Pandemic 1918

by Catharine Arnold

  Taken prisoner by the Germans, Billy attempted to escape four times in as many months, was court martialled and placed in solitary confinement. Sent on to Holzminden prison camp, in Lower Saxony, which was notorious for its brutality, Billy’s health suffered. By the time he was released, on 14 December 1918, he had become desperately weak. As if this was not enough, he contracted influenza and, in his delirium, relived the horrors of his captivity. One of the greatest heroes of the First World War, Billy died on New Year’s Eve, 1918.10 Many other anonymous prisoners of war from both sides died of Spanish flu, among them 30,000 Austrian troops who perished between August 1918 and August 1919.11

  Billy had become yet another victim of ‘the appalling outbreak of “influenza”’, as The Illustrated London News referred to it. ‘From the high North to the Tropics its victims are to be counted by the thousand, and it is still at its deadly work.’12

  Among the Spanish Lady’s 1919 victims were the mother and sister of baby John Burgess Wilson, whose father arrived home in Manchester from the army to discover:

  My mother and sister dead … The Spanish Influenza pandemic had struck Harpurhey. There was no doubt of the existence of a God; only the Supreme Being could contrive so brilliant an afterpiece to four years of unprecedented suffering and devastation. I apparently was chuckling in my cot while my mother and sister lay dead on a bed in the same room.13

  The fact that baby John was ‘chuckling’ when his father arrived home instead of ‘howling for food’ was thanks to Dr James Niven; Manchester’s Chief Medical Officer had mobilized mass provisions of food, particularly baby food, throughout the city as a response to the deadly second wave. A kindly neighbour had fed Baby Burgess Wilson a bottle of Glaxo baby food shortly before being struck down herself. The baby survived, and grew up to be novelist Anthony Burgess, author of A Clockwork Orange.14

  In March 1919, Clementine Churchill’s nanny Isabelle was struck down with Spanish flu. In her delirium, Isabelle took little Marigold Churchill, daughter of Clemmie and Winston, into bed with her. Clementine retrieved the child and spent the night running up and downstairs between the two. Marigold survived, but Isabelle perished.15

  Spanish flu was implicated in an outbreak of murder suicides, apparently caused by the depression that was a common feature of disease. Newspapers on both sides of the Atlantic carried stories of men and women who attempted to slay their families. In the East End of London an infected docker, James Shaw, killed himself and one child with a knife; an older daughter ran away and escaped.16

  Sir Mark Sykes’ death at the Paris Peace Conference on 16 February 1919, and his posthumous contribution to influenza research, has already been discussed. But the warm weather and confluence of delegates from all over the world contributed to ideal conditions for the spread of influenza in a city that had already experienced an influenza epidemic. It was at this same conference that American President Woodrow Wilson fell sick, although the actual nature of his illness remains a matter of conjecture. Wilson was taken ill at the conference on 3 April 1919 with what appeared to be the symptoms of gastric flu.17 After spending five days in bed, Wilson returned to the table on 8 April. But the President seemed utterly changed by the experience. Wilson’s secret service man, Edmund Starling, noted that Wilson seemed to have lost his ‘old quickness of grasp’,18 while Herbert Hoover observed that negotiating with Wilson was like pushing against ‘an unwilling mind’.19 Others commented on Wilson’s drooping left eye and facial spasms. Nevertheless, Wilson’s physician, Cary Grayson, informed Prime Minister David Lloyd George and other delegates that the President had suffered an attack of influenza.20 It was a convincing scenario: even before he reached flu-ridden Paris, Wilson had sailed to Europe aboard the George Washington, upon which eighty doughboys had perished from influenza in a single crossing a few weeks earlier. Among those who cheered as Wilson drove through the streets of Paris was Private Pressley, the same young soldier who had witnessed influenza in London and survived his own bout of Spanish flu in France.21 But Woodrow Wilson’s attack of ‘influenza’ may have been nothing more than a cover-up. Wilson, who was being treated for hypertension, had already suffered a number of strokes, but the public could not be allowed to know this: such a revelation would have shattered confidence in their leader, the man with the plan to end all wars. Dr Grayson was very conscious that his patient had undergone a serious episode, noting a curious scene during which Wilson rearranged the furniture in his Paris apartment, claiming that he didn’t like the way the colours of the furniture appeared to fight against each other. ‘The greens and the reds are all mixed up here and there is no harmony. Here is a big purple, high-backed covered chair, which is like the Purple Cow, strayed off to itself, and it is placed where the light shines on it too brightly.’22 Wilson appeared to recover within a few days, but he was never quite the same again. The following September, Wilson suffered a catastrophic stroke and was forced to retire from public life.

