American History Tellers - Sponsored | American Epidemics - The Great Pandemic | 1

Episode Date: May 23, 2019

This episode is brought to you by Wondery in partnership with National Geographic in anticipation of their new series, The Hot Zone. The three-night limited series is inspired by true events surrounding the origins of the Ebola virus and its arrival on US soil in 1989. One hundred years ago, the Spanish flu pandemic brought American society to the breaking point and 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. As the death toll mounted, Philadelphia ran out of coffins, New York City officials outlawed uncovered sneezing and coughing, and scientists raced to find a cure. The virus would have a profound effect on impact on medicine, politics, and the media. It would reveal deep flaws in the U.S. government’s ability to respond to such a disaster. And it would help usher in a new era of global collaboration in the medical community. 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. This episode of American Epidemics is brought to you by Wondery in partnership with National Geographic. The Hot Zone, starring Julianna Margulies, premieres this Memorial Day, May 27th at 9, 8 central on National Geographic. 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. It's 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 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, Sublet, 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. From Wondery, I'm Lindsey Graham, and this is American History Tellers. Our history, your story. For the next three episodes, we're partnering with National Geographic in anticipation of their new series, The Hot Zone. The three-night limited series is inspired by true events surrounding the origins of the Ebola virus and its arrival on U.S. soil in 1989. This is episode one of our three-part series about American epidemics, The Great Pandemic. One hundred years ago, the Spanish flu pandemic claimed millions of lives on nearly every

continent. Then, as now, people weren't used to dying from the flu. Spanish flu was different. It was a particularly malevolent strain of the virus that killed victims in three distinct waves between 1918 and 1919. It claimed the lives of the very young, the very old, and everyone in between. At a time when people were already dying on an unprecedented scale due to World War I, the pandemic brought society to the breaking point. The war killed 37 million people, but Spanish flu would take the lives of more than 50 million worldwide. In the United States, at least 675,000 people died in the course of one year. But the Spanish flu is not well remembered today. Few outside the medical community are aware of its history,

but this global pandemic had profound impact on medicine, politics, and the media. It devastated the American populace. But this global pandemic had profound impact on medicine, politics, and the media. It devastated the American populace. It revealed deep flaws in the U.S. government's ability to respond to a public health crisis. And it 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, often taking great personal risks along the way. For the first time in history, nature and modern science engaged in an epic

clash, one that would challenge scientists to apply all they had learned in a race against time. With war raging, nothing less than the direction of the world was at stake. 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. 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 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

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 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, 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. Pair 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. On that spring day in 1918, Park and Williams understood that with this flu pandemic, they were facing the highest stakes either of them had ever seen.

History has a way of repeating itself. And 70 years later, in 1989, Army scientist Nancy Jacks would stare down the face of a new terror, Ebola, and its arrival on U.S. soil. This is the premise of the upcoming series, The Hot Zone. Inspired by true events and starring Golden Globe and Emmy Award winner Julianna Margulies as Lieutenant Colonel Nancy Jaxx, The Hot Zone is a dramatic, high-stakes scientific thriller with a courageous and determined heroine at its center. I've watched the show. It's tense and frightening.

We were close to catastrophe and only have the cool resolve and professionalism of Nancy Jacks, played by Margulies, to thank for preventing an outbreak of the disease into the human population by putting her life on the line. The Hot Zone, a three-night limited series,

premieres this Memorial Day, May 27th at 9, 8 central on National Geographic. Be sure to stay tuned at the end of this episode to hear a trailer for The Hot Zone. The Camp Devons 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 Devons 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 Devons, 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. Bond 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 downplays the 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. Bond 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. 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.

I personally, 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 in 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. 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 11th, 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 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 if 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, nonstop 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, Cary 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 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 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 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 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 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 time in the special series on American epidemics, a conversation with the actors and creators of The Hot Zone, a new three-night limited series from National Geographic inspired by true events surrounding the origins of Ebola and its arrival on U.S. soil in 1989. The Hot Zone premieres on May 27th at 9 p.m. Eastern, 8 p.m. Central, and stars Golden Globe and Emmy Award winner Juliana Margulies as Lieutenant Colonel Nancy Jacks. We'll speak with her about her role and why she thinks it's important to tell the stories of epidemics and the people on the front lines who fight them. From Wondery, this is American History Tellers. I hope you enjoyed this episode brought to you by National Geographic. If you did, subscribe now on Apple Podcasts, Spotify, Google Podcasts, Wondery.com, or wherever you're listening to this right now. If you're listening on a smartphone, tab 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 the best way 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 a great book we drew on for this episode, The Great Influenza, the Story of the Deadliest Pandemic in History by John M. Berry. American History Tellers is hosted, edited, and produced by me, Lindsey Graham for Airship. Sound design by Derek Behrens. This episode is written by Hannibal Diaz, edited by Dorian Marina, edited and produced by Jenny Lauer Beckman. Our executive producer is Marshall Louis, created by Hernán López for Wondery. And now, the audio trailer of The Hot Zone from National Geographic.

This is one of the deadliest places on Earth. From National Geographic. Every known virus is here. Comes a terrifying story. What are we testing for? Ebola Zaire. This is one of the deadliest places on Earth. From National Geographic. Every known virus is here. Comes a terrifying story. What are we testing for? Ebola Zaire. Inspired by true events.

It's learning. This Memorial Day. It's evolved. When Ebola landed on U.S. soil. It will wipe us out if we don't get ahead of it. They risked everything to contain it. It's here. You brought it back here?

Julianna Margulies stars in... Oh, my God. The Hot Zone. May 27th at 9 on National Geographic.