2. Care and Community: York and the Second Wave

Cat Oakley

Note: This is the second post in our blog series “Rowntree, York and the 1918 Flu Pandemic”. You can read the first post here and find out more about the series here.

The Second Wave

By the end of July 1918, the influenza virus which had spread throughout York appeared to have subsided. The military authorities gradually lifted restrictions for soldiers in the city, who were allowed to return to theatres, music halls and other places of entertainment. The number of influenza-related deaths fell throughout August and September.[1] But by mid-October, the virus had returned. This was the beginning of the second wave, which would hit the city and the country with redoubled force.

Across York and the towns of the West Riding of Yorkshire – the administrative county which included Sheffield, Wakefield, Bradford, Leeds, Huddersfield among others – 8% of overall deaths from the pandemic had taken place in the first wave, but 65% would occur in the second wave.[1] In York, all schools were gradually closed once again.[2] Cinemas and theatres mostly remained open as they had done during the first wave, but with additional sanitary measures in place. Managers were required to ventilate auditoriums before and after performances and during intervals, supervised by local police and by staff from the Health Department.[3]

Despite these precautions, the city struggled to cope. The month of November 1918 saw the highest number of burials across a prolonged period on record at York Cemetery. 264 people were buried, including 164 whose cause of death was recorded as either influenza or pneumonia, and the local authorities had to seek assistance from the military to help with the digging of graves.[4]

Hospitals Overwhelmed

The numbers of medical staff on the home front were severely depleted by the deployment of doctors and nurses for the war effort, and during the second wave, the city’s health providers were overwhelmed. At York County Hospital on Monkgate, so many nurses were off sick with influenza at the same time that the hospital had to close for two months.[6] The Infirmary at York Workhouse admitted an overflow of patients from the city’s hospitals, and all beds there were full by early November. York Explore holds various records relating to the workhouse and its inhabitants and staff, including for the period of the pandemic. We know that twenty-six patients died there and that some of them were very young.[7]

With bed capacity at maximum and growing numbers of staff becoming infected and incapacitated, York’s Health Committee and hospitals mounted a huge coordinated effort. In late October, The Retreat and York City Asylum both sent nurses to Clifton Hospital, which had 139 patients with influenza and 51 staff who were sick.[8] At the York Fever Hospital near Yearsley Bridge – established in 1880 to manage regular epidemics of infectious diseases in the city – existing patients were transferred elsewhere to make space for an influx of influenza cases. The experiences of one nurse here – Mary Wilson – were captured in an interview conducted with survivors of the pandemic by the journalist Richard Collier. Mary’s memories – preserved at the Imperial War Museum archives in London – would make for fascinating reading when archive visits are possible again.[9]

Rear view of an open-air ward at the York Fever Hospital in the 1910s. The Rowntree Cocoa Works factory on Haxby Road can be seen in the distance. Rowntree & Co. donated three wooden shelters for patients in the hospital grounds.[10] Source: City of York Council/Explore York Libraries and Archives Mutual Ltd.

District Nurses and Volunteers

With many of the city’s doctors away on military service and hospitals overrun, residents who fell sick had to seek care in their own homes. In the early twentieth century, those with financial means could pay for a full-time nurse – referred to as a private duty nurse – to live with them until they recovered. A separate system of “district nursing” existed to offer care of the sick poor.

The sociologist Elaine Denny, who has researched the history of nursing in the 19^th and 20^th centuries, argues that domiciliary nursing – nursing carried out in peoples’ homes – has been “hidden from history”.[11] Various types of archival documents could help to reconstruct this history, but with local records and historic newspapers for York for 1918 and 1919 currently unavailable during the COVID-19 lockdown, we can only wonder what information they might hold about the experiences of ordinary district nurses in York during the outbreak. However, there is one major indication of the scale of their workload during the second wave: the Medical Officer for Health Edmund Smith had to recruit a group of untrained women – including “disengaged midwives and other handy substitutes” [12] – as volunteer domiciliary nurses.

Poverty and Infectious Disease: Influenza in York’s Slums

The majority of influenza deaths during the pandemic in York took place in the home.[13] District and volunteer nurses caring for the poor in the city throughout the second wave would likely have encountered some incredibly difficult scenes. In Leeds, their counterparts reported that in some of the most deprived areas they visited, families were living in cramped conditions, sometimes with only a single bed. One nurse was called to a house where multiple family members were seriously ill and had to take the decision to remove a sick infant from the family’s solitary bed so that the child’s father could die in it.[14]

York too had serious problems with poverty and housing at the time of the outbreak. Throughout the late nineteenth and early twentieth centuries, the Rowntree family had been involved in voluntary welfare activity in the city. This included campaigning for better housing, improved maternity services, and measures against infectious diseases.[15] At the turn of the century, Seebohm Rowntree’s pioneering social study of living conditions in York revealed that almost 28% of the city’s population – over 20,000 people – lived below what he referred to as the “poverty line”.

