In the same paper of October 22 is the obituary of Ethel Dickenson. #2 She had just returned from Overseas where she had nursed as a V.A.D. She volunteered to nurse at the Seamans Institute. She became ill on the same day as Pte.Alexander and died on October 19, 1918. The most prominent memorial to the Flu Epidemic is in Cavendish Square, opposite the Newfoundland Hotel. It commemorates Nurse Dickenson and the others who volunteered to nurse patients at this time.
The Fourth Horseman of the Apocalypse: Pestilence, in the form of the Spanish Flu had come to Newfoundland.
Though called the Spanish Flu, this epidemic did not originate in Spain. It was first reported in Canton in February, 1918, #3 and spread with amazing rapidity across the world-to Asia, Europe, North and South America, Africa, India, Australia and New Zealand. No country was spared. The first wave was relatively mild - symptoms sufficient to incapacitate a person but with low mortality. It is referred to in some accounts as the Three Day Flu. In May and June, the British First Army in France had 36000 sick.#4 The Royal Newfoundland Regiment was out of the line at this time. In March and April, during the German offensive, they had suffered such a high number of casualties that could not be replaced that they were withdrawn from the Front Line and assigned to guard duty at Haig's HQ at St.Omer. During May and June, there were 22 cases of Flu and no deaths. In June, the British Army in the U.K., had 31,000 cases, six times the number of the previous month.#5 The German Army had been affected in April as well.#6 General von Ludendorff partly blamed the flu for the failure of the German offensive in July.#7
The epidemic seemed to subside over the summer months. It was not until late August when the Second wave appeared- but this time with a difference -a lethal difference.
All of us have had the flu and know the symptoms and though we think we won't survive, fortunately, we do. The onset of the second wave was different. The sudden onset of high fever, severe incapacitating aches and pains, severe headaches, sudden collapse and prostration and death within hours or days, puzzled the doctors at first. Was it Cholera, or Typhus? Dengue Fever or Botulism were suggested.#8
At first some soldiers looked so surprising well, with a good colour (or flush) that the Regimental Medical Officers viewed them with scepticism and sent them back to duty. All too rapidly the symptoms would advance, the Heliotrope hue of air hunger, then cyanosis and death, as with Pte Alexander.#9
The epidemic reached its peak in September and October , slowly decreasing in November and December 1918. This was followed by a Third Wave in February, March, and April of 1919.
The previous Flu Epidemic of 1889-90 had high morbidity but a low mortality rate, affecting mainly the young, old and frail so that another flu epidemic was not viewed seriously except for the decrease in the numbers of Front Line soldiers, and War Production on the Home Front because of sickness. Those infected this time were not the young and old but young adults between 15 and 35 years.#10
It was well recognized by 1918 that when a group of relatively healthy young men were crowded into barracks, that epidemics of measles, mumps, scarlet fever and even meningitis would occur. This was especially true for those recruits from isolated communities. Since 1916, the Canadian Army had segregated all troops arriving in the U.K. for 28 days so as not to spread epidemics amongst those trained and ready to go to France.#11. The Newfoundland Regiment had its share of epidemics. Measles in 1916 which infected such numbers as to delay two drafts from proceeding Overseas. Measles and Mumps occurred in 1917. In the Spring of 1918, 115 men had Mumps, and a severe bout of Measles broke out in May, 1918 - 54 cases with 12 deaths. There were sporadic cases of pneumonia during the past few years. In May, 1918, 9 men of the Regiment died from pneumonia.#12
The Ledger of the Royal Newfoundland Regiment lists the service of every soldier, including the type of wound or sickness they had.Those overseas in England and France usually have definite diagnosis noted, but those in Newfoundland only list those who are ill as "sick". If they died, then a cause of death is usually recorded.#13
Fortunately, the records of the measles epidemic of June, 1918 and the Flu epidemic of October and November, 1918 exist and are the basis of some of the statistics used.#14
The First Wave was probably present in Newfoundland in the Spring of 1918, but not of sufficient note to even make the news. One case in June is recorded as Influenza as the cause of death, though some of the men who died of pneumonia may have had Influenza. Draft 20 of the Newfoundland Reg't. going overseas left St.John's June 11, 1918 to join a Canadian Convoy in Halifax. Two soldiers were hospitalized in Halifax and two more in Plymouth on arrival in England diagnosed as Flu.#15
The dissemination of news was slow in 1918. The Evening Telegram and the Daily News would only reach a limited number, with a circulation of about 2000 each. Undoubtedly, Mainland newspapers from Halifax, Montreal, Toronto and New York and even from England, would be read by a few, though delayed in the Mails. The main news was of the battles in France, Italy, Macedonia, the Revolution in Russia, and the arrival of the Americans in France. The Casualty List received prominent attention but very little about the Spanish Flu. The first note about the Flu epidemic I could find, was in the Evening Telegram of September 18, 1918 -a 1" filler about Spanish Flu amongst U.S.troops in Illinois.#16 The next, a week later, on September25, stated that the Flu was in the States with 30000 cases in Army camps.#17
It was on September 30, that the Evening Telegram reported 3 seamen from a steamer were admitted to, hospital with the flu.#18 The next day, the Daily News reported that two cases from the schooner Ariceen of Twillingate were taken to hospital.#19 On October 2, Mate Walter Hyson of the Ariceen had died 2 days after admission. #20 The Spanish Lady was in St.John's.
