Pandemic lessons from Baltimore’s reaction to the 1918 ‘Spanish flu’ | COMMENTARY

Cartoon from a 1918 issue of the Evening Capital Newspaper in Annapolis.

The wide and rapid spread of a disease like coronavirus, or COVID-19, may be unprecedented in our lives, but our ancestors experienced a similarly terrifying pandemic. From 1918 to 1919, the so-called “Spanish flu” ravaged the globe, infecting one third of the world’s population and killing at least 50 million people — 675,000 of them in the United States.

It’s tempting to think that one pandemic would be nothing like the other. Medicine, technology, transportation — they’ve all changed markedly in the past century, as have our attitudes toward socializing and our means to do it. Biotech didn’t exist 100 years ago; today many such companies are feverishly working to develop treatments and vaccines for COVID-19. And social media has made it easier than ever for people to “connect” across geographic boundaries, while never so much as breathing the same air. Both developments would seem to suggest we’re in for a shorter and less isolated duration today than our 1918 counterparts. Although jumbo jets and mass transit options have meant an easier spread from continent to continent and town to town.


And yet, some of the pandemic parallels — at least in these early days — are remarkable, particularly the reactions. The initial denials and eventual social distancing then look much like today’s.

Maryland took notice of the Spanish flu in late September of 1918, when a handful of soldiers at Camp Meade were diagnosed with the disease, according to a detailed account compiled by the University of Michigan in its “Influenza Encyclopedia.” While each infected soldier was quarantined, visitors and other soldiers were allowed to come and go at will. Within a few days, there were nearly 2,000 influenza cases reported at the camp.


Large gatherings on bases were banned, theaters closed and the YMCA shuttered. More cases were reported at more military bases, spreading to civilian contractors, who then took the illness home to their families. The Baltimore Health Department reported that the first cases to affect city civilians broke out among the laborers.

Until then, the city health commissioner, Dr. John D. Blake, underplayed the outbreak, calling it the “same old influenza the physicians have recognized and treated for a good many years,” according to a Sept. 26, 1918, story in The Baltimore Sun. Three days later, his tune changed some. Blake asked theaters and railway and street car operators to keep their spaces well ventilated, and to post signs suggesting travelers sneeze and cough into kerchiefs. He refused to take what he deemed the “drastic measures” of banning public gatherings to potentially lessen the burden on hospitals.

By Oct. 6, hospitals were too full to accept new patients, and makeshift medical facilities were set up. City businesses remained open, but many employees were too sick to work. On Oct. 8, the city school board closed public schools, then private schools followed suit. On Oct. 9, theaters were finally ordered closed, and large gatherings prohibited. On Oct. 10, retail store hours were restricted, though saloons remained in operation because of their “medicinal” value. On Oct. 11, churches and poolrooms closed.

A week later, the number of flu cases began to fall. But it was likely due less to the long-delayed social distancing measures, than the fact that infections had peaked.

The City Council approved $25,000 to help families afford funerals for the dead, and the health department temporarily waived an embalming requirement. Immigrant groups and the city’s black population were especially hit hard by the disease and the inequity and economic hardships that accompanied it.

Baltimore began to slowly reopen for business just two weeks after it started shutting down, though schools remained closed until November. More than 4,100 people died.

Baltimore was late to take action in 1918. Only time will tell if we’ve taken fast enough action today. We’re most certainly going to take longer action. There likely will be no two-week reopening. And perhaps we should be grateful for it.

The Baltimore Sun editorial board — made up of Opinion Editor Tricia Bishop, Deputy Editor Andrea K. McDaniels and writer Peter Jensen — offers opinions and analysis on news and issues relevant to readers. It is separate from the newsroom.