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WAR AND DISEASE: THE POLITICS OF PUBLIC HEALTH IN THE STATE OF UTAH
DURING THE 1918-1919 INFLUENZA PANDEMIC
by
JANET CANNON DUBOIS
B.G.S., Brigham Young University, Provo, 2010
A thesis submitted to the
Faculty of the Graduate School of the
University of Colorado in partial fulfillment
of the requirements for the degree of
Master of Arts
History Program
2017
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This thesis for the Master of Arts degree by
Janet Cannon Dubois
has been approved for the
History Program
by
Rebecca Hunt, Chair
Michael Kozakowski
Chris Agee
Date: December 16, 2017
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Dubois, Janet Cannon (MA History Program)
War and Disease: The Politics of Public Health in the State of Utah During the 1918-1919
Influenza Pandemic
Thesis directed by Associate Professor Rebecca Hunt
ABSTRACT
This historical examination looks at the uses of power by different entities to deal with and
control the influenza pandemic in the state of Utah during the 1918-1919 influenza
pandemic. Surprisingly, the story is not a narrative about the power of the Mormon Church.
The Utah State Board of Health relied on the direction of the federal government. The state
board of health’s firm leadership set in place restrictions and regulations and was vital in
dealing with problems faced by local Utah communities. The board of health relied on local
authorities to follow through with these mandates. Bans and restrictions were lifted after
many weeks, but the flu continued to manifest itself in Utah. Individuals in Utah were
forced to step up and take responsibility for their own health. Lessons learned include the
need for direction from federal government, followed by state and then local direction
when a disease pandemic occurs. However, these government entities cannot continue to
curtail the rights of individuals, businesses and communities for an indefinite period.
Though governing entities may not always give the best direction, they are essential to
keeping order and providing guidance to the society they have stewardship over at least
during the initial onslaught of the disease.
The form and content of this abstract are approved. I recommend its publication.
Approved: Rebecca Hunt
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ACKNOWLEDGMENTS
Early ideas for this this thesis began on a trip with my sister to Cabo San Lucas,
Mexico. My sister, Dr. Lisa Cannon-Albright, Chief, Division of Genetic Epidemiology in the
Department of Internal Medicine at the University of Utah School of Medicine, had
contributed to a paper titled, “Evidence for a Heritable Predisposition to Death Due to
Influenza.” I had recently written a paper on the historiography of the 1918-1919 influenza
pandemic. We had some great conversations during the week. She agreed to help me gain
access to the Utah Population Database through her department. Lisa spent countless hours
over a five-week period while I worked with her in Utah, answering questions, guiding my
research, and helping me gain access to medical and public health journals from 1918 and
1919. She spent more than a year mentoring and advising me when I had ongoing
questions. Partial support for all data sets within the Utah Population Database (UPDB) was
provided by Huntsman Cancer Institute, Huntsman Cancer Foundation, University of Utah,
and the Huntsman Cancer Institute’s Cancer Center Support grant, P30 CA42014 from the
National Cancer Institute.
I would also like to thank Rebecca Hunt, Michael Kozakowski, and Chris Agee for
reading several versions of this thesis and suggesting changes to improve the quality of the
finished product. Each of these professors also taught me valuable lessons during my time
in class with them.
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TABLE OF CONTENTS
CHAPTER
I. INTRODUCTION ................................................................................................................................ 1
II. INFLUENZA AND THE AMERICAN MILITARY .................................................................................. 10
III. FEDERAL AND STATE POWER......................................................................................................... 19
IV. THE PRESS AS GOVERNMENT MESSENGER TO AMERICA ............................................................. 25
V. OPPOSITION AND THE STRUGGLE FOR CONTROL ......................................................................... 27
VI. THE POWER OF ORDINARY PEOPLE AND THE INFLUENCE OF THE MORMON CHURCH ............... 31
VII. STATE EXPECTATIONS OF LOCAL AUTHORITIES ............................................................................ 34
VIII. LOCAL AUTHORITY........................................................................................................................ 41
IX. AMERICAN INDIANS ...................................................................................................................... 52
X. BUSINESS ELITES INTERVENE ........................................................................................................ 56
XI. PLANNING FOR THE FUTURE ........................................................................................................ 62
XII. CONCLUSION ................................................................................................................................ 64
BIBLIOGRAPHY………………………………………………………………………………………………………………………………. 68
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LIST OF FIGURES
FIGURE
1. Image of Roy Parkin Nelson and Family…………………………………………………………………………………….....1
2. Utah Influenza Death Count by Date, August 1918 - January 1919………………………………………………39
3. Utah Influenza Deaths by Month, August 1918 - January 1919…………………………………………………...40
4. Delta Town Proclamation…………………………………………………………………………………………………………….44
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CHAPTER I
INTRODUCTION
Roy Parkin Nelson was born in April 1897 in Randolph, Utah, the oldest child of
Samuel and Zipporah Parkin Nelson. He grew up on a large ranch, and in 1917, he left
home to attend the Agricultural College in Logan, Utah. When America entered the war in
Europe, Roy wanted to enlist, but his parents discouraged him. They finally realized he
would be drafted and so relented.1 He enlisted in the United States Army on July 15, 1918.
Roy was attached to Company B, Training Detachment, at the University of Utah as a
student officer.2 In his last letter home on October 9, Roy said he did not feel well, but told
his mom not to worry. Some days later, Roy’s family was notified that he was very ill. His
1 “A Short Sketch of the Life of Roy Parkin Nelson,” Contributed by Greg Ford, November 8, 2015, with permission https://familysearch.org/photos/artifacts/20423053?p=11180511&returnLabel=Roy%20P%20Nelson%20(K241-9ZK)&returnUrl=https%3A%2F%2Ffamilysearch.org%2Ftree%2Fperson%2FK241-9ZK%2Fmemories. 2 “Teachers Volunteer as Flu Nurses,” Salt Lake Telegram, October 17, 1918, accessed November 15, 2016, Utah Digital Newspapers.
Figure 1. Roy Nelson (center, back) with his family in 1918. Courtesy Greg Ford.
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father left for Salt Lake City to visit his son at Fort Douglas. Government officials and
military leaders at Fort Douglas were concerned about containment and stopping the flu
outbreak and had put in place regulations to protect soldiers and the nearby community.
There was a strict quarantine in place at Fort Douglas that required visitors to get a special
permit from the military commandant to enter the military post.3 Because so much red
tape was involved, it was some time before the father could see his son at the isolation
hospital. Roy was not conscious and died a few minutes after his father arrived at his
bedside. Regulations and red tape kept a father from communicating with his son before
he died of disease rather than warfare. It is surprising that regulations were not waved so
that a father could visit a dying son when it was apparent that quarantine was not
sufficient to stop the spread of the disease.
In his 1986 book, Pandemic Influenza 1700-1900: A Study in Historical
Epidemiology, David Patterson discusses the distinctive features of the 1918 pandemic by
remarking on three key characteristics: no disease ever killed so many humans; it “spread so
explosively,” and it killed many who were between the ages of twenty and forty.4 Scientists
and historians estimate that 50-100 million people died, worldwide, in ten months.5 Some
modern historians find it impossible to imagine that troop and civilian movements, as a
result of World War I, were not factors in the spread of the disease. Dr. Alfred Bollet, in his
book, Plagues and Poxes: The Impact of Human History on Epidemic Disease, proclaims,
3 “Teachers Volunteer as Flu Nurses,” Salt Lake Telegram, October 17, 1918, accessed November 15, 2016, Utah Digital Newspapers. 4 K. David Patterson, Pandemic Influenza 1700-1900: A Study in Historical Epidemiology (Totowa, NJ: Rowman and Littlefield, 1986), 91. 5 Patterson, Pandemic Influenza, 91.
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“Warfare…precipitate[s] the rise and fall of diseases.”6 Historians and other scholars have
written about the ways the 1918-1919 influenza pandemic influenced World War I, both on
the home front and the battlefront. The conflation of war and epidemic opened new
perspectives on political, social, and economic circumstances in America, on the Homefront.
New evidence about components of the pandemic has come to light over the years and old
evidence has been interpreted in new ways. This has provided an evolution in theories
related to subjects like the unusually high death rate for young adults during the influenza
outbreak and the value of “nonpharmaceutical interventions” in communities and given rise
to tropes like historical memory and political power.7 In his book, Epidemic and Peace, 1918,
published in 1976, Alfred W. Crosby proposed many of the ideas, questions and hypotheses
that subsequent historians still talk about in their histories today.8 As the world has faced
epidemics like the new strain of flu that emerged in China in 1957, academic historians have
realized it is important to learn from these outbreaks of the past. Because the influenza
pandemic of 1918 killed so many millions world-wide, it is vital that we understand its
impacts on governments, communities and institutions in 1918. By learning how those in
authority administered the fight against the pandemic, and looking at how all those
involved reacted, we will be better prepared to deal with a future global pandemic, mitigate
its spread and minimize the loss of life.
