Outbreak past

When the plague came to Chico, it was heralded not with anguished proclamations of doom, but with a joke, the kind of lazy one-liner dreamed up by a bored reporter who was trying to cram some humor into a public service blurb. On Oct. 7, 1918, the Daily Enterprise, one of two daily papers in Chico at the time, broke the story in a seven-line item buried on page 7, just above an ad for Castoria castor oil.

“SPANISH INFLUENZA STARTS WITH SEVEN: The latest fashion in diseases is with us. Dr. Baumeister reported this morning to the city health officer that seven cases of Spanish Influenza were located in Chico.”

And with that, the greatest pandemic in modern history made its first local appearance. It caused little stir, made nobody’s hair stand on end and caused almost nobody to make preparations for what was to come. There had been a story or two in the weeks before of a sickness that was making the rounds of Army camps and East Coast cities, but thanks partly to a governmental campaign to underplay its magnitude, the threat seemed fuzzy and remote. The flu may have been a killer, but it somehow lacked the emotional punch of stories depicting gas-shrouded battlefields in Belgium and France, where almost 2 million American soldiers were taking part in World War I. The country’s full attention was focused on winning that war, and no one was in the mood to be distracted by some foreign germ, especially in an era when modern medicine was thought to have all but conquered pestilence.

That was the beginning of October 1918, the deadliest month in American history, when an estimated 195,000 Americans succumbed to a form of Influenza that is thought to be in some ways similar to the H5N1 Avian Flu, today’s “latest fashion in diseases.” In terms of pandemic death, Chico was lucky in 1918. But it wasn’t immune.

While it was just a tiny dot on the map, Chico was nonetheless an important hub for business, agriculture and industry in California’s great northern valley. With a population of about 12,000, it hosted Chico Normal School, where hundreds of schoolteachers were trained to teach the state’s exploding population of children, brought here or born to the parents of immigrants from across America and the world.

Back then, almost everybody who lived in Chico was from somewhere else, drawn here by employment opportunities at farms, mines or construction yards, at the bustling Diamond Match factory, or at one of the mountaintop lumber towns that supplied the wood needed to fuel the region’s growth.

In some ways, the town—as well as the country itself—hasn’t changed all that much. It’s gotten bigger and more densely populated, but the concerns of everyday people are much the same. There were worries over wars and foreign entanglements, there was friction between different cultures and belief systems and there was, as always, a rushing mass of everyday people just living their lives and trying to make ends meet.

Electric lights had recently been installed downtown. Cars were on the verge of losing their novelty but were still used mostly by the well-off. Regular folks walked, rode streetcars or steered horse carts down dirt roads. The spectacle of an airplane flying over would cause children to run from their homes and gawk at the sky.

The telephone was the state-of-the-art form of electronic communication and the mass media were in their infancy, so locals got almost all of their news from Chico’s two daily newspapers, both of which relied heavily on wire service reports. Both fed the public vivid stories of the war, ag-boosting farm statistics and prosaic local gossip. In the weeks before the flu hit, the Record’s “Personal Mention” column carried such nonessential tidbits as “Denny Murphy was a visitor in Oroville yesterday.” In later weeks the column would become a grim litany of flu-stricken and bed-ridden residents.

The first death came seemingly out of the blue, on Oct. 11, when local businessman Earl Wightman died at his home on Cedar Street. He apparently got the bug from a business partner in Sacramento and carried the disease home to Chico, where he exposed his family and most of the employees at the Chico Nursery Company, which he managed.

On that day, the Enterprise reported 40 cases of Influenza in the city. Other Northstate towns were also falling ill. In San Francisco, 170 miles to the south, the first flu case had been reported Sept. 24, and by the time Chico had its second flu death on Oct. 14, San Francisco had logged almost 1,000 cases. Dunsmuir, a Siskiyou County hamlet with a population of 1,000, had by that time seen a third of its population fall ill.

Medical experts were at a loss to fully understand the virus, much less rein it in. The virus, which seems to have mutated from a form originally found in wild birds, first struck the American civilian population in Boston. By late August, it had begun sweeping the eastern seaboard and spreading relentlessly west.

