Spanish Flu

Spanish Flu in 1919

Her Lady’s Honor is set in rural Wales in the summer of 1919. The Spanish Flu infected approximately a quarter of the world’s population in 1918/19 and killed between 17 and 50 million people*. Returned soldiers were most affected by the flu and were also the most likely to spread the disease, which they brought home with them as they returned from the front. With regards to Her Lady’s Honor, the Flu peaked in South Wales in November 1918 coinciding with the end of WWI. By the summer of 1919, the pandemic had come to an end; local people were either immune to the flu or dead. The after-effects of the Spanish Flu would have lingered in these towns, but many didn’t talk about it because it coincided with the trauma of WWI. The double-hit of the war and the flu is not something easily imagined.

Many people have written about the naming of this flu. Spain was neutral during WWI, and they had a media free of censorship. This meant their press was free to report on the flu, while the media in the Allied nations and Central Powers used their wartime censors to cover up the news of the flu to try and keep morale high. The Spanish assumed the flu began at the frontline, and called it the French Flu, however, the rest of the world thought it came from Spain (because they were only ones talking about it). The first known case was in the USA at Camp Funston in Fort Riley, Kansas, where it was noted on March 11, 1918. During March and April, 202,000 soldiers from this camp were sent to the frontlines in France, where the flu spread rapidly through the trenches. The Spanish press weren’t too far from the truth.

Spanish Flu killed people quickly for a few simple reasons;
– it was a new virus so no one had immunity,
– medicine in 1918 was less advanced that now (for example antibiotics and paracetamol weren’t readily available until the 1950s),
– WWI had taken its toll on the world’s population in terms of war injuries and food rationing.

The second book in the series (currently without a title) is set in Amsterdam and London, while the unwritten third one will be set in London. For those books, the impact of Spanish Flu is more extensive with people still wary around going to hospital in case they caught the flu. One of the early treatments was a new drug called Aspirin (trademarked in 1899), however, doctors weren’t sure about dosage and basically experimented. In October 1918, there was spike in Spanish Flu deaths, and many believe this was due to Aspirin toxicity thanks to the USA Surgeon General recommending doses of 30 grams per day (four grams is toxic). Doctors were overwhelmed and hoped the new drug would do something to alleviate the rapid onset of symptoms.

The Netherlands was neutral during WWI, however, they still had many impacts from the war especially with regards to food imports. A bread ration was imposed in January 1917, then in June of that year, there was rioting in the streets of Amsterdam over a shipment of potatoes. With a severe shortage of potatoes across the country, the working women of Amsterdam plundered a ship filled with potatoes for soldiers, leading to general rioting and havoc. By July, there was widespread looting, which was ended when soldiers shot into crowds and killed nine people. With that as the background environment—a starving, desperate population—the Spanish flu hit Amsterdam hard. In October and November 1918, there were 20,000 more deaths than usual recorded (the Netherlands had a population of 6.5 million). Amsterdam was hit with two waves of the flu; a minor one in July/August 1918, then the most severe from autumn 1918 to spring 1919 after which the flu disappeared as rapidly as it had come and everything returned to normal with social gatherings such as the theatre and sports re-opened. There was a small third wave of flu in spring 1920, although there is no proof that it was related to the Spanish flu virus.

The second wave was the worst, and with the second Great War Ladies book set in summer 1919, this wave would have just ended. The population of Amsterdam would be traumatised by both a lack of food and the second wave of the flu. Additionally, the labourers who worked as grave diggers during this time were constantly drunk because many people thought alcohol killed the flu. By July 1918, doctors were certain there was no cure, and the Association Against Quackery managed to convince many newspapers to refuse to print advertisements promising a cure. Such (useless) cures included alcohol, antiseptic mouthwash, hot Indian spices, beetroot, abbey syrup, and an ‘electro-homeopathic’ remedy invented by the non-existent Italian Count Mattei.

In the second Great War Ladies book, the main characters move to London halfway through the book. In London, the flu arrived in June 1918 (having been first recorded in Glasgow in May 1918). This mild version disappeared by August 1918 but re-emerged in October 1918 with a much stronger version. Unfortunately the Armistice in November 1918 at the end of WWI only spread the flu faster with tens of thousands of people celebrating in the streets. The disease swept across Britain in three waves: mild in spring 1918; devastating in autumn 1918; and moderate in early 1919.

In terms of long term trauma for society, the Spanish Flu is sometimes referred to as the forgotten pandemic. Many of the deaths occurred simultaneously with WWI, and the world’s population was already reeling with war trauma. The other factor is that pandemics were a lot more common then, and therefore people were more accustomed to dealing with death from disease outbreaks. The Russian Flu outbreak of 1890 killed one million people across Europe, while in the hundred years leading up to WWI, there were six separate cholera pandemics that killed over 50 million people across Europe and India. Prior to the measles vaccine (1963), that disease killed approximately eight million children per annum, while small pox was devastating even with the use of inoculations (China from the 10th Century, and Europe from 1796) until an eradication program was successful in 1976.

With this series written in the summer and autumn of 1919, the Spanish Flu had been defeated, as much as any society can defeat a virus. The long term stress and impact would have lingered for the characters in this series, with each of them having different views based on their reality. For most of them, WWI looms much larger than the Spanish Flu.

* The wide variance in numbers is due to the difference in records in different countries and people are still arguing about the numbers. An estimate in 1991 declared it to be 39 million, but another in 2005 said 50 million. Yet another report in 2018 estimated the figure at 17 million. All these different estimates put the fatality rate at between 1% and 6% of the world’s population at the time.

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