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In early September 1918, World War I was reaching its dreadful climax in the same fashion that it had begun: in unprecedented death and destruction. A reader scanning the news and preoccupied with images of the nation’s soldiers donning gas masks and preparing for attack across “No Man’s Land” could be forgiven for skipping past the page 2 headline from the September 12 Minneapolis Tribune. “Spanish Grip Menace on East Coast Feared,” it read. The story was this: A strain of influenza, which had first appeared in a few Army barracks in Kansas in early 1918, crossed the ocean, inflicted armies and civilians in Europe, and picked up its nickname, “The Spanish Flu.” It was now back on the eastern seaboard of the United States, wreaking havoc in Army camps from Boston to Washington, D.C., and threatening to spread to civilians. The report in the Tribune sounded somehow restrained: “Spanish influenza, although short-lived and of practically no permanent serious results, is a most distressing ailment which prostrates the sufferer during which he suffers the acme of discomfort.” But like the footsteps of some lumbering monster, the stories kept landing with a thud in the columns of the daily papers, sounding more and more ominous with each passing day. On the 15th, 1,000 cases of influenza were reported at a single camp outside of Boston. On the 18th, two more Army camps were said to be ravaged by the flu. Three days later, that number had jumped to nine camps, and three days after that, more than 20,000 soldiers were reported sick with influenza. Worse, this was not simply “a most distressing ailment.” As the virus spread from the cantonments to the civilian population, “the acme of discomfort” was turning out to be death, in stunning numbers. More than 107 people died of influenza in Boston on a single day in late September. So many were dying in Philadelphia that city morgues couldn’t process the bodies. Meanwhile, on the campus of the University of Minnesota, administrators were preparing for the beginning of a fall semester with a mission different from any the college had known before. A recently enacted draft law had stipulated that all able-bodied men between the ages of 18 and 45 were to be subject to conscription as of August 30, 1918. To process and train these new recruits, the federal government enlisted the help of colleges and universities across the country, including the U of M. By mid-September, two weeks before the start of school, the administration had enrolled more than 2,600 student draftees in a newly instituted program called the Student Army Training Corps (S.A.T.C.). An additional 3,000 soldiers, who were receiving training in a variety of military occupations, from mechanic
Adding to the impending chaos: Fresh from the viral hotspots of Europe and the military camps of the eastern seaboard, a number of veterans of the war were coming to Minneapolis to oversee the military training of the newcomers. By sheer coincidence, another new entity arrived on campus that fall. In mid-September, just as early reports of the dangers of the Spanish flu were drifting westward, the University announced that Dr. John Sundwall, late of the University of Kansas, had been hired as the first director of the newly created University Health Service. Temporary space for the clinic was found in two vacated fraternity houses on the 1500 block of University Avenue Southeast. The week before school was set to begin, the health service opened for business. The health service had been years in the making. As early as 1904, a petition had been placed before the Board of Regents asking that “a fund for the care of sick students be created and used” to pay for hospital and medical care. A typhoid outbreak in southeast Minneapolis—one of many such scares in the city around the turn of the century—had prompted the request, and it was suggested that students be charged 50 cents a semester to cover the cost of the insurance. The Board of Regents said no to the idea of the fund, but it did urge the creation of a University health committee, which was duly constituted and immediately began to look into public health matters—particularly the quality of the University’s water supply. The health committee remained in existence after the initial typhoid panic, as did the idea, but not the reality, of a student health service. Another typhoid scare in late 1914 prompted an invigoration of health committee activities, which would ultimately include an attempt to survey and systematize the teaching of public health at the U. The committee urged that typhoid and smallpox vaccinations be given students at no cost and called for another examination of University water sources and uses. But still no health service, until Marion Leroy Burton arrived on campus as the newly appointed president of the University in 1917. While serving as president of Smith College, Burton “had shown much interest in provisions for adequate health-medical services for students,” according to a brief history of the beginnings of the health program at the U, written by Sundwall. Burton brought that interest to Minnesota
By October 1917, Burton had asked the regents if $5,000 of the University budget could be designated for the service. Students would be asked to contribute $3 per semester for use of the system, and most of the University’s contribution would be dedicated to the salary of a director. The regents agreed to the plan that winter, and by summer 1918 Burton was leading the search for a head doctor. Sundwall was hired just before the start of the school year. As reports of the epidemic on the East Coast were growing more ominous and the S.A.T.C reported for duty, there was a feeling of deep uneasiness at the newly formed University Health Service. “Influenza having reached Boston we felt certain that it would soon show up at the University of Minnesota among our Student Army Training Corps. Military officers—from abroad and all parts of our land—were reporting almost daily to conduct drills and offer instruction,” wrote Sundwall. “Nothing could be more favorable for the introduction and spread of this contagion.” On September 27, the Minnesota State Board of Health received its first two notices of influenza. The very next day, seven cases of flu were reported in North Branch, 100 in the town of Wells, 21 cases at Fort Snelling, and 30 at the