Fate in new clothes — Life under pandemics

This sign, one of millions like it at businesses and public buildings across the country, is a commonplace reminder of how much our society has changed in a single year. Photo by Jennifer Stambaugh.

It sometimes seems as though nothing is the same as it was a year ago, and that nothing will ever be the same again. 

The COVID-19 pandemic has proven to be one of those events that cleave History itself in two. Everyone alive today will likely sort their experiences into the pre- and post-COVID. Economists, sociologists, and philosophers will still be tracking the changes wrought by the pandemic generations hence.

But few of us need the help of posterity or statistics to know how we’ve been harmed. The event itself may be for the ages, but the suffering has been intensely personal. 

It’s sometimes hard to remember that previous generations of Americans dealt stoically with deadlier outbreaks in the past, as well as the strict measures deemed necessary to control them. 

In 1918, the Spanish Flu came to Knoxville. Within the space of a month, more than a tenth of the city’s population fell ill and close to 200 men, women and children died.

As hard as it may be to believe these days, Knoxville residents didn’t protest having their churches, bars and theaters shut down the last time a major pandemic started killing their neighbors.

No elected officials objected when it became a crime for more than two people to gather together on the street, or even to sneeze anywhere but into a handkerchief.

“Sneezing into the air could get you arrested,” said local historian Jack Neely of the Knoxville History Project. “There aren’t any records of people actually getting arrested, though. I doubt they wanted to put them in jail.”

Part of their differing attitudes might have stemmed from the fact that lethal diseases and the specter of early, violent death were commonplace when compared to the relatively safe, secure lives most Americans enjoy today.

“Today, we really do expect to live to be 75 or 80 years old and we don’t expect anything to get in the way of that,” Neely said.

 “To them, this was just an old foe in new clothes. It was fate.” 

Local historian Jack Neely says that America has changed in many ways since the 1918 Spanish Flu pandemic. Photo from the Knox County Public Library.

Now vs. then 

Today’s date is March 15, 2021, and most everyone is exhausted from a year that will be remembered not only for the fear and loss but also for the suspension of nearly all forms of recreation. 

The lack of entertainment options might seem like a small thing, at least until you remember how much of our time and money before COVID was spent on filling up our spare time. The pandemic meant that you could forget going to see a ball game, a movie, or a concert to forget your problems. Even restaurants have either learned how to depend on carry-out and delivery orders or closed their doors forever. 

For the first time in memory, teenagers complained about not being allowed to attend school. Many of their parents were no longer allowed to go to work, which soon led to tens of millions of Americans facing personal catastrophes. The economic news — which looked rosy a year ago — now sounds like some forgotten prophecy of the apocalypse, full of doom-speak about inflation and mass unemployment.

 With the widespread distribution of newly developed COVID vaccines, however, hopes are high for the first time in a year that the ordeal may soon be over.

Even if it ended today, however, the butcher’s bill demanded by the coronavirus would have seemed unimaginable to most Americans as recently as last year. 

The pandemic has killed nearly 532,000 people in United States, and has sickened more than 29 million. Worldwide the death toll stands at more than 2.6 million dead out of almost 120 million infected.

Knox County, secure in the mountain fastness of East Tennessee, has often felt like it was far removed from the troubles of the wider world. Even when it wasn’t, it often seemed easy to pretend otherwise.

No longer. 

As of yesterday, 594 people had died in Knox County from COVID since March 1, 2020, according to the Knox County Health Department. An estimated 1,048 people were battling active infections, with 31 of them sick enough to be hospitalized. 

Since the disease emerged a year ago and upended years of relative social and economic stability, there have been about 48,150 cases among Knox County’s estimated population of 470,313. The vast majority of those infected have recovered from the disease, although many continue to battle fatigue, pain and difficulty breathing.

It’s not clear if any event since the city and county were established in the 18th century has cost the lives of this many residents. 

In comparison to COVID, the Spanish Flu killed 209 people in Knoxville and another 16 in unincorporated areas of Knox County in late 1918. 

It’s impossible to know exactly how many residents got sick overall, but based on what authorities said at the time it was probably about 10,000 people out of a combined city/county population of approximately 110,000.

The Spanish Flu, which killed an estimated 750,000 Americans, was the most recent pandemic to cause anything close to the level of social and economic disruption as COVID. The fact that historians and medical experts know far more about the Spanish Flu than many previous outbreaks means that comparisons between it and COVID are relatively easy to make.

Perhaps the easiest lesson to learn from such a comparison is that the people of the United States in the early 20th century were vastly different than are their descendants today, with contrasting attitudes toward death and personal freedom as well as the government’s role in protecting public health.

“Some kind of unusual power

For years, Neely published the popular column “Knoxville’s Secret History” in the weekly paper, Metropulse. He is also the author of several books and something of an unofficial city historian who now runs the Knoxville History Project, a nonprofit educational organization.

Even the newspapers rarely put it on the front page, even when the city’s only hospital ran out of beds and a dozen people were dying each day.

