Campus Under Quarantine

In the fall of 1918, Mount Holyoke endured the deadliest flu outbreak the world had ever seen

1918 Flu at Mount Holyoke

In the weeks before students flocked to campus in the fall of 1918, a deadly strain of influenza reached the shores of Boston with a group of sailors who were docked at the Commonwealth Pier. The College opened its gates to students on September 20, and within three days, ten cases of the flu were reported. Over the next week the number of new cases reported climbed each day. Students complained of sudden high fevers, muscle and joint aches, and chills. Some developed pneumonia. The disease was highly contagious. On September 24, there were thirty-three new cases of the flu on campus. Two days later, there were thirty-one more. Over the course of just a few weeks, more than a quarter of the College’s entire student body of 864 were sickened by the worst influenza outbreak the world had ever seen. The epidemic on campus affected everything from living arrangements to student activities to beloved college traditions.

The influenza pandemic of 1918, commonly known as the Spanish Flu, ultimately resulted in death for as much as 5 percent of the world’s population, with estimates ranging from 20 million to 100 million victims in a period of less than two years. While the exact number is difficult to know for certain, experts say that more people died in the 1918 influenza epidemic than died of the bubonic plague or in World War II. One in four people was infected with Spanish Flu and, unlike with most flus that came before and after, the virus struck young adults aggressively, putting college-aged students and young faculty at particular risk. Almost half of all the influenza-related deaths in the outbreak of 1918 occurred in people between the ages of twenty and forty; as many as 8 to 10 percent of all young adults living at the time were killed by the virus.

1918-Flu-strain

Adding Sick Wards

The flu in South Hadley resulted in fewer deaths than in other communities across the country, perhaps in part due to the town’s relative geographic isolation. Still, in the first days of the semester, it became apparent that the Everett House infirmary, which was located on the site where the current Reese Psychology and Education building stands, would not be able to hold the rapidly growing population of sick students. Dr. Hooker’s House, located on Park Street, opened as an infirmary on September 25, adding forty more patient beds. At the time, the house was used as faculty housing and was known as Dr. Hooker’s House because it was built for Mount Holyoke botany professor Henrietta Hooker, class of 1873.

Adding a second infirmary was not enough. New reports of influenza among students and faculty emerged so quickly that Brigham Hall, at the time a residence for both students and faculty, was quickly converted into a third emergency hospital. The healthy residents of Brigham were moved to other dorms, and five nurses attended to the steady stream of sick patients. In the Health Services Annual Report for 1918 a nurse wrote, “The Superintendent of Residence Halls worked early and late in the most efficient fashion, ordering many new supplies, and doing the thousand and one things incident to preparing these houses for hospitals.”

The College’s quick reaction to the epidemic, isolating ill patients and quarantining those who may have been exposed, contained the outbreak, which could have devastated the community if left unchecked. Though College records put the total number of reported cases of influenza on campus at 219, many students were not formally treated because there was no room for them in the campus infirmaries. All sick students, even those with a mere hint of a cough or a slightly stuffy nose, were discouraged from attending class. “All classes are about halved by this epidemic,” wrote physics professor Mildred Allen in a letter to her mother. A student from the class of 1920 explained the half-filled classrooms in an October issue of the Mount Holyoke News: “It is almost a habit. Classes seem incidental. If we awake in the morning, feeling unusually sleepy, we decide to stay in bed—at least some people do. We excuse ourselves and the truth is not in us.”

» Read More: Q&A with Miriam Aschkenasy ’94, deputy director for global disaster response at Massachusetts General Hospital
Miriam-Aschkenasy-'94

Photo by Leslie Jones Smyrl ’01

Miriam Aschkenasy ’94 is the deputy director for global disaster response at Massachusetts General Hospital’s Center for Global Health. When she isn’t involved in daily management duties like planning and teaching, she leads teams in disaster response—including a twenty-two-day deployment to the Philippines after Typhoon Haiyan in 2013—and continues her own clinical work as an emergency department physician.

Aschkenasy has worked with several international organizations, including Oxfam America and the World Health Organization, and has run field hospitals during acute crises and responded to cholera outbreaks in Zimbabwe and Ethiopia.

