The last time Montgomery face a health crisis like this was 1918, and the advice then sounds eerily familiar
As a deadly epidemic entered Alabama in the fall of 1918, a public health officer made it clear: Avoid large gatherings and wash your hands.
“Those people who are well also may prevent an epidemic and can aid by refraining from gathering in large crowds,” Dr. Robert Oleson of the U.S. Public Health Service told the Montgomery Times on Oct. 2, 1918. “The hands should always be washed before eating and the face and hands washed after a person has come in contact with one who sneezes in his face.”
If that advice sounds like exhortations to avoid COVID-19 today, it aimed at a different disease. The coronavirus COVID-19 causes mild to moderate flu- and pneumonia-like illnesses in those young and relatively healthy, though some experts caution it is still more intense than the average cold or flu for many patients.
But it can be deadly, particularly in those older than 60 or with pre-existing health conditions, and young people may be transmitting the virus without even knowing it, says Alabama Emergency Management Agency Director Brian Hastings.
By contrast, surviving records of the 1918 epidemic suggest it was particularly deadly for pregnant women and those in their 20s. It was also a painful way to die. Some victims bled from their noses and ears. Other patients’ faces turned blue for lack of oxygen.
“It is only a matter of a few hours then until death comes,” one U.S. Army physician wrote in a letter. “It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies … we have been averaging about 100 deaths per day.”
The state's news media reported the first confirmed cases of influenza that year in Madison and Conecuh counties in late September. Soon after, Camp Sheridan, a U.S. Army training facility in Montgomery, reported several cases and what may have been the first 3 deaths in the area on Oct. 3.
Lucy Durr, who worked in the camp’s influenza ward, wrote to her son on Oct. 21 that if the flu kept apace, “the casualty list over here will be longer than the one in France.”
“A sweet looking blonde boy came in yesterday, and tonight his fever is running high,” she wrote. “He is on one of the upstairs porches. This afternoon, I went to see him and found nervous and frightened. I asked him if I could do anything for him, he replied, I’m lonesome. I knew that was an invitation for me to stay with him, so I got a chair and sat with him until suppertime.”
Unlike today, there does not appear to have been a centralized response to the outbreak. While the state health department reported cases, local authorities had to handle the outbreak themselves. On Oct. 8, Montgomery shut down schools and churches throughout the city, as well as “pool rooms … and the table compartments of soft drink parlors.”
But it's difficult to gauge the effectiveness of these measures. The Centers for Disease Control and prevention estimate that 675,000 people died in the United States during the epidemic, but the number of influenza cases and deaths in Alabama is not known. About two weeks into the outbreak, the state’s health department stopped disclosing the number of new cases and suggested “drastic steps” to fight the illness had resulted in “unnecessary alarm.”
The Montgomery Advertiser claimed the city escaped the worst ravages of the disease. This “escape” was fearsome: On Oct. 21, Montgomery’s health department reported there had been 1,200 cases of flu, and nine deaths. It added that “it is possible … that the report does not include all cases.”
The following year, Dallas County reported more than 5,000 influenza cases in 1918, and 213 deaths – more than the next four leading cases of death combined.
The public closings in Montgomery stayed in place until early November. The city allowed churches to hold a single daily service on Nov. 3. Schools reopened the following day, though the ban on soft drink parlors initially remained in place. The Advertiser criticized that part of the decision, saying the city’s residents needed a break.
“They have been subjected to more restrictions than ever before in their lives,” the newspaper said. “For months, they have gone through life with signs of ‘don’t do this’ and ‘You must do that’ on every hand. Their daily life has been a series of encounters with inhibitions and prohibitions.”
The city lifted the ban shortly after.
Contact Montgomery Advertiser reporter Brian Lyman at 334-240-0185 or email@example.com.