Drums coming everywhere but there was another fight about to take place right here on american soil, one that would eventually kill more people than the great war itself. It was the influenza pandemic of 1918, known back then as the spanish flu. And we wont come back until its over over there you said you cant understand how america dealt with the influenza pandemic in 1918 without understanding world war i. Because everything about the pandemic was related to the war, and everything about the war at that time was related in a sense to the pandemic. Historian Kenneth Davis says an early outbreak of flu was reported at camp funston, part of fort riley in kansas. Young men arriving for training and deployment were suddenly becoming sick. The outbreak in kansas was march of 1918. March 4th, 1918. We know the date and doctors are starting to note a strange influenza that doesnt look like anything else they have ever seen. What were the first symptoms that they started to see . Very high fever, tremendous body aches, like back breaking body aches. Then as it progressed, these very otherwise healthy young men who had just reported for duty were on their backs in tremendous pain. People would talk about it like being hit by bats or something. Thats how bad it was. Within weeks, more than a thousand soldiers were in the hospital, at least 38 died. These were men who should have recovered if it was a normal flu. Dr. Anthony fauci says thats when doctors began to realize this was a new pathogen. The fact that it was young, Healthy People who early on were getting it, was that a sign that this was a new influenza . This was devastating even to young people, so quantitatively and who it affected was really extraordinary, and unprecedented. This was something very special. It occurred in a way that crept up on us. You called the 1918 pandemic the mother of all pandemics. The Global Impact it had was unprecedented in recognizable history. It was a pandemic that gripped the planet. It was truly an enormously devastating pandemic. In 1918, the cdc didnt exist, and there were no requirements for doctors to report flu outbreaks to any officials, but by the end of march, the cases in kansas were so unusual, a local doctor decided to report what he called an influenza of severe type to the u. S. Public health service. The virus quickly spread. Historian and author john berry said it was traced to other army camps where it flourished to men held in close quarters. It also spread on troop ships headed to europe. Roughly half of the military camps in the spring of 1918 did have significant outbreaks, and according to a Nobel Laureate who spent most of his life studying influenza, you can follow the disease with american troops crossing the ocean and arriving in france. Over there, that was what everyone was singing over there, the yanks are coming the yanks are coming the yanks are coming by may of 1918, a million young men, dough boys as they were called land in france and thats when the flu really exploded. Looking back, historians can actually trace the spread of the flu to the movement of troops. Absolutely, and the port of breast in france which is where most of the american troops landed became like a ground zero for the spread of this, and the speed with which it spread was breathtaking. The reason why what would have been a localized epidemic perhaps became truly a worldwide pandemic was because the world was going on. Millions of soldiers going from the United States to europe carrying infection. This would turn out to be just the first wave of the flun influenza and it would last through the beginning of the summer of 1918. Where this outbreak originated is still unknown, though it wasnt in spain. How it started is more clear. Did it cross from animals to humans . Do we know the origins of it . Yeah, very extensive sequencing of the genetic makeup of the virus indicate very very clearly that it is of avion origin, its a bird like flu, likely from a wild water fowl. But the sequences very clearly indicate that it was zoenotic, and somewhere along the way jumped species. In a sense, all influenza viruses are bird flew, and sometime prior to the march of 1918, it might have been a few months. It may have been a couple of years, a virus jumps species from animals to humans and it spread very rapidly and created a pandemic. It certainly wasnt the first influenza pandemic in history. And its not going to be the last influenza pandemic. Troops overseas were getting infected as well on all sides of the conflict, though the death rate was relatively low, and most who got it recovered. It wasnt particularly lethal. People who did experience it as a general rule treated it with a shrug. The army, even on the front lines in april, troops referred to it as threeday fever. They had a very different attitude when the virus turned much more v much. It really did affect what was going on on the battlefield in germany, and in france. There was a major german offensive, for instance, that was supposed to take place in 1918. Half a million german soldiers were sick with the flu. They couldnt do it. So it didnt change the outcome of the war but it certainly affected it. And in fact, the german commander blamed the outbreak for the failure of the last german offensive, the last effort the germans thought that might win the war. The full impact of this first wave wouldnt be understood until much later. Countries involved in the war were censoring news about the influenza. Nobody was actually talking about it. The newspapers werent talking about