  Medical researchers had battled throughout 1918 to find a cure for a disease that they could scarcely identify, and in some cases the doctors themselves became victims. One such was Major H. Graeme Gibson, RAMC, who died in February 1919 at the No. 2 Stationary Hospital, Abbeville, along with two colleagues.

  Major Gibson was commemorated in his obituaries as a ‘martyr to science’. Working alongside Major Bowman of the Canadian Army Medical Corps, and Captain Connor of the Australian Army Medical Corps, Major Gibson had:

  Completed the discovery of what is very probably indeed the causative germ of this influenza epidemic. A preliminary note regarding this germ was published by these doctors on 14 December 1918, in the British Medical Journal, and thus Major Graeme Gibson’s work takes precedence over later publications. At the time, however, the proof of the discovery was not complete. It has now been completed, as we understand; and Major Gibson’s death furnishes a part of the evidence. His eagerness and enthusiasm led him to work so hard that he finally fell a victim to the very virulent strains of the germ with which he was experimenting. He himself caught the influenza, and pneumonia followed.23

  Sir Walter Morley Fletcher, the dynamic secretary of the Medical Research Council, was shocked by the deaths of Gibson and his colleagues, as they were ‘all bowled over with this beastly thing’.24 Gibson and his team were not the only victims; further correspondence to and from Fletcher indicates that many researchers were struck down with influenza, adding sick leave to the list of obstacles to developing a vaccine.25

  Research into the causes of the Spanish Lady was not without its bizarre moments. On one occasion a monkey, destined to be used as a test subject, escaped from the laboratory. According to Fletcher:

  Next day he was seen in New Scotland Yard, presumably about to report himself to the police. Chased by a policeman he crossed Whitehall, and was run over by a motor-bus. When they tried to pick up the dead body, he came to life and ran up the façade of the Home Office, to the great delight of a large crowd. He was found dead at the top of the Home Office that evening, dead, but not dishonoured.26

  Walter Fletcher lived through the Spanish flu epidemic, but his health had already been compromised by double pneumonia and pleurisy in 1916. A typical example of a doctor making a terrible patient, Fletcher undermined his health with his remorseless work ethic and never fully recovered from the operation to drain his lungs; an infection at the wound site eventually killed him at the age of sixty-three.

  Throughout the Spanish flu epidemic, Fletcher’s dedication to combating the disease had been absolute. ‘That late summer and autumn saw the appalling ravages of the black influenza pandemic,’26 wrote Fletcher’s wife, Maisie. ‘Walter himself fortunately escaped, but he was terribly concerned about it, and from then on he initiated a real attack on the disease.’27 This was to be Fletcher’s life’s work, an ‘attack’ on influenza ‘which was to include all the work done on dogs’ distemper, and the starting of the Field Laboratories up at Mill Hill where the vast Laboratory of the M
edical Research Council was to be built thirty years later’.28

  For some individuals, Spanish flu bequeathed such a legacy of pain that they could not live with the consequences, even when the pandemic had ceased. Dr James Niven, Manchester’s Chief Medical Officer of Health, had done much to contain the first wave of influenza when it hit the city in June 1918. His practical measures and recommendations to the city authorities saved many lives. But Manchester’s city fathers ignored Niven’s advice to ban Armistice celebrations, with the result that the death rate soared following the mass gatherings of 11 November. In the years that followed, Niven became increasingly despondent, despite his outstanding professional reputation and achievements. On 28 September 1925, Niven travelled to the Isle of Man and checked into a hotel. Two days later, his body was discovered in Onchan Harbour. Niven had taken an overdose, and swum out to sea.