Seebohm’s report, titled Poverty: A Study of Town Life, identified Walmgate and Hungate as areas of the city where poverty levels were particularly high.[16] Some of the poorest residents were living in tenements, sharing a single water tap in the street and one toilet with multiple other households. Many were unable to afford enough food to meet their nutritional needs. Such insanitary conditions made people vulnerable to outbreaks of infectious disease, and during the second wave of the Spanish flu, seven members of one household in Hungate were recorded as being sick at the same time. Resident Lydia Brown died in October: her two daughters, aged eleven and sixteen, followed her a few days later.[17] In Walmgate, 160 deaths from influenza or pneumonia were officially recorded in the aftermath of the pandemic – a notably high portion of the city’s overall death toll.[18]

Buildings of Bradley and Co. carriage builders in Hungate, York, 1911. A water pump is visible to the left of the middle door. The row of doors under the gallery were probably outdoor lavatories and coal stores. Source: City of York Council/Explore York Libraries and Archives Mutual Ltd.

Lessons for Today

The medical, civic and philanthropic histories we have explored here feel newly relevant in the context of the COVID-19 pandemic, as national and local authorities draw up responses to the outbreak and health and social care staff work to protect the vulnerable.

The tireless work of medical staff in the 1918 flu pandemic adds additional weight to our renewed sense of the value and risks of care work amidst COVID-19. NHS staff redeployed to COVID care wards at York Hospital echo the journeys taken by midwives and other “hardy” women who volunteered when district nurses were overwhelmed in the Autumn of 1918.

We might note the importance of a strong infrastructure for public health both then and now, at national and local levels. The historian Fred R. Van Hartesveldt has described England’s public health system at national level as being “in disarray” in 1918, and not solely due to the war. He notes that although public health in some areas was well-served, nationally it was “inefficient and uncoordinated.”[19] Therefore, responsibility for public health often lay in the hands of local authorities. Historians have previously identified Manchester as an example of good local practice during the pandemic. Its Medical Officer James Niven is renowned for having saved many lives by adopting social distancing measures and other precautions which went beyond those recommended by the London-based government. Having studied reports from the time, Van Hartesveldt names York as another positive example of a local authority response, citing the rigorous collection of data by the city’s Health Committee and a coordinated effort by medical staff to provide care and comfort to influenza patients.[20]

Another striking parallel between 1918 and the present day is the enduring connection between socio-economic disadvantage and poor health. In the conclusion to his 1901 report, Seebohm Rowntree had recommended that the government introduce measures to protect the very young, the old and the unemployed, who were the groups most likely to fall into poverty. Between 1906 and 1912, Seebohm drew on his expertise and social influence to work with David Lloyd George’s Liberal Government on a number of reforms which laid the foundation for Britain’s welfare state. They included free school meals, sickness and unemployment insurance for working men, and the introduction of state pensions: an unprecedented body of legislation at the time. These were important steps in addressing the stubborn problems of social inequalities in Britain, but they remain pervasive today. For example, recent research from the Office for National Statistics has shown that people in deprived areas are dying from COVID-19 at double the rate of affluent areas.[21]

Nurses and patients on the open-air ward of the York Fever Hospital in the 1910s. During the second wave of the influenza outbreak, the hospital moved all existing patients to other facilities and became an influenza hospital. Source: City of York Council/Explore Library and Archives Mutual Ltd.

Finally, we can also appreciate the strength and compassion of those living York 100 years ago, including within the most deprived communities. In Poverty: A Study of Town Life, Seebohm Rowntree observed the way that those facing hardship in York pulled together. In the slum districts, he noted, “life is lived more in common”:

Families which are, from any cause, in particularly hard straights, are often helped by those in circumstances but little better than their own. There is very much of this mutual helpfulness among the very poor. In cases of illness neighbours will almost always come in and render assistance, by cleaning the house, nursing, and often bringing some little delicacy which they think the patient would ‘fancy.’”[22]

Seventeen years later, the Yorkshire Evening Post noted the same dynamic of care in the community at the height of the second wave of the Spanish flu:

The district nurses can, of course, only pay what may be termed flying visits, and any continuous nursing has to be left to neighbours and friends. Generally speaking, report the nurses, the residents in the poorer neighbourhoods have been real Samaritans to their stricken friends. No thought of a risk of infection has deterred the neighbours from lending a helping hand, and in this way many a silent, unnoticed act of devoted self-sacrifice has been performed.[23]

Over a century later, hundreds of volunteers are working with the City of York Council’s Community Hubs to assist those who are older, who are sick, or who are shielding for medical reasons. The Supper Collective – an award-winning volunteer initiative set up by chefs, independent cafe owners and local residents in York – is cooking nutritious meals and delivering these for free to isolated and vulnerable people and to NHS staff during the COVID-19 outbreak. And the Joseph Rowntree Housing Trust has been working with the Joseph Rowntree Foundation to support older and vulnerable residents in their homes and communities across in York and across the North East. This includes a major staff redeployment programme from across the organisation to support essential services.