6 Alfred Jay Bollet, M. D. Plagues and Poxes: The Impact of Human History on Epidemic Disease (New York: Demos Medical Publishing, 2004), 1. 7 Richard J. Hatchett, Carter E. Mecher, and Marc Lipsitch, “Public Health Interventions and Epidemic Intensity during the Influenza Pandemic,” Proceedings of the National Academy of Sciences of the United States of America, 104, no. 18 (May 1, 2007): 7582. 8 Alfred W. Crosby, Epidemic and Peace, 1918 (Westport, CT: Greenwood Press, 1976).
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One way to approach the history of the pandemic is to study a specific geographic
area hit hard by the influenza during the second and third waves in 1918 and 1919. As David
Kyvig and Myron Marty suggest in their book, Nearby History: Exploring the Past Around
You, “Careful examination of what happened to particular families and communities can
clarify and illustrate the broader picture.”9 The advantage of choosing Utah as a case study
is that digitized copies of Utah death certificates, many Utah newspapers based in large and
small cities, and a pedigree based database of family histories with attached source
documents are all available online at no cost. I also gained access to the Utah Population
Database, “an extensive set of Utah family histories, in which family members are linked to
demographic and medical information” with the help of Dr. Lisa Cannon-Albright, Chief,
Division of Genetic Epidemiology in the Department of Internal Medicine at the University
of Utah School of Medicine.10 1918 and post-1918 era academic articles, especially in
medical journals and public health bulletins were another valuable resource. The
combination of these research sources provided a goldmine of information on the
pandemic in Utah and the nation.
During the pandemic in Utah, state and community public health officials,
policymakers, and other officials and elite businessmen, boosters and everyday Utahans
played a part in making decisions that influenced the health care, economy, transportation,
and personal aspects of life including social life, education and religion. The Utah State
9 David E. Kyvig and Myron A. Marty, Nearby History: Exploring the Past Around You (Lanham, MD: AltaMira Press, 2010), 9. 10 University of Utah Health Care, accessed November 19, 2016, http://healthcare.utah.edu/huntsmancancerinstitute/research/updb.
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Board of Health under the direction of Dr. Theodore Beatty, and with the support of
governor Simon Bamberger, set in place policies that impinged on the perceived missions,
rights, freedoms, and authority of citizens, businesses, service providers, and other
institutions. Public health was a relatively new area of governance for the state, so it is
understandable that lines of authority would have been unclear and contested during the
crisis. State health officials tried to consolidate and assert their authority. They tried to get
citizens, private doctors and local governments to follow their advice. On a human level, a
mixture of precaution, patience, and compassion, while putting aside fear, was essential to
getting through eight long months of bans and restrictions, illness and death. The politics of
disease forced disagreements between several groups in Utah during the influenza
epidemic in 1918-1919. The argument can be made that state and community officials felt
compelled to issue mandates they believed would slow the spread of the disease and curtail
the number of deaths. Their mission was to protect the health of the citizens of Utah.
Public health was a relatively new area of governance, not only in Utah, but in
America in 1918, though the American Public Health Association was organized in 1872.11 A
pioneer in the “new public health” of the time was Charles-Edward Amory Winslow, author
of The Evolution and Significance of the Modern Public Health Campaign, published in 1923.
Dr. Winslow originated the health exhibits at the American Museum of Natural History in
New York City in 1910. He promoted the idea that good personal hygiene was essential to
health and that the physician should be a valuable resource for the well patient in the
11 Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 181, 185.
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prevention of disease and the early discovery of disease for medical intervention.12 So, in
the era before and during the 1918 pandemic, it was unusual for a person to see a physician
regarding the prevention of disease. The doctor was called when the patient suffered from
pain or illness.13
By 1918, public health authorities did know enough about how disease spread to
focus attention on the responsible pathogen. Public health officials focused more on
personal hygiene and dependable, safe remedies (or therapies) and less on cleaning up the
environment. States and many local communities had public health departments or
boards.14 Many schools had health services for the children who attended. Some schools
provided smallpox vaccinations, and vision and hearing tests. Recommendation notes were
sent home to parents when children needed to see a doctor or dentist. Unfortunately, many
children still had the same medical or dental problems when they were examined the next
year.15
Protecting the health of Utah’s citizens was not the only motivation for restriction
and regulation during the pandemic. There were other motivations as well. These included
keeping businesses vital to the war effort and to the subsistence of citizens open and
operating. At the request of federal leaders, the people of Utah, like the people of other
states had made sacrifices in their personal lives to help the war effort in the years leading
up to the pandemic.
12 C.-E.A. Winslow, The Evolution and Significance of the Modern Public Health Campaign (New Haven: Yale University Press, 1984), 57. 13 Starr, The Social Transformation of American Medicine, 141. 14 Starr, The Social Transformation of American Medicine, 181, 185. 15 Starr, The Social Transformation of American Medicine, 187-189.
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Life in America and in Utah changed in many ways when the United States entered
the war in Europe. In November 1916, Woodrow Wilson was reelected president of the
United States. As American president, he had tried for more than two years to keep the
United States from entering the war. The conflict in Europe was an important issue during
the campaign for reelection.16 Many Americans did not want to become entangled in the
European war. On March 18, 1917, three American ships were sunk by German submarines.
Only a few weeks earlier, Wilson had learned that the German foreign secretary was
working to engage Mexico as an ally in the war against the United States.17 At the urging of
President Wilson, the United States Congress declared war on Germany on April 6, 1917.18
Everyday life for Americans began to change almost immediately with the introduction of
federally mandated programs, plans and procedures instituted to support the war effort.
Once America entered the war, there was a suspension of what life had been before.
For the most part, Americans accepted the new regulations, requirements, and
restrictions initiated by the federal government to help win the war. The government
established a Committee on Public Information on April 11, 1917 to “sell the war.”19 The
federal authorities were not above using popular movie stars of the time, like Douglas
Fairbanks and Mary Pickford, to promote Liberty Loan Campaigns to raise money to fight
the war. The first draft registration took place on June 5, 1917; all American males aged
16 David M. Kennedy, Over Here: The First World War and American Society (New York: Oxford University Press, 2004), 12. 17 Kennedy, Over Here: The First World War and American Society, 10. Barbara W. Tuchman, The Zimmermann Telegram: America Enter the War, 1917-1918 (New York: Random House, 1958), 180-1. 18 Neil M. Heyman, Daily Life During World War I (Westport, CT: Greenwood Press, 2002), xiii-xiv. 19 Donald M. Goldstein and Harry J. Maihafer, America in World War I: The Story and Photographs (Washington, D.C.: Brassey’s, 2004), 105.
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twenty-one to thirty were required to register. Mark Sullivan, in his book, Our Times: The
Turn of the Century, 1900-1925, Over Here, decried “the use of organized propaganda by
the government to bring about mass movements” and termed the all-male draft
registration “a surrender of their persons to the government.”20 Many Americans had been
collecting food and clothing for the beleaguered Belgians under the direction of Herbert
Hoover since soon after the war began in 1914. In August 1917, President Wilson appointed
Hoover as Food Administrator for the war effort. Hoover’s job was to persuade Americans
to waste less food, so that surpluses could be used to feed America, including the American
military and the Allies. Hoover had the full weight of the law behind him when
“manufacturers and dealers” were concerned, but propaganda and persuasion were the
tools he used to encourage the average American to voluntarily support the war effort.21 He
declared ‘“FOOD WILL WIN THE WAR,”’ and urged Americans to demonstrate their
patriotism “by eating less.”22 In October, the federal government began to fix prices on
goods like steel.23 In December, the government decreed that electric advertising signs be
turned off on Thursdays and Sundays to conserve resources for the war effort.24 The same
month, the government took control of the railroads to expedite shipments of important
goods to Europe. Americans were asked to donate scrap metal and the use of metal for
non-essential production was halted.25 Not only did the government take control of some
20 Mark Sullivan, Our Times: The Turn of the Century, 1900-1925, Over Here. vol. 5 (New York: Charles Scribner’s Sons, 1971), 300-301. 21 Sullivan, Our Times: The Turn of the Century, 1900-1925, 408, 410, 418. 22 Tammy M. Proctor, Civilians in a World at War, 1914-1918 (New York: New York University Press, 2010), 89. 23 Sullivan, Our Times: The Turn of the Century, 1900-1925, 634. 24 Sullivan, Our Times: The Turn of the Century, 1900-1925, 635. 25 Goldstein and Maihafer. America in World War I, 106, 108.
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industries, it mandated the reduction of alcoholic content in beer.26 A government poster
published during World War I encouraged Americans to save and donate fruit stones and
nut shells for the manufacture of gas masks.27 From food restrictions to victory gardens,
many of these regulations or suggestions touching regular Americans were voluntary.