  For others, though, it was a happier story. Vera Brittain, having served as a VAD in France and London, returned to her studies at the University of Oxford after the war and wrote about her experiences in Testament of Youth, one of the most graphic memoirs of the First World War. J. S. Wane, the army clerk who had chronicled his attack of Spanish flu in his diary while serving in France, also managed to complete his degree. Wane eventually returned home to England in the autumn of 1918, to be reunited with a young woman who, if not exactly his sweetheart, appeared to have been waiting for him. On Friday 31 January 1919, Wane recorded the experience of at last being able to graduate from Cambridge University: ‘The degrees were given in the Senate House at 2: I wore uniform, and we three went up together to the throne, holding Joey’s hand.’ (‘Joey’ was Vice Chancellor Sir Arthur Everett Shipley, and the hand-holding refers to the ancient Cambridge tradition of holding the VC’s hand as the degree is conferred.)29

  What of the USS Leviathan, the stricken ship which had carried flu-ridden doughboys to France? Following the Armistice, the vessel was decommissioned. She had one other claim to fame when a future film star served on board as a coxswain between 27 November 1918 and February 1919. His name was Humphrey Bogart.30 After a complete refit, the Leviathan returned to civilian life as an American passenger ship, her war service making her, if anything, more popular than in her glamorous pre-war days. She flourished during Prohibition, moored in waters outside US jurisdiction to serve ‘medicinal alcohol’ to all who sailed out to her. But in the end it was the Great Depression, and not the German U-boats, that brought about her downfall. High-maintenance and too expensive to operate, the USS Leviathan made her final voyage on 14 February 1938 to the breaker’s yard at Rosyth, Scotland, where she was broken up for scrap. Nothing of the ship now remains, apart from the memories of those who served on her, and this celebratory address:

  We view the grandeur of thy bulk,

  And gaze with wonder and with awe,

  At thy great magnitude and might,

  Which surpass visions we foresaw.31

  In Philadelphia, life swiftly returned to normal for Columba Voltz and her friend Katherine. Soon they were playing their old familiar games again, and roller skating through the park. ‘Everything seemed so marvelous. I knew my uncles would be coming home from army camps; and they hadn’t gotten sick. Everyone in our family had recovered from the flu and nobody else I knew was sick. We were all very, very happy. The war was over and the flu was practically gone. Peace and health had returned to the city.’32

  But Anna Milani never forgot the loss of her little brother, Harry: ‘I keep thinking about it. My brothers and sisters – there are eight of us living now – we talk about the flu, how we were all sick, what we went through. We talk about Harry.’33

  For Mary McCarthy, the loss of her parents and her comfortable, middle-class family life proved more difficult to comprehend. Mary recalled visiting her parents’ grave with her brothers as

  a regular Sunday activity, which involved long streetcar trips or endless walking or waiting, and that had the peculiarly fatigued, dusty, proletarianised character of American municipal entertainment. The two mounds that were our parents associated themselves in our minds with Civil War cannon balls and monuments to the doughboy dead; we contemplated them stolidly, waiting for a sensation, but those twin grass beds, with their junior-executive headstones, elicited nothing whatever.34

  In retrospect, Mary credited Spanish flu for changing the course of her existence. If her parents had lived, Mary believed, her own life would have been far more conventional: marriage to an Irish lawyer, rounds of golf and membership of a Catholic book club.35 As it was, the controversial author of The Group became an intellectual firebrand and mainstay of The Partisan Review and The New York Review of Books. Mary’s pragmatism was a very different response from that of William Maxell, who became Mary’s editor at the New Yorker. William recalled a poignant sense of loss when his own mother and new-born sibling died from the disease: ‘From that time on there was a sadness which had not existed before, a deep down sadness that never went away. We aren’t safe. Nobody’s safe. Terrible things can happen to anyone at any time.’36

  CHAPTER TWENTY-ONE

  ‘VIRAL ARCHAEOLOGY’

  PRIVATE HARRY UNDERDOWN, the English soldier who died at No. 24 Hospital in February 1917, now rests in peace beneath his plain white headstone in Étaples military cemetery, blissfully unaware of his status as the potential ‘Patient Zero’.1

  While the body of Harry lies undisturbed, the bodies of many other victims may hold the secret of the deadly virus, providing more information about the aetiology and causes of Spanish flu to avert the threat of future pandemics. This form of research has been conducted over the past seventy years, first by Swedish medical student Johan V. Hultin, later by Jeffery Taubenberger of the Armed Forces Institute of Pathology, Washington, DC and Professor John Oxford of the Royal London Hospital Medical School. While these men and their teams sought answers from the preserved bodies of influenza victims, it was not until the virus took a new and unexpected form, killing a three-year-old child in Hong Kong in 1997, that influenza research took on a new urgency.