She holds a medical degree from Tel Aviv University Sackler School of Medicine and a master’s in public health from Harvard School of Public Health.

The Quarterly spoke with Aschkenasy about the 1918 flu virus and the flu today.

Alumnae Quarterly: The flu of 1918 killed an estimated 30 million to 50 million people worldwide, with some estimates even higher. Why was this flu so deadly?

Miriam Aschkenasy: Every year the influenza virus mutates. In 1918 the virus changed dramatically, forming a new subtype of the flu that had not been seen before. When a shift like that happens the body doesn’t recognize past immunity to flu, the virus quickly spreads, and we see higher rates of complications and death.

In 1918, nobody knew what caused the flu. In fact, it wasn’t until the 1930s that influenza was determined to be a virus. Not understanding the cause prohibited the development of effective prevention and treatments and contributed to the pandemic’s toll.

AQ: What else medically contributed to the deadliness of the disease?

MA: While influenza is a virus, many people who get the flu also develop bacterial pneumonia, which may set in as a result of the virus weakening the lungs. Today we can treat pneumonia with antibiotics. In 1918 that wasn’t an option. This flu also spread faster than communication did at the time. And the pandemic happened during World War I, with masses of people moving around the world and living close together.

AQ: We’ve had pandemic flu in 1957, 1968, and, most recently, in 2009 with H1N1—or swine—flu, which had similarities to the 1918 virus. The death toll from the 2009 pandemic is estimated to be as high as 575,000, still considerably lower than in 1918. Is this indicative of our ability to cope with the flu now?

MA: We’re due for another pandemic flu, but we’re also more prepared to deal with it than people were in 1918. We understand the cause of the flu and how it spreads, our data collection and communication are better now, and we can build a vaccine that stops the flu or at least slows it.

That the 2009 H1N1 pandemic wasn’t so deadly was a bit of luck and a lot of preparation and good policy. During the outbreak we learned what works and where things can be done better. We know we need to be able to produce vaccine more quickly. And we need to continue to make improvements to preparedness plans for pandemic flu, because we will see it again.

AQ: So you’ve talked about being prepared for pandemic flu. What about seasonal flu?

MA: There are lots of viruses we get during “flu season,” but they aren’t all influenza. With the flu you get very high temperatures and body aches, and you are weak and drained for quite a while after. I tell people, if it wasn’t that bad, it wasn’t influenza.

The seasonal flu still kills with annual death rates ranging from 3,000 to 49,000 in the United States and from 250,000 to 500,000 worldwide. It’s a serious threat, especially to the elderly, the very young, and people with respiratory diseases.

AQ: What should people do to keep from getting the flu?

MA: Get a flu shot. I get my flu shot every year; my kids do, too. Even when it’s not 100 percent effective—and it isn’t always because scientists can’t know the exact strain they are manufacturing the vaccine for each year—you still get protection from seasonal flu.

AQ: In 1918, quarantine was used in an effort to contain the flu. Is this an appropriate response?

MA: It was one of the first widespread quarantines. In 1918, one town [Gunnison, Colorado] shut itself off from people coming in—closing off roads and not letting people off of trains—and they had no flu cases. Since flu is an aerosolized disease (one spread by tiny airborne particles) that can be transmitted before symptoms are clear, quarantine and isolating sick patients does make a difference in a pandemic.

AQ: As we speak, there isn’t much in the news about flu, but there is a lot about Ebola. Can you compare these two diseases and the American public’s risks of contracting them?

MA: Ebola is spread through exposure to body fluids, so you need much closer contact to be at risk of contracting Ebola. The flu is contagious before people show symptoms of being ill, so there is a much greater risk of exposure and infection. People ask me how they can be safe from Ebola. But Ebola is not a risk for Americans (and people living in the Northern Hemisphere in general) unless they are traveling and working in West Africa. Flu is a real risk. And I always recommend that people get a flu shot.

—By Sara Barry ’94
Sara Barry ’94 is a freelance writer in Western Massachusetts.

