Ep. 66: The 1918 flu and the U.S. military

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Social distancing. Quarantines. Improvised masks. These are not just the facts of American life today. They were also common for American soldiers in 1918. 

More of them died from the flu in 1918 than died from combat in World War I. And more Americans died from that 1918 flu pandemic than died from all the wars in the last century. It killed more young than old, with a death rate highest in the ages 15 to 40. That last fact was a distinct and unique feature of the 1918 flu pandemic. So this episode, we’re going to learn a bit more about what the influenza of 1918 did to the U.S. military.

Special Guest: Angry Staff Officer

• Part One: The First Wave (at the 1:35 mark);
• Part Two: The Second Wave (11:40);
• Part Three: The Show Must Go On (22:38).

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This episode is sponsored by Booz Allen Hamilton.

A transcript of this episode is below.

America at the start of the 1920s was a changed society.

Intimacy was redefined. An ordinary hug was no longer commonplace. 

That’s because by the end of 1918, the most lethal flu in history had just pummeled the world.

Fifty million people worldwide are believed to have died from complications related to the flu. That includes an estimated 675,000 Americans. As many as 45,000 of those were soldiers in the United States Army. One million men in the Army got sick from the flu. That was a quarter of the entire force. 

The 1918 influenza was first identified in the spring, according to the Centers for Disease Control, and in an Army camp, no less. It was called Camp Funston, in Kansas, near modern-day Fort Riley. 

Funston was one of 16 new sites built to help facilitate America’s draft, which began in June 1917. The cadre there helped eventually build an American Expeditionary Forces of less than 200,000 soldiers by the start of 1918 — to an Army of more than four million just 10 months later. 

ASO: “ So let's talk about this. This pandemic, it begins in the spring of 1918…”

That’s military historian Angry Staff Officer. He’s gonna join us today to help tell this whole story. 

By the way—

ASO: “In no way am I saying that, you know, COVID-19 is the same thing as influenza of 1918.”

Watson: “Let us be clear.”

ASO: “Yes. Right. What I can say is there are tactics, techniques and procedures to keep soldiers safe that are sort of timeless. And that's what we should be doing.”

ASO: “Ok, it begins in the spring of 1918. So the draft is bringing in people from all across the U.S. They're moving into regional cantonments. There's about 16 around the United States. And this is, of course, where it hits first. As far as we can tell, it is actually transmitted from U.S. soldiers gathering in a draft cantonment, Camp Funston.” 

Camp Funston could hold 40,000 soldiers spread across 2,000 acres.  

These training camps, by the way, were virtually nothing like what we think of as an Army base today. 

For one thing, the U.S. back then had a War Department — it would be relabeled the Defense Department in 1947. But in 1917, that War Department housed, fed, clothed and trained the soldiers at camps like Funston. The Public Health Service was put in charge of the health conditions. 

And each soldier earned about $25 a month for the job; and if they went over to Europe, got about eight dollars more. 

By the end of 1917, measles was the Army’s biggest health problem. Then came mumps, scarlet fever, meningitis — and then pneumonia. “These draft men brought measles on every train,” one medical officer wrote in late October. It was the leading cause of death for the service in 1917.

That would all change the following year.

And 1918 was a big year — not just for the United States. Germany, the main beligerantes in the Great War, was about to launch its great spring offensive, a drive meant to cut the Allies to pieces before the U.S. could send its Army to the fight. 

ASO: “You know, we can look back at it and be like, oh, my God, why didn't you do more? But their base of knowledge for us was not as sophisticated as maybe ours. But I want to caution us with that, the modernity piece, because the Navy surgeon general at the outset of the war boasts that, quote, 'infectious diseases that formerly carried off their thousands, such as yellow fever, typhus, cholera and typhoid have all yielded to our modern knowledge of their causes and our consequent logical measures taken for their prevention.' Well, it's this idea. Every age is modernity. 'It can't happen now. We're far smarter than that. We've seen everything we look at. Look at the the technology that we have at our fingertips.' If you look back at America's most recent large scale military conflict prior to World War One, it was the Spanish-American War in 1898, which was a complete and utter debacle. And everyone acknowledged that they went, oh, my God. Like, the army is like, we can't do this. And this is horrible. We had more people die in mobilization camps in the U.S. before anyone even fired a shot in Cuba. It was horrific. It was poorly managed. Disease was rampant. No one thought about like joint operations between the Army and Navy. But I mean, they only had one rail line in to the port of embarkation. So, I mean, one way. And that means troops, supplies, equipment, everything. And typhoid, yellow fever and malaria just absolutely destroyed U.S. forces, Army, Navy, Marines. So they could say between 1898, in 1917, there had been massive improvements. We talked about this era as the professionalization of the US military.” 