A “normal” flu, the kind many Americans get every year, tends to strike down mostly the old and infirmed. But this flu was different. It was quicker to strike and harder to get over, killing 2.5 percent of its victims. It seemed to relish killing people in the prime of their lives, between the ages of 20 and 40. It turned into pneumonia before doctors could even get to their patients, going straight to the lungs of its victims, causing them to flood their pulmonary systems with white blood cells, which in their fury attacked the very tissues they were sent to save. This caused the lungs to fill with a frothy, pink liquid that choked off the victims’ air supply, giving their complexions the bluish tint of a three-day old bruise.

Already, the cities of Boston, New York and Philadelphia had been crippled. Los Angeles closed all places of public assemblage. New York saw a day when 851 people died from Influenza in a 24-hour period. When public health officials in California asked their East Coast counterparts what they should do to prepare, the advice was sobering: Dig graves.

Yet in Chico, there seemed to be little concern. The city health officer at the time, who was the first to ever occupy that now-defunct post, was a layman by the name of Henry Marshall. Originally from Missouri, he was not a doctor and indeed had no experience in health care when he was hired by the town trustees in March 1915. The only qualification Marshall apparently had was his ability to secure a $1,000 bond.

Perhaps that is why, when asked by a reporter on Oct. 10 about the Spanish Flu, his answer was somewhat blasé.

“Influenza is not the only outbreak we must cope with at the present time. In one district due to lack of good sewerage conditions there are five cases of typhoid in one block …”

Marshall even took the opportunity to make a political pitch for an issue that still haunts the city to this day, saying, “The passing of annexation will probably clean up such conditions but at present they still exist.” (The trustees had recently annexed the Chapman and Chico Vecino neighborhoods.)

In the same article, Harold F. Gray, the state health officer for the area, seemed more concerned, noting that, “if the epidemic continues here at its present rate … a ban on all indoor assemblages must be put into effect.”

It would not be the last parting of ways between Marshall and his counterparts in Sacramento.

As the first death notices trickled in, the newspapers took to dispensing advice on how to avoid or cure the flu. The most helpful was usually the most basic, as the Enterprise urged people to “maintain their vigor by ample nourishment, plenty of fresh air … and avoid places where there is danger of contagion.” A few days later, the paper urged readers to snort boric acid as a “preventative.” Later still, the paper claimed that eating “a yeast cake a day” would ward off the disease. If that didn’t work, said Dr. C.L. Browning, president of the Butte County Medical Society, “take a small portion of Vaseline and mix 2000 parts … to one part of formaldehyde. Place this in the nostrils three times a day and one may be sure of avoiding contagion.”

Chicoans Francis Hammond, 66, and attorney Warren Neville must have ignored the good doctor’s advice. Both died Oct. 14, the day before Chico’s case count hit triple digits.

Around this time, Marshall began asking businesses to clean and “fumigate” their premises to avoid any further spread. This was generally done with a solution of formaldehyde or some other awful-smelling yet probably worthless concoction. A heavy rain kept many inside that week. On the 17th, the fumigation effort appeared to have been successful. Both papers carried the good news. The plague would soon be over.

“With 131 cases … doctors believe the epidemic has reached its crest,” reported the Enterprise. “City Health officer W.H. Marshall has decided that it will be unnecessary to close the theatres … as they are now fumigated daily.”

That same day, two more Chicoans dropped dead. One was an 11-year-old girl named Maria Silva, the first Chico child to succumb. Dozens more fell ill as they threw caution to the wind and attempted to get back into their everyday routines.

The next day’s papers, however, adopted larger headline fonts and a slightly panicked tone. Unbeknownst to the general public, many of the paper’s employees had already fallen ill, and two would later die. Dr. E.E. Baumeister, who himself had been laid out with the disease a week before, told both papers that the epidemic would soon be out of control if nothing was done to stop it.

“A week ago there was perhaps one case in those families that were affected, now in many instances the entire family is ill … The people of Chico do not understand the seriousness of the situation.”

Marshall, who was still relying on his fumigation campaign, told the paper there were no new cases that day, when in fact the town’s doctors were probably too busy treating patients to make their reports. Under pressure from local businesses, Marshall seemed reluctant to follow the state’s advice and close at least the vaudeville and movie theatres in town. That day, the Enterprise’s editorial took aim not at Marshall but at “The Sneezers,” writing, “The chap who has a touch of Influenza ought to be exceedingly careful not to sneeze so as to spray his neighbor.”

