Spanish Flu in Laois - A Lesson from History

Originally published in Leinster Express newspaper, 26th May 2020

Mark Twain is reputed to have once said ‘history doesn’t repeat itself, but it often rhymes’. Never has this been as true as today when one compares the last great pandemic to the current COVID19 world. From questions over its mysterious provenance, to its spread across the world, when overlaying the chain of events since January 2020 with that of the first wave of the influenza a century ago, one sees striking similarities. Perhaps, the key for the as-yet unwritten story of the autumn and winter of 2020 to avoid the tragedy of the same period 102 years earlier lies within the history books.

Just over a century ago, a strain of the H1N1 influenza virus infected hundreds of millions of people around the globe leading to the death of as many as 100 million people. For generations, scientists have warned that it was merely a matter of time before another global viral pandemic would emerge. The Asian flu, the Hong Kong flu, SARS, and a second H1N1 pandemic in 2009/10 all threatened to emerge as the feared major outbreak, but it was not until this year that a virus has emerged of comparable severity.

In the decades after the 1918/19 pandemic, scientists have theorised on where that virus emerged. In 2020 journalists and commentators around the world have shifted from being experts on politics and economics to being self-anointed authorities on immunology and virology. Several have commented upon the irony of an American President calling COVID19 the ‘Chinese virus’ when the pandemic a century ago originated in the United States. The truth is that the whereabouts of the origin of that pandemic are not known for certain. 

Doctors in Haskell County, Kansas, were warning about a virus that was striking down patients as if they had been shot as early as January 1918. On the other hand, there is evidence that the first recorded instance of the virus was in a British army camp in northern France in 1916. From there, it may have spread to a military hospital in Aldershot, outside London. Also, the barely documented mobilisation of tens of thousands of Chinese labourers to work in reconstruction efforts in France has led to some scientists linking the harmless impact of the pandemic in China to potential immunity among the population due the outbreak of flu in Northern China in 1917.

Whatever the origin, two things are certain; that it did not originate in Spain as the colloquial name of the outbreak suggests, and that total warfare of the Great War helped spread the virus all across the world. 

When the virus began to take hold in the trenches of Belgium and France, war-weary Allied and Central Powers were determined to sustain morale by supressing press reports of the virus’ spread. A near-identical accusation has been laid at the feet of the Chinese Government and the silencing of medical professionals in Hubei Province in January 2020.

However, things began to change when neutral countries began to be impacted by the virus. The most notable example of this was in Spain. On 22nd May 1918, Madrid’s largest newspaper reported upon a strange flu like illness emerging. On that very day, the city celebrated their Fiesta de San Isidro, to honour their patron saint. Thousands of people gathered in ballrooms and bars, unaware that they were contributing to a sudden surge in the spread of the virus in the Spanish capital.

There are obvious echoes of these festivities with 2020 equivalents such as the attempt in Wuhan to break a world record for the world’s largest banquet that tens of thousands of people attended, the so-called ‘biological bomb’ Champions League game between Bergamo-based Atalanta and Valencia in Milan, and the hosting of the Cheltenham Races in Britain and the Mardi Gras festivities in New Orleans despite obvious medical evidence to suggest they should have been cancelled. 

A week after the Madrid festival, King Alfonso XIII fell ill. He was followed by his Prime Minister, other cabinet members, and tens of thousands of civilians. Newspapers struggled to produce editions such was the volume of illness. But the papers that were printed portrayed a nation struck down with a deadly disease apparently from nowhere. Therefore, in June 1918, when the virus began to impact the general population of countries such as Ireland, it was known as the Spanish Flu.

