American History Tellers - Encore: What We Learned from Fighting the Spanish Flu | 1

Episode Date: March 11, 2020

In light of growing concerns about the coronavirus, we’re revisiting an episode we ran last spring. One hundred years ago, the Spanish flu pandemic forever reshaped the way the United States responds to public health crises. At a time when people around the world were already dying on an unprecedented scale due to World War I, Spanish flu devastated American cities, killing more than 675,000 people in the U.S. alone. The virus had a profound effect on impact on medicine, politics, and the media, revealing deep flaws in the U.S. government’s ability to respond to such a disaster. But it would also lead to the creation of new public health institutions that still endure today, and it would help usher in a new era of global collaboration in the medical community.For more information about the coronavirus, visit the following websites: Centers for Disease Control and Prevention:https://www.cdc.gov/coronavirus/2019-ncov/index.html  World Health Organization:https://www.who.int/emergencies/diseases/novel-coronavirus-2019Support us by supporting our sponsors!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Wondery Plus subscribers can binge new seasons of American History Tellers early and ad-free right now. Join Wondery Plus in the Wondery app or on Apple Podcasts. It's January, 1918, just outside the town of Copeland in Haskell County, Kansas. A rider eases his way into town, his gloved hands tight on the reins. Even two decades into the 20th century, this place still feels like the Old West. As the rider passes the Postmaster General's house, then the dry goods store, his horse and buggy fit right in. But something's off. Though this town is small,

it shouldn't be this quiet. There's something lying thick upon the dusty, sod houses, cracked dirt roads. What's stronger than the ever-present smell of manure is the stench of fear. The rider dismounts, collects his heavy leather bag, and ties up his horse. He's a large man with a thick handlebar mustache and a no-nonsense attitude. Bag in hand, he follows the long path to the front door of the squat wooden ranch house. The fenced-in livestock nearby take no notice of him. He knocks on the front door. Plainly dressed farmer's wife answers. The man removes his hat. Good morning, Mrs. Warner. Dr. Loring, thank you for coming. He's upstairs. Dr. Loring, thank you for coming. He's upstairs.

Dr. Loring Minor is the only physician in a hundred miles. Here in the Haskell County town of Copeland, the locals respect and rely upon him. Trained at Ohio University, the oldest university in the West, Loring Minor is dedicated to his profession, and at 58 years old, he's nearly seen it all, and what he hasn't seen, he's certainly read about. Minor is accustomed to feeling prepared for any problem a patient may have, but he is not prepared for this. Minor finds Mr. Warner's husband in bed, pale, sweating, every breath a dry rasp. He turns to Mrs. Warner. How long? Almost a week now, maybe more. Dr. Minor begins his examination. The sick man stares back at him. His eyes fix on the doctor momentarily. Then he coughs. Don't try to talk,

Bill. Keep your strength. Minor takes note of the symptoms. Bill Warner's been suffering from intense headaches and body aches. He barely has the energy to move, along with a high fever and a dry cough that won't go away. Each day is worse than the last, and he's not the only one. More and more people in this town are suffering from these same symptoms. But unlike other illnesses, this one is cutting down formerly healthy and robust farm workers, some of the strongest people Milner has ever known. Mrs. Warner can see the concern in the doctor's face.

Doctor, what's happening? What's wrong with him? Minor turns to her. He makes his diagnosis. This is influenza. The worst I've ever seen. Loring Minor collects a blood sample from Bill Warner, tips his hat to Mrs. Warner, and leaves. Two days later, Mrs. Warner, Bill's wife Eva, falls ill. One week later, both Warners are dead. More and more Haskell County residents get the flu, a dozen or more every week, and one by one, they die. This flu is violent and vicious. Minor attacks it with everything he has.

Alone in his lab, long into the night, he scours medical journals. He reaches out to other Kansas doctors, but they're just as perplexed as he is, and just as fearful. Influenza has now spread to the nearby towns of Santa Fe, Sublette, and Santana. Minor is a scholar of Greek history. He wonders if this could be the return of the Plague of Athens, the illness that wiped out a third of the Greek population during the Peloponnesian Wars. In desperation, he calls the U.S. Public Health Service, but they offer no aid. What Miner doesn't know is that this mysterious plague has already spread to the nearby town of Jean.

There, local soldiers visiting home will ferry it back to Camp Funston, 300 miles away. Camp Funston is the second largest military camp in the country, home to 56,000 men in training to be sent off to Europe. The First World War has just begun. But unbeknownst to military officials, political leaders, and top scientists, so has the deadliest epidemic of the century. ways of thinking. And Audible makes it easy to be inspired and entertained as a part of your everyday routine without needing to set aside extra time. As an Audible member, you choose one title a month to keep from their ever-growing catalog. Explore themes of friendship, loss, and hope with remarkably bright creatures by Shelby Van Pelt. Find what piques your imagination. Sign up for a free 30-day Audible trial and your first audiobook is free.

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Follow Scamfluencers on the Wondery app or wherever you get your podcasts. From Wondery, I'm Lindsey Graham, and this is American History Tellers. Our history, your story. Our new series on rebellion in the early republic will start next week, but today we're revisiting an episode we ran last spring. Over the past few weeks, there has been growing concern about the novel coronavirus.