While the headlines were about the War, more and more news about the Flu epidemic appeared in both papers.
In the Evening Telegram of October 9, it was announced by the Public Health Office: "In view of the experience of Canadian cities, it is the opinion of the Medical Practitioners that we are almost certain to be visited by an epidemic and a meeting will be held Monday night to consider what means might be adopted to prevent its spread."
The announcement listed the symptoms;that cases should be isolated as far as possible; and avoid spitting, coughing, and sneezing.#21
Dr.F.Stafford & Son, retail and wholesale druggist advertised a gargle to be used 4 times a day as a preventative and curative for Influenza at 25 cents a bottle plus 10 cents if by mail.#22 Peter O'Mara, the druggist advertised Nyal Throat Pastilles to protect from the Spanish Flu.#23 James Baird advised every precaution to combat the Spanish Flu by the use of Hydrogen Peroxide and Hypozone to kill germs.#24
On October 14, the newspapers reported on a meeting of the Medical Practitioners stating the Flu Epidemic was in St.John's and the cases were the same as in Canada. It announced that it is a contagion spread by contact.#25
The Public Health Notice by Dr.N.S.Fraser the same day in both papers, gave notice that public places would be closed.#26 The next day, Instructions to Outport Magistrates appeared.#27 The day after, the Seamens Institute was taken over as a hospital and 16 cases admitted.#28 By October 19, 50 cases had been admitted.#29
The Evening Telegram reported that one of the reporters on staff was off sick with the Flu-Mr. J.R.Smallwood.#30 Each day recorded more cases. The obituaries increased- 8 deaths on October 26 and that no Church Services would be held that Sunday. #31 From all over the island came reports of the Flu. Placentia-400 cases and 11 deaths; Lark Harbour 192 cases and 11 deaths; and so on over the Dominion.#32
On October 28, the Public Health Officer had a notice on "How to Avoid the disease"- good common sense advice that can't be faulted today.#33
On November 1, leave of absence was given to all men called up under the Military Services Act, 1918, and leave extended for those not in St.John's. This action probably helped spread the epidemic even further. One can find deaths of soldiers occurring all over the Island.#34
The Annual Report of the Registrar General for the years leading up to and including 1918 and 1919 show the impact this epidemic had on the population of Newfoundland. The dramatic increase of deaths was due to Influenza in 1918, mostly in October and November to 734. Not only this, there was a doubling of the numbers dying from Pneumonia and the deaths from Pulmonary Tuberculosis increased.#35 In 1919, the number of deaths from Influenza was 639, but 407 of these were from Labrador, undoubtedly late reporting of many cases, not discovered til the Spring as in the case of Okak.#36
If one assumes a mortality rate of 1% of all cases as is noted in most accounts, #37 one can extrapolate that there would have been over 75,000 cases in Newfoundland from a population of 250,000. St.John's, with a population of 25000 had 111 deaths - probably over 11,000 cases.