  In 1950, Johan V. Hultin (born 1925) had been attending medical school at the University of Uppsala ‘as part of a special program in Swedish medical schools that allowed students to leave halfway through their studies to pursue other interests and to return with no loss in standing’.2 Hultin had already decided to investigate the body’s immune reaction to influenza. Immigrating to the United States, Hultin enrolled in the microbiology department of the University of Iowa. It was here that Hultin was introduced to Professor William Hale, an eminent virologist from Brookhaven National Laboratory, then at Camp Upton, Long Island. Over lunch, Professor Hale made an offhand remark about the 1918 influenza epidemic. It was a remark that was to change the course of Hultin’s life forever.

  ‘Everything has been done to elucidate the cause of that epidemic,’ Hale said. ‘But we just don’t know what caused that flu. The only thing that remains is for someone to go to the northern part of the world and find bodies in the permafrost that are well preserved and that just might contain the influenza virus.’3

  This statement was Hultin’s light-bulb moment. Speculating that clues to the genetic code of Spanish flu might be found in the bodies of its victims, Hultin learned about the devastating outbreaks of Spanish influenza in Alaska in 1918, where its victims had been buried in the ‘permafrost’ – that is, ground, including rock or soil, at or below the freezing point of water: 0° C (32° F).

  Having found the subject of his doctoral thesis, Hultin travelled to the northern coast of Alaska to exhume the bodies in a bid to isolate the virus. Using a combination of local records and weather charts to pinpoint the burial sites, Hultin also had to take into account the changeable nature of permafrost itself. This naturally occurring process brought with it its own problems. The sequence of freeze and thaw was likely to affect the condition of the human remains. Hultin was taking a tremendous risk: he had no guarantee his project would succeed, or that
he would find any well-preserved bodies, let alone suitable tissue samples.

  Hultin applied to the National Institute for Health for funding but never received a response. However, according to Hultin, the US government got wind of his plans and carried out a research expedition of its own.4 In 1951, the US military planned a $300,000 mission code-named Project George, to exhume Spanish flu victims from the Alaskan permafrost.5 If this strikes the reader as unlikely, it is worth bearing in mind that these events occurred in the context of the Cold War. In 1918, 450,000 Russians had been killed by Spanish flu. In the event of the Soviet Union developing its own strain of the virus and using it as a biological weapon against the United States, the consequences were unthinkable.

  Ostensibly top-secret, Project George was discovered by officials at the University of Iowa and, within a day, Hultin found himself on his way to Nome, Alaska, with his associates Dr Albert McKee and Dr Jack Layton and $10,000 of funding.6 The team landed in Nome but, when they started to excavate, they soon discovered that the permafrost had been fractured by a small creek, which had changed course. As a result, any bodies buried in the permafrost would have decayed and not be suitable for sampling.

  As the virologist Jeffery Taubenberger later observed, the term ‘permafrost’ is a misnomer. Permafrost operates in a series of continual cycles, ‘where the temperature kind of goes just above and just below freezing. With biological material, freezing and thawing is the very worst thing you can do, because ice crystals form and poke holes in membranes of cells, and it causes all sorts of damage. So, basically, nothing biological survives freezing and thawing.’7

  Undeterred by their lack of success, Hultin and his team hired a pilot and flew to the Seward Peninsula in search of further burials, as the military personnel engaged in Project George arrived in Nome with a full complement of drilling and excavation equipment. While the army found nothing but bones, Hultin’s team travelled to Brevig Mission, previously known as Teller Mission, where 85 per cent of Brevig Mission’s inhabitants had died of Spanish flu in one week in November 1918.8 Bodies were exhumed and tissue samples taken from lungs, kidneys, spleens and brains, packed and sent to Iowa. The results, however, were disappointing. Despite comprehensive analysis, no traces of the live virus were discovered.9