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For the past two weeks, residents of Milwaukee have found themselves forced to confront the “new normal” brought about by COVID-19. Learning to live in a global pandemic is not easy; each day brings about situations and circumstances that seem to lack any sort of precedent. As municipalities around the world struggle to continue this highly contagious virus, we are constantly reminded that we are in uncharted waters.
But what if we have been here before? During 1918-1919, a global influenza epidemic killed an estimated 50 million people around the world. In Wisconsin, over 100,000 were stricken by the flu; 8,459 died from influenza itself or from related illnesses. To put such numbers into some perspective, the flu epidemic killed more than four times of number of Wisconsinites than did the battles of World War I.
Yet other states suffered many more casualties than Wisconsin. During the epidemic, the state’s death rate was 2.91 per thousand inhabitants; the national average was 4.39. Milwaukee, at the time one of the most densely packed cities in the nation, experienced just 20 to 30 deaths per 10,000 residents. This low mortality rate made it one of the least-affected major US cities throughout 1918-1919. In fact, by December 1918 cases of influenza were under control in Milwaukee, even as they increased throughout the country.
Such numbers were because both Wisconsin and Milwaukee were well prepared for such a crisis. In 1876, Wisconsin established a State Board of Health that had the authority to issue statewide quarantine orders. Seven years later, the Wisconsin state legislature mandated that every municipal unit across the state appoint local health boards, staffed by trained health officers. By the time of the 1918-1919 epidemic, 1,685 local boards of health had been created across the state. This local units took direction from State Health Officer Dr. Cornelius A. Harper, who understood the threat posed by influenza earlier than other medial officials. On Oct. 10, 1918—in a move that predates our current call for social distancing—Harper issued an order calling for all local boards of health “to immediately close all school, theaters, moving picture houses, other places of amusement and public gatherings for an indefinite period of time.”
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Closures Taken Seriously
City leaders in Milwaukee took such orders seriously: “SCHOOLS CLOSED TO STOP FLU” read a contemporary headline in the Milwaukee Journal. Much like the state, the city of Milwaukee was well prepared to face such a crisis. Many of Milwaukee’s Socialist political leaders, including Mayor Daniel M. Hoan (in office from 1916 to 1940), made matters of public health a priority for the city. As cases of influenza began to crop up in the city during September 1918, George C. Ruland, who served as City Health Commissioner under Hoan, put into place a vast educational campaign to get Milwaukeeans prepared for the coming of the epidemic. Of particular concern was the damage the flu could bring to poorer, densely packed immigrant communities. A simple, to-the-point informational leaflet was printed in a variety of languages by the city’s health department and then disseminated to neighborhoods across Milwaukee. Other pamphlets, posters, and placards, also produced by the health department, were distributed throughout the city by area Boy Scouts.
Yet the city did more than provide information—it also supplied a sort of infrastructure to deal with the epidemic. On the one hand this was physical: Milwaukee secured the City Auditorium (the current Miller High Life Theatre) and two private homes to serve as emergency hospitals for influenza patients. The work needed to transform these spaces into medical facilities was undertaken by the Citizens’ Bureau of Municipal Efficiency. The city also helped to provide the labor needed to staff such facilities, arranging for student nurses and instructors from the Wisconsin Anti-Tuberculosis Association to take the place of county health nurses, allowing the latter to focus exclusively on treating flu patients in these emergency hospitals. Young women from across the city were also recruited to turn their private automobiles into ambulances to aid in the movement of those stricken by influenza.
History, of course, does not neatly repeat itself. And it may be too late to apply the lessons of 1918 to the situation we face in 2020. But we see in this earlier moment a commitment to planning for such disasters, along with a belief that government can handle such moments—and indeed handle them well. The past forty years have seen an erosion such commitments and beliefs across the United States. If nothing else, the current pandemic should compel us to rethink such histories.