As the number of infections has climbed in the U.S. and abroad, the outbreak has drawn comparisons to another public health emergency, the Spanish flu, the worst pandemic in modern history. It's important to note that so far, today's coronavirus is much less deadly than the Spanish flu, and it's infected far fewer people. The Spanish flu first appeared in 1918, as the U.S. and other countries were already reeling from World War I, and they were unprepared for a pandemic. Though it's not known exactly how many people died, most experts estimate at least 50 million people worldwide lost their lives, with more than 675,000 people in the United States alone. Though it's largely forgotten now, the Spanish flu had a profound impact on medicine,

politics, and the media. It revealed deep flaws in the American government's handling of public health crises. It pointed to the role of misinformation in spreading the disease. And it led to the creation of new public health departments and institutions like the National Institutes of Health that endure today. Most importantly, the Spanish flu helped usher in a new era of global collaboration in the medical community. A number of brilliant men and women worked tirelessly to understand the virus, applying principles of organization and cooperation never before seen in medicine. Together, they made critical discoveries that saved lives. Global pandemics are not going away anytime soon,

but we can learn from the lessons of the past to take on the challenges of the present. It's May 18th, 1918, just over a year since the United States entered World War I. If there's one thing President Thomas Woodrow Wilson is sure of, it's this. America now faces an existential threat. As president, it is Wilson's responsibility to ensure the country he leads is victorious. He cannot afford to go down in the history books as the first American president to lose a war, leaving

American civilians subject to the tyranny of foreign powers. It is a war that must be won, no matter the cost. Inside the Oval Office, Woodrow Wilson peers at key members of his administration. He focuses a penetrating stare at each of them in turn, seeing if he can detect any hesitation or any lack of resolve. There can be no weak links, no compromise on the road to total victory. He's brought them here to make sure they understand their obligation to their nation and to him. But first, he must clear something up. Excuse me, what did you just say? Wilson glares at Secretary of State Robert Lansing. Me, sir. Yes, you. Repeat what you just told the Postmaster General so all of us can hear.

Lansing shifts uncomfortably in what is now a very hot seat. I said that by all accounts, our soldiers are acquitting themselves admirably upon the field of battle. The war so far is going well. The war is going well. I disagree. I say the war is not going well. not until it's been won by us. Is that clear? Yes, sir. I'm sorry, sir. In Wilson's opinion, the obligation to resist complacency is an obligation that falls upon every last American citizen, especially those in his cabinet, which is why he turns deliberately to his postmaster general, Albert Sidney Burleson. It isn't an army we must shape and train for war. It is a nation.

As postmaster, I want you to know that you have the right to refuse to deliver any periodical that you deem to be critical or unpatriotic of this administration. And then, Wilson makes his most important pronouncement of all. He looks at George Creel, recently appointed leader of the Committee on Public Information. Creel is a man much like Wilson, passionate, driven by conviction. He listens closely to the president. George, I need you to ensure that American citizens have the proper mindset in this time of war. Make sure your organization puts out press releases and features. I want those articles to run in every newspaper. These press releases must be positive and inspiring. Make sure no paper prints any story that could in any way possibly hurt

national morale or cause Americans to question victory, even for one second. Our soldiers are in Europe shooting bullets. It's your job to print them. Understood, sir. Everyone must know that going forward, I expect newspapers to censor themselves for the good of the country. No negative stories of any kind. Any man in the press who opposes this, I consider a friend to Germany. Creel and everyone else are well aware of exactly what Wilson is referring to. The rumblings that influenza has sickened Americans in various parts of the Midwest, even at military bases. As Wilson sees it, such negative information could compromise morale and the American will to fight. With so much at stake, even mentioning the outbreak amounts to an act of treason.

There is one man that spring, though, who has a sense of how disastrous such a policy could be. Surgeon General William Gorgas of the U.S. Army. He's an upbeat, deeply religious, and thoroughly good-natured man who has studied his army and world military history well. He knows, for instance, that throughout history, more soldiers have been killed by disease than in battle, that these diseases often migrate from the army into the civilian population. And he understands that with the largest war ever seen raging, history is in

danger of repeating itself. What Gorgas realizes, and everyone above him in rank should, is that the U.S. Army is extremely vulnerable to disease. For the first time in their lives, young men from the city are bunking with others from the country. These recruits have different disease immunities and vulnerabilities to illness, and they're being thrown together in close quarters. Gorgas fears that the American military camps could suffer from a nightmarish scenario, devastation by an epidemic. Because if an epidemic reaches an American military base, it will be nearly impossible to stop. Soldiers move rapidly

from camp to camp. A disease in one camp could arrive in the next one overnight. And so on and so on, resulting in untold devastation to the U.S. Army even before the boys can be shipped off to Europe to win the war. And if history is any indication, this would not be the extent of the damage. Any epidemic raging through military cantonments would almost certainly find its way into the civilian population and only wreak more havoc from there. Tens of thousands of people could die. Gorgas decides he must do all he can to prevent this from happening. He demands that military doctors receive training from the best scientists at the Rockefeller Institute, the premier center for medical research in the country. He stockpiles what antitoxins and vaccines he can, though none yet exist to fight influenza. He repurposes multiple