However, federal bureaucracy grew exponentially to support the war. John Barry, in his
book, The Great Influenza: The Epic Story of the Deadliest Plague in History, asserts the
“Wilson…had created great bureaucratic engines to focus all the nation’s attention and
intent on the war.”28 Federal government agencies provided direction and resources during
the war, but relied, for the most part, on state and local agents to enforce regulations and
restrictions.29 All these changes, whether forced or voluntary, were viewed by patriotic
American citizens as necessary sacrifices in the face of war. In Utah, Church of Jesus Christ
of Latter-day Saints leaders and civic leaders, including Governor Simon Bamberger,
supported President Wilson by urging Utahans to provide money and resources to support
the war in Europe.30 So, the federal government was already exercising power over many
aspects of American business and life. War with its regulations and demands had already
permeated life when the flu arrived in Utah in October 1918. Amazingly, most Americans
heartily supported the government, perhaps feeling it was their patriotic duty to help the
United States ensure that Germany did not undermine European democracy.
26 Sullivan, Our Times: The Turn of the Century, 1900-1925, 639-640. 27 Anne-Catherine Fallen and Kevin Osborn, eds., Records of Our National Life: American History at the National Archives (Washington, D.C.: Foundation for the National Archives, 2009), 156. 28 John Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (New York: Penguin Books, 2004), 300. 29 Barry, The Great Influenza, 309-312. 30 Richard D. Poll, ed. Thomas G. Alexander, Eugene E. Campbell and David E. Miller, associate editors, Utah’s History (Logan, UT: Utah State University Press, 1989), 424.
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CHAPTER II
INFLUENZA AND THE AMERICAN MILITARY
Large numbers of influenza cases appeared in the military before they appeared in
the civilian population. The first wave of the flu hit army camps in America in March 1918.
Symptoms came on suddenly and included body aches and fever, physical weakness and
exhaustion, sneezing and a cough, and a cold in the head with inflammation of the nose and
throat.31 Other symptoms varied: sometimes there was vomiting, diarrhea or constipation.
The most dangerous occurrence was the development of pneumonia in the patient. The
influenza spread from person to person by “contact infection…through droplets driven into
the air in coughing and sneezing.”32 The second wave began in August 1918 on the East
coast and spread west. A third wave appeared in the Spring of 1919 in many states in
America.
Military doctors had early experience with the flu and learned valuable information
that could be shared with the civilian community. As a result, the government was in a
knowledgeable, potentially helpful position from the start. Lieutenant J.J. Keegan, M.D. of
the United States Navy, provided the first early warnings to civilian American doctors,
through the Journal of the American Medical Association, about the degree of contagion
and the possibility for the spread of influenza across America. Dr. Keegan was a navy
physician attached to the United States Naval Hospital in Chelsea, Massachusetts.33 He was
one of the doctors at the American battlefront for the disease. When the naval base was
31 Therapeutics: “Epidemic Influenza,” Journal of the American Medical Association 71, (Oct. 5, 1918):1136. 32 Therapeutics: “Epidemic Influenza.” Journal of the American Medical Association 71, (Oct. 5, 1918):1137. 33 J.J. Keegan, “The Prevailing Pandemic of Influenza,” Journal of the American Medical Association 71 (Sep. 28, 1918):1051.
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overwhelmed by flu cases in August and September 1918, Dr. Keegan and his colleague, Dr.
Milton J. Rosenau, took specimens from two ill sailors and “introduce[d] the filtrate of the
washings” into the nasal passages of nine volunteer sailors.34 These military men were
essentially guinea pigs, though Dr. Keegan points out that none of them became ill.35
Epidemiologists like Chester A. Darling, lauded Keegan for his observations and experiments
proclaiming that the military could study the flu “under controlled conditions.”36 Perhaps
Dr. Keegan felt the seriousness of the epidemic warranted experimenting on “willing”
military men. He did explain, after all, that the flu demonstrated a “high degree of
communicability” and expressed his concern that it would soon “spread all over the United
States.”37 He further advised that for between five and ten percent of the patients, the flu
evolved into a serious case of pneumonia that could lead to death.38 Keegan estimated that
thirty to forty percent of the American people would become sick with influenza and that
the disease would last “four to six weeks in each community.”39 Keegan appears to have
been a knowledgeable doctor with the best interests of his patients at heart. He was also
concerned about what the epidemic could do to the civilian public. He had credibility,
because of his close association with and treatment of hundreds of patients. Other doctors
and epidemiologists relied on knowledge gained from Keegan’s experience working for the
government during the epidemic.
34 Keegan, “The Prevailing Pandemic of Influenza,” 1051. Nancy K. Bristow, American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic Oxford: Oxford University Press, 2012, 33. 35 Keegan, “The Prevailing Pandemic of Influenza,” 1055. 36 Chester A. Darling, Ph.D., “The Epidemiology and Bacteriology of Influenza,” American Journal of Public Health 8, no. 10 (October 1918):754. 37 Keegan, “The Prevailing Pandemic of Influenza,” 1051. 38 Keegan, “The Prevailing Pandemic of Influenza,” 1052. 39 Keegan, “The Prevailing Pandemic of Influenza,” 1055.
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At a time when there were no known cures or sure treatments for the flu, medical
doctors in America could rely on the federal government to study the disease and to
provide vaccines. Government funds and research led to a vaccine, labeled Navy, created
from “strains of influenza bacilli” from some of Dr. Keegan’s patients.40 However, Dr. Rupert
Blue, Surgeon General of the United States Public Health Service (USPHS) and the American
Public Health Association knew that the vaccines were very unreliable in the fight against
the flu. Nancy Bristow, in her book, American Pandemic: The Lost Worlds of the 1918
Influenza Epidemic, argues that vaccines were used by state and local officials as a
“prophylaxis against fear…or…to facilitate research.41
The federal government, under the direction of Blue oversaw the fight against the
influenza epidemic in America. Blue had jurisdiction over all state health agencies. He
determined that centralization and coordination of health agencies was paramount to
keeping health resources from being completely overwhelmed by the spread of influenza in
an area. From the beginning, Blue used his position to monitor and control the flu outbreak
in America. By the middle of September, he had determined through a telegram survey
that the flu had arrived in Newport News, Virginia, New London, Connecticut, Fort Morgan,
Alabama, Boston, New York City, New Orleans and Philadelphia.42 The only one of these
cities not situated on the ocean was Philadelphia, but it had a naval yard.43 The remaining
40 Timothy Leary, M.D., “The Use of Influenza Vaccine in the Present Epidemic,” American Journal of Public Health American Journal of Public Health 8, no. 10 (October 1918):754. 41 Bristow, American Pandemic, 97. 42 “Takes Steps to Stop Influenza Spread: Surgeon General Blue Says It Can Be Controlled Only by Intelligent Action of Public,” New York Times, September 14, 1918, accessed November 8, 2016, ProQuest Historical Newspapers: The New York Times. 43 Alfred W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918 (Cambridge: Cambridge University Press 1989), 57.
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cities were harbor cities that received ships from Europe, where the illness was rampant.
Blue used the Associated Press to share a summary of ways to fight the flu, until doctors
received a “special bulletin” he had prepared on treatments.44
In 1918, doctors in most countries, including the United States, were required by law
to notify public health departments about outbreaks of certain illnesses, including smallpox,
typhoid fever, and pneumonia. Unfortunately, influenza was not one of the illnesses.45
Health statistics for Utah show that 1918 was the first year influenza cases were recorded
by state government. In that year, 43,089 cases of influenza were reported.46 The Fall 1918
pandemic led to the establishment of influenza as a reportable disease in Utah. According
to Crosby, this was the case for many states in America. Crosby further asserts that many
physicians were slow to recognize “that Spanish Influenza…was truly a dangerous disease
and should be reported with speed and accuracy.47
Early on the USPHS issued short-term policy changes and mandates to the states to
slow the spread of the illness. Blue knew it was vital to have one person in charge in each
state in the nation to lead a coordinated effort against the flu. Most states had a public
health department in 1918. The head of the public health department in each state was
appointed director and was assigned to act as liaison with the USPHS. All contacts between
states and the federal government were made through this director.48 The ultimate
44 “Takes Steps to Stop Influenza Spread,” New York Times. 45 Richard Collier, Plague of the Spanish Lady: The Influenza Pandemic of 1918-1919 (New York: Athenaeum, 1974, 46. 46 State of Utah Open Data Catalog, https://opendata.utah.gov/Health/Total-Reported-Diseases-Utah-1910-1919/j3xq-ydp7/data, accessed November 6, 2016. 47 Crosby, America’s Forgotten Pandemic, 204. 48 Crosby, America’s Forgotten Pandemic, 49-50.
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responsibility for coordinating efforts in the fight against the flu rested directly on the
shoulders of Dr. Blue for all of America and on the shoulders of Dr. Theodore Beatty in Utah.
