The University of Montana has urged all students to stay off campus. Health officials stress hygiene above all else because there’s no vaccine. White gauze masks hang across the mouths of students and people on their way to work.
It’s the fall of 1918 as the biggest natural catastrophe of the 20th century washes over Montana in the form of a flu. COVID-19, the coronavirus, has managed to work its way from central China to Italy, Mexico, Iran and the United States. Since the World Health Organization declared a pandemic “demanding international attention,” confirmed cases surpassed more than 366,000 and killed more than 16,000.
In the opening weeks of its flight from China, the Associated Press reported that a doctor from the Mayo Clinic warned that although the coronavirus should be taken seriously by world leaders, one endemic disease still remained the biggest threat.
“The three biggest risks to Americans: No. 1 influenza, No. 2 influenza, No. 3 influenza,” Dr. Greg Poland said. In 1918, when scientists were still decades away from determining that the flu was a virus and not a bacterial infection, a third of the planet fell ill from H1N1 — Spanish influenza. In the United States, the Centers for Disease Control and Prevention tracked the number of deaths from the three waves of H1N1 that began that year to more than 675,000. The figure dwarfs the number who died in combat during World War I.
The closure of schools, businesses and theaters came to Missoula just over a century ago, and the city had to join the country in adapting to life under the threat of an outbreak. Despite the measures, the flu infected 25% of the county. Missoula County would not be immune to the statistic: one in four of its residents would be diagnosed.
By March 23, 2020, Missoula County had six presumptive positive cases of the coronavirus. Within the same week, everything shut down — schools, bars, dine-in restaurants, churches. The government recommended that at least until March 27, gatherings of more than 10 people should be canceled.
But in the autumn of 1918, scientists were 20 years away from the first flu vaccine and 10 years away from penicillin. Syphilis was still treated with arsenic. Two rows of ponderosa pines line the concrete path from the Adams Center toward the heart of campus. Of the 37 trees honoring those associated with the University who died in the service of their country during the Great War, the majority of them died of influenza, some overseas, some in training and some nursing the sick.
The ponderosas stand as silent tributes to the dead and as a history lesson for anyone visiting campus while its classrooms sit empty.
“When spring brings back
blue days and fair”
H1N1, deriving its name from its biological makeup, received its popular name through the press. To bolster morale both on the front lines and at home, warring nations suppressed reports of a possible epidemic. Neutral Spain filled the void and gave this new terror its namesake. It was one of the only European countries able to report cases without censors masking the real threat.
While the coronavirus may have come to the U.S. on a plane or cruise ship in the saliva of a tourist, Spanish flu found vectors in the 4 million U.S. troops mobilized and shipped to Europe in the spring of 1918. Many passed through Fort Riley, in Kansas, for their initial training. Although scientists debate whether the virus originated in China, France or Britain, the fort became ground zero for its breeding and spreading to Army camps throughout the South, then to the Western Front.
The mobilization mixed together rural and urban, healthy and infected. Millions found themselves packed on trains and in barracks built to meet just a fraction of the demand. In Missoula, the war effort landed at Fort Missoula and with the Student Army Training Corps at UM, a forerunner to the Reserve Officer Training Corps. Dozens of men cycled through on their journey to Europe and with them, the flu.
Missoula’s paper of record, then known as the Daily Missoulian, conceded the wave of influenza that washed over Boston, Philadelphia and San Francisco had reached the Garden City Sept. 30, 1918.
The paper wrote that on Oct. 7, commanders at Fort Missoula placed all 206 men under quarantine after confirming 25 cases of flu. Surrounded by stories of residents reacting to possible peace with Germany. Their distrust of the German people recognized collectively as “the Hun,” a three-inch article announced the arrival of the virus: “Spanish Epidemic Hits Local Post.”
With more than a month left in the war, the Montana Kaimin touted that nearly 300 of its total 665 students had enrolled in the S.A.T.C. University President Edward O. Sisson delivered an address to the “student army” on the oval, calling them the “brightest thing in all her [the University’s] war history.”
Elsewhere on campus, the Kaimin reported that a history professor gave his opinion on what he saw as the hypocrisy of German “Kaiser-worship.” The campus paper wrote that the freshmen had yet to be hazed by the sophomores as was tradition, and the Eloise Knowles cottage had just opened for women interested in home economics.
Back on the oval, Sisson said that 200 of the men gathered for the exercises that morning would be shipping for Europe on Oct. 15. Although the men of the S.A.T.C. would go into quarantine within days, influenza only appeared in the campus paper in a stab at some contemporary humor.
“Yesterday we had a lot of Spanish stew, which was very good. Only I don’t think they should give us that Spanish stuff since so much of that influenza is floating around. Do you, Unk?” wrote a fictional student-turned-soldier, Rookie, to his uncle from the front lines.
“Close my eyes and quench
Two weeks later, on Oct. 15, the school closed operations, and the men of the S.A.T.C. stayed stateside in their newly established barracks. The war department ordered their quarantine on campus Oct. 10 when 16 were diagnosed with influenza.