University Hospital, including 21 nurses. In a matter of hours, the newly inaugurated University Health Service was wall-to-wall students. According to Sundwall, “There were incessant calls for help.” The S.A.T.C. was hit first. Crammed into improvised barracks at the old Exposition Building near St. Anthony Falls, the student soldiers lived in the sort of elbow-to-elbow proximity that made the spread of infection a certainty. And unfortunately, there wasn’t much that anyone could do once the virus struck. “Two things in connection with the pandemic are indelibly impressed on my memory,” wrote Sundwall. “The one was the characteristic chain of symptoms—sudden onset; fever; extreme prostration; pains in back, head, and extremities; involvement of the respiratory system, and early pneumonia in a large percentage of cases. The other impression was the helplessness of the medical sciences.” Given the fears generated by the bloody news from the front in Europe, the patriotic press continued to downplay the bad news that a plague of influenza had descended upon the land. Headlines about the gravity of the flu one day would be followed the next by optimistic pronouncements about a “waning” epidemic. In fact, it was impossible to cover up the breadth of the epidemic. One thousand cases of the flu were reported in Minneapolis by the end of the first week of the outbreak. In addition, obituaries of local servicemen and of Red Cross nurses
On September 29, University President Burton announced that the fall opening of the University of Minnesota would be postponed for one week, “as a measure of precaution” against the contagion of the disease. A week later that postponement was extended a week, and it would be pushed back one final time before the month was through. On the 7th of October, 140 new civilian cases were reported in Minneapolis, along with eight deaths. On October 11, the city closed churches, schools, theaters, dance halls, and all other meeting places for the duration of the epidemic. Meanwhile, the newly opened health clinic was seeing 100 patients a day. When health service quarters became too crowded, students were looked after in their dorm rooms and barracks. Many were already desperately ill before they arrived at the converted fraternity houses on University Avenue. “I shall never forget the first victim at the University,” wrote Sundwall, “a handsome, robust young second lieutenant. In less than a week his body was sent home.” Sundwall enlisted medical help from the University Hospital, but the work itself was extremely hazardous. One of the October 7 victims of influenza, Edward Slater, was a 1918 graduate of the University Medical School who’d been assisting at the clinic. A second doctor, A.G. Alley (M.D. ’05), would also succumb to “pneumonia following influenza” after helping at the clinic. In all, during its first fall and winter of duty, the health clinic treated more than 2,000 cases of influenza that resulted in 20 deaths. By the end of the black month of October 1918, the influenza had waned just enough for the University to open its doors to students; but all through the winter the strength of the epidemic ebbed and flowed. Sundwall and the health service continued to see flu victims through February 1919, but the worst of the crisis came in the clinic’s first two months of existence. (This is to say nothing of a second outbreak of a related influenza virus, which struck with consequences nearly as gruesome the following school year.) As for the overall toll of the pandemic: It was awesomely brutal. In all of recorded history, including the Black Death of the Middle Ages, there has never been a more deadly outbreak. Estimates of the victims worldwide range from a very conservative 20 million to upwards of 200 million. In the United States, more than 600,000 died, and the relative youth
In time, health professionals would learn that this particular virus triggered a massive response in the immune systems of its victims. So massive that the response itself ended up destroying a sufferer’s lungs as it attacked the virus. Those with the strongest immune systems, people between the ages of 18 and 40, were the most likely to die. In fact, a curve charting the deaths by age groups would eventually be graphed in the shape of a W, whose peaks represented the deaths of infants, young adults, and then the elderly. No one has ever done a comprehensive assessment of the toll the pandemic took on University of Minnesota graduates and students. A simple count of the cause of death of 81 victims of the war memorialized in the 1920 Gopher annual shows that at least 15 succumbed to influenza. Along with the 20 who died on campus in the fall and winter of 1918–19 and another 16 who succumbed to the flu or pneumonia in 1919–20, those victims with an immediate or known connection to the U total 51. But in addition, the lists of the deceased in The Minnesota Alumni Weekly during the fall and early winter were lengthy and heartbreaking; and there were certainly many more victims who had no present connection to the campus or the war effort. For all of this, the student body at the University of Minnesota turned out to have been luckier than most. It had far fewer cases of influenza and a lower mortality rate than many other institutions across the country. In a grim annual report given to the president the next spring, the health service reported that, “100 deaths might reasonably have been expected. Under the conditions students were infinitely better off here than at home. From the standpoint of urgent need the University Health Service was organized at a most opportune time.” By the end of December 1918, a little more than a month after Armistice Day, the Student Army Training Corps was dismantled and troops were either sent home or stationed elsewhere. The fraternities on University Avenue were soon reoccupied by students, and the Health Service was forced to move to offices on the first floor of Pillsbury Hall in February 1919. In due time, full life returned to the campus, and health care would continue to be a service provided the students of the University. As for its beginnings, President Burton would write: “There seemed something almost providential about getting the Health Service started just in time to serve during that pandemic.” Tim Brady is a St. Paul freelance writer. | |||||||||||||||||||||||
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