railroad cars, turning them into mobile laboratories. If a disease such as influenza does break out in a camp, one of these railroad car labs can be sent to at least aid in containing the outbreak. Gorgas is also aware of the warning voiced to his superiors by Rockefeller Institute scientists Oswald Avery, Rufus Cole, and others. It concerns pneumonia, an often deadly complication of the flu. Pneumonia seems especially likely to attack raw recruits. The experience among the small number of troops in the Mexican border where pneumonia occurred in epidemic form in 1916 should be a warning of what is likely to happen in our national army when large numbers of susceptible men are brought together during

the winter months. Gorgas is also aware that, despite the evidence and warnings, his superiors have ignored the advice. If there is a price to be paid for this, it will likely be paid by American soldiers unaware of how vulnerable they truly are. Then again, maybe the troops are safe. Though influenza recently swept through Haskell County, Kansas, it now appears to have suddenly faded away. The epidemic caught fire in various army camps, but it failed to grow into an all-consuming inferno. Maybe Gorgas has nothing to worry about after all. It's May 26, 1918. In his office at the Johns Hopkins School of Medicine in Baltimore, William Welch looks over a disturbing Army report. At 67, Welch is the American medical community's preeminent physician. He's an expert in pathology

and bacteriology, dean of the Johns Hopkins University School of Medicine, and founder of the nation's first school of public health. He spent years working to transform American health care, setting standards for the education of doctors, and prioritizing rigorous scientific investigation. When influenza first hit Haskell County, Kansas, he took note of the deaths, but didn't pursue it further. After all, measles is still killing many more Americans than the flu. The influenza outbreak appeared to simply burn

itself out. Welch and his colleagues didn't see reason to give it much thought beyond that, until they received a report of what's happening in Europe. The report in Welch's hand indicates that in Europe, there is a strain of influenza going around, much like the one that recently struck Haskell County and Camp Funston. This flu is extremely deadly when it strikes, making it much more aggressive than measles. The Army report describes a patient whose flu developed into fulminating pneumonia with wet hemorrhagic lungs.

In other words, the patient's lungs were infected and filled with blood. This pneumonia, the report added, were infected and filled with blood. This pneumonia, the report added, kills within 24 to 48 hours. When Welch reads this, he drops the report, stands, looks out the window, down onto the campus. He's never heard of people dying so quickly from pneumonia. He decides to monitor that situation even though it appears that for now, those in the U.S. are relatively safe. Time will tell if America has seen the extent of the outbreak or only the first wave. In New York City, Anna Williams is one of the top bacteriologists in the country and at 55, one of the few women in the world in that profession. On her own time, she enjoys

mentoring other up-and-coming women in the field, taking machines apart to understand how they work, driving on the wrong side of the road when traffic on her side gets too thick, and soaring through the air in small airplanes piloted by stunt flyers. Few can keep up with her, but one of those who can is her boss, William Park, chief of the laboratory division of the New York City Department of Health. Williams is his deputy. They're a great pair in the lab. Park is strictly by the book, organized and straight-laced almost to a fault.

Williams may display a thrill-seeking, impulsive streak off the clock, but when it's time to go to work, she's rigorous, disciplined, prudent, and brilliant. In 1894, while Williams was still a volunteer with the lab and Park was away on vacation, she isolated a bacterial strain of diphtheria. Her discovery led directly to mass production of an antitoxin that greatly curtailed the menace of the disease all over the world. The strain became known as Park-Williams No. 8,

and later simply Park-8. Williams was gracious about sharing the credit with her mentor, though, later stating, I am happy to have the honor of having my name thus associated with Dr. Park. One day in the spring of 1918, Williams and Park are called out to the U.S. Army's base at Camp Upton on Long Island. Upton had recently suffered a series of deadly influenza cases, and the Army doctors there have no idea

what to do. They're hoping that Williams and Park can provide answers. Per examines the sick soldiers, swabs her nasal passages and throats to take samples for later study in the lab. The two scientists are then shown to the body of a recently deceased recruit. It is here, quietly in the morgue, that Williams conducts her first flu autopsy. She finds the experience eerie. The dead man's last name is also Williams, though he's from Texas. She wonders if perhaps he's a distant relative. She takes detailed notes and wonders at, death occurring so quickly,

it left little or no marks of disease anywhere except the lungs. Park and Williams take their notes and samples and make the long drive back to their lab in silence. They're each contemplating the same thing, a reality almost too frightening to address aloud. Whatever strain of influenza killed that young man from Texas, it had better not enter the civilian population on a large scale. The country is simply not prepared.

The result would be a catastrophe. I'm Tristan Redmond, and as a journalist, I've never believed in ghosts. But when I discovered that my wife's great-grandmother was murdered in the house next door to where I grew up, I started wondering about the inexplicable things that happened in my childhood bedroom. When I tried to find out more, I discovered that someone who slept in my room after me, someone I'd never met, was visited by the ghost of a faceless woman. So I started digging into the murder in my wife's family, and I unearthed family secrets nobody could have imagined. Ghost Story won Best Documentary Podcast at the 2024 Ambees, and is a Best True Crime

Nominee at the British Podcast Awards 2024. Ghost Story is now the first ever Apple Podcast Series Essential. Each month, Apple Podcast editors spotlight one series that has captivated listeners with masterful storytelling, creative excellence, and a unique creative voice and vision. To recognize Ghost Story being chosen as the first series essential, Wondery has made it ad-free for a limited time, only on Apple Podcasts. If you haven't listened yet, head over to Apple Podcasts to hear for yourself. In a quiet suburb, a community is shattered by the death of a beloved wife and mother. But this tragic loss of life quickly turns into something even darker. Her husband had tried to hire a hitman on the dark web to kill her.