The announcement, issued by the University’s president and its chancellor, halted all classes by noon of that day.
Students living in Missoula would stay at home, and those living more than a few hours away from campus would also return home and all would continue their coursework through the mail. Craig Hall, the women’s dormitory, remained open and under quarantine for any women who wanted to stay on campus.
While the city of Missoula was logging dozens of influenza cases a day, UM President Sisson wrote, “Our condition on campus is thoroughly good, but the general influenza situation is growing daily more serious.”
The decision to close the University’s doors came from the advice of J.P. Ritchey, the city health officer who also pressed city leaders to shut down all schools in the county, cancel church services and close theaters.
The Daily Missoulian wrote that, on Ritchey’s insistence, all the barstools in town had been rounded up by police and placed in storage to discourage crowds in pool halls and taverns.
On page two of the Montana Kaimin that an Oct. 15, Rookie wrote another letter to his uncle.
“You know, Unk, this is no good place to be, because most of the people have something called Spaniard’s Influence. It’s no bull, either, even if it is Spanish.” Residents of Missoula, including the soldiers living in quarantine and the students finishing the rest of the term through the mail, joined the rest of the country in facing the deadliest month in its history.
The CDC tallied 195,000 people in the U.S. died between Oct. 1 and 31 of 1918, all of them either of the flu or its typical follow-disease of pneumonia.
Dr. Jay Evans, who for 20 years has researched the possibility of a universal influenza vaccine, directs the Center for Translational Medicine at UM. In 2018, the center received a $10 million grant toward research that could help influenza join smallpox and polio in becoming close to eradicated. Evans said the strain of H1N1 that struck the world in 1918 was unique in populations it targeted.
Typically, both then and now, those most vulnerable to flu are those with the most vulnerable immune systems: the very young, the very old and pregnant women.
When analyzed according to age groups, the Spanish influenza impacted both those with compromised immunities and those with healthy immune systems. With the surge of patients between the ages of 20 and 40 stricken with influenza, this phenomenon confounded doctors and prompted medical professionals to commit serious research into the seasonal flu.
“It’s your own immune response that makes you feel so horrible when you get the flu,” Evans said.
When the flu virus infects the lungs, the body reacts by becoming inflamed, and fever follows. In the case of the 1918 outbreak, Evans said the healthy became vulnerable because the virus was so foreign.
“Because they had the strongest immune system, they got the rapid, quick inflammation. Their lungs filled up with fluid, they got pneumonia and they died,” he said.
Evans said the WHO and the National Institute of Health coordinate to produce vaccines that stay a step ahead of the upcoming flu season by anticipating its evolution.
“Because of how that infection cycle works, it’s prone to a high mutation rate,” he said.
The high mutation rate keeps the protein surface of the virus (in the case of H1N1, haemagglutinin and neuraminidase) constantly changing. Selective pressures placed on the virus both by vaccines and the environment drive the virus to evolve and seek out hosts who are the least protected.
With viruses brewing on the saliva of a duck, or in the lungs of a pig, Evans said it’s only a matter of time before the latest evolution of a virus manages to sidestep vaccines that the WHO has exhaustively produced.
“A new virus emerges that’s a pandemic virus every so many years, just like what happened in 1918,” Evans said.
“The one thing that’s saved more lives in the world than anything else is clean water. [It’s] saved more lives than any other advancement in human history. The second thing is vaccines,” Evans said.
Despite the CDC reporting influenza killing between 12,000 and 60,000 people in the United States, a portion of the population still treat vaccinations as though they are the threat. Some cite religious reasons, and others point to pseudoscience linking vaccinations with autism.
Evans said “although these individuals are entitled to their right to refuse vaccinations, they are wrong.”
“We don’t talk about polio. We don’t talk about measles. We don’t talk about smallpox. We don’t talk about the deaths that happened during the 1918 flu. It’s because we have vaccines against those things now,” Evans said.
“Pulse nigh to pulse, and breath to breath”
When the Montana Kaimin returned for the spring semester nearly 102 years ago, it welcomed students who rode out the epidemic in the city, or came back from their homes in Darby, Butte and Anaconda.
By January, operations on campus returned to normal.
Mail was no longer fumigated. The S.A.T.C. members no longer had to wave to friends behind the “hedge” that surrounded their new barracks-turned-hospital. By the end of the year, influenza cases came to nearly a quarter of campus.
Sisson, who hoped for an ease on the campus-wide shutdown prior to the new year, had to report that despite the reduction in influenza cases, scarlet fever had also broken out in the barracks in November.
One student, a sergeant in the S.A.T.C., spent two weeks at St. Patrick’s hospital, only to return to campus and be again hospitalized for scarlet fever. By the end of November, the Armistice took precedence over the epidemic.
Margaret Coucher, a former columnist for the Montana Kaimin, reported on the jubilation from Camp Lewis in Washington: “The night that the peace news came was a big night here,”she wrote. “The ‘flu’ ban which was to have remained on for another week was lifted by force when all the sailors from the camp here broke loose and went to the main part of the city, cheering thousands tramping along with them.”