Both men worked tirelessly to determine the most effective methods for fighting the
influenza across the nation and in Utah. Because early estimates of fatality rates were as
high as three to five percent of patients, their job was to mitigate as much as possible the
spread of the disease.49 On October 4, Blue exhorted each state health officer, by telegram,
to “close all public gathering places” once the flu arrived.50 Unfortunately, the October 4
injunction came one day before the Utah State Fair (September 28-October 5), the perfect
breeding ground for the spread of the influenza ended.
At the fortieth Utah State Fair at the end of September 1918, the war was a key focal
point. The federal government had already determined that “state fairs [were]…a distinct
part of the national defense regime.”51 The federal railroad commission, led by William
McAdoo, instituted a reduced fare between Salt Lake City and outlying areas to promote
tourist and business trips to Salt Lake City during the week.52 A fair ad in the Salt Lake
Telegram included a picture of a bald eagle at the top and at the bottom; the statement,
“Uncle Sam wants all Utahans to be there and take part in this great harvest festival.”53 An
ad in the Logan Republican showed two German sailors looking in horror through a
49 “Weapons Against Influenza,” American Journal of Public Health American Journal of Public Health 8, no. 10 (October 1918):787. 50 Crosby, America’s Forgotten Pandemic, 74. 51 “Cheap Rate Granted for Utah,” Salt Lake Tribune, August 4, 1918, accessed February 7, 2017, Utah Digital Newspapers. 52 “Cheap Rate Granted for Utah,” Salt Lake Tribune, August 4, 1918. “Dates for Tickets to Utah Fair Fixed,” Salt Lake Herald, September 5, 1918, accessed February 7, 2017, Utah Digital Newspapers. 53 “Utah State Fair Ad,” Salt Lake Telegram, August 17, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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periscope at the United States War Exhibit.54 On the first night, there was a parade followed
by a liberty loan mass meeting, to raise money for the war. Many daily opportunities were
available for the visiting public for the duration of the fair: vaudeville acts, fireworks, free
moving pictures, horse races, carnival attractions, and all kinds of domestic, agricultural and
horticultural exhibits.55 In 1917, Earl Jay Glade, secretary of the Utah state fair had
contacted the federal government seeking items for a war exhibit that would stir “patriotic
spirit.”56 As early as February 1918, the fair committee, together with Governor Bamberger,
began advertising and promoting the government exhibit, which included films showing life
in the military and the efforts of the American farmer to produce and conserve food as part
of the war effort.57 It is clear from newspaper articles and state fair ads using war and
patriotic rhetoric and images that the federal government exhibit would support it’s “one
national aim of preserving popular rule for the world.”58 City boosters like the
Manufacturers’ Association of Utah urged merchants and manufacturers to use the fair as a
means for advertising and building up business.59 During the last weeks of September and
first week of October, there does not seem to have been too much concern about the
spread of influenza in Utah.
54 “Utah State Fair Ad,” Logan Republican, October 1, 1918, accessed November 7, 2016, Utah Digital Newspapers. 55 “Utah State Fair Ad,” Salt Lake Herald, September 29, 1918. “Welcome! Multitude Surges to Utah’s Big State Fair,” Salt Lake Herald, September 29, 1918, accessed November 7, 2016, Utah Digital Newspapers. 56 “Death Dealing Implements of U. S. Asked for Fair,” Salt Lake Telegram, February 19, 1918, accessed November 7, 2016, Utah Digital Newspapers. 57 “Place is Selected for Federal Exhibit,” Salt Lake Tribune, May 21, 1918. “Big War Show to be Staged at State Fair,” Salt Lake Herald, July 27, 1918, accessed November 7, 2016, Utah Digital Newspapers. 58 “Big War Show to be Staged at State Fair,” Salt Lake Herald, July 27, 1918, accessed November 7, 2016, Utah Digital Newspapers. 59 “Utah Merchants Urged to Advertise,” Salt Lake Herald, September 14, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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The federal government could not have known that in providing full support for the
fair, it was setting the stage for the spread of disease not only in Salt Lake City, but in Utah
and surrounding states. It is ironic, that the Utah Board of Health exhibit at the fair was
titled, “How the State is Kept Healthy,” when many in the state would soon be very
unhealthy.60 Dr. Beatty was busy promoting the Utah state board of health exhibits at the
Utah State Fair. Both the state and the federal government were responsible for “keeping
the populace healthy as a war necessity.” 61 State officials urged every person who visited
the fair to pay close attention to the health messages.62
Those persons with specialized knowledge or experience became the early leaders in
the fight against the flu in Utah. Dr. Theodore B. Beatty was the Utah state health
commissioner. He had received his medical degree from Rush Medical College in Chicago,
Illinois and worked in a New York City hospital before moving to Utah in 1889 and joining
the staff at St. Mark’s Hospital in 1891. Beatty was the Salt Lake City health commissioner
from 1893 to 1894. In 1898, he became secretary to the State Board of Health. Beatty was a
forward-thinking advocate for public health in Utah. He standardized forms listing causes of
death, advocated “clean water and improved sanitation,” and established “most of the
divisions of today’s State Health Department in Utah.”63 Dr. Ralph Richards, prominent Salt
Lake City surgeon and professor of surgery at University of Utah Medical School, said, Dr.
60 “Welcome! Multitude Surges to Utah’s Big State Fair,” Salt Lake Herald, September 29, 1918, accessed November 7, 2016, Utah Digital Newspapers. 61 “Bennion Receives Key of Patriotic Exposition,” Salt Lake Herald, October 1, 1918, accessed February 7, 2017, Marriott Library Digitized Newspapers. 62 “Bennion Receives Key of Patriotic Exposition,” Salt Lake Herald, October 1, 1918. 63 W. Dee Halverson and David M. Walden, St. Mark’s Hospital, 1872-1997: A 125 Year Legacy of Quality Health Care in Utah (Salt Lake City, UT: Heritage Associates, 1997), 42-43.
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Beatty “did more for the improvement of health of the people of Utah than any other
medical man who ever practiced within the borders of the state.”64 Dr. Beatty had the
necessary credentials, but did not yet realize the fearful job that awaited him and many
other health officials across the nation. On September 27, a New York Times article
lamented the fact that health authorities had persuaded Americans that the disease would
be less extensive and dangerous, because Americans were better fed and had less “mental
strain” than war weary Europeans. The same day, Dr. Beatty, announced that the state of
Utah was free of influenza cases.65 But this statement would not be true in Utah in less than
a week. The Times article also accused health authorities of waiting too long to put
restrictive measures in place, hinting that getting American troops to Europe was a factor in
the omissions.66
The New York Times article was in fact on track. American military leaders were
concerned about outbreaks of flu in crowded army and navy training camps. On September
27, General Enoch Crowder, who oversaw the draft, announced that all draftees scheduled
to report between October 7 and 11 should not do so. General Crowder made it clear that
the reason was the influenza epidemic in military camps. He suggested that the draftees
would not be asked to report until the flu was curtailed. President Wilson met with General
Peyton March, Army Chief of Staff, on October 8 to discuss the situation. General March
64 Martin Kaufman, Stuart Galishoff, and Todd L. Savitt, eds., Joseph Carvalho, III, editorial associate, Dictionary of American Medical Biography (Westport, CT: Greenwood Press), 1984, 636. Halverson and Walden, St. Mark’s Hospital, 43. 65 “State is Free of Influenza Say Doctors,” Salt Lake Herald, September 28, 1918, accessed November 7, 2016, Utah Digital Newspapers. 66 “Topics of the Times: A Danger Too Late Realized,” New York Times, September 27, 1918, accessed November 8, 2016, ProQuest Historical Newspapers: The New York Times.
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was against slowing or stopping the movement of American troops to Europe, despite the
death tolls in camps and on ships from influenza. President Wilson agreed that American
soldiers must continue to be trained and sent to France and draftees began reporting to
duty again on October 23. Meanwhile, in Europe 70,000 U.S. troops “reported sick” in
October and a third of those suffering with influenza perished.67
67 Bollet, Plagues and Poxes, 107.
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CHAPTER III
FEDERAL AND STATE POWER
The United States federal government exercised power to minimize the spread of
the disease and the impact on soldiers when influenza began to disrupt military training and
fighting, but did they do enough? Carol Byerly, in her book, Fever of War: The Influenza
Epidemic in the U. S. Army during World War I claims that the decisions made by the
government, including ignoring advice from medical officers, led to high rates of mortality
from influenza. Army medical officers, who had been doctors in private life, worried about
the health of soldiers and asked for policy changes to keep them healthy. Medical officers
suggested ways to quell the spread of the illness, like setting up quarantine camps, reducing
crowded conditions in living spaces, and setting up initial camps where new recruits could
be screened for infection before going to training, but the government did not follow these
suggestions. The War Department had other overriding concerns. Byerly accuses the
American government of failing to protect the health of American soldiers during World
War I. She points out that 30,000 American soldiers died in training camps in the United
States before they could be shipped off to fight in Europe. The government decided the
rights of the individual in the military had to be overruled by the need to meet the greater
good.68 In President Wilson’s defense, Crosby asserts that quarantine in army training
camps was not possible because soldiers and supplies were desperately needed in Europe
and the needs of the war could not be curtailed.