And she wasn't the only target. Because buried in the depths of the internet is The Kill List, a cache of chilling documents containing names, photos, addresses, and specific instructions for people's murders. This podcast is the true story of how I ended up in a race against time to warn those whose lives were in danger. And it turns out, convincing a total stranger someone wants them dead is not easy. Follow Kill List on the Wondery app or wherever you get your podcasts. You can listen to Kill List and more Exhibit C true crime shows like Morbid

early and ad-free right now by joining Wondery Plus. Check out Exhibit C in the Wondery app for all your true crime listening. The Camp Devon's army camp just outside Boston is home to 15,000 enlisted men. After it opens in August 1917, soldiers there, like at other camps, suffer through measles and pneumonia. The Camp Devons medical staff are among the best prepared in the country. They respond to these diseases with calm efficiency. When inspectors visit, they remark upon the excellent conditions within the camp's hospital. But in early September 1918, bad things begin to happen at Camp Devons. On September 1st,

four soldiers at Devons are diagnosed with pneumonia and taken to the hospital. On September 7th, a soldier with D Company, 42nd Infantry, is hospitalized. He is experiencing body aches so excruciating that the lightest touch to his flesh elicits a howl of pain. Despite their expertise, the Camp Devons medical staff fail to connect the dots. They believe these cases to be isolated incidents. They do not institute a quarantine policy. Meanwhile, hundreds more soldiers pour in, and with no quarantine in effect, the cases spread. Influenza has hit the base. 1,543 soldiers at Camp Devon's report ill in one day. The virus takes only 24 to 72 hours to incubate. Men who were healthy just the week before are now dead or dying of

pneumonia and other flu-related complications. The Camp Devon staff is completely overwhelmed. A September 22nd Army report put it, stated briefly, the influenza occurred as an explosion. One of Devon's doctors, Roy Grist, examines an afflicted man and is appalled and terrified by what he sees. He writes, these men start with what appears to be an ordinary attack of Le Grip or influenza, and when brought to the hospital, they very rapidly develop the most vicious type of pneumonia that has ever been seen. Two hours after admission, they have the mahogany spots over the cheekbones. A few hours later, you can begin to see the cyanosis extend from their ears and spreading all over their face. The condition Grist described, cyanosis, occurs when a person's lungs aren't able to transfer

oxygen into the blood. Without oxygen to make the blood red, a victim of cyanosis turns blue. Hours later, they die. The doctors and nurses of Camp Devons begin to die alongside the soldiers, dropping at a rate of 100 per day. Grist knows that Surgeon General William Gorgas must be informed. It appears that Gorgas' ultimate nightmare, the one he desperately tried to prevent, is now coming true. When Gorgas hears of the chaos at Camp Devons, he doesn't hesitate. He's in Europe at the front, but he contacts his deputy, who then contacts William Welch at John Hopkins and a team of other top scientists. They include Frederick Russell, Surgeon General's Deputy for Scientific Matters, Victor Vaughn, Dean of the Medical School at the University of

Michigan, and Rufus Cole, Director of Rockefeller University Hospital. The deputy's instructions are brief and urgent. You will proceed immediately to Devon's. Then in the instructions, the deputy uses a term that's been coming up more and more lately. Though the virus is striking all over the world, most governments, like that of the United States, have imposed media blackouts around negative events. The only country openly reporting on its battle against influenza is Spain. As a result, observers falsely assume the virus originated there and name it accordingly. Now, Gorgas' deputy directs the scientist to Devins with the f originated there, and name it accordingly. Now, Gorgas' deputy directs the scientist to Devins with the fateful phrase, the Spanish influenza has struck that camp.

The rain comes down hard, and it's freezing. When the four doctors arrive at Camp Devins, they head straight for the hospital. What they discover within is haunting and grim. It's utter chaos as the few remaining Army doctors sprint back and forth, the tattered stretchers they carry wet with blood. Victor Vaughn, the University of Michigan's medical school dean, covers his face to keep out the stench. Every cot is filled. Over there, look.

They're carrying in men ten at a time. They can't possibly have space for all these people. Vaughn spots a hospital worker and flags her down. Miss, miss, over here, please. The woman approaches with a traumatized look in her eyes. Did they send you? Yes. Are you the only nurse? Where are the others?

We have 200 nurses, but 70 are sick, and we're losing more every day. The men are too weak to clean themselves. There's no one to help. William Welch looks around, aghast. He can smell urine, feces, the recently deceased. These ravaged young men are in various stages of turning blue. Every last one of them is doomed. Dead bodies in every direction. Red stains smear the linens and the walls. He addresses the nurse. Miss, we must go to the morgue, please, immediately. The scientists follow the nurse as she steps over a body and leads them downstairs to the morgue.

Once inside, Welch gets to work. There are autopsies to be performed. He begins with the body of a teenager lying nearby on a cold metal table. Scaffold, please. A little more light over here, thank you. Okay. Take note of the fact that when I move this boy even slightly, there is copious fluid discharge from the nostrils.

