The tragedy played out with varying degrees of severity across the country. The city of San Francisco, where the flu hit hardest in late October, mandated that gauze masks be worn in public at all times. The mandate was widely followed, though in reality, masks did little to prevent the spread of flu. They were also uncomfortable and inconvenient, and the public would not tolerate them for long. Even officials showed a less than vigilant attitude when the mayor, a city supervisor, a Superior Court judge, a congressman and a rear admiral were photographed at a prizefight sans their protective masks. And there were those who claimed the act was an unconstitutional attack on personal freedom:If the Board of Health can force people to wear masks, said the San Francisco Chronicle,then it can force them to submit to inoculations, or any experiment or indignity.

Doctors searched desperately for a cure, or at least a stop-gap measure. But they were on the wrong track. Conventional wisdom held that the flu was caused by bacteria; vaccines to fight bacterial infections, however, had no effect on the disease. (Flu was not identified as a virus until 1933.) The epidemic was a crushing blow to medical science, which had only recently come to be seen as a professional discipline.

Government agencies fared no better. Surgeon General Rupert Blue, head of the U.S. Public Health Service, was aware that an outbreak of flu was possible. But in July 1918, he denied a request for $10,000 to be dedicated to pneumonia research, and he made no other preparations. Blue’s first public warning came in mid-September and included such tips asAvoid tight clothes, tight shoes, tight gloves — seek to make nature your ally not your prisoner andHelp by choosing and chewing your food well. Congress appropriated $1 million in emergency funding for USPHS; Blue eventually returned $115,000 to the government.

Worse still, the government contributed to the national paranoia surrounding all things German. The USPHS officer for northeastern Mississippi planted stories in the local papers thatthe Hun resorts to unwanted murder of innocent noncombatants….He has [at]tempted to spread sickness and death thru germs, and has done so in authenticated cases. Lieutenant Colonel Philip Doane, head of the Health and Sanitation Section of the Emergency Fleet Corporation, which oversaw U.S. shipyards, theorized that U-boats had delivered German spies to Americato turn loose Spanish influenza germs in a theatre or some other place where large numbers of persons are assembled. So persistent was the belief that Germany had somehow launched a biological attack that USPHS laboratories devoted precious time to investigating claims that Bayer aspirin, which was manufactured in the States under a German-held patent, had been laced with deadly flu germs.

“Let the curse be called the German plague, declared The New York Times in October.Let every child learn to associate what is accursed with the word German not in the spirit of hate but in the spirit of contempt born of the hateful truth which Germany has proved herself to be.

Over There
The death toll mounted at home through September and October even as President Woodrow Wilson was faced with General Pershing’s demands for more soldiers. Through the summer, Americans were being sent to Europe at the rate of 250,000 a month. But flu was running rampant on troopships, and those who survived the interminable voyage simply spread the disease to frontline staging areas. Wilson was urged by several advisers not to dispatch additional troops until the epidemic had been contained. The president consulted with his chief of staff General Peyton March, who conceded that conditions on the overseas transports were hardly ideal. He would not, however, concede anything that might stand in the way of winning the war.Every such soldier who has died [on a troopship], said March,just as surely played his part as his comrade who died in France. Wilson relented. The transports continued.

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