The Plague Sweeps Canada
Canada’s Spanish Influenza Epidemic
A story of heartache and progress
by Andrew Belyea, Queen’s University School of Medicine, Class of 2021
In the fall of 1918, at the tail end of the First World War, a unique and deadly influenza virus travelled around the world, killing between 20 and 50 million individuals.[1] The Spanish influenza, as it came to be known, was one of the most devastating pandemics in recorded history. While nations recovered both physically and emotionally from the tolls of the war, another battle was underway. In Canada, the horrors of the Spanish flu left communities struggling to put themselves back together. Through the flu’s misery, the nation as a whole experienced frustration, devastation, and the odd sprinkling of hope.
The Canadian population in 1918 witnessed about two million of its eight million people infected by the 1918 influenza virus. Of this subset, roughly 30,000 to 50,000 deaths occurred; many of these deaths were due to pneumonia, which was the ultimate cause of death for many who contracted the flu. Ontario alone had more than 300,000 cases of influenza, which was not a reportable condition at the time, experiencing nearly 10,000 deaths.[2]
The flu’s unusually high morbidity and mortality created significant frustration on the war front. On this topic, Lieutenant-Colonel J.L. Biggar of the Board of Pension Commissioners wrote, “The most authoritative information goes to show that one man in every four of those of military age was found to be incapable of active service because of physical unfitness, and that this, in the majority of instances, was the result of preventable disease.”[3] The fact that influenza was believed to be largely preventable made the situation even more frustrating for the military because the flu, among other illnesses, kept soldiers from being recruited. Of 261,695 Canadian soldiers examined in 1918 for suitability to serve in the First World War, 181,225 were deemed unfit – an astonishing 69% of potential recruits.[4]
When news of the epidemic began to spread around the country, business owners
were quick to use its powerful marketing potential. This example shows a Kingston business advertising a phonograph that suggests people obey the “Doctor’s Orders” by staying indoors and indulging in the high-quality sound it emitted. (Daily British Whig, October 11, 1918)
By mid-October 1918, communities were beginning to understand that serious action needed to be taken. A surge of increased mortality was not new to people: during the early 1900s, cities were accustomed to bouts of typhus, scarlet fever, and, of course, influenza. In response to the flu, emergency hospitals popped up around the country, including the Great War Veterans’ Association Hospital in Kingston, Ontario; servicing exclusively influenza patients, the hospital opened on October 19, 1918, and treated 57 people from 22 different families. Understanding that the flu of 1918 was significantly worse than many others led to a change of its management on October 16, 1918. On that day, Dr. John McCullough, Ontario’s provincial medical health officer, finally provided recommendations to municipalities around the province: shut down public places. Although met with frustration by many local businesses and schools, the action was a welcomed change from the prior idle waiting.
This change coincided with a number of other developments that began ramping up around the country, including attempts to proactively and reactively manage the flu as it crossed from east to west. Quarantine attempts abounded throughout the country, including on the St. Lawrence island of Grosse Isle and in the Albertan capital of Edmonton. The scientific community continued chasing an effective treatment for the flu, with vaccine trials occurring throughout North America. Many attempts involved transfusing convalescent patient serum into ill and healthy individuals.[5] Although valiant efforts for discovery occurred throughout the continent, most were far from close; it was not until the 1933 invention of the electron microscope that the contagion was identified as a virus and not a bacteria.[6] The value of blood transfusions, first instigated out of necessity during the First World War, provided the framework for the flu’s only significant treatment.
Of all the devastation that accompanied the Spanish flu in Canada, one outcome stood out as notably positive: the development of a Federal Health Department. Prior to 1919, the Department of Agriculture was responsible for national health matters. During the 1918 flu, frustration abounded because there was an absence of a cohesive national strategy. As indicated in The Report to the Vice-Chairman of the War Committee, “The recent epidemic of Spanish Influenza points to the need of a Federal Health authority. Throughout this crisis there was no organization competent to handle the problem on a national scale. The control of disease was necessarily left to local boards, many of them ill-informed and all of them inevitably lacking in co-ordinated effort”.[7] This inaction was evident in Kingston, as the local medical health officer, Dr. Archibald Williamson, made no formal effort to contain or prevent the flu’s spread. Leading up to the October 16 decision to close public places, Williamson’s public advice had been limited to “Avoid public assemblies”.[8] When the Federal Health Department was finally formed in 1919, physicians and public alike were relieved to know a more organized approach would be taken if a health disaster ever struck again.
This public notice, published in Kingston newspapers on October 16, 1918, indicated that all public places were to shut down until further notice; similar notices were published throughout Ontario. The closure of Queen’s University at this time remains the sole reason the university has closed for a medical reason; it reopened 14 days after this announcement. (Daily British Whig, October 16, 1918)
When the Spanish flu invaded Canada in the fall of 1918, communities were ill prepared for the devastation that would follow. Within two months, healthy and thriving communities became sick and grief-stricken. However, despite all the illness and loss that accompanied the Spanish flu, it led to significant advancements in medical science and policy that remain fundamental to daily life 100 years later.
For those interested in reading more about the Spanish influenza’s local impact on Kingston, please refer to a series of blogs I wrote during the summer of 2017 while holding the position of Margaret Angus Research Fellow at the Museum of Health Care at Kingston. The blogs can be found here: https://museumofhealthcare.wordpress.com/author/museumofhealthcare/
ENDNOTES
[1] K.D. Patterson and G. F. Pyle. 1991. “The Geography and Mortality of the 1918 Influenza Pandemic.” Bulletin of the History of Medicine 65 (1): 4.
[2] Registrar General, Province of Ontario. Report Relating to the Registration of Births, Marriages and Deaths in the Province of Ontario, 1918. (Toronto: A.T. Wilgress. 1919.)
[3] J.L. Biggar, “State Medicine and Rehabilitation,” Canadian Medical Association Journal 9, no. 11 (November 1919): 1013.
[4] J.L. Biggar, “State Medicine and Rehabilitation,” Canadian Medical Association Journal 9, no. 11 (November 1919): 1013.
[5] https://museumofhealthcare.blog/dr-guilford-b-reed-the-influenza-vaccine-that-sort-of-worked/
[6] Wilson Smith, C. H. Andrewes, and P. P. Laidlaw. 1933. “A Virus Obtained from Influenza Patients,” The Lancet 222 (5732): 66-8.
[7] The Report to the Vice-Chairman of the War Committee, p. 14.
[8]Daily Standard. October 9, 1918:3.