All right, I must open the chest cavity and remove the lungs and organs. What Welch finds troubles him deeply. The boy has misshapen and fluid-filled lungs, telltale signs of aggressive pneumonia. Finally, Welch can handle no more. He pauses to close his eyes and wipe the sweat from his brow. Rufus Cole asks the question on everyone's minds. Do you have any idea what's happening here? Welch doesn't open his eyes at first. He needs a moment to simply shut all of this out. But then finally he replies, this is, this is some new kind of infection or plague. Welch dashes from the autopsy room and finds the nearest telephone.

He calls Charles Richard, the acting Army Surgeon General, while Gorgas is at the front in Europe. Welch gives a precise description of the disease and his predictions of what is going to happen next. The truth is unavoidable. This virus can be none other than an extremely destructive strain of influenza. He warns Richard it will spread, and specifically requests that immediate provisions be made in every military camp in the country for the rapid expansion of hospital space.

Richard takes action and initiates quarantine protocol. He orders medical staff to isolate all stricken soldiers from civilians. He shuts down Camp Devons. No men in or out. When Richard hears of outbreaks at other camps, he contacts the Army Chief of Staff. The deaths at Camp Devons will probably exceed 500, he writes. The experience at Camp Devons may be fairly expected to occur at other large cantonments. Then he concludes, it may be expected to travel westward. Richard recommends that soldiers no longer be transferred from camp to camp unless in urgent cases of military need. Welch and his team of scientists then turn their

attention to finding the true cause of the deadly disease and potentially a cure. But it's a daunting task. They must first isolate the strain that causes the Spanish flu, and then devise a vaccine. But it's slow, methodical work, and the clock is ticking. As Welsh predicted, the disease spreads in spite of the quarantine measures. It festers at Newport Naval Base in Rhode Island, shows up at the New Orleans Naval Hospital, and creeps into the Philadelphia Naval Yard. And it's in Philadelphia that the Spanish flu will truly make its presence known with horrific results. Dr. Wilmer Crewson is Philadelphia's Director of Public Health. Crewson regards himself as a man struggling to do his best in a dishonest system. Philadelphia in 1918 is rife with city government corruption and machine politics.

Though Crewson is not himself corrupt, he owes his job to that system. When Crewson is told that the Spanish flu is infiltrating nearby naval installations, he's asked what he intends to do about it. And Crewson's response is nothing. He refuses to believe that the virus poses a threat to the city at large, and he's mindful of President Wilson's insistence on keeping things positive under all circumstances. Crewson knows that if he tells his citizens to prepare for an epidemic, panic might result, and panic would certainly put a damper on wartime morale. In his public statements,

Crewson aims to minimize concern over the Spanish flu threat. This despite the fact that on September 17th, 14 nurses and 5 doctors at the Pennsylvania Hospital collapsed after helping to treat hundreds of sailors sick with the virus. On September 21st, the Philadelphia Board of Health finally addresses Spanish influenza, but the board is still wary of drawing attention from the Wilson administration. There can be no dire predictions, no warnings that may disquiet the public. The board admits that there may be cases of flu, and yes, some have died. However, it's easy to avoid becoming sick if one simply keeps the feet dry and the body warm. Their last piece of advice is to avoid

crowds. Avoiding crowds is going to be a problem for the city. The Liberty Loan Parade is planned for the following week. It promises to be the most extravagant parade in the city's history, an event designed to sell millions of dollars of war bonds. Thousands of people will march. Hundreds of thousands will watch. With days to go until the parade, Crewson is approached by public health experts, infectious disease specialists, and local physicians. They beg Crewson to cancel the parade, but he refuses. The city has war bonds to sell. One public health expert, Dr. Howard Anders, tries to bypass Crewson and go directly to the press. Anders warns reporters that the rally will spread the deadly flu, calling the potential parade attendees a ready-made, inflammable mass for a conflagration. But no papers print his warning.

Pressure mounts on Crewson. As director of public health, the choice of whether or not to move forward with the parade rests on his shoulders. September 28th is getting closer. Then Crewson gets what he considers to be good news. Noted virologist Paul Lewis declares that he's made progress in identifying the pathogen that causes the flu. If this is the case, then a vaccine and serum to eradicate the virus can't be far off. For Crewson, this tilts the scales. He announces that the parade and all associated rallies will proceed. He assures the public they're in no danger.

September 28, 1918 is a beautiful fall day. Soldiers, sailors, marines, Boy Scouts, women's auxiliaries, and more form a procession that stretches for miles. Hundreds of thousands of excited revelers cram shoulder to shoulder along the streets, cheering the marchers on. It's nearly evening when people finally begin to return home. The citizens of Philadelphia spread out in every direction, to every corner of the city. They have no idea what's coming. On September 30th, two days after the parade, Crewson issues a public statement. The epidemic is now present in the civilian population

and is assuming the type found in naval stations and cantonments. He doesn't mention the sudden spike of deaths or that the daily death toll from Spanish flu is exceeding the city's total average weekly death toll from all other causes, including crime, accidents, and other illness. The following day, every last bed in every single one of Philadelphia's 31 hospitals is filled. Those turned away for lack of resources go home to die. Crewson warns the public not to get frightened or panic-stricken over exaggerated reports, but that's hard to do when the city is running out of coffins. People huddle at home, forced to wrap their dead loved ones in sheets before shoving them into corners. Others simply leave their relatives in the beds where they have died, staring lifelessly at the

ceiling. The Spanish flu brings down hundreds of thousands in Philadelphia. The streets and sidewalks turn quiet. Philadelphia becomes a ghost town, dominated by a virus that spreads deadly carnage with no end in sight. Surrounded by uncertainty, terror, and death, those at the forefront of modern medicine step up their war on the virus. In order to have any hope of defeating it, they realize they must learn three things, and learn them quickly. One, the epidemiology of the flu, how it spreads.