The first documented case of the virus in Ireland was aboard the USS Dixie, an American naval cruiser docked on a semi-permanent basis in Queenstown (Cobh) to accommodate American troops. However, it is difficult to pinpoint at what point the virus actually entered Ireland. With daily developments from the War occupying the column inches of unionist leaning newspapers, and the fallout from the arrest of the leadership of Sinn Féin as a result of the German Plot receiving most attention from nationalist newspapers, the rapid spread of the virus across Ireland went unnoticed. The first sign that there was a serious problem came on 11th June in Belfast. The Belfast Newsletter reported that ‘an epidemic of an influenza type’ was prevalent in the city. In another echo with 2020, the subheading stated ‘No Cause for Alarm’ adding that nobody had died yet and it normally took its course over three days. The message was clear – this was a normal flu.

However, within the first week of this initial report, the same newspaper began to report on the sudden spreading of the virus across the city leading to three deaths. 12 schools were closed on the recommendation of Belfast’s Medical Officer who was quoted as saying that the epidemic was rampant in Berlin and across Continental Europe – the first public confirmation in Ireland of the grave seriousness of what had turned from something that should barely register alarm to global pandemic. 

On 18th June, two shop workers in Ballinasloe collapsed behind their counters with the same condition. Two days later it was confirmed that 60 people in the town were ill - 40 soldiers among them. Days later, hundreds of cases were reported from Tipperary Town, with soldiers once again viewed as the main carriers. Detailed analyses of the spread of the flu by Trinity College and Dr. Ida Milne has shown that the virus was largely spread by returning troops along Ireland’s rail network. Evidence suggests that parts of Ireland with poor rail connectivity at the time such as north-Mayo and Roscommon had lower fatality rates in the first two waves of the virus.

But as soon as the virus had appeared, it had vanished. The first wave of the virus had little recorded impact in Laois. The Leinster Express made no reference to the virus whatsoever. However, things were an altogether different matter when the virus returned for a second devastating wave. 

In late September and early October the flu began to spread again in Dublin with clusters emerging in secondary schools, such as the Loreto on Stephen’s Green. People from rural areas who had business dealings in Dublin began to fall ill upon their return home and die by the middle of October.

The first area bordering Laois hit by the second wave was Carlow town. By late October, the situation in the town was said to be dire with over 500 people gravely ill. In an era when the understanding of viruses was minimal, postmen, doctors, shopkeepers, and any other profession that meant close contact with various members of the community were hardest hit. 

In Kildare, Naas became no-go area. By late October, the Leinster Leader newspaper, based in the town, was apologising for shortcomings in its production owing to the great numbers of staff that were ill. In an editorial, it solemnly announced that of the great number of people that had perished, ‘many or most … have occurred amongst our youth, and all are of the saddest character’. By early November, eight funerals were taking place in the town a day. In Athy, there were a backlog of bodies in the workhouse as staff squabbled over whose responsibility it was to dig graves owing to undertakers being too busy.

The first cluster of cases in Laois occurred in Rathdowney, which would become the hardest hit town in the county. Most of the shops and schools in the town were forced to close. It was reported that people in the rural hinterland were running out of commodities as they would not come into the town to do their shopping. Among the dead in the second wave there were the Head Master of the National School, and one of his teachers. Another 10 Rathdowney people, all reportedly fit and heathy beforehand, died in the first two weeks of November.

Portarlington, Ballybrittas, Ballinakill, and Mountmellick were also crippled by the outbreak with almost every home being afflicted to one degree or another. In scenes not dissimilar to a few months ago, chemists in these towns began to experience shortages of disinfectants as people cleared the shelves in a panic once the virus took hold.

In a very different looking health service to the more centralised one that we now have, the medical frontline in many parts of Ireland, including Laois, solely consisted of the rural G.P; a role that was not permitted to be filled by men of military age during the War years. At a time when the life expectancy of men was about 60, G.Ps were being forced to work beyond the point at which they may have been expected to die of old age. Thoughts of a peaceful retirement were a certain impossibility.

The case of Dr. T. F. Emerson, the G.P in Emo, became an example of the consequences of such a short-sighted policy. Emerson, 63 years of age, was leaving his home one morning to tend to gravely ill patients when he collapsed and died. The coroner’s court returned a verdict of exhaustion. 

