Take a walk in any park in the United States right now, and you may be tempted to believe that the coronavirus pandemic is all but over. Every state has loosened its lockdown restrictions, and the warmer weather has Americans eschewing sweaty masks to take in the summery air. Plus, hundreds of thousands of people across the country have congregated in the streets—with and without masks—to protest racial injustice, defying bans on large gatherings, albeit for a righteous cause. More Americans are going to work in person and the percentage of Americans who wear masks in public, which rose steadily in April, has leveled out at around 70 percent, according to data from YouGov. Still, many states are seeing COVID-19 case counts rise, and public health experts don’t expect the pandemic to resolve anytime soon.
June 11, 2020
During the 1918 Flu’s Second Spike, Americans Resisted Social Distancing. Could That Happen Again?
If history is any indicator, attempts to reinstitute social distancing measures to flatten a potential second wave of the virus could face more opposition than the initial lockdowns. The widespread business closures and mask ordinances implemented during the 1918 influenza pandemic weren’t especially popular. Yet a second round of restrictions put in place to stem a second wave of the flu was so hated that dissenters in San Francisco formed a 2,000-person Anti-Mask League and some mayors openly violated public health orders. Similarly, it’s not hard to imagine the return of ferocious anti-lockdown protests if authorities enforce new lockdowns when COVID-19 counts start to tick back up.
To understand the echoes of the flu pandemic in our current moment, I contacted historian J. Alex Navarro. Navarro was one of the researchers who, as part of a Bush-era initiative to prepare for for a possible pandemic, helped the Centers for Disease Control and Prevention by studying newspaper archives from 43 American cities to determine whether social distancing measures during the 1918 outbreak reduced mortality. (They did.) Navarro, along with Dr. Howard Markel, is coeditor-in-chief of the online Influenza Encyclopedia, which hosts a fascinating page about the anti-mask sentiment that abounded in 1918 San Francisco.
I spoke with Navarro about a historical constant: humans’ tendency to buck authority, even if it means putting their health at risk.
Abigail Weinberg: What major political differences should we be aware of when comparing 1918 to today?
J. Alex Navarro: In 1918, there’s this overriding sense of hyper-patriotism that is not only being driven by the war effort, but is also being purposefully stoked by [President] Woodrow Wilson. It was not a very popular war, so Wilson created the Committee on Public Information, basically a propaganda effort. Patriotism is being ginned up as much as possible, and that probably had a large effect on the initial reaction to the epidemic from the public.
You can see this in the newspaper coverage. For example, in places where mask ordinances were passed, like San Francisco, the Red Cross prints out this PSA in the newspapers and basically says, “Save a life. Wear a mask. Do your part.” It actually used the term “slacker,” which had been used for people who weren’t doing their part to support the war effort.
In what ways did people resist or defy public health measures?
There were some notable acts of pushback, from actual legal challenges to outright defiance. For example, about three weeks into Atlanta’s epidemic, a group of businessmen come to the mayor, Asa Candler, and they say, “We need to reopen.” He’s a pro-business leader, and he decides unilaterally, over the objection of his board of health, to reopen Atlanta—and Atlanta’s epidemic was not over. In fact, we don’t really know the course of Atlanta’s epidemic, because the city stopped reporting cases in the same way. [Sound familiar?]
In San Francisco there were two mask orders, but it’s the second one in January of 1919 that leads to this Anti-Mask League. Even during the first mask ordinance in the fall, there are hundreds of people who are arrested for not wearing their masks. It’s hard to know how many of those people were being defiant because they just didn’t think that they needed to wear one, or the government had no right to tell them to wear one. Some of them probably simply forgot or thought they could get away without wearing a mask because they were uncomfortable, but they got caught and were arrested.
But then it leads to that second mask order when there’s a resurgence in cases, and that one was definitely despised. People did not like wearing the masks, and there was opposition from prominent physicians. There was a member of the California Board of Supervisors who was part of the Anti-Mask League. There were 2,000 people who met in an auditorium to hear speeches to protest the wearing of masks.
Perhaps the most notable example of defiance came from the mayor of Newark, Charles P. Gillen, who implemented the state Department of Health’s closure orders, which closed many places of public amusement including saloons, but at the last minute changed the saloon order and allowed them to sell liquor by prescription out of their side doors. Saloons took that to mean they could more or less remain open, which they did. They flagrantly flouted the ordinance. When the state department of health pushed back, Gillen didn’t back down, and he said that he was in charge of the Board of Public Health in Newark and that the state had no jurisdiction. He at one point decides that the epidemic’s over. It wasn’t quite over, he lifts the orders, and he said everyone can go back to life as normal.
How did Gillen’s constituents feel about his defiance?
Church leaders were not happy that churches were required to close, but saloons were basically allowed to be open. They complained to Gillen, and Gillen said, “If you want to reopen, I’m gonna look the other way at churches.” The Newark Evening News was aghast that he would do this, and they ran scathing editorials about the mayor. He in fact ordered them out of his office. He said, “None of your reporters are welcome until you stop printing lies.” He had no authority to do it, but he threatened to close the newspaper down under public health rules for being a public health nuisance for questioning his authority. It’s kind of reminiscent of what’s going on today.