What about the Royal Newfoundland Regiment? In France, there had been 24 cases of Flu in May, June and July. In October, there were 16, 13 in November and 28 in December but no deaths. In 1919, there were 39 cases in Jan., February, and March with two deaths. Three members of the Regiment who were P.O.W's in Germany and another in Poland died of the Flu.#38
The 2nd. Battalion in England did not appear to be affected severely by the Epidemic. There were a few cases from July to September In October , there were 4 deaths, three from pneumonia and one from flu. In November, three died of pneumonia. In the early months of 1919, there were a few cases of flu and no deaths.#39
However there were 13 other cases. These all came from those on transports coming Overseas. Four died en route and 6 died following arrival in England.#40
It was in Newfoundland where most of the cases occurred. One fatal case in June, and another non fatal case in August. The epidemic hit the Regiment at the same time as the civilian population. In October there were 148 men diagnosed with Influenza with 6 deaths - one being Pte.J Alexander and there were twenty- seven more in Novemberwith one death.#41 From May to November, 1918, there were on average about 400 men in barracks at Princess Rink on Factory Lane, and in billets in St.John's.#42 There were other military units in St.John's at that time but the records are not available. At least 4 men of the Royal Naval Reserve died, as did one in Ireland. Two of the Forestry Battalion also died of the flu.#43
This, in spite of such preventive measures as a parade morning and night to gargle with a dilute solution of Pot.Permang.#44 I suspect this was on the suggestion of Dr.Cluny Macpherson who told me he prevented any cases of flu at the Royal Stores by having them all gargle with this solution. In the Newfoundland plot of the Wandsworth Hospital in London are the graves of 16 Newfoundlanders who died of wounds or disease, and one Nursing Sister, named Bertha Bartlett, who died of Influenza in October, 1918. Crowding men in barracks is a certain way of spreading infectious diseases. Confine them to a crowded troopship and it can be explosive. Draft 24 of 173 officers and men left St.John's on September22, 1918 en route Overseas via Nova Scotia. One soldier is buried in Cape Breton and 3 died on the voyage. Nine men were hospitalized on arrival at Plymouth, six of whom died within the next week.#45
The Canadian Army had the same experience. Of the 1,057 officers and men on the "City of Cairo" that left Quebec on September 28, 32 died at sea and 224 were hospitalized on arrival in Devonport.#46 It was even worse for the American Army. A convoy arriving at Brest on October 8 with 24,000 men, had 4,000 with the flu and 200 died at sea. In the next few days, over 200 of those hospitalized from the "Leviathan" died.#47
One aspect of the Flu Epidemic in the Regiment, was the men it attacked. Most were young healthy new recruits, barely out of civilian clothes. Those in Newfoundland had regimental numbers over 5,000, meaning they had enlisted after May, 1918. Those in France, were mainly number 3,000 and up, having enlisted after May and June 1917 and arrived in France late in 1917 or early in 1918. I can only find two Veterans of the trenches and battles of 1916 and the first half of 1917 who contracted and died of the flu. Sgt.Joy, M.M.and bar, number 502, returned to St.John's in May, 1918 for Special Duty. He returned overseas on Draft 24 in October and died 2 days after arrival in Plymouth. The cause of death is listed as Pneumonia. Another man who had been overseas since 1916 was home on leave and died in St. John's.#48
It is said only Haig's Tommys remained unscathed by the Flu in September and October as if the Spring attack had created immunity to resist,#49 though the British from mid October to Mid November had 62000 cases and 3600 deaths.#50 This is compared to the American Expeditionary Force in France, with about 1/3 the number of men, there were 113,000 cases with 9,000 deaths.#51 Over 621,000 of all American service men had Flu-1/6 of the total of all Services, of whom 43,000 died.#52 The French Army had 132,000 cases with 10,000 deaths.#53 It is difficult to get statistics of the German Army, but one estimate places the number at 14% of the 1.2 million men under arms-about 168000 deaths.#54 Another source states that Germany suffered an estimated 2.75 million cases with 186,000 deaths in the military and 400,000 civilian deaths.#55 The Canadian Army in Canada, Britain, and France had 45,960 cases with 776 deaths.#56
Of civilians, 675,000 Americans died of the Flu, 225,000 in Britain, an estimated 6 million in India--20 million worldwide.#57 It is strange that there is very little mention of the Flu Epidemic in the Military literature. There is no mention of it in Nicholson's "The Fighting Newfoundlander", though the epidemics of dysentery and enteric that afflicted the Regiment in Gallipoli is recorded in some detail.<a href="#f58">#58" " The History of the 29th. Division" has only one line.#59 And in other histories, there is nothing. But Lyn MacDonald's "Roses of No Man's Land" gives graphic descriptions, both British and American, of the pandemonium and horror in hospitals in France and Britain, caused by the Flu Epidemic in May and June, and in October and November#60
