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Century after Spanish flu 'nightmare,' pandemic remains concern
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Century after Spanish flu 'nightmare,' pandemic remains concern

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A century ago, the mid-Willamette Valley was in the midst of a harsh winter, with heavy rains and flooding, but even worse was the Spanish flu.

“Whole families would be sick at the same time and a mother or father would get up in the cold to care for some other family and then the next day they would be congested, turned blue, cough and spit blood all over the room and die. It was awful, the number that died during that epidemic,” wrote Dr. Emil Washington Howard in his memoirs.

“That winter was a nightmare,” he added.

Every day, local newspapers carried macabre updates to the nightmare: Residents were dying of influenza. Many were in the prime of their lives.

“That was one of the terrifying things about this. It was knocking down healthy young men and women,” said Charlie Fautin, deputy director of the Benton County Health Department.

Lists of quarantined homes were published in the Corvallis Gazette-Times, said Mary Gallagher, collections manager for the Benton County Historical Society.

On Jan. 20, 1919, 76 houses in Corvallis were under quarantine. Some homes belonged to the most important families in the area.

“It didn’t matter, rich or poor. The flu didn’t discriminate,” Gallagher said.

Gallagher took out a manila folder and showed the last photograph taken of Vena Rickard Clark, the daughter of an early Benton County sheriff and a prominent graduate of Oregon Agricultural College. The newlywed died at age 28 in New York City in September 1918, while her husband was away with the YMCA in France for World War I.

“She looks perfectly healthy and young, so it’s quite sad,” Gallagher said.

The state of Oregon’s population was about 750,000 in 1918-1920. About 50,000 people, or 1 in 15 Oregonians, became sick with the Spanish flu, and roughly 3,500 people died from influenza in that time period, Fautin said, citing estimates.

Even those who survived faced lasting medical problems.

According to the U.S. Centers for Disease Control and Prevention, at least 50 million people died worldwide, with 675,000 deaths in the United States due to the pandemic.

“This was the first time in the modern era there was this massive, lethal global event,” Fautin said. “It will happen again. With our transportation and our interconnectedness, it will be very fast in spreading throughout the world.”

The World Health Organization lists a global influenza pandemic as one of its top threats to health in 2019, as it has for several years.

Like travel, medicine has advanced by leaps and bounds during the last century — Corvallis didn’t even have a hospital in the modern sense 100 years ago, so people ill with the Spanish flu were treated in their own homes.

“We’ve learned more about how people can protect themselves. We’ve learned more about how communities can protect themselves,” said Dr. Richard Leman, chief medical officer for the Oregon Health Authority.

A century ago, mid-Willamette Valley residents couldn’t go to an intensive care unit and get oxygen, nor could they take antibiotics for pneumonia, which actually caused the death of nearly half of the people who perished from the Spanish flu, said Leman and Dr. Ann Thomas, who does flu surveillance for the Health Authority.

“We happily have a few more tools than we had in 1918, both in terms of medication and vaccines, but also in terms of what we’ve learned over time,” Leman said.

But Fautin said the best methods to prevent the spread of such a pandemic — whether influenza or another illness — might be those urged locally, and often ignored, during the Spanish flu pandemic of 1918-1920.

Genetic drift vs. genetic shift

Influenza pandemics occur because a strain of flu mutates. “It’s related to old strains, but is somehow different,” Fautin said.

“The flu is really good at that, and it does that all the time. That’s why you need a flu vaccination every year. We call it genetic drift. It just creepingly changes,” he added.

That genetic drift can even occur during a single winter, making the flu vaccine specifically tailored for certain strains ineffective or less effective against emerging varieties.

Sometimes, however, there’s a big evolutionary jump with the flu, which Fautin called "genetic shift."

“Depending on what strain of flu and how big the genetic shift is, we don’t know how bad it will be. … There’s no question it will happen again,” he added.

Fautin said there have been four influenza pandemics since the Spanish flu, though none of them was nearly as deadly.

The last such pandemic was in 2009, and in that instance, like in 1918-1920, most of the deaths were in people younger than age 65. That differs from seasonal influenza, where 80 to 90 percent of deaths occur in senior populations, according to the CDC.

Scientists have been closely watching strains of flu that have been mostly restricted to birds, primarily chickens. “Once in a while, one of these bugs makes a jump to a human. … Somebody who works with fowl can catch it from a bird,” Fautin said.

Researchers worry that those avian flu varieties will have a genetic shift that will allow them to spread from person to person, as well.

Scientists, however, don’t have methods to quickly tailor a vaccine to combat a pandemic strain of the flu, said Fautin and Oregon Health Authority representatives.

Vaccines currently are manufactured using a special variety of chicken eggs, and they have to grow and incubate in those eggs.

“It’s a long, laborious process,” Fautin said. “It’s basically the same technology we’ve been using for 100 years.”

Scientists are working on using RNA to quickly synthesize vaccines, and while it holds promise, it’s still experimental and without mass production capabilities.

The Spanish flu came in waves, however, with local officials thinking that the pandemic had ended several times.

Though a vaccine for a modern pandemic might not be ready for the first outbreak, it could help with subsequent waves, Thomas said.

