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What the 1918 flu pandemic taught Kansas City about dealing with outbreaks like COVID

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Some researchers say the 1918 flu outbreak, the deadliest pandemic in history, may have started in Kansas. How a corrupt political system and the end of World War I led to such a bungled response and an overwhelming loss of life.

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As the world is in the middle of a vast coronavirus pandemic, it’s worth remembering that the 1918 Spanish flu pandemic may have started in Kansas. And it hit Kansas City particularly hard.

Lessons from that time still resonate today.

“It’s always a good idea to remember your history so you don’t repeat those mistakes,” says Susan Sykes-Berry, a retired nurse and librarian with the UMKC Health Sciences Library who wrote a graduate thesis about the 1918 pandemic flu in Kansas City. 

Some researchers say the 1918 flu outbreak, the deadliest pandemic in history, may have started in Kansas. A Haskell County doctor is believed to have first documented the deadly flu strain and it was believed that soldiers from Haskell County transported the disease to Fort Riley. Camp Funston at Fort Riley was particularly hard hit. And then U.S. troops sent from Fort Riley to fight in World War I in Europe may have carried the virus with them and it spread from there.

Eventually, the 1918 pandemic is said to have claimed between 50 million and 100 million lives worldwide, with as much as one-third of the world’s population infected.

In Kansas City, the disease infected more than 11,000 people and killed more than 2,300, or nearly 1 percent of the population. Kansas City experienced one of the worst outbreaks of any city in the U.S., according to a report by the University of Michigan Center for the History of Medicine.

Of course, advances in medical science, vaccines, antibiotics and other treatments have vastly improved in the last 100 years. But many public health experts say the world is still insufficiently equipped to effectively battle another pandemic outbreak, and more public health resources and global cooperation are needed.

Lesson 1: Politics matter.

In a 2018 interview with KCUR’s Central Standard, Sykes-Berry said Kansas City was hit very hard by the 1918 flu “because of politics.”

The beginning of the outbreak was reported by The Kansas City Star in September 1918.  It raged until  spring 1919.

Sykes-Berry said the city was divided in its response between public health advocates and followers of Tom Pendergast.  The Board of Health ordered schools, theaters and churches closed. But business owners resisted.

“Tom Pendergast controlled saloons,” she said. “When they did finally get around to putting in a quarantine, saloons were exempt. They just let them stay open because nobody wanted to challenge Tom Pendergast.”

Courtesy of the Missouri Valley Room
Kansas City Public Library, Kansas City, Missouri
Streetcars were never closed during the 1918 flu pandemic in Kansas City.

In addition, she said, other business owners and managers of the streetcars didn’t want streetcar ridership limited.

“It was a business decision,” she said.

While schools closed in Kansas City, Kansas, the order to close schools in Kansas City, Missouri, was lifted in October 1918. And the epidemic spread more rapidly in Kansas City, Missouri.

There was no vaccine and no good treatment. But Sykes-Berry notes some approaches worked and are still relevant today.

“The best treatment you could get was good nursing care,” she noted. “And the Visiting Nurses Association, they have records that show that they treated 2,300 some people and they only had 35 deaths in that number.”

Credit Courtesy of the Missouri Valley Room / Kansas City Public Library, Kansas City, Missouri
Kansas City Public Library, Kansas City, Missouri
St. Joseph Hospital on Linwood and Prospect saw many flu patients during the pandemic. Some of its nurses and doctors reportedly died of the disease.

Lesson 2: The quarantine worked.

“St. Louis had a very strict quarantine and St. Louis had about half the death rate that we did,” she told KCUR. “Kansas City, Kansas, and the whole Kansas side, they had a better response because they weren’t politically divided.”

While 1918 still resonates, the good news is that Kansas City and the world have seen tremendous advancements in medical approaches since then.

Researchers are already working on a coronavirus vaccine, and clinical trials should start soon, although it may not be widely available for many months.

In the 2018 interview with KCUR’s Central Standard, Dana Hawkinson, an infectious disease specialist with the University of Kansas Health System, said flu vaccines work. Good hand washing and hygiene are also preventive measures.

“Promote good health practices,” he said. “That means promoting good vaccine rates, promoting hand hygiene, all those things help reduce influenza infection but also the severity from influenza.”

Lynn Horsley is a freelance writer in Kansas City. Follow her on Twitter @LynnHorsley.
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