it. Spain was neutral in the war, and their newspapers were allowed to report on this fast spreading virus that had even infected their king. That is how the influenza became known as the spanish flu. The first report of an epidemic comes out of madrid. Its published, mysterious disease strikes spain, the king of spain was sick. They shut down the Transit System in madrid. That news report went to england, and then from there on, thats about may of 1918, it becomes the spanish flu, at least in the English Speaking world. Historian, Doris Kearns Goodwin said president wood row wilson was concerned about anything that would hurt the war effort. You talked about how the influenza is barely mentioned when you read about Woodrow Wilson as president. Why is that . Its extraordinary that when you read about wilsons presidency, the way he handled the flu, and even the flu itself is hardly mentioned. Historians who have now studied the flu epidemic argue that he had two crises to face, the first was the flu and the second was the war and that the war went first. And so that anything that he would say about the problem of the flu and the soldiers getting it in great numbers and the barracks would hurt recruitment and hurt the war effort. Wilson wanted nothing to distract from the war effort or in any way hurt morale, therefore, National PublicHealth Leaders said things like this is ordinary influenza by another name or you have nothing to fear if proper precautions are taken. So there was no motivation for the president back then to get america focused on fighting this flu . President woodrow mention never mentioned the spanish flu. Never mentioned it . Never mentioned it during his presidency. For president wilson, the war was all that mattered and for most americans the war was all that mattered. Now, the war effort doesnt just mean sending troops over, it also means keeping factories going really around the clock, making uniforms, making tanks, making airplanes. And raising money for the war. And raising money, and thats where this question of misplaced priorities is so important. There were misplaced priorities in 1918. The war was the priority. And that took precedence over everything. The war and the influenza would later directly impact wilson personally in a way that may have changed the course of history. With summer and warmer weather, the new influenza seemed to die down. British medical journal even declared the epidemic over in august of 1918. They were wrong. The death and misery had barely begun. Did people know that there was going to be a second wave . They did not. The force with which it came just took everyone by surprise. And it was just totally devastating. The capability of the virus to cause devastating disease was really unprecedented. In september, an article in the journal of the American Medical Association warned of a severe and rapidly spreading ekg of influenza. It said it was undoubtedly the spanish influenza but warned of the new outbreak saying its often more severe, the complications are more frequent and serious, and has shown an extraordinary degree of contagiousness. Concluded therefore we have every indication this outbreak will soon spread all over the United States. A second wave had arrived. We made usaa insurance for veterans like martin. When a hailstorm hit, he needed his insurance to get it done right, right away. Usaa. What youre made of, were made for. Usaa youre late lets do this bring it woo haha. Whoa rated t. Lets go every minute. Understanding how to talk to your doctor about Treatment Options is key. Today, we are redefining how we do things. We find new ways of speaking, so youre never out of touch. Its seeing someones face that comforts us, no matter where. 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But the second wave of the influenza is just beginning. And now its spreading faster, and its far more deadly. Historian john barry says the virus may have mutated into a new strain. The 1918 virus combined to cells in the upper respiratory tract that made it easily transmissible. But it could also bind to cells deep in the lung. Many reports of people dying 24 hours after the first symptoms appeared. Some of the symptoms could be very unusual and very frightening. Whether it was a new strain or a new virus altogether, the effects were terrifying. Well, the second wave was so deadly. You know, its very interesting. We talk about the first and the second wave. We were presuming that the virus that hit us in the spring of 1918 was essentially the same virus that accounted for the socalled second wave. We knew there was disease in the spring of 1918. We knew there was a lull in the summer. And then we got hit very, very badly in october and november of 1918. Call it a second wave or what, it was a devastating wave of infection. In early september, an outbreak at camp devens outside of boston was reported. Young healthy soldiers were getting infected and dying fast. Scientists went to investigate. Thats where four doctors, probably the best virologists, epidemiologists, in america at the time, go up. And theyre seeing these men being brought in by the dozens. And then by the hundreds. Thats when one of the doctors says, i think this might be a new plague. By the end of september, more than 14,000 flu cases were reported from camp devens. 