The Last 100 Days
Influenza and the Canadian Expeditionary Force: April to November 11, 1918
Two of the three waves of the influenza pandemic hit the Canadian Expeditionary Force (CEF) overseas before the end of the First World War, but thanks to the timing of the waves these had little overall effect. The official history of the medical services reported that the CEF experienced 776 out of 45,960 influenza cases overall.1 Historians now regard these numbers as low estimates, of both cases and deaths.2 To provide context for the size of the CEF in 1918, it had overseas 130,000 recruits, instructors, wounded, medical staff, and administrators stationed in England. Another 105,000 men served in the Canadian Corps, with a further 47,000 men and women serving outside the Corps in France and Belgium.3
CEF in England
In England, the CEF’s primary task was training recruits for the Canadian Corps and treating the wounded so they could return to the front. With thousands of men in crowded camp conditions, senior military officials worried about the spread of infectious disease. In reaction to the first wave, they set up two “segregation camps,” in April 1918, to hold arrivals from Canada for 28 days.4 While the time the new recruit spent in those camps slowed down the normal training cycle, it did not adversely affect the flow of men to the front. At this time, most of the Canadian Corps was away from the front line and not suffering battle casualties.
The second wave hit Canadians in England in late September 1918 and continued into October. With 45,835 casualties suffered by the Canadian Corps in the Hundred Days campaign, the CED faced an enormous call for replacements, which meant the training services in England had to operate at maximum capacity.5 The military was forced to place a major training camp at Bramshott under quarantine, closing the facility’s cinemas, bars, churches, and other meeting places to prevent its spread.6 This greatly limited the recreational opportunities for troops and meant dull nights confined to barracks. As a further precaution, the medical authorities ordered that the men were not to be worked so hard that they sweated while they trained. However, the limitations on training had little effect: by the middle of October, the need for replacements had dropped. With the end of the war imminent, the slowdown in training had no military consequences.
The flu first hit in late April 1918 and spread through the Corps, with the symptoms lasting until July. The timing of the outbreak was fortunate, as it hit when three out of the Corps’ four divisions were out of the line, training. In some instances, up to 40% of some units’ men had fallen ill, but they usually returned to duty within a week, with no lasting effects.7 Through June and July, about 25% of the 3rd Division fell ill, but only 8% of these received treatment at a field ambulance.8 These mobile units provided second-line medical care. Few soldiers had to go to a hospital. At the peak of the first outbreak, the 4th Division sent only 40 men to hospital over two days, which was only 15 men above the daily average for the month.9
As a whole, the military was far better equipped to treat illness and injury than civilian institutions simply because illness and injury were much more common among troops than in the civilian population. During the first wave, units treated their afflicted troops in local accommodations in the rear. When there were too many afflicted troops for a unit to handle, additional medical personnel, tents, and supplies assisted. The military had the advantage of more doctors, orderlies, accommodations, and supplies. In Canada in 2015, there were 2.6 beds per 1,000 people, while in 1918 the CEF had 146.1 beds per 1,000 troops.10, 11
When the Canadians were on the offensive again, during the Hundred Days campaign starting on August 8, 1918, the first wave had run its course. The Corps launched further attacks at Arras in late August, crossed the Canal du Nord in September, and captured Cambrai in October. During the peak of fighting, there were new influenza cases. The flu wave’s biggest impact was on the strength of the German army. It hit the enemy much harder, with men ill for longer – and this during a period of active operations. Only late in October did influenza again become an issue for the CEF, when the Corps liberated large numbers of civilians. In one town alone, the Corps’ medical services had to deal with hundreds of cases.12 With civilian hospitals far in the rear, it was up to Canadian medical services to provide help.
The troopships crossing the Atlantic to England experienced the worst of the flu wave. For instance, nearly all 1,057 troops on the City of Cairo arrived in England on October 11 sick with influenza, with 32 deaths at sea.13 On top of the cramped conditions, sinking hazards and seasickness, the recruits had to endure sickness, with only limited medical care.
Overall, the most important effect that the outbreak of influenza had on Canadian operations during the war, indirect though it was, was that it debilitated the German strength at the front.
- Andrew Macphail and Canada. Dept. of National Defence. Historical Section., Official History of the Canadian Forces in the Great War 1914–19. The Medical Services, (Ottawa,: F. A. Acland, printer, 1925), 266.
- Tim Cook, Shock Troops: Canadians Fighting the Great War, 1917–1918, (Toronto: Viking Canada, 2008), 584.
- Demobilization Factors, 41, 74/672 Box 8, Directorate of Heritage and History, Department of National Defence.
- Report on the Work of the General Staff Branch During the Month of April 1918, MG30 E46 v6, Turner Fonds; Library and Archives Canada.
- Cook, Shock Troops: 579; William F. Stewart, The Embattled General: Sir Richard Turner and the First World War, (Montreal & Kingston: McGill-Queen’s University Press, 2015), 228–9.
- Summary on the Work of the General Staff Branch During the Month of October 1918, MG30 E46 v6, Turner Fonds; LAC.
- See for example 2nd Brigade Canadian Field Artillery War Diary, 2 July 1918, RG9 III-D-3 v4965, LAC; 4th Battalion War Diary, 30 June 1918, RG9 III-D-3 v4916, LAC; 14th Brigade Canadian Field Artillery War Diary, RG9 III-D-3 v4972, LAC; R. C Fetherstonhaugh, The 13th Battalion Royal Highlanders of Canada, 1914-1919, (13th Battalion, Royal Highlanders of Canada, 1925), 242.
- See Chart 3rd Division Influenza rate.
- Assistant Directory of Medical Services, 3rd Division War Diary, 25-26 June 1918, RG9 III-D-3 v5026, LAC.
- Macphail and Canada. Dept. of National Defence. Historical Section., Medical Services: 248; “Hospital Beds Total, Per 1,000 Inhabitants, 2015,” OECD, https://data.oecd.org/healtheqt/hospital-beds.htm, (8 February 2018).
- This is not to suggest that the CEF in 1918 was better equipped to deal with the flu than contemporary doctors and hospitals: rather, this comparison shows just how many resources were provided by the military to get soldiers back on their feet as soon as possible.
- ADMS, 3rd Division, 23 October 1918, LAC.