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As a new strain of coronavirus (COVID-19) swept through the world in 2020, preparedness plans, masking policies and more public policy changed just as quickly. WVXU has covered the pandemic's impact on the Tri-State from the very beginning, when on March 3, 2020, Ohio Gov. Mike DeWine barred spectators from attending the Arnold Sports Festival in Columbus over concerns about the virus, even though Ohio had yet to confirm a single case of COVID-19.

What it was like to live in Cincinnati during the 1918 flu pandemic

 An example of how beds were set up during the 1918 influenza epidemic from the interior of a Red Cross House at U.S. General Hospital #16, in New Haven, Conn.
Library of Congress
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An example of how beds were set up during the 1918 influenza epidemic from the interior of a Red Cross House at U.S. General Hospital #16, in New Haven, Conn.

The manager of reference and research at the Cincinnati History Library and Archives says in September 1918, the Enquirer reported the flu was showing up in Boston. Jill Beitz says just days later, the first local cases appeared.

"By October 3, they barred hospital visitors and asked people to stay home and away from movie theaters and things, but there was no cause for alarm."

A week later there were between 4-5,000 cases in the city, and the north wing of Music Hall was turned into a hospital ward.

"The health commissioner — William Peters at the time — said that the closures had saved lives and so the epidemic would be over in 10 days," she says. "But a few days later, the cases were at the highest level. Peters attributed this to burning leaves in the basin because it polluted the air."

A few weeks later, Dr. Peters came down with the flu. Beitz says his replacement issued a mask mandate not only for nurses, but for barbers and hotel workers.

She says just like with COVID restrictions, there was resistance to anti-flu measures.

"They couldn't close the restaurants at the time, or saloons, because a lot of people lived in boarding houses and needed to eat their meals out. So they did make a rule that if you were a saloon or bar you couldn't serve inside, you just had to give them their beer bottles and send them on their way."

Beitz says a lot of bars ignored the rule, until police started checking up on them. Restrictions continued until case numbers dropped.

"By November 11, Mayor (John) Galvin declared the public was tired of hearing about it and he lifted all of the restrictions. The kids all went back to school, cases among the children spiked and by Thanksgiving more than 50% of cases were kids 3 to 14 (years old)."

Schools, including the University of Cincinnati, were technically open, but many shut down because so many students were absent. Beitz says soon children were banned from public places, and their parents were threatened with misdemeanor charges if kids were caught out.

The Cincinnati Fire Department was particularly hard hit by the pandemic. Two companies were abandoned, and civilians had to step in. Beitz says the number of firefighters who came down with the flu overwhelmed General Hospital, and overflow patients were sent to the county infirmary.

Restrictions returned until December when cases dropped again.

"It kind of fizzled out in the beginning of 1919, which it did worldwide. When it was all said and done, the 1918 death rate in Cincinnati was 25% higher than the two preceding years. And 64% of those deaths were people in their prime."

The flu didn't skip Northern Kentucky. Krysta Wilham wrote an article in 2016 in the Northern Kentucky Tribune highlighting the spread of the disease and the reaction. After the first deaths in late September 1918, doctors, hospitals and health officials were ordered to report new cases, how many people were hospitalized, how many hospital beds were open, and what buildings could be used as make-shift hospitals.

Public funerals and open casket viewing were prohibited for flu victims. Covington's Board of Health ordered fumigation for streetcars and theaters. Kenton County streets had to be flushed or oiled clean. Citizens were advised to wear masks across the region, as schools, theaters, and churches closed. Children under 18, and military personnel were banned from riding the streetcars.

By the end of 1918, around 8,000 people had died from the flu across Kentucky. Wilham's research says the number of new cases started dropping in November, and stayed low until March 1919 when another wave roared through the region.

The Cincinnati area had more than 22,000 lives lost from the flu or a related ailment. They were among at least 50 million people around the world who died before herd immunity kicked in.

About two years ago, another disease reached the region, forcing closures, and claiming lives. WVXU is looking at the COVID-19 pandemic, and the short-term and long-lasting effects.

This story has been updated to correct Jill Beitz's title.