757 people had died. The deaths were gruesome. Victims turned purple and black from cyanosis, a lack of oxygen. To give you a sense of what it was actually like, id like to read a letter that a physician at camp devens wrote to a colleague. Said, these men start with what looks like an ordinary tap of la grippe, or influenza. But when brought to the hospital, they very rapidly develop the most vicious type of pneumonia that has ever been seen. It is only a matter of a few hours then until death comes. It is horrible. It takes special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce. It beats any sight they had in france after a battle. Goodbye, old pal, god be with you until we meet again. Despite the Alarming Number of cases, servicemen from the boston naval yard continued to deploy around the country. Those same ships from boston also went to new orleans, chicago, they went out to the west coast. Every one of these port cities where boats from boston docked, the flu exploded very quickly. It was extremely, extremely virulent. The infection rate was very high, and the mortality rate was very high. On september 7th, 1918, a navy ship from boston arrived in philadelphia. Public Health Officials there had downplayed the seriousness of the influenza. The city would soon pay the price for that. Philadelphia was one of the hardesthit cities in the country. And i think that was closely related to the political and Public Health leadership. Philadelphia leaders had organized a liberty loan parade, scheduled for september 28th, 1918. It was an effort to boost morale, but also a way to raise money for the war effort by encouraging americans to buy war bonds. Parades like these were drawing large crowds throughout the war. Americans were eager to show their patriotism. The medical community was very, very concerned by that. Urged the Public Health director to call the parade off. He allowed the parade to go on. Thats correct. And he had specifically been told in a meeting, two days before, by other doctors, not to allow it to go on. He was a political appointee. Philadelphia had at that time a notoriously rather corrupt government. And he was not willing to go up against the bosses. So he went ahead with this. There were hundreds of thousands of people in the street, packed close together, shouting and singing songs. And like clockwork, 48, 72 hours later, the disease exploded in philadelphia. 200,000 people are in the streets. Days later, every hospital bed in philadelphia was filled. And philadelphia had a lot of hospitals. It became a superspreader event . It was the mother of all superspreader events in 1918. And philadelphia was probably the hardest hit. They knew it was coming. They should have seen it coming. They shouldnt have allowed this parade. They did, because again, priorities. What were the priorities . The war effort, and selling these war bonds. When i was reading about the parade in philadelphia, this huge liberty loan parade that was going to be in 1918, i was thinking to myself, dont do the parade, dont do the parade then the week later, i think its thousands of people die. Perhaps 14,000 people. And then you go to st. Louis, another city also had prepared a parade. They listened to the medical authorities. The next week, only 700 people died. So when youre reading this as a historian and you know the end of the story, you want to say, stop, do the right thing the day after the parade, the Philadelphia Inquirer printed this picture. The caption, fighting men of navy thrill vast crowds as they march along broad street. No mention of the influenza. Less than a week later, the board of health finally begins shutting down the city. In the streets of philadelphia, people were actually dropping dead in the streets. There was stories, rather well documented stories, anderson, of people who would wake up in the morning feeling maybe a little bit under the weather. Get up and go to work starting to feel really very, very sick. And by the time the end of the day came, they were dying in bed and would die literally within a 24hour period. It was that fast . Oh, absolutely. The situation was so dire, it couldnt be ignored any longer. This issue of the philadelphia evening bulletin dated october 15th, 1918, reports entire families dying from the flu. It reads, husbands and wives, mothers and children, brothers and sisters have died within a few hours of one another. They were using steam shovels to dig mass graves, at one point. You had priests literally driving horsedrawn carts down the street, calling upon people to bring out their dead. It sometimes would be a couple of days before a body could be disposed of, and you had to live with the body in your home. And the fear really emptied the streets. There were empty streets in cities across the country. All were experiencing the same fear and panic as philadelphia. In the month of october, more than 195,000 americans died from the virus. Many of them in excruciating pain. It was a terrible way to die. You can picture these young men, and eventually young women and nurses, family members, literally choking to death on their own body fluids. Turning blue and dying. One of the doctors in one of the hospitals in new york said, theyre coming in by the hundreds, theyre turning blue, and theyre dying. One doctor says, i see them twice. Once when they check in, and once when i sign their death certificate. This is rare footage of an influenza patient being brought in for treatment. But there was little doctors could do. This was no way to treat the influenza. Doctors and nurses just had to watch their patients die. This letter was written by a volunteer nurse in washington, d. C. When i was in the officers barracks, she wrote, four of the officers of whom i had charge died. Two of them were m