On Oct. 20, just three days after the epidemic was said to have gone into decline, the number of cases skyrocketed. One doctor estimated half the people in Chico were affected. After a spirited debate, Marshall issued an order he hoped would stop the flu in its tracks. The next day, every “motion picture house, pool room, dance hall and other place of amusement” was ordered closed. The schools and churches voluntarily followed suit. Attendance had by then fallen off so badly there was little need for them to stay open anyway.

Finally, the seriousness of the situation sunk in. Traffic in town began to thin as crowds seemed to evaporate overnight. Those who weren’t bedridden or caring for sick family members tried to carry on their business as well as they could, but the downtown portions of the city had lost much of their allure.

The new streetlights went dark to discourage people from going out. Drug stores remained open and by all accounts did a fantastic business, staying open late to dispense questionable cures and preventatives. Other businesses simply defied the order, some with official collusion. When downtown pool rooms failed to close, the Enterprise asked one of their managers, W.D. Walker, why.

“There is not a man in Chico who is more willing to do his share against the prevention of the spread of Influenza in Chico than I am, but I did think it was an unfair proposition to make a distinction against my place of business,” Walker told the Enterprise. “On an average not more than two men are at the tables playing and then they are never in close proximity.”

Marshall, who either wasn’t in a position to enforce the closure or didn’t see the wisdom of it in the first place, allowed the pool rooms to stay open, provided they “remove all the chairs from their parlors and thoroughly fumigate their cuspidors.”

Department and general stores also stayed open, but most began demanding cash for goods, whereas in the past they had offered credit to regular customers. No business wanted to try to collect a debt from a broke and grieving family, and beyond that, supplies of basic goods had begun to tighten. With a quarter of the country sick, less was getting done at a time when many were already strapped by the demands of winning WWI.

Just days after the flu hit, profiteering began to emerge, innocently at first, as seen in ads for shoes to keep one’s feet warm and thus help one to avoid sickness. Snake oil cures abounded. A local music shop advertised phonograph players that might relieve the boredom of quarantine, advertising that with “no place to go [and] no opportunity for entertainment,” a “talking machine” might be the perfect investment. Unfortunately, the best-selling record that year was the U.S. Field Artillery March, with its morbid refrain, “the caissons go rolling along,” a reference to the grim parade of horse carts carrying the dead away from the trenches of the western front. Half of those deaths were caused not by combat, but by the flu.

By the end of October, just three weeks after the flu’s arrival, Chico had begun to resemble a ghost town. Under pressure from ministers and prohibitionists, Marshall ordered all saloons and soda shops to close. Residents stayed home if they could, and many who did go out wore gauze masks over their faces, creating a surreal and ghoulish atmosphere on the near-deserted streets.

Those who didn’t want to wear masks had to be forced to do so. Two days before Halloween, Marshall announced an emergency ordinance declaring that masks must be worn by anyone who ventured outside. This came after a week that saw 13 people die in a two-day period. Chico’s case count climbed to 850. Nurses and undertakers were suddenly in great demand.

That Halloween night, under the last sliver of a waning moon, residents of the city sat anxiously inside their homes, prisoners of a virus that had taken near-complete control of their lives. There was no trick-or-treating or bobbing for apples that year. No parent in her right mind would send children out to be infected by a killer that had already claimed 30 lives in town, and had any children gone out, it’s unlikely people would have opened their doors and given them candy.

It wasn’t a good time to be a kid. The schools were closed and the authorities had issued warnings about allowing children to play with neighbors. Many children fell ill or had to care for family members, but the ones who remained well had to deal with excruciating boredom. Unlike kids of today, the generation that grew up during the turn of the 20th century had almost no distractions. There was no toy industry to speak of, few books for kids and no forms of electronic entertainment—not even radios. As a result, having to stay inside was one of the worst punishments a kid could receive.

Ralph Silva, 98, was quarantined for three weeks in Richmond when he was about 11 years old.

