We all know that Manchester does things better than London, but, in this tragic case, it’s not really a reason to smile. When Spanish flu swept across the country in 1918, the medical authorities in Manchester took steps to try to stop it from spreading. Whilst still affected, our city therefore suffered considerably less than other cities did. Meanwhile, the idiots in Westminster did very little, for fear of affecting munitions production and causing a panic that would affect morale. What, and letting a highly contagious pandemic rage unchecked didn’t cause any problems?! 228,000 people died in the UK alone. Maybe that number would have been far less had something been done about it. I expected this programme to make me feel sad. It did, but it also made me feel angry.
The Spanish flu pandemic of 1918 killed an estimated 50 million people. It could have killed as many as 100 million people: no-one really knows. It’s thought that around 500 million people caught the flu – and, due to the interaction between the virus that caused it and the immune system, healthy young to middle-aged adults were the most likely to die. It first seems to have broken out in Kansas, in late January 1918, with a second wave then beginning in Massachusetts (Wikipedia says, although the programme didn’t, that the second, even more severe, strain also appeared in Brittany and Sierra Leone at around the same time) in September 1918. Nobody’s sure where the virus actually originated: there are various theories. And it spread pretty much right across the world, even to remote areas. Then it seems to have mutated into normal flu, and the pandemic ended fairly quickly. But so many people had died, and so many survivors had lost loved ones.
Of course, this coincided with the final year of the Great War. People thought that, finally, it’s over, we’ve survived, we can try to get on with their lives – and then this happened. Celebrations of the Armistice were breeding grounds for the flu, all those people in close proximity. And one of the main reasons it spread so quickly was that so many people were on the move because of the war.
Many British (including, at that time, Irish) troops falling ill were brought home to be treated. Did it not occur to anyone just what a bad idea that was? This was 1918, not 1348: people understood about infection. Little was known about viruses at that time, so doctors and scientists weren’t able to isolate the cause of the flu and find anything to try to counter it – keeping people warm and giving them Bovril was mentioned, sadly not really much help – but how can it have been considered a good idea to move people around when they had a highly contagious disease? Healthy troops coming home on leave also carried the virus with them. A map showed how it spread from the Channel ports across the country. As with most contagious diseases, densely-populated, overcrowded areas were hit worst.
On 29 September 2018, USS Leviathan, carrying 11,000 people, left New York for France. By the time she reached Brest, around 2,000 people were ill, with the deadly second strain of the flu, and 80 had died. Patients were carried on shore: there are reports of a convoy four miles long. The programme was done partly as a docu-drama, and the representation of conditions on the ship was just horrific – talk about a plague ship.
Why was the ship allowed to dock? Why wasn’t it put into quarantine? Why weren’t arrangements made to try to treat people on board? I don’t know: maybe leaving healthy people on there would have been cruel – but couldn’t some sort of arrangements for isolation have been made? Maybe it just wasn’t practical. Or maybe they wanted to get the healthy soldiers off the ship and to the Front – that’s the one explanation that does make some sort of sense, I suppose. Ships travelling all over the place carried the disease with them.
Going back to the first wave of infection, the flu reached Manchester in June 2018. James Niven, the local Medical Officer of Health, kept detailed records and statistics of the spread of the flu. It was worse on the north side of the city, my side, more densely populated and more industrialised. A graphic showed the flu moving from the city centre, where it’d arrived at the railway stations, into the outskirts and suburbs. It was very strange and frightening seeing it moving across North Manchester, my home turf, right through the areas where most of the older people I knew as a kid would have been living in 1918.
Thanks to Dr Niven, steps were taken in Manchester to try to reduce the spread of the disease. Leaflets were distributed, posters put up, and a film called “Dr Wise” shown at cinemas, advising people how to reduce the risk of infection. Schools, Sunday schools and some places of entertainment were closed. OK, there were still many cases and many deaths locally. The programme followed the story of a young girl called Ada Berry. Her entire family caught the flu. She survived – and lived to be 99 – but her parents and brother both died. Many others died too – to the extent that there was a backlog of funerals, because there weren’t enough coffins or enough gravediggers to keep up with the number of deaths. But the pandemic was definitely much less severe here than it was in other cities. Had even those steps been taken everywhere, things wouldn’t have been nearly as bad as they were.
But the powers that be in London – and, whilst public health matters were still dealt with at local level at the time, orders from the central government would have applied nationwide – decided that no steps should be taken to try to stop the flu spreading, on the grounds that suspending public transport, closing factories etc would have affected the war effort (and the spread of the flu didn’t??), and wouldn’t even go as far as Niven did, closing schools and places of entertainment, and even just advising people on what precautions might help them, because of concerns about the effect on morale. Apparently (although this wasn’t mentioned in the programme) the Cabinet didn’t even discuss it until Lloyd George himself caught it, in the September, and it wasn’t brought up in Parliament until the end of October. There had actually been plans in place for dealing with an epidemic, but they weren’t brought into force. I understand that difficult choices have to be made in wartime, but it’s hard not to think that the authorities got this one very badly wrong indeed.
And it wasn’t just the British authorities. The reason for the name “Spanish flu”, when the pandemic actually started in Kansas and affected many other countries before it reached Spain – killing, amongst others, King Alfonso XIII – was that the press in neutral Spain were able to report in detail on what was going on, whereas the press in combatant countries, on both sides, said very little. And, when the second, and far more deadly, strain of the flu broke out, in an American army camp, a doctor who wanted to seal the camp off to stop the disease from spreading was shouted down by his superior. The Australian authorities, by contrast, refused to allow any ships at all to dock in their country until the pandemic was over. OK, it wasn’t really practical for every country in the world to try to seal itself off, but surely more could have been done.
Sadly Dr Niven’s story didn’t end happily. He did a huge amount to improve public health in Manchester: the death rate per 1,000 population almost halved during his term of office. And he was recognised for his work, during his lifetime. But he suffered from depression after he retired, and ended up taking his own life. What a tragedy.
The Ministry of Health, now the Department of Health and Social Care was set up as a result of the pandemic. It was also mentioned that female doctors came to the fore whilst all this was going on. We didn’t hear about the long-term effects of the pandemic in other countries, but there’s only so much you can say in an hour. Quite a bit of that hour, especially at the end, was spent talking about what lessons can be learnt from the events of 1918, and what might happen if a similar virus took hold today. Without wishing to sound complacent, I’m not quite sure what the point of that was, seeing as medical science today is so much more advanced as to make comparisons with 1918 rather inappropriate. Having said which, as the programme – which seemed determined to scare the hell out of viewers, telling us that 200,000 people would be killed in the UK if a virus with a similar infection rate and similar fatality rate took hold – pointed out, new viruses do seem to appear from nowhere, and then mutate.
I could really have done without that bit. Those killed by the 1918 pandemic deserve to be remembered, without either scaremongering or trying to make their experience relevant to the present day. Whilst it’s important to learn from the past, there’s no need to try to make everything about today – like that bizarre programme last year which tried to turn the 500th anniversary of Martin Luther’s 95 theses into a discussion about the wretched European Union. As we mark the centenary of the end of the Great War, let’s also spare some thoughts for those killed by the Spanish flu.
There’s a book called Song of Songs, by the late Beverley Hughesdon (also from North Manchester!), about a Great War nurse. It’s not the best book ever – some of it’s very odd – but there’s a section in it in which the main character says that she feels as if vengeance thinks it’s been cheated by the end of the war, so it’s played its trump card – the flu pandemic. That’s how it must have felt. What a horrible, horrible time – and how frustrating to think that the government could have taken steps to ameliorate it, and chose not to do so.