68 Carol R. Byerly, Fever of War: The Influenza Epidemic in the U. S. Army during World War I (New York: New York University Press, 2005), 7-8, 41-2, 48, 53-4.
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During the second wave of the pandemic in October 1918, the United States Army
countermanded the conscription of 142,000 men and put off the enlistment of 78,000 new
recruits because of the epidemic.69 Ultimately, government leaders in the United States put
concerns for the outcome of the war before the pandemic until the situation was grave. The
First World War ended the month after the War Department began to realize the
devastating effects of minimizing the severity of the threat and not following through with
safeguards to protect soldiers.
Bollet advises that thousands of troop deaths by disease could have been averted if
the draft had been suspended and troop shipments had ceased for a time. American
military leader, General John Pershing in Europe was begging for more soldiers.70
Ultimately, President Wilson and his military leaders made decisions concerning the lives of
both prospective soldiers and established soldiers based on their perceptions about how to
win the war. Bollet suggests that perhaps the continued arrival of American troops in France
not only boosted the fighting force, but boosted the morale of the other Allied soldiers
leading to a timelier end to the war and thus saving more lives than those lost to the flu.71
Not only did the United States federal government exercise power to minimize the
spread of the disease among the military, but it also exercised power to minimize the
spread of disease among civilians. On October 11, Surgeon General Blue urged all states to
make influenza a reportable disease.72 Federal involvement ramped up as Blue called for
69 Crosby, America’s Forgotten Pandemic, 31, 49. 70 Bollet, Plagues and Poxes, 107-108. 71 Bollet, Plagues and Poxes,108. 72 “1000 Cases of Influenza Reported in Utah,” Salt Lake Tribune, October 12, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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railroad ticket agents across America to deny ticket sales to potential passengers who
exhibited flu symptoms and to remove ill patients from trains as soon as they exhibited
symptoms. Just a few days earlier, passengers on the Oregon Short Line train in Utah had
noticed a family of six with flu-like symptoms and hurriedly left the car where the family
was riding. The conductor ordered the family to remain in the car until the train arrived in
Salt Lake City late at night. The next morning the family was taken by ambulance to a
hospital.73 On October 24, the state of Nevada announced it would stop all passenger trains
at the Utah - Nevada border and quarantine any sick passengers.74 Blue was addressing
situations that were already taking place across the nation, but each state was also doing
the same to protect its citizens.
To get on top of the spreading epidemic, Blue also urged state public health boards
to contact each community in their state to determine how many doctors and nurses were
available in that community and to send help where it was needed most urgently, because
of the shortage of medical personnel.75 In Utah, many physicians and nurses joined the
United States military or the Red Cross to serve during the war. From St. Mark’s Hospital
alone, twenty doctors and forty-five nurses left to help in the war effort.76 On October 16,
Blue offered Beatty the position of “acting assistant surgeon general” which he accepted.77
73 “Doctor Dies of Influenza”, Salt Lake Telegram, October 11, 1918, accessed November 8, 2016, Utah Digital Newspapers. 74 “Health Agents Optimistic Over Influenza Drop,” Salt Lake Herald, October 24, 1918, accessed November 7, 2016, Utah Digital Newspapers. 75 “Flu Continues to Spread; 26 Homes Report Disease,” Salt Lake Tribune, October 14, 1918. “Fifty Towns in Grip of Influenza,” Salt Lake Tribune, October 13, 1918, accessed November 7, 2016, Utah Digital Newspapers. 76 Halverson and Walden, St. Mark’s Hospital, 56-57. 77 “Teachers Volunteer as Flu Nurses,” Salt Lake Telegram, October 17, 1918, accessed November 15, 2016, Utah Digital Newspapers.
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This new position was “a means of expanding [Beatty’s] powers of authority during the
epidemic.”78
By October 22, Blue required each state health director to send a wire report daily to
Washington, D.C. on the situation in his jurisdiction. In each state, cities with populations
over 1500 were required to report the number of flu cases and deaths each day to their
state health director. The government paid for these reports.79 Utah state officials followed
through on these federal mandates, but instituted their own mandates as well. Early in
October Dr. Beatty issued a statement ordering physicians to immediately report influenza
cases to his department and urging stricken victims to go to bed immediately if they felt
they had contracted the flu.80 He asked all Utah town leaders to close schools and ban
public gatherings in their towns.81 Fort Douglas, an army training camp in Salt Lake County,
was not quarantined by Washington, D.C. officials, so local authorities quarantined it for the
protection of the soldiers. If a soldier was seriously ill, only one relative could visit him.82
Beatty knew that the 1907 compiled laws of Utah, state health board statute, title 29,
allowed for the enforcement of quarantines in fighting against the spread of disease. State
attorney general, Dan B. Shields, Governor Bamberger and Secretary of State, Harden
78 “Teachers Volunteer as Flu Nurses,” Salt Lake Telegram, October 17, 1918, accessed November 15, 2016, Utah Digital Newspapers. 79 “Disease is Checked, Dr. Beatty Reports,” Salt Lake Tribune, October 22, 1918, accessed November 7, 2016, Utah Digital Newspapers. 80 “Preparing Here for Spanish Influenza,” Salt Lake Tribune, October 4, 1918, accessed November 7, 2016, Utah Digital Newspapers. 81 “State Health Board Issues a Warning that Influenza Has Appeared in this State,” Ogden Standard, October 5, 1918, accessed November 17, 2016 Utah Digital Newspapers. 82 “Scores of Influenza Patients in Utah Suffer for Lack of Nurses,” Salt Lake Telegram, October 15, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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Bennion stood firmly behind Beatty.83 The state board of health made a plea for doctors
and nurses to go to communities without medical personnel to give aid.84 Salt Lake City
Mayor W. Mont Ferry and Utah Red Cross Director Robert Shields supported Beatty by
notifying hospitals that surgeries that could be postponed for the foreseeable future should
be postponed. This would allow doctors and nurses to focus their full attention on flu
patients.85 State board of health officials began to visit industrial plants to be sure that
owners were doing all they could to protect workers, so plants could stay open to support
the war effort.86 The board of health encouraged businesses to operate with open windows
and asked large businesses to appoint one employee whose duty it was to check each
employee for signs of the disease daily.87 On October 19, Beatty announced a ban on
weddings, proclaiming that only immediate family members could attend.88 He also
declared that bride and groom and guests must wear masks and no one should kiss, as
kissing spread the flu.89 In October, Beatty considered assigning private physicians to
geographic zones to conserve resources and help the most patients in the shortest amount
of time. He realized this would be a complex undertaking and that people would be upset
83 “350 Residents of Salt Lake Flu Victims,” Salt Lake Telegram, October 10, 1918 accessed November 7, 2016, Utah Digital Newspapers. 84 “State Board of Health Issues Drastic Order Effective Immediately,” Salt Lake Telegram, October 9, 1918, accessed November 7, 2016, Utah Digital Newspapers. 85 “Red Cross Acts to Stop Spread of 'Flu' in City,” Salt Lake Herald. October 14, 1918, accessed November 17, 2016, Utah Digital Newspapers. 86 “Influenza Gets 1200 Patients in State,” Salt Lake Herald, October 12, 1918, accessed November 7, 2016, Utah Digital Newspapers. 87 “Doctor Dies of Influenza,” Salt Lake Telegram, October 11, 1918, accessed November 7, 2016, Utah Digital Newspapers. 88 “Wage War on Flu to Cut Death Rate, Urges Dr. Paul,” Salt Lake Telegram, October 18, 1918, accessed November 7, 2016, Utah Digital Newspapers. 89 “Brides Masked and 'Kissless,' Beatty Decrees,” Salt Lake Herald, October 19, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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by not having access to their family doctor.90 A solution did not come until November when
the state board of health divided Salt Lake County into five zones and assigned one resident
or assistant county physician to each zone to care for the poor victims of the flu.91
90 “Fear of Disease Prevents Care of Scores of Victims,” Salt Lake Telegram, October 21, 1918, accessed November 7, 2016, Utah Digital Newspapers. 91 “County Divided into Flu Zones,” Salt Lake Telegram, November 4, 1918, accessed November 7, 2016, Utah Digital Newspapers.
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CHAPTER IV
THE PRESS AS GOVERNMENT MESSENGER TO AMERICA
In 1918, the primary source for news for the average American was the newspaper.