The school year also started with the University’s president calling in sick. While he fell ill with bronchitis, his son was diagnosed with influenza.
The quarantines had ended, but campus still maintained a required sick call for students.
These six-day-a-week checkups ran through January. By the order of W.E. Schreiber, then the chairman of the faculty health committee, students reported for a health inspection daily under the threat of suspension.
Ellen Leahy, the current director of the Missoula City-County Health Department, said the initiative, intellect and courage was present among officials in 1918, but the science was still young. Leahy has written articles published on both the Spanish flu and smallpox epidemics that hit Montana.
“Science doesn’t rule the day. You have to consider science, society and culture and make policy around that. Take the conversations I’m in right now. We have to consider what people will think when they hear the word ‘quarantine.’”
Long before the days of HIPPA guaranteeing the privacy of patients, the Montana Kaimin confirmed cases on campus by listing the names of afflicted students. By the time soldiers began appearing less and less in the paper, new cases emerged from the formerly quarantined Craig Hall.
A week after reporting that the president’s son had been diagnosed, the Montana Kaimin wrote that Helen Gipson, 23 and studying to be a nurse, died of influenza. More names made their way into the “Personals” section of the paper, or in small announcements on the second page.
By Jan. 21, the Kaimin reported that 25 people on campus had influenza, all of them women, many who stayed in Craig Hall during the campus closure. The dormitory’s second floor was converted into a hospital.
“You can not cohort people into quarantine. You might not have symptoms, but you could be contagious,” Leahy said.
The same risk of housing all of the women staying on campus in one dorm in the autumn and through the winter of 1918, Leahy said, faced the passengers on the cruise ship that eventually docked off the course of California.
Leahy referred to the cruise liner Grand Princess, which remained at sea for over a week in March 2020 with nearly 2,500 passengers after health officials linked the ship to a fatal case of COVID-19. Twenty one people on board tested positive.
“You actually put them in incubators,” she said.
Leahy said that although quarantine protocols have evolved since 1918 to allow medical workers to safely cordon off individuals, nothing kept the women in Craig Hall from spreading influenza during their stay.
As of publication, UM students who left for spring break received an announcement from campus administrators urging them to stay where they were. Although the dorms would stay open, they would only be available to those students with nowhere else to stay.
In the same edition confirming 25 cases on campus, the Kaimin ran an article detailing the scene at sick call. Dozens lined up for an inspection conducted by the university physician, including the student government, president and the freshman class president.
At the sound of “Next,” students snaked their way through the campus gym.
One woman, according to the article, was forgotten and left “holding a thermometer between her lips for 20 minutes.”
“When spring trips north again this year”
By the spring, reporting on the influenza outbreak dried up. Other than the occasional report of a student forced to leave campus to recover at home, or a graduate falling ill abroad, articles looked ahead to baseball season, breaking the enrollment record next fall and chastised students for their lack of enthusiasm for making costumes in a parade scheduled for May.
On March 25, it reported on plans to honor the dead, the “former university men who died in service, but also for those men who died while at Fort Missoula and in the S.A.T.C. camp.”
“I think there were a lot of heroes that we are never going to know about, like Dr. Ritchey, the city health officer,” Leahy said. “I can’t imagine looking back in his journal and his log, and in the end, he got sick too. There were a lot of nurses too, like Mrs. Yoder. She was only here three days before she was stricken and died,” she said.
Hazel Yoder worked as a nurse for the sick in the S.A.T.C. before contracting the flu herself. She and four other nurses who answered a national demand when WWI left the U.S. with a chronic shortage of healthcare workers were among those honored by campus in the spring of 1919 with a plaque and a ponderosa.
Another nurse, who joined in the effort to combat the epidemic when the University asked all of its students to stay home and keep their distance from others until the pandemic passed, provided an eyewitness account of her experience at Fort Missoula in the March 25 edition of the Kaimin.
Like the Facebook groups and non-profits organizing volunteer efforts to bring food and medical supplies to Missoula residents today, she opted against staying indoors and keeping her distance. Her story ran below the names announced for the newly established R.O.T.C. program, rants against the oncoming prohibition of alcohol and an upcoming speech from a Washington judge who would take to the pulpit of a city church to promote “Americanization.”
Along with being smothered by the concerns of campus in 1919, the nurse and journalism student remained further buried under the sod of anonymity.
Along with the soldiers, some men from a lumber camp and a boy from a cattle farm 50 miles away laid on “snowy beds” in a basement converted into a hospital ward. Men gave up their ice packs for a young man going into hysterics in a corner of the ward.
In the monotonous work of nursing, she wrote that the sick begged for “that soothing sleep-bringing ‘shot.’” She and the other nurses helped to guide shaking hands over final wills and testaments and became accustomed to lying, just a little, when patients asked about their temperatures.
“But no matter how hard or trying their work, they all say they prefer to take care of the ‘flu’ rather than to have it,” she wrote.