Did it affect the outcome or the length of the War? I could find no military authority who indicated that the Fall of Germany was brought on, even indirectly, by the Spanish Flu. McGinnis suggests that both sides suffered almost to the point of exhaustion. The railways in France and Germany were both almost brought to a halt from lack of men to run them. It is possible that the epidemic may have shortened the War.#61
During October, 1918, the politics of Germany was chaotic. Prince Max had replaced Von Hindenburg as Chancellor. Ludendorff wanted to continue the War in spite of peace negotiations already in progress. At this vital stage, on October 23, Prince Max was sick with the flu and confined to his room for two weeks-possibly delaying the final surrender til November 11.#62
The Flu may have had an affect on the Peace negotiations at Versailles. Crosby, in "Epidemic and Peace" suggests that the flu epidemic may have had a deleterious effect on the proceedings. President Wilson had a severe bout of the flu in the Spring, and was reported as close to death. His main advisor and confident, Col.House, was ill from the flu ever since he arrived in France in late 1918, and is said not to have recovered during the time of negotiations.#63 Lloyd George had a mild bout in April. All this illness delayed negotiations and may have had an effect on the final decisions on Reparations and Wilson's 14 Points - one of the factors leading to the Second War.#64 It is said that Wilson was still not well when he returned to the U.S. to drum up support for the U.S. entry in the League of Nations. He failed to get this support.#65
Influenza sputtered on through 1919 and 1920 but with much less ferocity than in the last 3 months of 1918 and early 1919.#66
The Influenza Epidemic had a tremendous impact at the time, but was soon forgotten, except for so many bereaved families. But then the War had such an impact on the lives of people for 4 long years, that the epidemic, even though it killed more than the total number killed in the War, was not remembered in the same context as the horrors of the War.
In Canada, the flu epidemic did have a positive impact on Public Health. Funds for expanding hospitals became available, Public Health Nursing courses were started at Dalhousie. The C.M.A. had been pressing for Federal health coordination since 1900. In 1919, the Department of Health Act was passed. The flu epidemic was also one of the reasons that the International Red Cross decided to extend it's programs to peacetime activities.#67 It was the one time that there was no Stanley Cup playoffs. In Newfoundland, there is no evidence that the epidemic had any specific effect on Public Health matters. What effect did the Spanish Flu have on the Newfoundland Regiment. A total of 351 cases and 29 deaths. In the later months of 1918, the regimental strength in Newfoundland, Britain, and France was about 3000. Battle casualties in September and October in Belgium were 74 killed in action or died of wounds, and 270 wounded.#68 One can see why the flu epidemic had such little consequence to the Regiment. And the majority of cases were recent recruits, such as Pte. Joseph Alexander.
The Royal Newfoundland Regiment was a citizen's Army, one with and of the society from which it was raised. While the country was able to raise and equip a regiment, train them to kill and be killed, fighting a military enemy, it was powerless to fight the killer that was amongst it's own people at home. The soldiers at home suffered equally with the rest of the population. The part of the Regiment that was distant in place and time from this society, that is, those in France and Flanders, were not so affected.
Despite our best efforts to kill, maim, and disfigure each other deliberately in war, a more powerful and perhaps more effective killer, came from within the ranks of our own home towns.
A case in point is Sgt.Joy. He had fought overseas for 4 years and was decorated for bravery at Monchy and Marcoing. He had been through the bitter fighting at Gallipoli, at Beaumont Hamel and Gueudecourt, only to die of disease contracted while on leave in Newfoundland. Was this a civilian tragedy greater than the military? . How are these victims remembered? The man made destruction is well documented in many histories and commentaries on the War. The monuments are visible in every city and town. The silent killer of the Spanish Lady, a more sinister killer against which little could be done, is all but forgotten save for an almost anonymous granite plinth in the traffic island on Cavendish Square - and the silent graves of Pte. Joseph Alexander and his comrades.
Dr Parsons has a particular interest in the military history of Newfoundland and is the author of the book, Pilgrimage, a Guide to the Royal Newfoundland Regiment in World War One, Creative Publishers, St.John's, Newfoundland, published in 1994.
Newfoundland was a self governing Dominion in 1914, similar in status to Australia, Canada, New Zealand and South Africa (although without their size or population). The Newfoundland Regiment was sent to England on the outbreak of war, and was quite distinct from the Canadian forces (although it is said that over 3000 Newfoundlanders enlisted with the Canadians.