“They had a major distraction in the First World War,” Neely said. “October of 1918 was the worst of men dying in the trenches. Many died of bullets, but many died from the flu, too.”

It was the same month, after all, that Sgt. Alvin York performed the acts of heroism that made him a national hero, Neely continued. More than half of the local men who were to give their lives in the conflict were to die that month as the final Allied offensive slowly crushed the German army.

It was a busy month in other ways: the East Tennessee Division Fair (later to be known as the Tennessee Valley Fair) was set to kick off in Chilhowee Park. 

At the time, there was no county Health Department or volumes of regulations on the books to cover crises like pandemics. 

In fact, in a fit of sanity, the leaders of that time had apparently decided that politicians had nothing of value to contribute in such a crisis. Instead, the community’s response would be decided strictly by medical professionals.

In 1918, that meant Dr. William Robinson Cochrane, a 53-year-old physician who lived with his wife on Walnut Street. Cochrane held the post of secretary of the city’s Board of Health, a strictly part-time gig that made him the most powerful man in Knoxville if a public health emergency were to erupt.

That emergency, of course, came with the Spanish Flu.

The first cases showed up among the soldiers-in-training camped near the fairgrounds. By Oct. 5 there were 350 cases, and Cochrane became convinced that a deadly contagion was loose in the community.

Red Cross members stand with soldiers in Knoxville, 1918. Photo from the Knoxville History Project.

On Oct. 9, Cochrane issued a declaration saying. “All public meetings, except those of war purposes, will be forbidden until further notice. The closing order will affect any public gathering of any kind. No one need think that they can hold any public meetings in Knoxville, because any gathering for any non-essential purpose will not be tolerated.”

Neely said local medical officials seemed to have far more power 100 years ago than do their modern day counterparts. Also, elected officeholders didn’t seem to be involved much at all in deciding how the community handled the flu.

“You didn’t see the mayor, you didn’t see the governor talking about it,” Neely said. “The City Physician (Cochrane) was in charge. They closed theaters, churches, pool halls …. He seemed to have some kind of unusual power to shut all those down.”

His recommendation to shut down “non-essential places of amusement” meant shuttering the Fair at Chilhowee Park; all the schools; places of worship; 25 pool halls, six movie theaters; several dance halls, and the Bijou Theater. The decision cost the jobs of an estimated 100 workers for the duration of the outbreak.

“They closed down the Fair on the third day, and that was really disastrous for the investors in it,” Neely said.

“It was just over”

Still, the newspapers of the time didn’t carry editorials claiming that civil rights were being violated and no citizens seemed to protest the order. Of course, there are also no indications that most private businesses were required to close.

But perhaps the main reason that no one objected was that they knew firsthand what an epidemic could do and were more than willing to suffer some inconveniences — even major ones — if those were needed.

“They knew smallpox, which is in many ways much worse (than the Spanish Flu or COVID),” said Neely. “They knew about Yellow Fever, and some of the older people remembered cholera.” 

Knoxville General Hospital, the only medical facility in town, was swamped with patients and soon ran out of beds, even with the help of the Red Cross. Thousands now lay sick, battling high fevers, body aches and violent coughing. 

Knoxville General Hospital, the only medical facility in town when the Spanish Flu pandemic struck in 1918.

The newspapers reported several heartbreaking tales, such as the Maxwell family who lived on Lowe’s Ferry Pike. The household consisted of a “man” who died on a Monday, followed by his mother on Friday and his father on Saturday.

Another tragedy took place when a young woman died only hours after watching the flu kill her 5-year-old daughters. One teenage girl was taken to Knoxville General, where she seemed to be recovering until she succumbed to appendicitis, which at the time was always fatal.

Eventually, however, the outbreak began to die down. After four weeks, Cochrane lifted the order and public meetings (and public partying) resumed. Cases of the flu didn’t go away entirely until early 1919, but by that time the triumphant end of the First World War was pretty much the only news that anyone wanted to talk about.

Knoxville got off lightly, Neely said. Chattanooga, which was a much smaller town, lost over 1,000 dead from the flu. So did Nashville.

While there are certainly similarities between the two pandemics, the differences seem far more pronounced.

 COVID has killed more than two-and-a-half times as many Knox County residents as the Spanish Flu did. Also, the many disruptions associated with it have lasted far longer.

“The Spanish Flu was deadly for six weeks and then it was just over,” said Neely. “We’re not seeing that this time.”

Still, the people alive in 1918 might have considered their ordeal to be more cruel in at least one way,  Neely said.

It took only a little more than a week for Cochrane and other doctors to realize the Spanish Flu’s most disturbing characteristic, Neely said. 

COVID and most other respiratory infections mainly kill the elderly and those with underlying health problems, he explained. The Spanish Flu, however, seemed to take a perverse delight in destroying the young and the healthy.

“It was kind of creepy, because it seemed to select younger people,” Neely said. “We’re used to modern flus killing older people. This one seemed to target younger children and young adults. That was a mystery at the time. It was scary.” 

J.J. Stambaugh can be reached at jjstambaugh@hardknoxwire.com

Published on March 15, 2021