As we navigate the challenges of this contemporary pandemic and its consequences, care work and community remain some of our most deeply valuable practices.

We aim to publish a new blog post every fortnight. To be notified when future blog posts are published, you can follow us on Twitter @rowntreesoc, and on our Facebook page. 

References

[1] Knight, p. 8 Martin Knight, The Influenza Pandemic of 1918-1919 in the Towns of the West Riding and York, PLACE, 2015, p.8

[2] Knight, p. 8

[3] Knight, p.23

[4] York MOH, City of York: Annual Report of the Medical Officer of Health for 1918 (1919), cited in Knight, p. 24

[5] David Poole, “Busy Days in the Cemetery”, Friends of York Cemetery Newsletter, November 1995.

[6] Katherine A. Webb, From County Hospital to NHS Trust: The History and Archives of NHS Hospitals, Services, and Management in York, 1740-2000, Vol 1, Borthwick Publications, 2002, p.165

[7] Gary Brannan, “When the guns fell silent: York and the 1918 flu”, Borthwick Institute Blog, 19 November 2018, http://borthwickinstitute.blogspot.com/2018/11/when-guns-fell-silent-york-and-1918-flu.html; Chloe Adams, Caption from “York and the 1918 ‘Spanish’ Influenza Epidemic” exhibition at York Explore Library and Archive, 18 March 2018.

[8] Knight, p.19

[9] See Richard Collier, The Plague of the Spanish Lady, Macmillan, 1974, p. 375

[10] Webb, p. 142

[11] Elaine Denny, “The emergence of the occupation of district nursing in nineteenth century England”, D.Phil, University of Nottingham, 1999, p.4, http://eprints.nottingham.ac.uk/11094/1/297754.pdf

[12] York MOH, City of York: Annual Report, cited in Knight, p.14

[13] Brannan, “When the guns fell silent”

[14] “Splendid Work of the District Nurses”, Yorkshire Evening Post, Thursday 7 November 1918, p.3

[15] Webb, From County Hospital to NHS Trust, p. 3.

[16] Seebohm Rowntree, Poverty: A Study of Town Life, Macmillan and Co. 1901, pp.199-201 https://archive.org/details/povertyastudyto00rowngoog/page/n8/mode/2up

[17] Karyn Burnham, York in the Great War, Pen and Sword Books, 2014, p. 94

[18] Brannan, “When the Guns Fell Silent”

[19] Fred R. Van Hartesveldt, “The Doctors and the ’Flu’: The British Medical Profession’s Response to the Influenza Pandemic of 1918-1919”, International Social Science Review, 85. 1-2, 2010, p.35

[20] Van Hartesveldt, p.35

[21] Poverty and Social Exclusion (PSE), “The coronavirus (COVID-19) has had a disproportionally higher impact on the most deprived areas”, 1 May 2020, https://www.poverty.ac.uk/editorial/coronavirus-covid-19-has-had-proportionally-higher-impact-most-deprived-areas

[22] pp. 77, 43

[23] “Splendid Work of the District Nurses”

1. A Forgotten History through a Rowntree Lens

Cat Oakley

The First Peak

In mid-June 1918, people across the UK began to fall sick. An article in the Yorkshire Evening Post described the signs of their illness for readers fortunate enough to have escaped infection so far:

“Those people who have not yet been affected will be interested to learn that the first symptoms…are an attack of aches and pains all over the body, along with dizziness. Then follow headache, pains in the back, and occasionally sickness, with a feeling of absolute helplessness.”^[1]

The disease caused acute suffering. In the most severe cases, the infection led to an immune system response known as heliotrope cyanosis, in which the body turned black or blue as fluid leaked into the lungs and drowned the sufferer. There were also multiple incidences of delirium and psychological disturbances, leading to violence and self-harm.^[2]

As the illness spread throughout the population, it disrupted patterns of everyday life which had already been transformed by the turmoil of the First World War. Northern England, with its industrial base and high urban population, was badly stricken. In some streets in Sunderland, every household was affected, and entire families laid up. In Newcastle, police, fire brigade and hospital staff were absent in significant numbers, and in Manchester, more than 200 tramway car drivers and guards went off sick.^[3]