William A. Thomson, advertising bureau director for the American Newspaper Publishers’
Association visited Salt Lake City in June 1918 to speak to business and newspaper men at
the Commercial Club. In his speech, Thomson declared, “the newspaper… acts as a
messenger from the government to the people.”92 Thomson claimed that newspapers were
powerful, because they “reache[d] everybody, everywhere, every day.”93 Thomson was
specifically referring to war propaganda, like promoting Liberty Loans and the Red Cross. He
mentioned that half the stories in American newspapers were devoted to the war or “war
propaganda.”94 Once the influenza epidemic arrived in full force in October, newspapers
were the source of basic and vital information about the progress of the flu, including how
officials were doing in their fight against the crisis. Local newspapers in Utah carried daily
lists of the names of the dead with their addresses and ages and sometimes the names of
the ill. This news must have been very disheartening to read day after day. Bylines like
“Twenty-Six Deaths Have Occurred in Salt Lake” and “20,000 Influenza Cases in Utah”
greeted readers each day.95
92 “Newspaper Held Great Aid to War Work,” Salt Lake Herald, June 26, 1918, accessed December 7, 2016, Utah Digital Newspapers. 93 “Newspaper Held Great Aid to War Work,” Salt Lake Herald, June 26, 1918, accessed December 7, 2016, Utah Digital Newspapers. 94 “Newspaper Held Great Aid to War Work,” Salt Lake Herald, June 26, 1918, accessed December 7, 2016, Utah Digital Newspapers. 95 “Twenty-Six Deaths Have Occurred in Salt Lake,” Ogden Standard, October 17, 1918. “20,000 Influenza Cases in Utah,” Salt Lake Telegram, October 23, 1918, accessed December 7, 2016, Utah Digital Newspapers.
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Some newspapers railed against the restrictions brought about by the entrance of
the United States into the war and the pandemic. Goodwin’s Weekly, a Salt Lake City
newspaper that called itself “A Thinking Paper for Thinking People” was one of these
papers.96 Five days following the Armistice, an article in the paper called Beatty “ridiculous”
without specifically naming him, for refusing to lift bans on churches and theatres after
thousands of citizens had poured into the streets to celebrate the end of the war
together.97 The paper further indicated that “equally reliable medical authorities to those in
Salt Lake” say that bans on gatherings are not necessary.98 The editors of the paper were
concerned that with the war’s end, freedom from social restrictions should be restored as
soon as possible.
96 Utah Digital Newspapers, accessed April 7, 2017, https://digitalnewspapers.org/newspaper/?paper=Goodwin%27s+Weekly. 97 “The Spectator,” Goodwin's Weekly, November 16, 1918, accessed April 7, 2017, Utah Digital Newspapers. 98 “The Spectator,” Goodwin's Weekly, November 16, 1918, accessed April 7, 2017, Utah Digital Newspapers.
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CHAPTER V
OPPOSITION AND THE STRUGGLE FOR CONTROL
Once the flu did arrive in Utah, anyone making unsubstantiated, unauthorized or
incorrect claims that threatened the fight to mitigate and stop the spread of influenza came
under fire from the state government, specifically Beatty. In July 1917, Dr. Woods
Hutchinson, President of the American Academy of Medicine was pronounced “famous
physician author” by the Salt Lake Tribune and “world’s foremost physician author by the
Ogden Standard.”99 In 1917 President Wilson sent Hutchinson to the European Front, where
he remained for about one and one-half years, to observe the fitness of the military medical
services. Hutchinson proclaimed that the medical profession had “practically wiped out
disease in war.”100 Perhaps this experience caused the press in Utah to give credence to his
words when he visited Utah and consulted with state officials and physicians in October
1918. While in Utah, he indicated that Utah’s exceptional climate, lack of tenement housing,
and small number of very poor residents was a best-case scenario for a shorter epidemic
with the possibility of fewer fatalities than Eastern areas of the United States.101 Almost
immediately, a “prominent [and unnamed] physician” disputed Hutchinson’s claims that an
ill patient did not need to call his doctor and that doctors and nurses could do nothing for
99 “Military Training May Free Schools of Some of Absurdities of Past,” Piute Chieftain, June 7, 1917. “Why It’s Becoming a Disgrace to Catch a Disease,” Salt Lake Tribune, July 8, 1917. “Science Explains What Happens When Your Skin Goes on Strike,” Salt Lake Tribune, October 7, 1917, accessed November 22, 2016, Utah Digital Newspapers. 100 “Wonderful Advance in the Army Medical Corps,” Ogden Standard, December 29, 1917. “Dr. Hutchinson to Be Dinner Speaker,” Salt Lake Tribune, October 1, 1918, accessed November 22, 2016, Utah Digital Newspapers. 101 “Influenza Spreads and State Authorities Call for Help in Caring for the Afflicted,” Ogden Standard, October 16, 1918, accessed November 22, 2016, Utah Digital Newspapers. Dr. Hutchinson had published such books as Preventable Diseases (1909), Exercise and Health (1911), A Handbook of Health (1911), Common Diseases (1913), Civilization and Health (1914) and The Doctor in War (1918).
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patients.102 He called Hutchinson to task for “encouraging carelessness” concerning the
disease.103 Beatty also disputed Hutchinson’s decrees, particularly that climate was an
important factor in the spread of the disease. He reiterated that the flu was spread by
contact.104 Beatty characterized Hutchinson as a “sensational newspaper writer” and not a
medical expert.105 Beatty felt so strongly that statements by Hutchinson would be injurious
to the public health that he wrote a letter to the Salt Lake Tribune on October 17
proclaiming that Hutchinson was misleading Utahans.106 In an open letter to the public
printed in the Ogden Standard, Beatty accused Hutchinson of making assertions that were
“calculated to seriously interfere with the health authorities of the state.”107 He further
asserted that members of the medical profession did not view Hutchinson as a “medical
authority.”108 If Beatty could help it, no unauthorized person would usurp his power as state
appointed public health director. Even though the press had painted Hutchinson as an
experienced and knowledgeable authority, he did not have the power of government
behind him and it was not his responsibility to keep the people of Utah healthy. That power
102 “Nurse at Dee Hospital Dies and Three Other Deaths of Same Disease Are Reported,” Ogden Standard, October 16, 1918. “Influenza is Old La Grippe, Avers Expert,” Salt Lake Herald, October 16, 1918, accessed November 22, 2016, Utah Digital Newspapers. 103 “Nurse at Dee Hospital Dies and Three Other Deaths of Same Disease Are Reported,” Ogden Standard, October 16, 1918, accessed November 22, 2016, Utah Digital Newspapers. 104 “Influenza's Hold on State Grows,” Salt Lake Telegram, October 16, 1918, accessed November 7, 2016, Utah Digital Newspapers. 105 “Influenza’s Hold on State Grows,” Salt Lake Telegram, October 16, 1918, accessed November 7, 2016, Utah Digital Newspapers. 106 T. B. Beatty, “Don't be Misled; the “Flu” is Real Menace, Dr. Beatty Declares,” Salt Lake Tribune, October 17, 1918, accessed November 22, 2016, Utah Digital Newspapers. 107 T. B. Beatty, “'Flu' Real Menace Says Dr. Beatty of Utah,” Ogden Standard, October 17, 1918, accessed November 22, 2016, Utah Digital Newspapers. 108 T. B. Beatty, “'Flu' Real Menace Says Dr. Beatty of Utah,” Ogden Standard, October 17, 191, accessed November 22, 2016, Utah Digital Newspapers.
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and authority belonged to Beatty. Hutchinson used the press to gain credibility and Beatty
used it to establish both his and his medical colleagues’ credibility and take away
Hutchinson’s. Physicians were not only duty bound to help their patients, but it was vital
that they be advised when their patients became ill so that all could be done to protect
other family and community members, particularly children.
When the state Board of Health stepped in to advise school officials to close schools,
school board officials challenged what they considered to be a hasty decision. A fight
between government officials ensued. Dr. Edward Rich, a member of the Ogden school
board of education, asserted that children could best be protected from the flu if they
arrived at school every day and could receive immediate attention from the school nurse if
they developed symptoms. As an example, he pointed to the recent smallpox epidemic. The
schools had been closed then and the smallpox had turned epidemic in a very short time.
Not only did Beatty face the opposition of board of education members, but Dr. Samuel G.
Paul, Salt Lake City health commissioner called Beatty’s school closing decree a form of
“hysteria,” claiming there is “certainly no good reason whatever for closing down the public
schools.”109 He pointed to the latest United States Public Health Bulletin sent out by
Surgeon General Blue that claimed, “The disease is too mild to make it advisable to stop all
the activities of a city.”110 Paul openly opposed Beatty. Beatty defended his action by saying
it was better to act to curtail the epidemic than to wait until it was any more widespread.111
109 “City Schools Closed After Official Advices are Received from the State Board of Health,” Ogden Standard, October 10, 1918, accessed November 17, 2016, Utah Digital Newspapers. 110 “City Schools Closed After Official Advices are Received from the State Board of Health,” Ogden Standard, October 10, 1918, accessed November 17, 2016, Utah Digital Newspapers. 111 “City Schools Closed After Official Advices are Received from the State Board of Health,” Ogden Standard, October 10, 1918, accessed November 17, 2016, Utah Digital Newspapers.