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And while a pandemic influenza would spread fast today, medical professionals would be able to detect it quickly. A century ago, many towns, including Corvallis, had no regulations about reporting infectious disease.

What officials urged 100 years ago, to mixed success, might be the best initial method of prevention today, however.

“If something like this happens, or when something like this happens, the only tool we will have for the first six to eight months is social distancing measures,” Fautin said.

Social distancing 

People know more about how to prevent the spread of diseases now, Leman said.

“Influenza is typically transmitted by droplets, little droplets of spit or mist that come out when somebody coughs or sneezes. These are pretty heavy and they fall out of the air two yards away from a person,” Leman added.

Essentially, if you stay more than two yards away from an infected person, you’ll be relatively safe.

The trick is getting people to pay attention when a pandemic hits.

“Every year, we come out and say, ‘Don’t share water bottles. Stay at home when you’re sick.’ How do we do this so it’s not just background noise?” Fautin said.

He added that health officials fought to be heard during the recent meningococcal outbreak at Oregon State, encouraging students not to share cups or cigarettes and transmit the virus.

Those same types of prevention methods — washing hands and social distancing — were urged 100 years ago.

The Benton County Historical Society & Museum’s current exhibit, “Circa 1920: Roaring into the Modern Age,” includes a section on the Spanish flu. One of the featured artifacts is a tin collapsible cup, the sort that many people carried to prevent the spread of the illness.

The first case of the Spanish flu in Oregon was in early October 1918, from a soldier who came from Kansas. Influenza quickly spread among the troops due to crowded conditions as soldiers were training and traveling around the globe. Other parts of the United States were hit earlier than the West Coast.

“Because of what was going on in other parts of the country, it got some pretty fast action in Oregon,” Fautin said.

Corvallis passed a quarantine ordinance for the city on Oct. 8 that year, prohibiting people from gathering at the movies, church, pool halls, card rooms, dance halls and other locations.

At some points, local schools also were shuttered due to the Spanish flu.

Even Oregon Agricultural College “Aggies” sporting events were impacted. Two Civil War football games were scheduled for 1918, but one of them, set for Nov. 9 that year in Eugene, was canceled due to influenza. (The University of Oregon prevailed 13-6 in the second scheduled matchup, held in Corvallis.)

In 1920, the wrestling squad hosted the University of Washington for a dual meet, but the contest was held behind closed doors due to a quarantine.

Businesses pushed back against the social distancing measures, however, and public officials came under pressure.

Politicians, newspapers and residents seemed to alternate between deep concern and a blasé attitude.

“They were so afraid of closing businesses and closing the town,” Gallagher said. “They kept going back and forth on these quarantines, according to City Council minutes.”

A Dec. 6, 1918 headline from the Corvallis Gazette-Times states “Flu Situation Not Regarded Serious At All: Exaggerated Rumors Floating About Town Causing Annoyance.”

The next day, the big news was about another quarantine order for the town due to a rash of flu cases.

Albany also had similar ordinances in place at various times during the pandemic, according to the Albany Democrat.

But mid-valley residents, at times, completely ignored the quarantine order, and the Gazette-Times has stories of seemingly hearty people collapsing at work from influenza. A quarantine, after all, made it difficult to get supplies and earn a living.

Newspaper advertisements urged people to frequent businesses to clean their clothes to prevent the flu, or to buy oranges and other citrus at grocers to stay healthy.

Fred Minshall, owner and editor of Philomath’s Benton County Review, was frustrated with his town’s lack of prevention.

“In spite of deaths and the precautions of other communities, we seem to care nothing for the experience of others, but steadily disregard any and all precautions. … Here in this town, schools, churches, dances and public gatherings for any desired purpose are held and the ‘flu’ flourishes on,” Minshall wrote in a Jan. 23, 1919 editorial.

Even people from relatively remote communities such as Blodgett and Summit fell ill and died from the Spanish flu, Gallagher said.

There weren’t social programs in place, so residents raised money for children orphaned by the illness.

Oregon Agricultural College seemed to do better than the rest of Benton County, Gallagher said.

“With any student, they immediately quarantined them and they really took care of them, as opposed to these people who had to try and do it on their own,” Gallagher.

Howard, who was stationed at Oregon Agricultural College as a doctor for the U.S. Army, turned Waldo Hall into a makeshift hospital and cared for hundreds of sick soldiers and students.

“With this care, we only lost three boys out of the camp of 3,000 and each of these three had other diseases that they had come with,” Howard wrote. “We did not have this result with our civilians. We could not control the other people as we could the soldiers.”

The pandemic led directly to the construction of Corvallis General Hospital in 1922, which Howard helped create.

The Spanish flu also, perhaps ironically, had a major role in ending the carnage of World War I. The sides had to come to an armistice because so many people were sick and dying that the nations couldn’t sustain fighting, Fautin said.

The “war to end all wars” killed about 10 million people — only about a fifth of the low estimate of those who died from the Spanish flu.

Kyle Odegard can be reached at kyle.odegard@lee.net, 541-812-6077 or via Twitter @KyleOdegard.

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