In other parts of Laois, doctors were forced to cover vast swathes of land, leading to a tremendous toll on the body. Dr. O’Reilly of Portarlington, Dr. McKenna of Ballylinan, and Dr. O’Brien of Mountmellick all fell ill in early November 1918. When they apparently stopped visiting patients without warning, people assumed that they had all perished of the flu, leading to widespread panic.

In Abbeyleix, the notoriously rickety ambulance of the local workhouse was called upon to come to the aid of a young girl dying of the flu. She was brought, along with her sister to the workhouse for medical aid. But when they arrived, the sister, herself weak with the flu, was greeted by no one. Her sister died on the steps of the workhouse as her sister struggled to get help from an institution crippled by the outbreak.

Whilst not as badly struck as other smaller towns, one account from Maryborough (Portlaoise) illustrated the fear of infection that was pervasive. Gerald J. Burke was a very popular man in the community, heading several local organisations. He was also a talented singer and musician. When his lung’s succumbed to the flu in early November his family instructed mourners to pray for the repose of his soul in private. A funeral, like so many nowadays, which would otherwise have lined the streets of the town was attended by a handful of family members, themselves failing from the illness too.

In a similar manner to the first wave, the second, although severe, was relatively brief. The Great War ended with Armistice on 11th November 1918. The silencing of the guns across Europe came to the forefront of people’s minds as the virus abated. Laois was certainly spared the worst excesses of the first two waves of the pandemic. The Registrar General for Ireland, Sir William Thompson, in his report on the mortality rate from the virus in 1918, indicates that 105 people died of influenza in Laois, with a further 54 dying from pneumonia. Laois’ mortality rate was on a par with counties such as Meath and Tipperary South but was more than Offaly and Westmeath. The highest mortality rate was in Kildare, probably due to the great concentration of soldiers in both the Curragh, and Naas, where the Royal Dublin Fusiliers were based.

In early-February 1919, a third wave of the flu arrived in Ireland. It became embedded in towns such as Enniscorthy, Cellbridge, and Mullingar. By far, Dublin became the epicentre of the third wave with Grangegorman, Drumcondra, and Glasnevin hardest hit. 

In Laois, the third wave made its presence known in early March. Several people died, albeit it was noted that, as opposed to a few months earlier, those who died ‘were persons whose powers of resistance were weakened by previous illness of delicacy’. However, this was not exclusively the case. The virus once again returned to Rathdowney with vigour and claimed several lives including that of Charles Kent, Chapel Street, a draper in his late thirties. His 21-year-old assistant, Dudley Bond from Church Street also died. 

Potentially, the greatest lesson to be learned from the Spanish flu comes when comparing the second wave to the third wave. Relatively little heed was placed upon the first wave when it struck in the summer of 1918. The War was still starving the resources and the attention of the masses – there was no scope available for reflection. It was inevitable that a second wave would return with vigour, which it did, killing tens of millions of people. But with the conclusion of the War, and the devastation caused by the second wave, the world’s governments did put in place measures to somewhat alleviate the impact of the third wave. 

When it was detected in Ireland on 3rd March, there was a genuine sense of fear and public health figures sprung to action. Charles Cameron, the man who held the position most closely resembling that of Tony Holohan today, began to urge people that were ill to self-isolate. Some St. Patrick’s Day parades were cancelled. Cameron closed all national schools in Dublin. He urges people to stop visiting hospitals and residential homes. All public events in the Mansion House are cancelled.

Within a short space of time these measures began to work as Cameron reported a 30% week-on-week drop in cases. It was too late to avoid tragedies such as the ones that took place in many parts of the city, or in Rathdowney, but with the very limited scientific resources they had at their disposal, it did help save lives. By listening to the advice of medical experts in 2020 we have also saved lives, and can continue to do so in the coming weeks and months.