Army Bob: The Spanish Flu in Minneapolis vs. St. Paul

by Robert M. Traxler

In researching the spread of the Spanish Flu 1918-1919 I came upon a study of the differences between Minneapolis and St. Paul during the world’s most deadly pandemic, two cities side by side that had differing approaches to mitigation efforts.

One of the interesting facts was the naming of the pandemic. Spain was neutral in World War I, and its press was free to report bad news, so it was the first to published news of the outbreak, and that is how it got its name, even though it had been in other countries for months.

Most epidemiologists now feel that the 1918-1919 pandemic started in China in the Wuhan area, and was spread to France by some of the one hundred and fifty thousand Chinese laborers hired by the allies to help with the war effort. Some will say that the flu started in Fort Riley, Kansas; possible sure, but very unlikely. Military personnel with combat experience were moved from France back to training posts, camps and stations in the United States, some bringing the flu from France. Contrary to popular belief WWI was still raging when the Spanish Flu pandemic started.

The side by side studies of the “twin cities” is normed by rate per thousand and by percentages, not using raw numbers. So what did the after action study teach us? We will all be familiar with the recommendations, social distancing, aggressive protection for health care providers, strict usage of protective masks, sanitation, sanitation and sanitation, limiting numbers of people allowed in areas where fresh air was not available, closing schools, churches, sporting events and more, but the number one recommendation was education.

In the days before even radio, educating the public was a herculean task, especially with the schools being closed. Boy Scouts, postal workers, church groups and civic groups were mobilized.

One of the policies enacted to “bend the curve” was banning the use of common cups in drinking fountains, along with the banning of community multiple use cloth towels for washing. Utensils, cups, glasses and plates were required to be washed in a way that sanitized them in public restaurants.

Two vaccines were developed, one by the Mayo Clinic and one by the University of Minnesota. Both were ineffective, but given to tens of thousands free of charge. Interestingly both vaccines were effective for other communicable diseases, but not the Spanish Flu.

Public outrage was widespread in Minneapolis/St Paul; the association of bowlers petitioned the government as did football fans and folks who used elevators. Elevator use was reinstated, though at a reduced rate.  Some school boards only acted when threatened with arrest; many high schools had “scrimmage games” with rival schools, as football practice was allowed. Bars had back doors with code words used to gain access, a precursor to the speakeasy of prohibition fame. The night before the bans on large groups went into effect, movies and plays were standing room only and there were lines at houses of ill repute.

We see a direct link between aggressive segregation and stemming the growth of the Spanish Flu. St. Paul was more aggressive in mitigation than Minneapolis, and the numbers prove the value of limiting the spread. In October 1918 with strong mitigation, St Paul had a rate of 60 per one hundred thousand while Minneapolis had more than 500 per hundred thousand.

As you know if you read this column, I am an advocate for wide use of face masks. Many in 1918 believed that virus could not live on cloth, so during the early days of the pandemic masks were not sterilized. Later the value of washing masks with soap and water was discovered, and overall masks were important.

The largest lesson learned from the world’s worse pandemic in this study of two side-by-side American cities is aggressive distancing and good old-fashioned washing of common areas work, along with masks. The Spanish Flu went on for two years; with our aggressive actions and with modern medicine, the newest virus should be controlled in months rather than years.

Stay safe my friends. This too will pass; how soon it passes is up to all of us.