Two, the disease's pathology, what course it takes once inside the body. Third, and most important, they must identify the microorganism that causes influenza, the pathogen itself. William Welch has been relentlessly trying to do his part to answer the three essential questions, along with Surgeon General William Gorgas, Rufus Cole of Rockefeller University Hospital, researchers William Park and Anna Williams, and many others. But Welch is on his way back to Baltimore from Camp Devons when he realizes something's wrong. He's been on the go for 18-plus hours a day for weeks, and he's pushing 70. But that doesn't explain the sudden, brutal headache, cough, and fever. Welch doesn't panic.

He's rational. He appraises himself objectively and makes the diagnosis. It's Spanish flu. Welch declines to go to the hospital. He knows how overburdened they are, how compromised the care has become. Welch does the one thing that can be done in this situation. He takes to bed and hopes for the best. He spends weeks in recovery, remarking to his nephew that the disease seemed to have localized in his intestine rather than the respiratory tract, which is fortunate for him. No pneumonia.

Welch's cohorts continue their crusade against the virus, but Welch himself is now sidelined. He will remain so for the remainder of the epidemic. Meanwhile, William Park and Anna Williams are on the front line. They refuse to compromise their lab work, though they know other scientists are resorting to sloppy practices in their desperation to find a cure. So far, all are unsuccessful. Meanwhile, Spanish flu is spreading around the globe, leaving a breathtaking toll in its wake. It kills 7% of the population in Russia and Iran, 10% of the population in Guam. In a single hospital in Delhi, India, more than 7,000 of the 13,000 people afflicted die. Yet as the flu ravages families, towns, and cities in the United States,

American newspapers and government officials are silent, or worse, spread misinformation that contradicts what scientists, soldiers, and civilians are seeing and experiencing with their own eyes. One Colonel Down plays a threat by claiming, the so-called Spanish influenza is nothing more or less than an old-fashioned grip. In other words, nothing more than a common flu. And nothing to fear. The quote is given to the Associated Press and winds up in hundreds of papers. As the tide of death continues to rise, however, certain city governments do take limited preventive measures. The state of New York

outlaws coughing or sneezing without covering the face, punishable with a $500 fine plus a year in prison. Prescott, Arizona makes it illegal to shake hands. The question is, though, can such measures be enough? Will the scientists make a breakthrough in time? Victor Vaughn of the University of Michigan is not optimistic. The latest death toll figures look grim. He meets with the Surgeon General of the Army and the head of the Army's Division of Communicable Diseases.

Vaughn tells him, if the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the Earth within a matter of a few more weeks. Dracula, the ancient vampire who terrorizes Victorian London. Blood and garlic, bats and crucifixes. Even if you haven't read the book, you think you know the story. One of the incredible things about Dracula is that not only is it this wonderful snapshot of the 19th century, but it also has so much resonance today. The vampire doesn't cast a reflection in a mirror.

So when we look in the mirror, the only thing we see is our own monstrous abilities. From the host and producer of American History Tellers and History Daily comes the new podcast, The Real History of Dracula. We'll reveal how author Bram Stoker raided ancient folklore, exploited Victorian fears around sex, science, and religion, and how even today we remain enthralled to his strange creatures of the night. You can binge all episodes of The Real History of Dracula exclusively with Wondery Plus. Join Wondery Plus and The Wondery App, Apple Podcasts, or Spotify.

This is the emergency broadcast system. A ballistic missile threat has been detected inbound to your area. Your phone buzzes and you look down to find this alert. What do you do next? Maybe you're at the grocery store. Or maybe you're with your secret lover. Or maybe you're robbing a bank. Based on the real-life false alarm that terrified Hawaii in 2018,

Incoming, a brand-new fiction podcast exclusively on Wondery Plus, follows the journey of a variety of characters as they confront the unimaginable. The missiles are coming. What am I supposed to do? Featuring incredible performances from Tracy Letts, Mary Lou Henner, Mary Elizabeth Ellis, Paul Edelstein, and many, many more, Incoming is a hilariously thrilling podcast that will leave you wondering, how would you spend your last few minutes on Earth?

