are asked to apply to the Red Cross immediately.

December 2, 1918

397 cases are reported today, breaking all records at the Health Office. Health Officer Anderson says he believes the death rate can be reduced if additional nursing help can be found. He warns against public gatherings. The Board of Education is called into special session tonight to discuss school closures. For twenty-five cents all citizens of Spokane can receive the anti-influenza serum at City Hall.

December 3, 1918

The City Board of Health orders all public schools to close, and bars children under twelve from entering public places. Parents are asked to keep children at home during the epidemic. As surrounding cities do not have bans, Health Officer Anderson does not believe a ban in Spokane would be effective.

December 4, 1918

City parochial schools close voluntarily today. Other schools await Board of Health orders. The Board of Health bans all gatherings today. This includes public dancing, theater crowding, and public meetings. Theater managers are not allowed to provide “standing room only” tickets. Anti-influenza serum is in high demand at City Hall.

December 5, 1918

Health Officer Anderson says he believes there will be an increase in influenza cases before the crest of the latest outbreak passes. There continues to be a shortage of nursing help in Spokane.

December 6, 1918

The Board of Health and Health Officer Anderson authorize a modified quarantine order today. Overcrowding is prohibited in churches, stores, theaters, and elevators. All public and private dancing is forbidden. Homes with influenza present must be placarded and restrictions are placed on healthy workers from placarded homes. Businesses that violate the modified orders will be closed.

December 8, 1918

Health Officer Anderson announces that meetings of executive trustees and committees are exempt from the modified quarantine order in the interest of necessary business. Churches conduct services today under the new orders, with congregational singing eliminated and every other row of pews occupied.

December 9, 1918

To date there have been 9,169 cases of influenza reported in the city. There is still a great need for nurses at the hospital. Health Officer Anderson closes the Empress Theater for violating the quarantine. Workers are putting up 5,000 placards on homes where influenza is present. Anderson reminds citizens that parochial schools and Sunday school meetings are included in the quarantine orders. The City receives a second supply of anti-influenza serum.

December 10, 1918

The Empress Theater is allowed to reopen today after promising to abide by the rules outlined under the quarantine order.

December 11, 1918

Health Officer Anderson says he believes the quarantine may not be lifted until the first of the New Year. The Spokane Police Department gives the Health Department fifteen cases of whiskey to be used in treating influenza sufferers. Graduate nurses are still needed at the influenza hospital. The Health Department administers 100 doses of anti-influenza serum today.

December 12, 1918

Due to low case reports over the past few days, Health Officer Anderson says the influenza situation is rapidly improving in Spokane.

December 14, 1918

Theater managers ask Health Officer Anderson to remove or modify the other requiring every other row remain empty, but their request is denied. Dr. Anderson says the quarantine is expected to continue until 1/6/1919.

December 16, 1918

Calls to the Health Department for anti-influenza serum have tapered off. According to County Health Officer Stuht the situation is improved, but the city must remain vigilant.

December 17, 1918

Theater men are pushing for the removal of the influenza quarantine, or a set date at which they may resume business as usual. There continues to be a great demand for nurses at the influenza hospital. The Health Department issues 75 doses of anti-influenza serum to the public.

December 18, 1918

The City Council authorizes the purchase of additional serum. 1200 doses of anti-influenza serum are issued today. Health Officer Anderson reiterates that he will not consent to removing the quarantine

December 19, 1918

Health Officer Anderson reiterates that he will not consent to removing the quarantine until after the first of the New Year.

December 20, 1918

Upon Health Officer Anderson’s request, there will be a health inspector posted at each department store in Spokane. The public is reminded that crowding and the unnecessary presence of children in department stores are prohibited under the quarantine order. County Commissioners grant the influenza hospital $1,500 for operating costs so it may remain open.

December 23, 1918

According to County Health Officer Stuht, conditions are improving and the epidemic will soon be over.

December 24, 1918

Health Officer Anderson denies a petition against the quarantine by theater men. He reminds the public that the quarantine will not be removed until after the first of the New Year.

December 26, 1918

Health Officer Anderson says that theaters with modern ventilation systems will receive first consideration when the quarantine is ended. It is predicted that if current conditions continue the influenza hospital will close shortly.

December 27, 1918

If there are no ill effects from the holiday shopping season, Health Officer Anderson says he will be prepared to take steps towards lifting the quarantine.

December 30, 1918

Health Officer Anderson announces that quarantine orders will be lifted beginning 1/1/1919. Tomorrow, theaters and churches will no longer be required to operate at half capacity. Schools are to reopen next Monday (1/6/1919). However, public and private dancing is still banned, and children are not yet allowed in churches and theaters. The City Council passes an ordinance declaring influenza to be a dangerous, contagious disease that must be reported.

December 31, 1918

The Health Department issues a warning reminding the public that violators of the anti-crowing rules on streetcars and the ban on community singing will be subject to police authority.

January 3, 1919

While it is expected that influenza will continue to be present until June, the latest outbreak is believed to be under control. The emergency hospital is predicted to close on 1/15, and remaining patients will be sent to area hospitals. The ban continues on community singing, despite the fact that churches have resumed regular service.

January 6, 1919

The ban on admission of children under 16 to theaters is lifted today. Dances are still banned.

January 11, 1919

Theater men request a refund for the forty-one days they were closed, and an allowance for the time they were required to run at half capacity.

January 13, 1919

After 89 days of operation the influenza hospital in the Lion Hotel closes today. The hospital treated 617 influenza patients while it was open. The remaining twelve patients are to be discharged or sent to area hospitals.

January 15, 1919

According to Health Officer Anderson a slight increase in cases over the past few days is not a cause for alarm. Twelve city firefighters are off duty this evening due to influenza.

January 23, 1919

Streetcars continue to keep windows open on cars. The ban on dancing continues.

February 14, 1919

No record is being kept of the number of people under quarantine, but the figure is thought to be over 11,000.

February 19, 1919

Despite an increase in cases over the past few days the situation is not considered serious.

February 26, 1919

According to Dr. James E. Drake, Spokane School Physician, the influenza is having a serious impact on attendance numbers. Children have returned to school before they are well and have spread influenza to others.

February 27, 1919

Today there are 112 new influenza cases. Health Officer Anderson says there is no reason to be alarmed.

February 28, 1919

Health Officer Anderson predicts influenza will remain in Spokane through the summer and the next two winters. He attributes the recent rise in cases to misdiagnosis of colds as influenza. Anderson is confident that the disease is in check, as the death rate has not risen. There are 26 new cases of influenza reported today.