In York, all elementary schools were closed in the first week of July and remained closed throughout the whole summer.^[4] Independence Day celebrations planned for American troops stationed in the city – including a baseball match, tea at the Assembly Rooms, and a parade – were all cancelled. Cinemas and other places of entertainment were designated as off-limits for soldiers, though they remained open for civilians.^[5] Across the city, trained medical staff struggled to meet increased demand for their skills as they contended with an existing national shortage of doctors and nurses. In January 1918, over half of the country’s doctors were on military duty, and of those remaining, nine in York reported at one point that they had visited 6000 cases between them in response to the outbreak. Edmund Smith, the city’s Medical Officer of Health, reported that “the professional nursing staffs of the city and district were absolutely overwhelmed”.^[6]

This was the ‘Spanish flu’, so-called because Spain, which remained neutral during the First World War, did not censor news of the epidemic whereas participating nations did. Historians and scientists disagree on the origins of the virus, which may have first emerged on a farm in Kansas, USA. Whatever its origins, it spread across the globe, beginning its journey in early March 1918 and ending with the last recorded infection around March 1920. Throughout this period, one in three people on the planet – 500 million – were infected, and one fifth them died.^[7] In the UK, a quarter of the British population contracted the virus and one estimate places the national death toll at 228,000.^[8] Mortality figures are, however, likely to be underestimates: many deaths will not have been recorded as influenza-related but as pneumonia, tuberculosis, bronchitis or even suicide, all of which were documented secondary complications.^[9] The arrival of the virus in England and Wales can be dated around mid-June 1918 and by the end of July, it had diminished. In mid-October, it returned, and this “second peak”, far more deadly than the first, lasted until the end of the year, only to be followed by a third wave between February and May 1919.^[10]

Image from the American National Red Cross photograph collection of a woman in the US suffering from influenza during the second wave of the 1918 pandemic. An accompanying note to the photograph says that the Red Cross Home Service was called to the house by the woman’s sister, who had not seen her for a week. The sick woman’s husband was away fighting in France. Source: Library of Congress Prints and Photographic Division.

A Forgotten History

“Don’t talk about influenza. It is already wearing itself out and will go all the sooner if you don’t talk about it. Influenza is a disease that likes to be noticed.”

– From a public information leaflet circulated by a senior London hospital official in 1918 ^[11]

This advice from one senior medical official, circulated in a public information leaflet in 1918, captures one contemporary attitude to the flu. The government was centrally concerned with the war effort, and wartime censorship may played a part in suppressing information about the scale and spread of the epidemic at the time. But the pandemic has also gone relatively unnoticed in the years since. Despite the scale of disruption to everyday life and the massive death toll, it has been largely overlooked by historians and epidemiologists over the last 100 years. As we experience the extraordinary transformations wrought by COVID-19, it’s difficult to imagine that the 1918 pandemic was an unremarkable event for those who experienced it, even amidst the scale of horror and suffering brought about by the First World War. The two events are a century apart, so any comparisons must take into account the many differences between them, but there are also many remarkable parallels.

Why do we know so little about the Spanish flu? A growing number of historians have been exploring the answers to this question in recent decades.^[12]

Those of us with an interest in social history might highlight some key factors at play which sound familiar in the context of today’s crisis. People of all social backgrounds were susceptible to the 1918 virus. Yet, there is evidence to suggest that working class communities and those living in poverty were hit particularly hard and their experiences under-documented. In addition, the history of the pandemic is, at least in part, a history of care work, and the history of care work is predominantly the history of another marginalised group: women. “Women were the ones who registered the sights and sounds of the sickroom, who laid out the dead and took in the orphans”, notes historian Laura Spinney.

Spinney also points to the dominance of Western historiography, noting that deaths in Europe and North America were lower than in other areas of the world which were more severely affected.^[13] One very early report published by a medical officer of the British Empire in 1920 examined the effects of the virus in the Punjab province of India, and the historian David Killingray has done important research on the effects of the pandemic in Africa and the Caribbean, but there is still much more to explore in this area.^[14] We might therefore ask ourselves what social history research with an intersectional approach could reveal about the experiences of the working classes, women, and people of colour in former British colonies during the 1918 pandemic.