“Can I tell you about it? No,” he retorted when asked for an account of the time. “How can I remember? Somebody came right along and put a tag on the outside that said ‘quarantine.’ Neighbors could come to the front porch if we needed things … and I guess my mother would go out and pick them up. What’s a kid know about such things? All I wanted to know was why the hell I couldn’t go outside and play.”

Esther Kidwell, 96, a lifelong Chico resident, was 9 when she fell ill with the Spanish Flu. Her memory of that time is spotty.

“I had gone out to the library and walked home,” Kidwell remembered. “I was sitting down and my mother said, ‘Well, you don’t feel well.’ I said, ‘Oh, I’m just tired.’ I can’t remember that anyone was in bed. We all had it except for one sister … I can remember people wearing masks. I think we wore them to school.”

One can only imagine what effect the weeks of isolation must have had on those kids and their families. Those with telephones took to calling friends and neighbors instead of visiting, but even that was discouraged, as the pandemic sickened so many operators the phone company had to plead with its customers to make only emergency calls.

Doctors were swamped with cases and sent out urgent requests for nurses. Many of the schoolteachers and students at the Normal School volunteered to help, and the Red Cross, which had been busy already with war relief efforts, was overwhelmed with patients, along with the task of making enough gauze masks for every man, woman and child in the county. Eventually they would set up shop in the original Enloe Hospital building on Flume Street, which had been vacant since the outbreak of war. Captain N.T. Enloe, who was in San Francisco at the time, was summoned back to reopen the 60-bed facility, which soon overflowed with sick and dying patients.

The flu was an equal-opportunity killer, as Mayor William Robbie found out. His 30-year-old son George passed away after nursing the rest of his family back to health. John Briscoe, the publisher of the Enterprise, crumpled in the street in front of his house after waking from a feverish dream with delusions he was being restrained in a mental hospital. His mother followed him to the grave a few days later.

At City Hall, the trustees debated their options. Official advice from state and federal authorities was confusing and often contradictory. Several times the papers announced that a cure or vaccine had been found, yet none ever emerged. Health officer Marshall continued to perform his duties as best he could, but he was overwhelmed by the tragedy unfolding before him. In a mid-November interview, he vented his frustration.

“I am in a quandary just what to do,” he told the Enterprise. “We have a board of health; they shift the responsibility to my shoulders. They tell me to use my best judgment, and when I have rendered a decision one way or another, they promptly call me down for doing so.”

Marshall had a mistrust of medical experts that bordered on contempt, and publicly lashed out at local doctors, who he accused of failing to accurately report flu cases. He also berated state health officer Gray, who had already expressed his own low opinion of the city’s public health efforts.

“I am between the devil and the deep blue sea,” Marshall said. “I believe and am positive that the danger is over; but until the physicians live up to the letter of the law and file their reports up to the last minute, I cannot arrive at a definite conclusion.”

The downtown merchants, as potent a political force then as they are now, clamored for their stores to be allowed to open and for the mask ordinance to be lifted. Saloon owners particularly chafed at the closures, causing some to defy the orders altogether. In a fit of piety, The Enterprise gleefully reported that cigar stands were being hit particularly hard by the mask ordinance, as it was impossible to smoke and wear a mask at the same time. The paper also reported an epidemic of public drunkenness downtown, as a creeping fatalism seemed to enshroud the town. A Bangor man whose fears of the flu “preyed upon his mind” attempted to drown himself and was locked in the county jail,"charged with insanity,” the Enterprise reported.

In an emergency meeting held Nov. 13, most of the town’s doctors agreed that, while flu cases were now on the wane, it would be unwise to open all the schools and businesses just yet. Striking a compromise, Marshall allowed the soda shops, saloons and pool rooms to open, but kept the mask ordinance in place. Many of those businesses had already reopened on their own by then, seeing that the seven-member police force had been completely crippled by the demands the flu had brought.

By Nov. 16 there had been 1,500 reported cases in Chico, and deaths were still occurring on a daily basis. But as the war drew to a close and people started looking forward to the holiday season, a new, defiant mood took over the townspeople. Letters and editorials began appearing that called for a return to business as usual, the flu be damned.

“Let’s officially open house Saturday,” one anonymous letter to The Enterprise read. “Let the theatres resume, let’s have the city lighted like a real town. Let the schools reopen Monday and the churches open Sunday and let everyone who can get out and enjoy the God-given air and freedom without so much official restraint.”