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The superintendent of the Ogden school district defied the order to close schools in
Ogden.112 Beatty continued to stand his ground by adding public libraries and public
funerals to the list of closings and bans.113
Utah State Board of Health bans were reinforced by federal authority on the very
day Beatty came under fire. Surgeon General Blue advised all state boards of health to call
on municipal authorities to enforce the ban of public gatherings and school closures where
influenza was in evidence. Utah Governor Simon Bamberger put his full support behind
Beatty in maintaining bans and closures. So now Beatty and Bamberger, with the support of
the federal government, stood against Paul and Rich. Though, Blue, Beatty, Paul and
Hutchinson were all medical doctors, they had different ideas on how to win the fight.
Ultimately, Blue and Beatty, as federal and state government leaders had the final say in
controversial decisions, because they had the power and authority of their positions behind
them.
112 “Ogden School Officials Defy Closing Order,” Ogden Standard, October 10, 1918, accessed November 17, 2016 Utah Digital Newspapers. 113 “Utah Bans All Meetings, Tries to Curb Influenza, Bars Amusement Doors,” Salt Lake Herald, October 10, 1918, accessed November 17, 2016, Utah Digital Newspapers.
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CHAPTER VI
THE POWER OF ORDINARY PEOPLE AND THE INFLUENCE OF THE MORMON CHURCH
The core beliefs of Mormons are enumerated in thirteen Articles of Faith penned by
the prophet Joseph Smith in 1842. Number twelve states, “We believe in being subject to
kings, presidents, rulers, and magistrates, in obeying, honoring, and sustaining the law.114
For devout Mormons, it is essential to obey the law of the land. Thus, it was incumbent
upon Mormons to obey bans and restrictions put in place by the state and national
government. Ordinary men and women of Utah went forward and did what they had to do
to cope and even survive during the pandemic. Important to the Mormon culture was an
ethos of communalism, a strong work ethic, and a belief in caring for one’s neighbor in
times of trouble. It is not surprising then that on October 26, Mormon President Joseph F.
Smith, together with his two counselors, asked Mormon women to take care of their own
family members who contracted the flu. This was done to allow the Red Cross nurses to
serve people not of the Mormon faith during the epidemic. The First Presidency felt that
many Mormon women were skilled and competent nurses and could take care of their ill
family members themselves. In this way, health authorities and the Red Cross could use
dwindling resources more effectively in the state.115 The statement by Mormon church
leaders is one of the few interventions by church leadership during the epidemic. Church
114 Joseph Smith, History of the Church of Jesus Christ of Latter-day Saints, vol. 4, Period I: History of Joseph Smith the Prophet (Salt Lake City, UT: Deseret Book Company, 1978), 535, 541. 115 “Influenza Mask Order Held in Abeyance,” Salt Lake Telegram, October 26, 1918, accessed November 22, 2016, Utah Digital Newspapers.
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leaders allowed government leaders to direct the fight against the flu and members of the
Church worked together to get through a challenging and difficult time.
During the Fall of 1918, Charles Hyrum Goates was a thirty-seven-year-old husband
and father of five working as the farm manager at the Utah State Industrial School in Ogden.
He was from a close Lehi, Utah Mormon family living in Ogden. Two of his brothers were
serving in the United States army when the flu arrived in Utah. On October 18, Charles’s
nine-year-old son Kenneth died of the flu. When Charles’s father, George, arrived in Ogden
to take his grandson’s body to be buried in the family plot in Lehi, he discovered Charles
was very ill with the malady. Charles died three days later, and his father and younger
brother picked up his body at the railroad station for burial in Lehi. On October 24,
grandfather George returned to Ogden to retrieve the body of Charles’s seven-year-old
daughter, Vesta. Before George reached Lehi, Elaine, Charles’s five-year-old daughter had
died. George returned to Ogden again to collect the body of Elaine. During this week when
four family members died, George and his son, Franz had not been able to finish harvesting
their beet crop – the family’s source of income. Winter had set in early and the ground was
frozen. As George and Franz set off for the fields, they knew it would be a difficult job to
wrest the beets from the frozen earth. They passed many of their neighbors driving wagon
loads of beets to the sugar beet factory. All greeted them and expressed their condolences.
Father admitted to son that he wished the harvested beets were his own. When they
arrived at the beet fields, they couldn’t believe their eyes. All the beets had been harvested.
Their neighbors had gathered together and harvested the beet crop and were delivering it
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to the factory in their behalf.116 Similar incidents happened all over Utah as ordinary citizens
like George Goates, who lost a son and three grandchildren in one week, continued to
march forward and do what they had to do, and neighbors stepped up to fill in the gaps and
help with things they could not do.117 No politics were involved, no ulterior motives, only
the power of compassion and charity.
116 Vaughn J. Featherstone, “Now Abideth Faith, Hope and Charity,” Ensign, July 1973, 36-37. 117 Family Search, accessed April 7, 2017, https://familysearch.org/tree/pedigree/K2WD-QB8/landscape.
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CHAPTER VII
STATE EXPECTATIONS OF LOCAL AUTHORITIES
During the epidemic, the state board of health expected local Utah community
officials to advise and inform the local public in the best way to avoid the flu and to put in
place restrictions and regulations mandated by the state agency. Beatty did not take lightly
any loss of life or spread of disease he felt was caused by carelessness or even recklessness.
He made it clear that he would place blame on town officials that did not follow board of
health mandates. On November 7, the state board of health, satisfied the disease had run
its course, lifted restrictions on public gatherings in the towns of Tremonton and Green
River.118 Meanwhile, in some other outlying communities, like Sego in Grand County, and
Eureka in Juab County, the crisis was heating up. Eureka, a mining town with a population of
3500, had thirty deaths in two weeks. Only about thirty percent of the miners were
reporting to work each day; some were ill, and others were caring for the ill. The high school
was turned into an emergency hospital and most of the dead in Eureka were the heads of
families.119 At the Chief Consolidated Mining Company, five shift bosses had died. On
November 6, there were over 200 cases of flu reported, thirty were expected to die, and
twenty bodies were at the undertaker.120 In Sego, a town with a population of 250, 102
people had the flu.121 The American Fuel Company was forced to close because of the
118 “Epidemic Loses Badly in Fight, only 28 Cases,” Salt Lake Herald, November 8, 1918, accessed November 22, 2016, Utah Digital Newspapers. 119 “Utah Community Scourge-Stricken,” Salt Lake Tribune, November 7, 1918, accessed November 22, 2016, Utah Digital Newspapers. 120 “Influenza Still Claims Victims,” Richfield Reaper, November 9, 1918, accessed November 22, 2016, Utah Digital Newspapers. 121 “Only 7 Cases of Influenza Are Reported,” Salt Lake Herald, November 11, 1918, accessed November 22, 2016, Utah Digital Newspapers.
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epidemic.122 Dr. Beatty contended that Eureka and Sego had not followed the
recommendations of the state board of health. Sego did not close its schools until a week
later than ordered and Eureka town residents did not take the disease seriously.123 In an
article titled “Took Hysterical Action,” published on page one of the Eureka Reporter on
October 11, editor C. E. Huish accused the Salt Lake newspapers of yellow journalism and
deliberately trying to stir up fear. He made light of people imagining themselves to be ill and
said schools and public places should not be closed.124 When town officials in Eureka were
accused of negligence by Beatty, they lashed out at him. In a letter signed by the mayor, city
marshal, city board of health and other city leaders, they denied Beatty’s claims. They
explained that they had followed every order, that the town board of health had not been
influenced by the newspaper and that the people of Eureka have cooperated in every way
to fight the epidemic. They blamed the high number of deaths on lack of nurses, denseness
of population in the mining camp, and small homes with large families.125 Beatty denied
criticizing the Eureka board of health. His denial was important, because the Eureka board
of health was an extension of his office. It was important for him to support them, while at
the same time pointing out that town residents were heedless to restrictions. He blamed
the citizens of the town who did not take the threat of the disease seriously and did not
cooperate with the town doctor, Dr. Laker. He also blamed the newspaper editor for
122 “Epidemic is Definitely on Decline,” Salt Lake Telegram, November 5, 1918, accessed November 22, 2016, Utah Digital Newspapers. 123 “Utah Community Scourge-Stricken,” Salt Lake Tribune, November 7, 1918. “Epidemic Loses Badly in Fight, only 28 Cases,” Salt Lake Herald, November 8, 1918, accessed November 22, 2016, Utah Digital Newspapers. 124 “Took Hysterical Action,” Eureka Reporter, October 11, 1918, accessed November 7, 2016, Utah Digital Newspapers. 125 “Strong Language Used in Letter from City Officers,” Salt Lake Telegram, November 9, 1918, accessed November 22, 2016, Utah Digital Newspapers.