The Rowntree Lens

I took up the post of Director of The Rowntree Society in early February 2020 and over the last few weeks, have begun the work of immersing myself in the rich histories and legacies of the Rowntree family, company and trusts. The Society exists to facilitate and support activities that engage critically and creatively with these histories through collaborative work with partners in the public sector, education, the voluntary sector and the cultural industries. Our work is driven by our belief in the continuing importance of the Rowntree legacies to the local, national and global challenges facing our contemporary world. As the world entered lockdown, it became clear that the COVID-19 pandemic is not just one of the most pressing of these challenges, but that it has profound implications for the others.

Members of the Rowntree family undertook pioneering work driven by their Quaker values, advocating for equality, democracy and social justice; work which is continued today by the three trusts Joseph Rowntree established in his name in 1904. At The Rowntree Society, we believe that historical perspectives have a distinctive role to play in helping to navigate the current crisis and uncertain future. We share the perspectives of the Social History Society on the distinctive contributions historians can make in navigating the complexities of our situation:

This is a time of illness, grief, and profound economic and social change.

As historians, we know context is everything. We know that we must analyse the short term in relation to longer term trends.

Much cultural and social history is qualitative in nature, describing and explaining changes and continuities in earlier societies. It complicates our understanding of the past and warns against simplistic comparisons with the future.^[15]

Mindful of historical precedent and the resonance of Rowntree heritage, we have found ourselves wondering: How did the 1918 flu pandemic affect the Rowntree family and Rowntree workers? How was the outbreak experienced among vulnerable communities in early 20^th century York – those living in the slums Seebohm Rowntree wrote about in his pioneering survey of poverty published in 1901, and those working on the Rowntree & Co. cocoa estates in the British West Indies? What were the responses of Rowntree family members to the crisis as individuals, as employers, and in their roles in civic and public life? And what might the answers to these questions tell us about life with COVID-19, and the world that lies beyond it?

The fullest answers to these questions that we might find lie in the archives. The Borthwick Institute at the University of York is now home to the Rowntree Archives, and an important collection of materials relating to medicine and health in the city. Other relevant records are kept by York Explore, including minutes from the city’s Health Committee meetings, Medical Relief Lists from the Poor Law Unions and diary entries from ordinary people who lived through it (the library hosted a small exhibition on the Spanish flu back in 2018). Both are currently closed due to the lockdown (though doing some fantastic work around the continuation of their services online: see here and here). It’s tantalising to have these documents so near and yet so far, and I’ve developed a renewed appreciation for our libraries and archives now that they are temporarily inaccessible.

In the face of these closures, I reached out to the archivists there, together with our volunteers, trustees and local history groups, for help in finding some provisional answers. My original plan was for a single blog post, but the search turned up more information than initially expected. I’ll therefore be sharing thoughts and information on the 1918 pandemic, York, Rowntree’s and COVID-19 in a new blog post series here on our website.

In the meantime, we’d love to hear what you think. You can get in touch with us via email at info@rowntreesoc.org.uk, on Twitter @rowntreesoc, or through our Facebook page. We’ll be sharing subsequent blog posts in the series through these channels while we work on designing a brand-new newsletter.

You can read the second instalment of the blog, on care and community in the city’s responses to the pandemic, here.

Acknowledgements

Collating sources for the blog series while libraries and archives are closed has been a collaborative project, with help from the following people:

Anne Grant and Stan Young, The Rowntree Society

Margaret Atherden, PLACE York

David Poole, Janet Jawando and Dennis Shaw, York Cemetery Genealogy

Dick Hunter, Clements Hall Local History Group

Gary Brannan, Borthwick Institute for Archives

Hannah Mawdsley (@HannahMawdsley)

Julie-Ann Vickers, York Explore

Joseph Oakley

References

[1] “Influenza Plague Still Active”, Yorkshire Evening Post, Wed 3 July, 1918, p.3.

[2] Hannah Mawdsley, “‘Infectious’ Humour in the Face of History’s Deadliest Pandemic”, Viewpoint, pp.4-6 (p.4) https://www.bshs.org.uk/wp-content/uploads/Viewpoint_118_Web.pdf

[3] Influenza Ravages, Yorkshire Post and Leeds Intelligencer, Wed 3 July 1918; “Influenza Plague Still Active”.

[4] Martin Knight, The Influenza Pandemic of 1918-1919 in the towns of the West Riding and York, Place: 2016, p.p. 22-23

[5] “Influenza Ravages”, Yorkshire Post and Leeds Intelligencer, Wed 3 July 1918

[6] Fred R. van Hartesveldt, “The Doctors and the ‘Flu’: The British Medical Profession’s Response to the Influenza Pandemic of 1918-1919”, International Social Science Review 85.1-2, 2010, p. 32; “Medical Officer of Health report for York, 1919, Borthwick Archives, MOH/Y/10, cited by Gary Brannan, “When the Guns Fell Silent: York and the 1918 Flu”, http://borthwickinstitute.blogspot.com/2018/11/when-guns-fell-silent-york-and-1918-flu.html

[7] Laura Spinney, Pale Rider: the Spanish Flu of 1918 and how it changed the world, Jonathan Cape, 2017, ebook, n.p.