You can binge Incoming exclusively and ad-free on Wondery+. Join Wondery in the Wondery app, Apple Podcasts, or Spotify. On October 30th, 1918, in a conference room at the New York Department of Health headquarters in Albany, New York, Cole, along with William Park, Paul Lewis, and Harvard scientist Milton Rosenau, meet to discuss the flu. William Welch is still home recovering. The damage from the flu has been monumental, but it seems like the worst days have passed. The death toll has slowed. Still, there are more questions than answers, especially for the country's scientists. The group gathered here today are not accustomed to being this clueless. All are desperate to explain how things could have gotten to this point. They take seats around a long wooden table,

and at that very moment, Herman Biggs, New York State Commissioner of Public Health, bursts into the room. He takes a seat at the head of the table, skips greetings, skips introductions. He's angry. Gentlemen, you were here today for the first meeting of my influenza commission. Yes, the Spanish flu epidemic has faded in the East, but there has never been anything which compares with it in importance, in which we were so helpless. The damage this virus was allowed to do is a serious reflection upon public health administration and medical science. Virologist Paul Lewis speaks up. With all respect, we did our very best.

You personally all but promised a vaccine, one that never came. But if I had more time, sir. More time? You saw this epidemic coming, all of you. You had months to prepare. You didn't do enough. Everything that we know about Spanish flu now, or six months from now, we should have known before the pestilence spread.

But are we even 100% certain it was influenza? I was told by a Navy scientist that the disease had a number of symptoms in common with bubonic plague. Plague? Mr. Rosenau here was telling me just the other day he had no doubt it was influenza. Well, can he prove that? Mr. Biggs, it's imperative that we- Enough! There's not proof on either side. Clearly, you can't come to consensus on what the disease is,

or its pathogen. If you could, you would have by now. Let's move on. We must plot a course forward. In the months ahead, I suggest you work to identify the source and cause of the disease, the epidemiology. Be vigilant in your laboratories and follow up on any promising clues. The men look at each other quietly, and each one nods. They may have been lucky this time, but this may not be over. If it returns, what can we do? The world is counting on us. The second and deadliest wave of Spanish influenza finally comes to an end in late October, following an especially grim week in Philadelphia, when nearly 4,600 people die of the disease.

But just 10 days later, new infections have dropped so steeply that the city lifts its order demanding that all public places close their doors. The virus has mutated into a less deadly form. It appears humanity will be spared. Then again, the virus has infected so many people, it's simply run out of new people to infect, like a wildfire that extinguishes itself after running out of trees. With infections on the wane, those in laboratories analyze the data the best they can. They study samples, peer through microscopes, and compare notes with other doctors throughout the world. Chief Army Investigator George Soper pours over

reports and talks to medical officers at the various military bases across the United States. He confirms that the only effective response to the epidemic has been total containment. When camps were able to isolate victims, the damage was limited. When they didn't, or did so haphazardly, sickness and death followed. Soper also discovers that nothing else has worked against the virus. The only thing human beings have been able to do is wait for it to mutate and hope the mutation lessens the virus's potency. This is why the cities most devastated by the virus have tended to be those that saw the virus first, like the cities in the East and South.

The West Side of the country and Middle America, where the virus spread late in its second wave, were hit less brutally. But if the only thing that appears to stave off the devastation is isolation, the country is left with not much to fight it, and they need another remedy, fast. Two weeks later, on November 11, 1918, World War I ends. It appears the threat of Spanish flu has ended as well, and as a result, emergency councils and health boards across the country allow schools, theaters, and churches to reopen. People are no longer afraid to go outside. There's no need for the newspapers to lie.

The grind of war and threat of disease have left their mark, but the worst appears to be over. Survivors of the Great War and the Spanish Influenza breathe a sigh of relief. But then the third wave begins. Cities hurt badly by the second wave survive largely unscathed by this latest mutation. But it's a different story for cities that were less exposed to the second wave, like San Francisco. The citizens there have felt safe. They haven't suffered like Philadelphia or New York, but this makes them all the more vulnerable. San Francisco is slammed towards the end of 1918 in ways no one

could have possibly predicted. City officials promote the use of face masks and medicine, believing that an organized response will keep casualties low, but their preventative measures are useless. The final death rates in San Francisco are the worst of any West Coast city. The third wave also hits communities in Iowa, Kentucky, and Michigan. St. Louis scrambles to contain 1,700 new cases in three days. Phoenix sets new records for the number of people stricken. Officials wonder when and, an end will come.

In February 1919, President Woodrow Wilson is in Paris, hashing out post-war peace terms. He is joined by Georges Clemenceau, the French premier, and Lloyd George, Prime Minister of Great Britain. Wilson recognizes that with the defeat of Germany and the devastation of France and Britain, he's now the most powerful politician in the world. He wishes to wield this power sensibly. He believes the best plan to securing lasting peace and America's new prominent status is to ensure the losing side isn't humiliated by the winners. He calls this peace without victory. But the leaders of France and Great Britain,

still reeling from German destruction to their homelands, are in no mood to hear about it. Wilson argues with Clemenceau and George at the top of his voice, non-stop for days. The three men and their translators go back and forth. Clemenceau calls Wilson pro-German. Wilson calls Clemenceau damnable. The bickering continues, but Wilson doesn't care how long it takes. He's not going to give in. Then on Thursday, April 3rd, at 6 p.m., Wilson begins coughing uncontrollably. He's coughing so hard he can barely breathe. His physician, Kerry Grayson, is on hand and fears an assassination attempt has been made. But this is no assassination attempt.

The coughing is followed by more symptoms, familiar symptoms. Grayson makes sure the president is confined to his quarters and stays in bed. Then he makes his diagnosis. President Wilson has influenza. He can barely move for the next several days, but insists on returning to the negotiating table after regaining a modicum of strength on April 8th. Only the negotiating table must be brought to him, for Wilson is still confined to his sickbed. The discussion is just as arduous as before, only something is different. Wilson is different. He feels run down and tired. In the evening, he can hardly recall the details of meetings he participated in just that afternoon.