Mountain Day came and the few of us who had not been laid low by the ‘flu’ tramped about while the rest of us, wrapped up in steamer rugs, sat around lackadaisically on back porches with an emaciated, let-me-die look.
Llamarada, class of 1921

Taking it Easy

Faculty understood that attendance would be sparse, but unlike at the surrounding colleges—Smith, Amherst, and UMass—they voted not to cancel classes at Mount Holyoke. At a meeting on October 1, a member of the faculty said, “It would be better to go on with the daily routine with the understanding that the momentum would be less.”

All other student gatherings at the College, including Sunday chapel and daily chapel exercises were canceled until mid-October. President Mary Woolley, about halfway through her tenure as leader of the College, asked the students to use the chapel period “as a time for walks in the open” to ward off the flu. She insisted that “the day, while spent in the open, should not be used as a general picnic day, but should be observed in a quiet and reverent manner,” according to an October 1918 Springfield Republican article titled “God’s Out of Doors.”

Despite the quarantine, the College still held Mountain Day on September 30. In their Llamarada yearbook, members of the class of 1921 recounted, “Mountain Day came and the few of us who had not been laid low by the ‘flu’ tramped about while the rest of us, wrapped up in steamer rugs, sat around lackadaisically on back porches with an emaciated, let-me-die look.”

Because so many students were too ill to climb the mountain in September, a faculty member put forth a motion at a faculty meeting a few weeks later to hold a second Mountain Day. The motion passed, and it was decided that October 17 “be called a holiday and not mountain day in order to eliminate some risk of students taking too-long walks.”

Containing the Threat

1918 Flu graph

Click to enlarge graph.

The College’s efforts to contain the campus outbreak were quite successful. There had been no new cases reported on campus since the first week in October. And by mid-October the Everett House was, once again, the only infirmary on campus. “Nearly all the girls are back in classes again,” wrote Evelyn Eaton, class of 1919, in an October 13 letter to her mother. “We feel that so far as the immediate college is concerned that we are out of the woods,” Mildred Allen wrote to her mother the same day.

Though vitality had largely been restored, the campus was still under strict quarantine. A notice from the dean’s office, read at lunch on October 22, urged, “Students are not to leave town nor to eat in public places in town. The permission to use the Amherst Trolley was for Mountain Day only.” And, “Friends of students are not to visit or call at the College.” Even the trustees weren’t permitted to come to campus that fall for their annual meeting, and Founder’s Day festivities were reported to be lackluster.

By early November restrictions had been loosened. In a letter dated November 7, Allen noted that students could now have visitors to campus. The following evening, it was arranged for students to go into Holyoke to see the New York Philharmonic. And on November 12, 1918, a day after World War I had officially ended, Mount Holyoke students participated in the city of Holyoke’s armistice parade. The campus quarantine was officially lifted the following day on November 13. Still, the faculty was wary of a second outbreak—as had happened at nearby Amherst College—and students were encouraged not to go home for Thanksgiving if there was “no special reason they should go.”

Remembering the Victims

In South Hadley, the epidemic had not cursed the campus as it had ravaged the rest of the world, where mail piled up at post offices and garbage piled up in the streets because sick workers couldn’t come to work. But even the Field Memorial Gate could not entirely shield Mount Holyoke from the tragic reaches of the global outbreak that wiped out entire families.

“Almost every day we hear of a death of some alumna,” wrote Mildred Allen, “that in spite of the good condition here we realize the seriousness of the whole situation.” Mount Holyoke had survived the flu with one death, a first-year student from southeastern Pennsylvania named Elizabeth M. Smith, class of 1922. A memoriam for Smith was included in the winter issue of the Alumnae Quarterly. “The sadness of her death was very real,” wrote Ethel Barbara Dietrich, professor of economics and sociology, “because we could understand those freshman hopes, because we know something of what her loss means to her father and mother, and because we felt that in her death from influenza and pneumonia Mount Holyoke was paying one of the sacrifices of the war.”

—By Olivia Lammel ’14

Olivia Lammel ’14 is a former editorial assistant at the Alumnae Quarterly and an aspiring writer.
This article appeared in the winter 2015 issue of the Alumnae Quarterly.

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