People who refused to wear masks in 1918 claimed that they were ineffective or that mask ordinances were unconstitutional—many of the same justifications we hear today. How did the Anti-Mask League differ from the vocal minority of anti-mask protesters that we see on the news today?
In terms of why there was such widespread organized opposition in San Francisco in particular, I think that has to do with timing. Denver, Seattle, Oakland, and San Francisco all used masks, and they were all hated in each of these cities. There was definitely opposition to wearing them. The difference, I think, in San Francisco, is San Francisco implemented a second mandatory mask order that came after the end of World War I, so that sense of patriotism and doing your duty is starting to dwindle. In other communities those mask ordinances ended right around or shortly after Armistice Day, so that patriotism is still hanging around a little bit, and then as it starts to dwindle, people want to get back to life as normal. That’s when San Francisco rolls out this second mask order.
Did the virus disproportionately affect minorities and lower-income communities, as we’re seeing today?
We don’t really know, and that’s because the data just doesn’t really exist. We don’t even know the number of aggregate cases.
Chicago had a very long, very detailed public health report on the pandemic. They do include some racial data, but it’s really interesting the way they include it. They calculated the percent change increase in the number of deaths for whites versus African Americans due to the epidemic, and what they found is that that percent change was much higher for whites. They concluded therefore that Black residents may have had some sort of immunity to influenza. It’s not at all the case. It’s just that the way that they reported and were looking at the data, if you have a group of people who are already dying of other underlying medical conditions at a higher level than their white counterparts, then the epidemic comes along and kills people at roughly the same level, probably more heavily impacting African Americans, the difference in that decrease is going to be much greater for the group that had fewer underlying health conditions and better access to health care initially. So the percent change seemed greater for whites than Blacks, but the reality was that was because African Americans were already dying from other endemic diseases and malnourishment and diseases of that sort at higher levels.
The coronavirus in the United States has stoked xenophobia and racism against Asian-Americans, particularly people of Chinese descent. Given that epidemics have historically lent themselves to scapegoating, did the 1918 flu exacerbate racism in the United States?
It probably did not exacerbate racism. This is probably the first pandemic, in fact, where we don’t see widespread scapegoating. There is one example that comes to mind. When Denver released its closure orders on Armistice Day, there was a great rush for everyone to congregate downtown and celebrate. They had another spike in cases that was actually worse than the first spike. A public health official for the city complained that that second spike in cases was caused by Italian and Hungarian immigrants, because they were congregating to care for sick relatives and friends. That is probably true. They probably were. Culturally, people from various communities probably were likely to take care of each other, especially if you live in a community like Denver which had a history of anti-Italian prejudice. But to blame them for causing the continuation of the epidemic was of course completely inaccurate. But that’s the only case that we saw of that, and I think it’s pretty striking.
Why do you think cases of scapegoating were so rare?
I think because it hit so hard and across all segments of the population—all ethnicities, all racial groups—with equal ferocity, that you couldn’t easily pinpoint it to a particular group of people and then scapegoat that group of people. It seemed to pop up out of nowhere.
Public health crises tend to spawn misinformation. I’m sure you remember the president suggesting that people ingest disinfectants to cure the coronavirus. Were there any dangerous folk remedies in 1918 that people had to look out for?
There were lots, and they range from dangerous to silly. One of the typical ones was “clean heart, warm feet, clean bowels.” Some people advocated cutting an onion in half and rubbing that on your chest and that would protect you. There may have been something to that: If you smell like raw onion, people are probably gonna stay away from you. There were some who recommended taking a bath of creosote—which is a pretty dangerous, toxic chemical—and taking copious amounts of brown sugar.
What lessons can we take away from studying the 1918 pandemic?
These closure orders are very onerous for society as a whole, particularly business owners, but they’re meant to just initially get a handle on an explosive pandemic. They’re not meant to be in place forever. As we come out of this and as we see states starting to reopen, if we don’t have an effective mitigation strategy in place that people are actually going to use and buy into, that’s a huge problem.
In 1918, when cities removed these social distancing orders and closure orders, in cities that faced another spike in cases when the epidemic wasn’t quite done yet, it was almost impossible to reimplement closure orders a second time, because the business community in particular and residents overall pushed back so much. Today, if we’re not gonna do things like socially distance whenever possible, if we’re not going to wear masks while in public and get widespread compliance, I don’t see how we mitigate the pandemic as it rolls on.
This epidemic will be around with us for a lot longer than influenza, because the threshold for herd immunity is at least twice as high for COVID. Human nature being fairly static despite changes in historical context, I fear that whatever the level of opposition is now—it seems small but rather vocal—that that’s gonna turn into a combination of outright defiance and noncompliance.
This interview has been edited and condensed.