From March to July, the war’s outcome hung in the balance. And that was pretty much the duration of the first wave of the 1918 influenza. March to July.

Early in the morning of March 11, 1918, a young Private Albert Gitchell reported to the Army hospital at Funston presenting symptoms that included a fever, a sore throat and a headache. Then, another sick soldier appeared, then another and another. By noon, he’d been followed by 106 others just like him. 

Severe headache. Back ache. Chills. Pain in the bones. A high fever. Sometimes a cough. Sometimes ear infections. Almost always nausea. And later, in the second wave, delirium from temperatures as high as 106.

ASO: “The problem is it hits there. They don't identify it right away. And then it spreads a little bit more rest, a little bit more into the heartland because they haven't established travel regulations until it's too late and until the the disease is spreading. By the time it hits some of the camps in the Midwest, they realized, OK, we have to do quarantines, which is, of course, incredibly unpopular… No one in the military likes the quarantine. No one wants to have to sit out the fight now at which the military draws people who want to do things. And it's so hard to not do things. And I think that is that's one of the biggest things you see, I think. It's not people acting out of malice. It's people going, well, we have to do. And sometimes this is like one of those times where literally, no. Just don't do anything. Just dance, sanitize. Don't do anything.”

For treatment, soldiers were prescribed—

• Rest;
• To eat less;
• They were given aspirin for the fever and pain;
• And extra blankets to keep the sick soldiers warm on the belief that that would prevent pneumonia.

After a few days, most soldiers recovered. But others weren’t so lucky.

The skin of the worst influenza victims would lose color from a lack of oxygen as their lungs filled up and they literally drowned in their own body fluids. A blue sort of paleness set in from the ears and down the face as the virus took hold. Some doctors said it seemed to continue to attack even after death. 

Forty-eight soldiers died at Funston that spring. Men were falling out of formation everywhere, including coastal France as early as April 15th. Back stateside, hundreds and thousands were suddenly “sick and unfit for duty” in Army camps from Georgia to New Jersey, California to Kansas. And no one knew why. 

Well. In a way they knew. 

As one Army medical officer wrote, “Whenever you mobilize and call to the colors a thousand men, you call with them at least 20 billion tubercle bacilli, 10 billion typhoid, 5 billion pneumonia, and a couple million dysentery germs.”

Their problem, though they didn’t know it at the time: They were looking through germs for bacteria. But it was a virus doing all the work in 1918. Researchers wouldn’t even see a virus under a microscope until 1933.

But that previous measles outbreak forced new changes to Army camps, including calls to watch the troops more closely to make sure they’re cleaning themselves. Because, you know, those disgusting men. The measles outbreak also drew calls for the Army to build new quarantine and observation sections. No one could have known how much use those would get in the Army’s struggle to contain influenza heading into the fall of 1918.

One curious sidenote: black soldiers were generally less sick from the flu than the non-segregated white soldiers. And it would take some time before this piece of the puzzle was connected with all the others to realize the impact of quarantines. The U.S. wouldn’t desegregate its military until July 1948.

Across the world, the flu hit pretty much two waves. The second was a particularly ruthless one for both the U.S. Army and the United States. But like the first wave, no one expected it when it hit again at Camp Devens, outside of Boston, on September 8. 

A memo just two days prior from the Army’s Medical Department didn’t even list influenza as a possible threat to the force. 

By the end of the month, 6,000 patients were crowded into Camp Devens’ 2,000-bed hospital. 374 patients died in one night. And who moved these bodies to the collection area inside a circus tent? More soldiers.  

The Army rushed investigators to the camp in late September, and they drew up 16 recommendations. Those included: 

• More nurses and doctors
• New screening measures at mess halls and in hospitals
• Taking all the beds and alternating them in a head-to-foot arrangement
• Avoid crowds (good luck)
• Restricting movement in and out of the camp to only family members of the deceased (this was not always followed) 
• Covering your mouth and nose when sneezing
• A good diet
• And ultimately dropping the number of people inside the camp by 10,000 to spread people out.

Other camp commanders stopped the sale of soft drinks and pies. 

But it would all be too late. The next month would be the deadliest month in America’s history. 

ASO: “So the Army chief of staff, General Peyton March, said, listen to the army surgeon general who's like warning everyone this is unprecedented, actually says, ‘No disease, which the army surgeon is likely to see in this war, will tax them more severely. His judgment and initiative, then, you know, this influenza.’ And then there's army chief of staff in March was like, ‘There's kind of a war on.’ Army surgeon general says, ‘Hey, no troops from infected camps are gonna go to the front.’ And March is like, ‘OK, fine, I guess we can do that.’ More orders come out instructing camp commanders to reduce crowding, increased medical personnel. But the Army surgeon general really wants, Brigadier General Charles Richard, he wants a quarantine and screening of troops prior to embarkation — and then reducing the capacity of troop ships to prevent overcrowding. Because troop ships, of course, you know—”

Watson: “Sardines.” 

