Forgetting the Influenza Epidemic of 1918

In this fourth and final installment on the Influenza Epidemic of 1918, Paul Andrews considers its enduring legacy–or lack thereof.


As the United States celebrated the end of the First World War on November 11th, 1918, they also celebrated the end of the worst of the Influenza Epidemic that killed so many. Although waves of influenza did still hit parts of the world through 1920, they were not as deadly as the strain that killed so many in 1918.  One theory posits that the strain that killed so many had taken all the victims it could, and mutated into something more benign.  As the worst of the effects of the epidemic faded, so did the memory. It’s as if the world had decided that it just wanted to forget the flu epidemic had happened at all. Alfred Crosby, in his 1976 book America’s Forgotten Pandemic wrote ‘the flu never inspired awe, not in 1918, and not since.’ The epidemic simply disappeared from the American consciousness.  With the exception of Katherine Anne Porter, and a few other writes, the epidemic was never part of American culture or public memory.

Why did one of the deadliest modern plagues simply disappear from memory? Some believe that it was because illness and death was still something familiar in the early 20th century, as it was in earlier times. The loss of so much life from a sickness, especially if the victim died at home, just didn’t impact individuals as much as that kind of death would affect us today. We rely on science and medicine to deal with illness more than ever today.  In 1918, science failed completely to find the cause or cure to the epidemic. Dr. Victor Vaughn, the head of the Army’s communicable disease division, said, when the worst of the plague was over, ‘Never again allow me to say that medical science is on the verge of conquering disease.’ The epidemic was a huge blow to the ego of doctors.  They could do nothing but watch the tragedy unfold.  About the only thing that could be done for the victims of the flu was bed rest, manage their pain, keep them warm, and to isolate them as much as possible.  While doctors could do little, it was nurses that took care of the sick and dying.

Elizabeth Onion believes this is another reason the Influenza Epidemic of 1918 was so quickly forgotten.  The true heroes of the disaster were women; nurses, and home caregivers.  Care of the sick at home has always been a thankless task, mainly left to women.  Today hospital and home care nurses act as care givers to those who don’t have that kind of support available. Onion writes ‘A close read of recent history suggests that the 20th century silence about the flu epidemic of 1918-19 shows how uneasy many Americans have been with failure, death, and loss, and how strongly most of the nation seems to prefer stories that celebrate heroic achievements to those that memorialize acts of caregiving.’ She also believes that the optimism that often typifies American behavior and culture made it easier for the country to simply forget the failure of an epidemic that ran out of control.

Hand in hand with this optimism is the belief people have about their own health.  After the 2009 swine flu epidemic, Mark Davis conducted a study of how people reacted to the flu outbreak that infected so many, but that had relatively few victims. His research showed that most people believe that their health choices- diet, exercise, and general good habits- allowed them to push through the worst of a flu. They believed flu was inevitable, but they would be able to survive it.

And flu is inevitable.  Seasonal flu has killed somewhere between 3,000 to 48,000 people in the last forty years.  The numbers are hard to pin down, because flu deaths are often misreported.  The 2009 H1N1 swine flu killed 60 people in Mexico.  One of the two major avian flu strains, H7N6, jumped to humans in 2013 in China, killing something between 1,030 to 2,400 people.  The threat of another epidemic is always present, and many believe that it’s not a matter of if another pandemic strikes, but when.  Science and medicine have may vast advancements in the last 100 years, and we are better prepared to deal with a crisis like the influenza epidemic as before, but we are still unable to know what vaccines will work against what flu strains. 

Although the history of the 1918 Influenza Epidemic is being studied more now than in the past, many of the lessons of the crisis have not been learned.  John Barry, author of the book The Great Influenza, believes that one of the most important lessons to learn from the 1918 epidemic was that government officials must be up front and honest with the public. He was asked to speak at an emergency preparedness event that centered on an epidemic, and made this clear, to the agreement of all the attendees. When the event started he was stunned that the first ‘statement’ drafted to the public was meant to minimize the threat of the disaster.  Even then, the lessons of 1918 weren’t learned.