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Spanish flu: the mother of all pandemics

In the Spanish flu pandemic there were 2052 deaths in nine months in Newcastle from influenza or its complications. This compares to the 617 Covid-19 related deaths we have experienced up until the end of 2021.

John Matthews by John Matthews
24-05-2022 07:39 - Updated on 08-07-2022 17:11
in Audio, Health
Reading Time: 4 mins read
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Women wearing surgical masks 1919

Women wearing surgical masks 1919 Photographer unknown from flickr

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Just over a hundred years ago schools were closed and public meetings discouraged as the country struggled to contain the worst pandemic in modern times, possibly in the whole of human history. This was the ‘Spanish Flu’ that until recently had been largely forgotten but in the light of our recent pandemic experience it has attracted a lot of interest. Worldwide, this influenza pandemic killed more people than died in the First World War.

Newcastle escaped relatively lightly compared to many other cities, but the suffering was still far worse than the Covid-19 pandemic we are experiencing. In nine months there were 2052 deaths in the city from influenza or its complications compared to the 617 Covid-19 related deaths we have experienced up until the end of 2021. In Jesmond there were 45 deaths recorded, amongst these was a prominent member of St Barnabas Church, a Mrs Ralston-Smith who died within a few days of contracting the virus infection and whose death was reported in the Evening Chronicle, 19 February, 1919. The impact of this influenza was even more devastating because it particularly affected the working age population more than the elderly and led to the closure of factories, and food and coal shortages. In Sunderland there were insufficient undertakers, and the army was brought in to make coffins and dig graves. There were three waves of infection that occurred over a nine-month period. The infection became more virulent with each new wave, particularly amongst the youngest. 24% of cases occurred between the ages of 5 to 15 and there was a very high mortality in children below the age of 5 years who accounted for 35% of all the deaths.

Closed schools but not churches

There was no effective treatment for influenza or pneumonia and hospitals providing nursing care were overcrowded so prevention was the most important strategy.  Measures were particularly directed towards children; schools, including Sunday schools, were closed, and children were banned from places of entertainment.  Whilst the last measure was understandably not popular with children, an article about ‘empty schools’ in the Newcastle Daily Chronicle on February 14 1919 commented that “the children were just as unanimous as the doctors as to the wisdom of closing schools”!  

Empty Schools
Empty Schools

Church services continued and it is interesting to observe that the belief in the importance of fresh air and good ventilation influenced the design of Holy Trinity Church where the risk of infection was reduced by drawing fresh air through the vents behind the radiators which would then rise and be extracted via the high ceiling.

Spread due to troop movements at end of war

The ‘Spanish Flu’ did not originate in Spain but during a period of wartime censorship it was in neutral Spain when the King fell ill that it was first publicised. The infection most likely came to Europe with American soldiers in April 1918 and spread widely due to troop movements followed by demobilisation at the end of the war in November 1918.  Tragically, whilst many were celebrating victory others were grieving the sudden loss of husbands, wives and children. The scale of the epidemic prompted calls for improvements in the inadequate voluntary hospital system (reported in Newcastle Daily Chronicle 21 February 1919). So it was, following the war, the Ministry of Health was formed to co-ordinate health services. However, it took the tragedy of another world war to provide the necessary impetus to create a system of universal health care to provide care on the basis of need rather than the ability to pay.  What lessons should we learn from the current pandemic as we look forward to the next century?

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John Matthews

John Matthews

John is a retired GP having worked for 29 years in Wallsend.. During this time he promoted GP practices working together and founded Care First a community interest company for GP practices to support each other to improve care in North Tyneside. For 5 years he was the Chair of North Tyneside Clinical Commissioning Group. He now volunteers at the Joseph Cowen Health Centre which provides health services for homeless people, is treasurer at his local church and is a trustee at the Wallsend Memorial Hall - a hidden gem. Otherwise he can be found messing about in a boat

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