ASO: “Everyone's packed in. And you would have them absolutely crammed into a small spaces for a week or so time crossing the Atlantic, but not till October does the draft get canceled. So now you've got no more troops coming into these camps.” 

More than 195,000 Americans died from the flu in October 1918. 

Eight Army camps suffered more than 500 deaths from the flu. One camp commander in Illinois, Col. Charles Hagadorn, lost more than 500 soldiers before he shot himself in the head with a pistol on the 7th of October. 

Elsewhere in America, everyone wore masks and entire cities were shut down for weeks at a time. Sometimes to control the spread. Sometimes because everyone was sick, or worse. 

No one seemed to be able to run from what was happening.

People put kerosene and turpentine on sugar. Surely the awful smell would do the trick. Elsewhere families wore garlic cloves around their necks as they milled about the house or the farm. Honey was used as a mixer in many folk remedies, none of which worked. Old Crow whiskey and aspirin was another go-to. 

Meanwhile, America was running out of caskets. 

In Philadelphia, the dead were put on front porches and trucks drove the city streets, picking up George and Roberta, Frank and William. People hid inside their homes, afraid to contract something, whatever it was, from their neighbors. 

Literary titans of the day largely ignored the flue as a subject, which is kind of puzzling to me. But it’s all part of the kind of censorship that was going on at the time. It’s the same kind of reason why the deaths weren’t really publicized from the flu, or weren’t really well understood — but Spain was reporting deaths. That’s kind of why we tended for years to have called it the Spanish influenza, even though as far as we know today did not originate in Spain at all. And among the literary titans to kind of stay mum about it was Ernest Hemingway, who famously volunteered as an ambulance driver in 1918 and remained in Europe until his return to the states in early 1919, when the third and last wave of the flu was still rippling across the world.

ASO: “If you're an American expeditionary forces and you're in a frontline division in October of 1918, it's probably one of the worst times to be in the U.S. Army because you are not only getting shot at dealing with machine guns and these Germans are in literal concrete pillboxes that are reinforced with realities like literally, you like you'll see them. And it's just like railroad ties run through like rebar. And then everything else is concrete. You can just hit it all day with artillery and you know, someone one side's going to have a headache or maybe some ears bleeding, maybe kill him with a concussion. But it never the guy can step in and take over the machine. And so, you know, going up against just — people were very, very prepared and very determined to defend these these lines. You're dealing with getting gassed, the German army, their campaign from like October 15th. The armistice is like dump all the games, like just hit everybody before. It used to be even sort of like localized gas shoots like before an offensive or to deny terrain or something like that. At the end, they're just like, dump it all. You're also dealing with the fact that your unit is down to a really shadow of itself, not just from battlefield casualties, but to all the people who are in the hospital because of the Spanish influenza, because of pneumonia, because of trench foot, because of shellshock. Then you get a letter from home that says, hey, mom and dad just died.

Watson: “Christ.”

ASO: “Or your wife just died like, holy shit. And in there, these soldiers are writing like saying, hey, we're more worried about the folks at home than we are for us over here. So October is really a very, very dark month for the U.S. Army in 1918. I guess what the most incredible things is, in spite of all of this, U.S. divisions still make breakthroughs and they are still advancing and they achieve objective after objective after objective. And it's a real testament to the resiliency of humanity, to the loyalty of soldiers, which is what their leaders to each other and really just dogged persistence and determination.”

ASO: “For the U.S. It really hits at this crucial moment in American history. The beginning of the Meuse–Argonne offensive. We're talking frontlines here because a lot of the talk today is about readiness, right?

Watson: “I mean, that's right. Yeah. You've got the balance between protecting soldiers and also defending the nation.”