The newspapers referred to in the references were from St.John's, Newfoundland - The Evening Telegram and the Daily News.
1 Daily News, October 22, 1918
2 Ibid October 22, 1918
3 McGinnis, J.P.D. "The Impact of Epidemic Influenza in Canada Medicine in Canada. Historical Perspectives, 1981. p.448 .
4 Influenza Epidemic in the British Army in France, 1918. Influenza Committee of the Advisory Board to the D.G.M.S., France. BMJ, 1918(ii), 505
5 Crosby, A.W.Jr. Epidemic and Peace." p.26
6 Ibid p.26
7 von Ludendorff, Erich. "Ludendorff's Own Story p.317 Harper & Br., New York. 1919.
8 Collier, Richard. "The Plague of the Spanish Lady p.305 Atheneum, New York. 1974.
10 McGinnis, J.P.D. op.cit. p.453.
10 History of the Canadian Forces 1914-1919. Medical Services. Sir Andrew MacPhail, ed. D.N.D.1923. p.271.
12 Sick List of Royal Newfoundland Regiment for Measles Epidemic, Mar.1918." Manuscript Document.
13 Ledger of the Royal Newfoundland Regiment. A listing of the service of all members of the Regiment from Number 1 in Aug., 1914 to Number 6400 in November, 1918, including deaths, wounds, sickness, and location of occurrence.
14 Sick List of Royal Newfoundland Regiment for Flu Epidemic from September 29, 1918 to November, 1918. Manuscript Document.
15 Ledger of R.Nfld. R.
16 Evening Telegram September 18, 1918.
17 Evening Telegram.September 25, 1918.
18 Evening Telegram September 30, 1918.
19 Daily News October 1, 1918.
20 Daily News October 2, 1918.
21 Evening Telegram October 9, 1918.
22 Daily News October 15, 1918.
23 Evening Telegram October 16, 1918.
24 Daily News October 17, 1918.
25 Daily News October 14, 1918. Evening Telegram October 14, 1918.
26 Daily News October 14, 1918 Evening Telegram October 14, 1918.
27 Daily News October 15, 1918 Evening Telegram October 15, 1918.
28 Daily News October 16, 1918.
29 Daily News October 19, 1918.
30 Evening Telegram October 18, 1918.
31 Evening Telegram October 20, 1918.
32 Daily News October 29, 1918.
33 Daily News October 28, 1918.
34 Evening Telegram November 1, 1918.
35 Annual Report of the Registrar General of Births, Marriages, and Deaths for the year ending December 31, 1918. St.John's, 1919.
36 Annual Report of the Registrar General of Births, Marriages, and Deaths for the year ending December 31, 1919. St.John's 1920.
37 Collier, Richard. op.cit.p.305.
38 Ledger op.cit.
41 Ibid .
42 Journal of the Assembly, 1919 PANL J 125 K3
43 Evening Telegram October 12 and October 18, 1918.
44 Evening Telegram October 18, 1918.
45 Ledger op.cit.
46 History of the Canadian Forces. op.cit. p.272.
47 Crosby, A.W. op.cit. p.124
48 Ledger op.cit.
49 BMJ, 1918 (ii) p.71.
50 Crosby, A.W. op.cit. p.19.
53 Ibid p.158.
54 History of the Canadian Forces. op.cit. p.272. McGinnis, J.P.D. op.cit. p.470.
55 McGinnis, J.P.D. op.cit. p.470.
56 History of the Canadian Forces. op.cit. p.271. Bouchard, A. CMJ.8, December 1918. p.1087.
57 Collier, R. op.cit. p.305.
58 Nicholson, G.W.L. "The Fighting Newfoundlander." Gov't.of Newfoundland 1964.
59 Gillon, Cap't.S.."The Story of the 29th.Division." Thomas Nelson & Son, Ltd. 1925.
60 MacDonald, Lyn. "The Roses of No Man's Land. Michael Joseph Ltd. 1980.
61 McGinnis, J.P.D. op.cit. p.470.
62 von Ludendorff, E. 0p.cit. p.199. Rudin, Harry R. "Armistice 1918. Archon Books.1967.
63 Crosby, A.W. op.cit. p.181.
64 Osborne, June.E. (ed.) "Influenza in America. p.152. Prodist. New York. 1977.
65 Crosby, A.W. op.cit. p.152.
66 Ibid p.181.
67 McGinnis, J.P.D. op.cit. p.471.
68 Ledger. op.cit.