A businessman quoted in the Record spoke for many shopkeepers when he said, “The merchant wants … to see the influenza stamped out as soon as possible, but it must be remembered that he is paying rent and clerical hire and other expenses …”

The sudden burst of optimism may have come from the signing of the armistice that ended WWI, which brought everyone, sick or well, masked or unmasked, into the streets for a spontaneous celebration. By that time, many who initially got sick recovered and went back to living their lives. Others probably tired of living in fear and simply vowed to go on.

Whatever the reason, Chico trudged through the rest of the pandemic with a stubborn sense of pride. Although spikes occurred throughout the year—especially after holidays and public gatherings—the Spanish Flu had pretty much shot its bolt by January. By then, there was nothing left to do but count the dead and point fingers. In Chico, there were 104 deaths out of 1,958 flu cases. The city death count that year was two persons higher than its birth rate. Butte County death records show 63 flu or pneumonia deaths in the last three months of 1918, but most of the Chico deaths are not represented, and many rural residents were no doubt left off the official record. In any case, half the deaths that occurred in the county that year were recorded during the three-month peak of the pandemic.

Marshall opened the businesses and let the mask ordinance expire in time for the Christmas shopping rush, but continued to receive scores of letters criticizing his performance. By December, he faced what the Enterprise called a “revolt,” in which hundreds of citizens said they would refuse to wear masks. Some called for Marshall to resign, while others defended his efforts. He rode out the storm and served as the city health officer for a number of years afterward, continuing all the while to feud with his state counterparts, charging that they “did little or nothing but write letters to combat influenza.”

In a tirade that echoes more recent friction between local and higher government over botched disaster response plans, Marshall blasted the state in a letter published by The Record.

“To one of my limited knowledge of health work, these past four months have taught me to be serious. Serious, because I have found out how little the ‘highly trained and well qualified experts’ you refer to really know. The public have accustomed themselves to rely on the state … for information relative to health matters, and they now realize, as do I, that no relief can be expected to come from your office.”

The city got out of the public health business long ago, so the modern-day equivalent to William Marshall would have to be county public health officer Dr. Mark Lundberg.

Unlike Marshall, Lundberg is a bona fide doctor with 11 years’ experience running a large public health department. His basic duties include monitoring infectious disease cases, gathering outbreak data and working in the county’s two public health clinics. He works out of a small, cluttered office in the county’s new public health building in Oroville.

Lundberg himself is a clean-cut, former farm boy with deep ties to Butte County. His family runs the Lundberg rice farm and he jokes that he got into public health as a youth, trying to convince people that brown rice and organically grown produce could be healthier than conventionally grown and processed foods.

Lundberg has not done a great deal of research on the 1918 flu, but he does have a personal connection to it. He opened up our interview by reading a letter his great-grandmother sent in October 1918 from rural Nebraska to relatives in Richvale.

“Sure was glad to get [your letter]. Hope you are all well and that the flu will not reach you. Joe said they were quarantined. Hope he will not get it.

“There are some cases of the flu out here also. One man died north of town and there are some cases in town but our school has not closed. In town there has been no school or church service in two weeks … We are all well, feeling just fine, better than I have been for a long time.”

Lundberg’s great-grandmother, who had four children and was pregnant with a fifth, died of the flu a few weeks after the letter was written.

When Lundberg was asked to update the Board of Supervisors on the county’s plans should a flu pandemic break out, he told the board his department was worried most about hospital bed capacity and that, using a formula developed by the U.S. Centers for Disease Control (CDC), Butte County could expect around 200 deaths in the next flu pandemic.

“That’s actually good news,” he told the board, “in that it’s not the entire population.”

His comments were ostensibly accurate, but they mask a deeper problem, in that nobody really knows how high the mortality rate would be if the H5N1 virus mutated into a form which could be passed easily from person to person. Already, there have been a few cases of human-to-human transmission, and if World Health Organization statistics are correct, more than half of those who have come down with the H5N1 flu have died.

“As of the end of January they were reporting 160 cases in the world and 85 deaths,” Lundberg said. “That is petrifying. It’s just a huge number. How could any community handle a disease like that?”