ASO: “Same thing then. So as troops in CONUS are beginning to get hit with this thing, what's happening on the forward end of the why? Why do we need readiness? Because it's because we are now involved in the largest battle in American history, which is the Meuse–Argonne offensive, which kicks off on 26 September 1918 and goes till November 11th. It's also the bloodiest campaign in our history between the Argonne Forest, which is, you know, the Germans have created it into an impregnable fortress and the Murres River, which is just north of Verdun. So, you know, really nice, nice neighborhood now that it's been fought over for the past four years by millions of people. You have American divisions just pounding away against German lines. Successive German lines of defense. And it is a very high profile moment because one, you know, everyone kind of knows Germany's Germany is looking down the barrel of a gun that's being pointed by lots and lots of American soldiers, not the most experienced, but they keep coming and they keep coming. And American strength continues to build in Europe. And as long as American strength continues to build in Europe, you know, American influence in this war, especially political influence on what the outcome of the war will be, grows as well. And so you have two American armies, the First and the Second Army just smashing away between the Argonne and the Meuse River. And it is a bloodbath. The divisions are getting used up. Raw divisions are getting thrown in with little training. A lot of these draftee divisions, veteran divisions. You know, the 1st and 2nd and 3rd, 42nd, 26th are they are used up essentially and then filled with a lot of them are filled with more draftees and pushed on continually rotating in and out of the front lines, getting replenishments with with new troops, then going back in...

ASO: “It's kind of one of these great tragedies. The armistice breaks the quarantine because everyone is partying. The war is over and people are just running around everywhere and troops break quarantine, go into towns and spread infections with each other and with civilians. You know, it's one of those great ironies of history that this thing that was supposed to bring peace brings, unfortunately, a lot of deaths because of inability to maintain quarantines.”

“Thousands of families lost loved ones; countless children were orphaned,” one scholar recounted. This awful reality is perhaps why many Americans seemed to have erased it from their collective memory in the 1920s and the decades after. 

Because just as abruptly as it struck, the flu vanished. A third wave would come in early 1919; but it was nothing like what devastated the world in October. 

Perhaps the biggest and most obvious difference between the pandemic of today and the pandemic of 1918 — we are not in the middle of a war that was so big and so important that certain folks of the time thought it would be a war to end all wars. 

But it was quite possibly one of the Army’s most well-known traits — bureaucracy — which may also have helped identify the flu in its earliest stages. The Army’s tendency to track anomalous information helped leave a record of this illness in the Army’s medical corps. It may have been at Funston as far back as September 1917.

At any rate, that medical corps that had never even seen a virus before. And the U.S. had a world war to end once and for all over in France. 

Esper: “There seems to be this narrative out there that we should just shut down the entire United States military and address the problem that way. That’s not feasible.”

That’s current U.S. Defense Secretary Mark Esper, speaking about the coronavirus at a press conference on April 1. 

In the days since Esper spoke, the U.S. Army announced a halt to Basic Training for two weeks. The Navy had already delayed its new boot-camp arrivals by a week after a recruit tested positive. The Marines kept training until more than 20 recruits at Parris Island put a halt on new arrivals until mid-April.

These sort of halts have happened before. So far at least the U.S. military seems to have learned from its awful past with the influenza of 1918. 

Measures that weeks ago seemed extreme are now, at least temporarily, the standard. No unit formations essential personnel only. Mandatory face masks until the threat from the coronavirus finally passes, whenever that is. 

Esper: “We have a mission. Our mission is to protect the United States of America and our people. And so we live and work in cramped quarters, whether it’s an aircraft carrier, a submarine, a tank, a bomber. It’s the nature of our business. But the chain of command has very clear guidance. And I’m confident between the commanding officers and the senior non-commissioned officers, that they’re taking every reasonable precaution to make sure we practice, as best we can, social distancing, sanitizing environments, et cetera, consistent with that mission.”

Milley: “Across the entire uniform military, we've got about — call it a little less than 2,000 so far, COVID-positive patients.”

That’s Joint Chiefs Chairman Army Gen. Mark Milley, speaking at a town hall on Thursday. 

Milley: “It'll probably go up; but 2,000 out of 2.3 million is not huge… The U.S. military is very, very capable to conduct whatever operations are necessary to defend the American people. And we are ready today, we'll be ready tomorrow. And we will adapt ourselves to be able to operate within a COVID-19 environment. We're already doing that.”

By the way: The 1918 flu didn’t get everyone. 74 percent of the U.S. military did not get sick from it. But that means about one million did. 

And that first reported soldier showing symptoms at Camp Funston, Army Private Albert Gitchell? He lived another 51 years until his death in 1968. 

That’s it for us this week. 

An extra special thanks to Angry Staff Officer. And we’ll leave links to the research that guided this episode, which includes Carol Byerly’s excellent and thorough 2005 book, “Fever of War.”

Our music this week is by James Brett; Barrie Gledden, Sulene Fleming, Richard Lacy and Chris Bussey; Lincoln Grounds and Thomm Jutz; Patrick Hawes; Richard Lacy and Sarah MacDonald; Daniel Goldman; Arthur Fields; Billy Murray; Frederick Wheeler; and U.S. Army camp songs from the First World War.

Thanks for listening, everyone. Cheers, everyone. And until next time.