[8] Jennifer Meierhans & Daniel Wainwright, “Spanish flu: ‘We didn’t know who we’d lose next’”, BBC News, 20 September 2018 https://www.bbc.co.uk/news/uk-england-45097068

[9] Knight notes that “In 1918 there were about 2,700 pneumonia deaths compared with an average of about 1700 in 1916, 1917, and 1919.” (p.10) Several inquests reported in the Yorkshire Evening Post in Spring 1919 delivered verdicts of suicide in which influenza was cited as a factor (see also Knight, p. 43).

[10] Knight, p.8

[11] “Hints to the Public”, Newcastle Daily Chronicle, Thurs 31 Oct 1918, p.6

[12] See Laura Spinney, Pale Rider; Mark Honigsbaum, Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918, Macmillan, 2009; Hannah Mawdsley, https://ahrc.ukri.org/research/readwatchlisten/features/remembering-the-spanish-flu/; David Killingray and Howard Philips (eds.) The Spanish influenza pandemic of 1918-1919: new perspectives, Routledge, 2003; Niall Johnson, Britain and the 1918-19 influenza pandemic: a dark epilogue, Routledge, 2006.

[13] Laura Spinney, Pale Rider, ebook, n.p.

[14] Thomas Herriot, “The Influenza Pandemic 1918, as observed in the Punjab, India”, PhD Thesis, University of Edinburgh, 1920, https://era.ed.ac.uk/handle/1842/22305; David Killingray, “A new ‘Imperial Disease’: The Influenza Pandemic of 1918-19 and its impact on the British Empire”, Caribbean Quarterly 49.4, December 2003

[15] “COVID-19 and the future of our discipline”, Social History Society, May 7, 2020 https://socialhistory.org.uk/2020/05/07/covid-19-and-the-future/

Rowntree’s, York, and the 1918 Flu Pandemic: A New Blog Series

Cat Oakley

The First Peak

In mid-June 1918, people across the UK began to fall sick. An article in the Yorkshire Evening Post described the signs of their illness for readers fortunate enough to have escaped infection so far:

“Those people who have not yet been affected will be interested to learn that the first symptoms…are an attack of aches and pains all over the body, along with dizziness. Then follow headache, pains in the back, and occasionally sickness, with a feeling of absolute helplessness.”[1]

The disease caused acute suffering. In the most severe cases, the infection led to an immune system response known as heliotrope cyanosis, in which the body turned black or blue as fluid leaked into the lungs and drowned the sufferer. There were also multiple incidences of delirium and psychological disturbances, leading to violence and self-harm.[2]

As the illness spread throughout the population, it disrupted patterns of everyday life which had already been transformed by the turmoil of the First World War. Northern England, with its industrial base and high urban population, was badly stricken. In some streets in Sunderland, every household was affected, and entire families laid up. In Newcastle, police, fire brigade and hospital staff were absent in significant numbers, and in Manchester, more than 200 tramway car drivers and guards went off sick.[3]

In York, all elementary schools were closed in the first week of July and remained closed throughout the whole summer.[4] Independence Day celebrations planned for American troops stationed in the city – including a baseball match, tea at the Assembly Rooms, and a parade – were all cancelled. Cinemas and other places of entertainment were designated as off-limits for soldiers, though they remained open for civilians.[5] Across the city, trained medical staff struggled to meet increased demand for their skills as they contended with an existing national shortage of doctors and nurses. In January 1918, over half of the country’s doctors were on military duty, and of those remaining, nine in York reported at one point that they had visited 6000 cases between them in response to the outbreak. Edmund Smith, the city’s Minister of Health, reported that “the professional nursing staffs of the city and district were absolutely overwhelmed.[6]

This was the ‘Spanish flu’, so-called because Spain, which remained neutral during the First World War, did not censor news of the epidemic whereas participating nations did. From its origins at a farm in Kansas, USA, the virus spread across the globe, beginning its journey in early March 1918 and ending with the last recorded infection around May 1920. Throughout this period, one in three people on the planet – 500 million – were infected, and one fifth them died.[7] In the UK, a quarter of the British population contracted the virus and one estimate places the national death toll at 228,000.[8] Mortality figures are, however, likely to be underestimates: many deaths will not have been recorded as influenza-related but as pneumonia, tuberculosis, bronchitis or even suicide, all of which were documented secondary complications.[9] The arrival of the virus in England and Wales can be dated around mid-June 1918 and by the end of July, it had diminished. In mid-October, it returned, and this “second peak”, far more deadly than the first, lasted until the end of the year, only to be followed by a third wave between February and May 1919.[10]