While Lundberg said the general public seems to be overreacting to the current flu scare, he admits that the worst-case scenario of a bird flu pandemic is not something that can really even be planned for. For example, the CDC advises that 15 to 35 percent of the population might become ill. In Butte County that translates to as many as 75,000 people. Of those, as many as 900 would need to be hospitalized. There are currently only 610 hospital beds in the county and most are generally already full.

But the mortality figures are what bother Lundberg.

“You put those numbers in, the mortality rates of those that are ill would be somewhere between .1 to .66 percent. That’s the kind of thing they’re asking us to think of in planning,” he said. “[But] if avian’s running at over 50 percent mortality, it kind of blows that planning right out the door.

“This disease could mutate so that it is highly contagious but preserved its highly pathogenic nature. Of course, a lot of times when it becomes more contagious, it doesn’t keep its highly pathogenic nature, but if it did … that would be impossible for the health care system to really deal with that.”

Lundberg was surprised to hear that his 1918 counterparts were organized enough to take the measures they did. Masking, he said, is good for keeping sick people from spreading germs but doesn’t do a lot to keep healthy people from getting sick. If a pandemic were to break out next week, Lundberg would likely try to implement what are now called “social distancing” measures on a voluntary basis. That basically means urging people to stay at home and avoid crowds.

Lundberg has broad legal authority in such a situation, but he might be reluctant to use it.

“There is a legal basis for [quarantine or isolation measures] but we’re going to be awful careful to implement those,” he said. “You’re talking about violating people’s civil rights here and so we’re not going to be jumping at any of these measures unless there’s some way to justify them.”

Technology adds several new twists to the pandemic scenario. Scientists can now track the virus as it spreads and mutates in any corner of the world, giving researchers much more time to come up with defenses against it. But we are also a highly mobile society, meaning that we can carry germs farther and faster than ever before. As many as 22,000 people enter California from Asia, where most H5N1 cases have occurred, every day. If one of them is host to a transmissible form of the virus, the entire state could be infected in a matter of weeks, if not days.

We also have a lot better medicines than they did in 1918, but we don’t have enough of them. Tamiflu, an antiviral drug, might be effective against avian flu, but it’s expensive and in short supply.

“Our county has not purchased any,” Lundberg said. “You look at the number you’d have to buy … there’s an estimate that in Butte County there’s 500 health care workers. Say you targeted those people and you were going to give them an eight-week course of prophylaxis, Tamiflu, to try and get them through the season. Some people, you might have to give them that just to convince them to come to work … That would be about 284,000 pills. Current price is about $7 a pill, so that’s about $2 million of inventory there, and that’s not looking at public safety people or high-risk outpatients, the elderly, diabetics—there’s something like 62,000 of those in our county. It’s kind of an overwhelming thought.

“The other advantage we have over 1918 is that we do have a vaccine industry. But there are great limitations there too,” he said. “They’ve created what could be a vaccine for this virus, but … if genetic changes occur, would it make it ineffective? They claim that our production of vaccine would be such that we could deliver five million doses per week. Well, that presents a challenge—who’s going to get that first five million? With such a new virus, they think it will take two doses over a one-month period of time [to be effective] … Every community would be trying to make a case why we need more, and then every county would have to make decisions how to distribute it.”

The real advantage we have today over 1918 is easy access to a wealth of information. Yet even that is a double-edged sword, Lundberg said. Media stories about the flu will cause some families to be more prepared and others to form irrational fears. Those who worry about H5N1, he said, should remember they are much more likely to die from a car crash, heart attack or an anvil falling on their head than they currently are of bird flu.

Polls show most Americans don’t care much about avian flu, and at this point, they have no real need to. The virus can only be caught by close contact with an infected bird or by very close contact with an infected person. There are currently no infected birds in North America.

Still, history compels us to watch the H5N1 virus very carefully. The 1918 flu was, after all, a similar bug, and it killed at least 20 million and as many as 100 million people around the world, shortening the U.S. life expectancy by 11 years. Flu pandemics seem to occur naturally, every 20 to 30 years. The last one was the Hong Kong flu of 1968, which killed some 700,000 people. No one knows when the next one will appear, but one thing is certain—it will be back. When it returns, we can only hope Chico will be as lucky then as it was in 1918.