He begins to capitulate to George Clemenceau on every last point. He appears nervous, spiritually broken. Grayson hides his flu diagnosis from the public, announcing that the president merely has a cold. But privately, he fears lasting harm from the sudden and severe illness, confiding that these are terrible days for the president physically and otherwise. The illness cripples Wilson's resolve and mind at a critical time. The deal Wilson finally agrees to is a reversal of his previous points. It forces Germany to agree to harsh terms, including admitting full blame for the war, giving up land, and paying staggeringly high reparations.

The deal forever puts Wilson's dream of a League of Nations and a new peaceful international order in jeopardy. A second global conflict, provoked by German aggression, will come. But in April of 1919, there's no way to know that. For now, France, England, and America have won the war, and the third wave of Spanish influenza is now finally, blessedly, over. Back in New York City, a breakthrough occurs. Anna Williams continues to analyze the virus with William Park.

They are after the holy grail, a vaccine and serum that can counter the effects of Spanish influenza. They study the B. influenzae bacterium, also known as influenza bacillus. It's widely believed to be the bacterium responsible for Spanish flu. But their research leads them to a different conclusion. In a statement to The World, they declare that the evidence of multiple bacteria strains seems to be absolutely against influenza bacillus being the cause of the pandemic. Instead, they continue,

The influenza bacilli, like the streptococci and pneumococci, are in all probability merely very important secondary invaders. The discovery comes like a thunderbolt to the scientific community. It undermines the dominant thought of the day about what caused the deadly pandemic and makes the hunt for a cure even more elusive. Anna Williams, after a long and difficult night in the lab, opens her journal. She writes, More and more, evidence points to a filterable virus being the cause.

This is a meaningful discovery, because if Spanish influenza is caused by a virus, a vaccine created to beat a bacteria-caused influenza would be doomed to fail. Scientists must find some other path to a remedy. By 1920, the modern world is a changed and new place. There is a wariness about the future following the combined effects of World War I and the Spanish flu outbreak. The war resulted in 37 million deaths. No one is exactly sure how many people were carried away by the Spanish flu. 50, maybe even 100 million people, 5% of the world's population. At least 675,000 Americans died of the flu out of a population of 105 million. The pandemic of 1918 leaves a legacy of death, but it also opens the door to further modernization

and growth within healthcare and science. It is the first pandemic in which there is global communication between nations. Scientists are able to share insights with each other almost in real time. These scientists build upon each other's successes and failures. New efforts are made to set up systems for international cooperation in matters of health. Domestically, new protocols are established, so devastation on the scale of the Spanish influenza can never happen again. The New Mexico Department of Health is created. Philadelphia rewrites its city charter to overhaul its public health department.

Emergency hospitals constructed to treat flu victims become permanent. And Senator Joe Ransdell establishes the National Institutes of Health. The study of influenza also leads directly to the monumental discovery of DNA's purpose. Oswald Avery, studying the bacteria that causes pneumonia, often a deadly complication of flu at the time, realizes that DNA carries genetic information. Scientists have been aware of the existence of DNA since the 1860s, but it isn't until Avery's experiments with pneumonia's pathogen pneumococcus that they understand why it's important. Out of tragedy emerges a path to the future.

The influenza crisis challenges global society in ways that it has never been challenged before. The global response to Spanish flu, though imperfect, forces scientists and government officials to learn hard lessons and begin preparations for outbreaks to come. They will use the experience to fight the next threat, the next mystery to threaten global health. Next on American History Tellers, in the 1780s, the dust had barely settled on the American Revolution when new turmoil put the country's hard-won independence to the test. It was a world ablaze with class revolt, racial conflict, and rebellion in the early republic. From Wondery, this is American History Tellers. I hope you enjoyed this episode. If you did, I have two other podcasts you might like, American Scandal and American Election's Wicked Game. Search for them and subscribe wherever

you're listening to this right now. If you're listening on a smartphone, tap or swipe over the cover art of this podcast. You'll find the episode notes, including some details you may have missed. You'll also find some offers from our sponsors. By supporting them, you help us offer this show to you for free. And if you do like this show, one of the best ways to show your appreciation is to give us a five-star rating and leave a review. I always love to know your thoughts, and reviews are one of the best ways for others to find the show. Tell your friends and family and show them how to subscribe. You can also find us and me on Twitter and Facebook. Follow the show at A.H. Tellers, and I'm at Lindsey A. Graham, and thank you. If you'd like to learn more about the Spanish influenza,

we recommend The Great Influenza, the story of the deadliest pandemic in history by John M. Barrie. And in the show notes is more information about protecting yourself from today's coronavirus. American History Tellers is hosted, edited, and produced by me, Lindsey Graham, for Airship, sound designed by Derek Behrens. This episode is written by Hannibal Diaz, edited by Dorian Marina. Our executive producers are Jenny Lauer Beckman and Marshall Louis. Created by Hernán López for Wondery. If you like American History Tellers, you can binge all episodes early and ad-free right now by joining Wondery Plus in the Wondery app or on Apple Podcasts.

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