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mocking the closing orders from the state board of health and downplaying the seriousness
of the situation.126
In early November, the reported number of new cases of the flu and of deaths
caused by the flu began to decrease. The State Board of Education began to press the State
Board of Health to reopen the schools. Beatty remarked that reopening the schools would
be “suicidal.”127 He understood that the premature ending of sanctions, like lifting the ban
on school closings could lead to a resurgence in the disease if it happened too soon. An
announcement in the Salt Lake Herald on November 6 claimed that Beatty had agreed to let
city schools reopen and bans would be lifted on November 11, because the number of
influenza cases was declining every day.128 Dr. Beatty used the Salt Lake Telegram, to deny
the claims. Robert J. Shields, Red Cross manager for the Salt Lake City chapter, came to
Beatty’s defense. He accused the Salt Lake Herald of printing “deliberate falsehoods.”129
Shields asserted that hundreds of parents had told him the schools should not be reopened
and that if they were reopened, they would not send their children. Shields also argued that
the many teachers who were acting as nurses needed a vacation before schools reopened.
Shields speculated that many cases were not being reported and that this was the reason
the epidemic seemed to be declining.130
126 “Physician Maintains His Rebuke of Editor Was Merited,” Salt Lake Telegram, November 9, 1918, accessed November 22, 2016, Utah Digital Newspapers. 127 “Schools are to Remain Closed, Epidemic Shows Slight Decrease,” Salt Lake Tribune, November 2, 1918, accessed November 22, 2016, Utah Digital Newspapers. 128 “City's Schools Will Reopen Next Monday,” Salt Lake Herald, November 6, 1918, accessed November 22, 2016, Utah Digital Newspapers. 129 “Theatres to Reopen Soon, Says Beatty,” Salt Lake Telegram, November 6, 1918, accessed November 22, 2016, Utah Digital Newspapers. 130 “Theatres to Reopen Soon, Says Beatty,” Salt Lake Telegram, November 6, 1918, accessed November 22, 2016, Utah Digital Newspapers.
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Though Beatty felt some hope from the apparent lull in flu cases and deaths, he
continued to stress constraint and adherence to safeguards during an optimistic early
November when the Salt Lake public appeared to forget that the flu was still a huge
concern. Salt Lake newspapers reported large crowds in stores in the city.131 Utahans were
optimistic that the war in Europe was coming to an end. On November 4, the Salt Lake
Telegram, quoted Beatty saying the “situation is better today than it has been at any other
time during the epidemic.”132 October had been a devastating month for influenza deaths;
there were 287 deaths reported in the state.133 This number of deaths is relatively small,
when you consider that almost 20,000 Americans died of the flu across the nation during
the same period.134 And, in fact, there was a drop in the number of influenza deaths in Utah
between November 1 and November 10, but November proved to be the deadliest month,
overall, during the eight-month time frame from September 1918 to April 1919 with 428
reported deaths statewide.135
Figure 2 shows number of deaths in Utah from influenza reported on specific dates
from August 1, 1918 to January 30, 1919. There were three reported deaths from influenza
in August and three in September. In October, the flu began to kill in earnest. On October
31, the number of reported deaths was twenty-one, clearly a peak. In early November, the
131 “Epidemic of Pneumonia is on Wane Here,” Salt Lake Herald, November 3, 1918, accessed November 7, 2016, Utah Digital Newspapers. 132 “Scourge Crisis is Passed in Utah,” Salt Lake Telegram, November 4, 1918, accessed November 22, 2016, Utah Digital Newspapers. 133 Huntsman Cancer Institute, University of Utah, accessed April 10, 2017, https://healthcare.utah.edu/huntsmancancerinstitute/research/updb/. 134 Ann Hagedorn, Savage Peace: Hope and Fear in America, 1919 (New York: Simon and Schuster, 2007), 6. 135 Huntsman Cancer Institute, University of Utah, accessed April 10, 2017, https://healthcare.utah.edu/huntsmancancerinstitute/research/updb/. See Figure 2 and Figure 3.
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number of reported deaths began to drop, until November 17 (seven deaths reported.) No
doubt the huge celebrations across the state on Armistice Day led to the resurgence of the
disease and consequently a resurgence in death rates beginning November 18. It may be
that Thanksgiving Day celebrations on November 28 also led to a resurgence of the disease
and death rates. Figure 3 indicates that November was the deadliest month for Utah,
followed by January and October.
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Figure 2. Utah Influenza Death Count by Date, Aug. 1918 – Jan. 1919, accessed April 10, 2017, https://healthcare.utah.edu/huntsmancancerinstitute/research/updb/.
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Figure 3. Utah Influenza Deaths by Month, Aug. 1918 – May 1919, accessed April 10, 2017, https://healthcare.utah.edu/huntsmancancerinstitute/research/updb/.
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CHAPTER VIII
LOCAL AUTHORITY
For the most part, local authorities in communities, both large and small, relied on
state mandates and accepted help sent from the state board of health. In 1896, the first
Utah state legislature passed legislation requiring that a board of health be created in each
county and that a county health officer be designated.136 Many communities in Utah had at
least a part-time designated health officer. Beatty relied on officials in each community to
keep him informed. On October 9, he asked officials in each community where the influenza
had struck to contact him immediately, by phone or wire, and to take steps to close schools
and places of amusement.137 He also asked physicians to report cases to city and local
health boards rather than to his department directly.138 By delegating some authority and
requiring communication on the situation in each community, Beatty kept a handle on the
situation across the state. He did not work alone; there were six other members of the State
Board of Health and the board employed sanitary inspectors.139 During the epidemic these
inspectors, among them nurses like A. H. Smith, travelled to hard hit communities to assist
in the fight against the flu.140 Beatty understood that he could not manage the epidemic in
the entire state on his own and he sought help locally.
136 Robert E. Parson, A History of Rich County. Utah Centennial County History Series (Utah State Historical Society: Rich County Commission, 1996), 282, 284. 137 “Two Victims of Influenza Dead in City,” Salt Lake Herald, October 9, 1918. “City Schools Closed After Official Advices are Received from State Board of Health,” Ogden Standard, October 10, 1918, accessed November 10, 2017, Utah Digital Newspapers. 138 “Influenza is Spreading Rapidly Here,” Salt Lake Herald, October 5, 1918, accessed November 17, 2016, Utah Digital Newspapers. 139 “Open the Town,” Goodwin's Weekly, December 7, 1918, accessed November 17, 2016, Utah Digital Newspapers. 140 “Traveling Nurse Returns,” Salt Lake Tribune, December 9, 1918, accessed November 17, 2016, Utah Digital Newspapers.
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In Salt Lake City, government officials overlooked business contracts, privacy and
personal rights to manage the spread of the disease. In October 1918, officials from the Red
Cross, Salt Lake County Medical Society, local hospitals, and the Short Line Railroad
Company met for a conference with Salt Lake City mayor, W. Mont Ferry, to make
emergency plans to handle and minimize the spread of the flu in Utah’s capital city. These
officials at the meeting asked the state board of health to “demand rigid enforcement of
federal laws” to prevent the movement of ill patients from outlying areas to Salt Lake City
by railroad to help slow the spread of disease.141 City officials were concerned that
businesses all over Utah had “contracts for medical attention in Salt Lake hospitals” and
that their ill employees would be transported to Salt Lake City on the railroads.142 Mayor
Ferry suggested he could procure city “rooming houses” for use as hospitals became
overcrowded.143
On two consecutive October days, state board of health inspectors and doctors
visited 157 homes in Salt Lake City where at least one person had the flu.144 The individual
rights of residents were intruded upon as door to door visits by city health officials to find
the ill and to supply facts and advice on how to deal with influenza in the home were
141 “Red Cross Acts to Stop Spread of 'Flu' in City,” Salt Lake Herald. October 14, 1918, accessed November 7, 2016, Utah Digital Newspapers. 142 “Red Cross Acts,” Salt Lake Herald. October 14, 1918, accessed November 17, 2016, Utah Digital Newspapers. 143 “Red Cross Acts,” Salt Lake Herald. October 14, 1918. “Flu Continues to Spread, 26 Homes Report Disease,” Salt Lake Tribune, October 14, 1918, accessed November 17, 2016, Utah Digital Newspapers. 144 “Influenza Gets 1200 Patients in State,” Salt Lake Herald, October 12, 1918, accessed November 17, 2016, Utah Digital Newspapers.
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made.145 State health officials felt justified in overstepping not only individual rights, but the
rights of businesses to stop the spread of disease.
Smaller communities like Park City and Ophir, Utah put drastic measures in place to
protect residents from the flu. Park City officials announced that any person entering town
must obtain a permit and then be examined. For the most part, Park City had managed to
escape the flu and officials wanted to keep it that way.146 Beatty voiced support for
communities with zero or few cases of influenza setting up a quarantine.147 On October 18,