_{Image from the American National Red Cross photograph collection of a woman in the US suffering from influenza during the second wave of the 1918 pandemic. An accompanying note to the photograph says that the Red Cross Home Service was called to the house by the woman’s sister, who had not seen her for a week. The sick woman’s husband was away fighting in France. Source: Library of Congress Prints and Photographic Division.}

A Forgotten History

“Don’t talk about influenza. It is already wearing itself out and will go all the sooner if you don’t talk about it. Influenza is a disease that likes to be noticed.”

– From a public information leaflet circulated by a senior London hospital official in 1918[11]

This advice from one senior medical official, circulated in a public information leaflet in 1918, captures one contemporary attitude to the flu. The government was centrally concerned with the war effort, and wartime censorship may played a part in suppressing information about the scale and spread of the epidemic at the time. But the pandemic has also gone relatively unnoticed in the years since. Despite the scale of disruption to everyday life and the massive death toll, it has been largely overlooked by historians and epidemiologists over the last 100 years. As we experience the extraordinary transformations wrought by COVID-19, it’s difficult to imagine that the 1918 pandemic was an unremarkable event for those who experienced it, even amidst the scale of horror and suffering brought about by the First World War. The two events are a century apart, so any comparisons must take into account the many differences between them, but there are also many remarkable parallels.

Why do we know so little about the Spanish flu? A growing number of historians have been exploring the answers to this question in recent decades.[12]

Those of us with an interest in social history might some highlight key factors at play which sound familiar in the context of today’s crisis. People of all social backgrounds were susceptible to the 1918 virus. Yet, there is evidence to suggest that working class communities and those living in poverty were hit particularly hard and their experiences under-documented. In addition, the history of the pandemic is, at least in part, a history of care work, and the history of care work is predominantly the history of another marginalised group: women. “Women were the ones who registered the sights and sounds of the sickroom, who laid out the dead and took in the orphans”, notes historian Laura Spinney.

Spinney also points to the dominance of Western historiography, noting that deaths in Europe and North America were lower than in other areas of the world which were more severely affected.[13] One very early report published by a medical officer of the British Empire in 1920 examined the effects of the virus in the Punjab province of India, and the historian David Killingray has done important research on the effects of the pandemic in Africa and the Caribbean, but there is still much more to explore in this area.[14] We might therefore ask ourselves what social history research with an intersectional approach could reveal about the experiences of the working classes, women, and people of colour in former British colonies during the 1918 pandemic.

The Rowntree Lens

I took up the post of Director of The Rowntree Society in early February this year and over the last few weeks, have began the work of immersing myself in the rich histories and legacies of the Rowntree family, company and charities. The Society exists to facilitate and support activities that engage critically and creatively with these histories through collaborative work with partners in the public sector, education, the voluntary sector and the cultural industries. Our work is driven by our belief in the continuing importance of the Rowntree legacies to the local, national and global challenges facing our contemporary world. As the world entered lockdown, it became clear that the COVID-19 pandemic is not just one of the most pressing of these challenges, but that it has profound implications for the others.

Members of the Rowntree family undertook pioneering work driven by their Quaker values, advocating for equality, democracy and social justice; work which is continued today by the three charitable trusts Joseph Rowntree established in his name in 1904. At The Rowntree Society, we believe that historical perspectives have a distinctive role to play in helping to navigate the current crisis and uncertain future. We share the perspectives of the Social History Society on the distinctive contributions historians can make in navigating the complexities of our situation:

This is a time of illness, grief, and profound economic and social change.

As historians, we know context is everything. We know that we must analyse the short term in relation to longer term trends.

Much cultural and social history is qualitative in nature, describing and explaining changes and continuities in earlier societies. It complicates our understanding of the past and warns against simplistic comparisons with the future.[15]

Mindful of historical precedent and the resonance of Rowntree heritage, we have found ourselves wondering: How did the 1918 flu pandemic affect the Rowntree family and Rowntree workers? How was the outbreak experienced among vulnerable communities in early 20^th century York – those living in the slums Seebohm Rowntree wrote about in his pioneering survey of poverty published in 1901, and those working on the Rowntree & Co. cocoa estates in the British West Indies? What were the responses of Rowntree family members to the crisis as individuals, as employers, and in their roles in civic and public life? And what might the answers to these questions tell us about life with COVID-19, and the world that lies beyond it?

The fullest answers to these questions lie in the archives. The Borthwick Institute at the University of York is now home to the Rowntree Archives, and an important collection of materials relating to medicine and health in the city. Other relevant records are kept by York Libraries and Archives. Both are currently closed due to the lockdown (though doing some fantastic work around the continuation of their services online). It’s tantalising to have these documents so near and yet so far, and I’ve developed a renewed appreciation for our libraries and archives now that they are temporarily inaccessible.

In the face of these closures, I reached out to the archivists there, together with our volunteers, trustees and local history groups, for help in finding some provisional answers. My original plan was for a single blog post, but the search turned up more information than initially expected. I’ll therefore be sharing thoughts and information on the 1918 pandemic, York, Rowntree’s and COVID-19 in a new blog post series here on our website.

In the meantime, we’d love to hear what you think. You can get in touch with us via email at info@rowntreesoc.org.uk, on Twitter @rowntreesoc, or through our Facebook page.

Acknowledgements

Collating sources for the blog series while libraries and archives are closed has been a collaborative project, with help from the following people:

Anne Grant and Stan Young, The Rowntree Society

Margaret Atherden, PLACE York

Janet Jawando and Dennis Shaw, York Cemetery Genealogy

Dick Hunter, Clements Hall Local History Group

Gary Brannan, Borthwick Institute for Archives

Hannah Mawdsley (@HannahMawdsley)

Julie-Ann Vickers, York Explore

Joseph Oakley

References

[1] “Influenza Plague Still Active”, Yorkshire Evening Post, Wed 3 July, 1918, p.3.

[2] Hannah Mawdsley, “‘Infectious’ Humour in the Face of History’s Deadliest Pandemic”, Viewpoint, pp.4-6 (p.4) https://www.bshs.org.uk/wp-content/uploads/Viewpoint_118_Web.pdf

[3] Influenza Ravages, Yorkshire Post and Leeds Intelligencer, Wed 3 July 1918; “Influenza Plague Still Active”.

[4] Martin Knight, The Influenza Pandemic of 1918-1919 in the towns of the West Riding and York, Place: 2016, p.p. 22-23

[5] “Influenza Ravages”, Yorkshire Post and Leeds Intelligencer, Wed 3 July 1918

[6] Fred R. van Hartesveldt, “The Doctors and the ‘Flu’: The British Medical Profession’s Response to the Influenza Pandemic of 1918-1919”, International Social Science Review 85.1-2, 2010, p. 32; “Medical Officer of Health report for York, 1919, Borthwick Archives, MOH/Y/10, cited by Gary Brannan, “When the Guns Fell Silent: York and the 1918 Flu”, http://borthwickinstitute.blogspot.com/2018/11/when-guns-fell-silent-york-and-1918-flu.html

[7] Laura Spinney, Pale Rider: the Spanish Flu of 1918 and how it changed the world, Jonathan Cape, 2017, ebook, n.p.

[8] Jennifer Meierhans & Daniel Wainwright, “Spanish flu: ‘We didn’t know who we’d lose next’”, BBC News, 20 September 2018 https://www.bbc.co.uk/news/uk-england-45097068

[9] Knight notes that “In 1918 there were about 2,700 pneumonia deaths compared with an average of about 1700 in 1916, 1917, and 1919.” (p.10) Several inquests reported in the Yorkshire Evening Post in Spring 1919 delivered verdicts of suicide in which influenza was cited as a factor (see also Knight, p. 43).

[10] Knight, p.8

[11] “Hints to the Public”, Newcastle Daily Chronicle, Thurs 31 Oct 1918, p.6

[12] See Laura Spinney, Pale Rider; Mark Honigsbaum, Living with Enza: The Forgotten Story of Britain and the Great Flu Pandemic of 1918, Macmillan, 2009; Hannah Mawdsley, https://ahrc.ukri.org/research/readwatchlisten/features/remembering-the-spanish-flu/; David Killingray and Howard Philips (eds.) The Spanish influenza pandemic of 1918-1919: new perspectives, Routledge, 2011; Niall Johnson, Britain and the 1918-19 influenza pandemic: a dark epilogue, Routledge, 2006.

[13] Laura Spinney, Pale Rider, ebook, n.p.

[14] Thomas Herriot, “The Influenza Pandemic 1918, as observed in the Punjab, India”, PhD Thesis, University of Edinburgh, 1920, https://era.ed.ac.uk/handle/1842/22305; David Killingray, “A new ‘Imperial Disease’: The Influenza Pandemic of 1918-19 and its impact on the British Empire”, Caribbean Quarterly 49.4, December 2003

[15] “COVID-19 and the future of our discipline”, Social History Society, May 7, 2020 https://socialhistory.org.uk/2020/05/07/covid-19-and-the-future/