It was late-September 1918 when Nashville heath officials first caught wind that the influenza sweeping across the nation might be within their community as well. On September 27, local newspapers reported that there were at least a handful of cases within the city, but that authorities could not be certain since influenza was not a mandatory reportable disease in either Nashville or Tennessee. Two days later, city health officials as well as Captain Dr. Robert C. Derivaux, the local representative of the United States Public Health Service, reiterated that influenza was in Nashville. No cases had yet been confirmed officially – physicians had been diagnosing the cases as simply grip – but welfare department nurses reported being called to care for many victims.1 Dr. W. F. Fessey, Superintendent of City Hospital, reported that thirty cases of influenza had been admitted to his hospital and that 75 cases had to be turned away due to lack of space. Fessey predicted that, at this pace, Nashville would experience a serious outbreak within the next “five to six days.”2 It occurred even faster: within a day, City Hospital was almost completely full with influenza patients.3 Meanwhile, officials at the Old Hickory powder plant – a DuPont factory some ten miles to the northeast that produced smokeless powder for the war effort – vociferously denied that an epidemic of influenza had broken out among its 35,000 men workforce, despite admitting to many cases of grip at the plant. With the need for maximum wartime production, sick employees were separated from the well, but were still put to work.4 Nashville’s epidemic was off to a roaring start.
By October 5, Nashville Health Officer Dr. W. E. Hibbett estimated that there were between 10,000 and 15,000 influenza cases in the city. In order to get a better sense of the geographic spread of the disease, asses the needs of the state’s counties, and allocate nurses and other resources more efficiently, the Executive Officer of the State Board of Health, Dr. Olin West, requested that city and county health officers report local conditions directly to his office. He also notified all local agencies that requests for Red Cross aid must be made through the US Public Health Service, and that requests for Public Health Service assistance needed to be made through his office. In short, Olin placed himself at the head of Tennessee’s epidemic response. He urged local officials to consider school closures if absenteeism rates warranted it, and added that children in schools should be monitored closely for any and all signs of illness.5
On Sunday, October 6, Hibbett met with Olin, Derivaux, and several other public health officials to discuss Nashville’s rapidly growing epidemic. The next day, he announced the immediate closure of all theaters, movie houses, and other non-essential amusement venues. Schools and churches would remain open for the time being, although Hibbett was quick to add that he might extend the closure order to those institutions as well if conditions warranted. Mayor William Gupton fully endorsed Hibbett’s action, stating that he was in complete accord with the opinions of federal, state, and city health officers and would “lend them every assistance in his power.”6 In surrounding Davidson County, the Board of Education ordered all schools closed effective immediately. The decision came not as a result of high levels of influenza in county schools, but rather because of the long distances physicians were required to travel between patients. Tamping down on the county’s epidemic therefore would not only save lives, it would spare doctors precious time that they now found themselves needing rather desperately.7
Theater managers were reported to be “cheerfully acquiescent” as they closed their venues. There was no doubt, however, that the closure order would impact their businesses heavily. The order came right at the start of the busy season, when the city’s theaters made arrangements for special shows. Pool halls and other such places were also placed under financial duress. Rents and other expenses for these businesses were high, and even a short-duration closure placed them in jeopardy of having to close their doors permanently.8
On October 8, Olin issued a statewide request that local authorities close places of amusement and strongly consider closing their schools too. In Nashville, Hibbett immediately put the request into action and closed the city’s schools effective at noon the next day, giving education officials, teachers, and principals time to prepare for the closures.9 Hibbett asked that churches close as well, although he did not order them to do so. Immediately, clergy across the city voluntarily agreed to cancel all prayer meetings. At a subsequent meeting, the Ministers’ Alliance agreed to cancel regular church services.1 Nashville’s public gathering places were now effectively closed.
Within a week, it appeared as if the epidemic was waning. Reliable case tallies were not available, but Hibbett was optimistic based on the decreased number of calls to his office for help and because drugstores were reporting fewer requests for prescriptions. Hospitals reported fewer intakes.11 The health officer cautiously let on that the city’s closure orders might be removed soon of conditions continued to improve, and Deveraux agreed. October 21 saw no cases of influenza reported, the first such day since the start of the epidemic.12 Encouraged by the news, Hibbert, West, and Deveraux met two days later to consider removing the bans. Their decision: the local, regional, and national epidemic situations were improved enough to allow Nashville’s closure orders to be lifted on Sunday, November 3.13 Nashville’s affected businesses eagerly waited for that day.
Over the course of the next week, Nashville’s epidemic situation improved dramatically enough for Hibbett, Deveraux, and West to agree to rescind the closure order effective Friday, November 1, with schools reopening the following Monday.14 When they did, principals found attendance rates were back to normal. Education officials decided to modify the curriculum (dropping “informational” topics) and to shorten the Thanksgiving and Christmas breaks in order to make up for lost classroom time. Teachers were happy to learn that they would be paid for the period when schools were closed.15
On November 1, Derivaux filed a comprehensive report on Nashville’s epidemic with USPHS officials in Washington. According to him, Nashville experienced 40,000 influenza cases and 392 deaths during the epidemic, with an additional 10,000 cases and 267 deaths occurring at the Old Hickory powder plant. In Nashville, the first case appeared on September 16, with influenza becoming epidemic ten days later. It peaked between October 4 and October 7, and ended about October 20. Derivaux believed that conditions in Nashville had improved enough to allow him to sent two USPHS doctors back to St. Louis.16 Two weeks later, with only a handful of new influenza cases reported each day, Derivaux announced that Nashville could “close the book on the epidemic.” There would continue to be some cases, he reminded residents, “but they will so few and far between that they will not be deserving of exclusive scrutiny.”17
Nashville and the Old Hickory powder plant did see some cases and deaths over the rest of the fall and winter, but fortunately epidemic conditions did not return. By the end of February 1919, physicians reported that a total 875 epidemic-related deaths had occurred since September. The result was an excess death rate of 610 per 100,000, slightly higher than that of Birmingham (592) and significantly higher than of Louisville (406). In fact, Nashville’s epidemic was one of the most severe in the country.
1 “Think ‘Spanish Flu’ Has Appeared Here,” Nashville Banner, 27 Sept. 1918, 16; “Spanish Influenza Reported in City,” Nashville Tennessean, 29 Sept. 1918, 2.
2 “Scourge of Flu Closes Y. M. C. A. at Old Hickory,” Nashville Tennessean, September 30, 1918, p. 8
3 “Doctors to Confer on Local Epidemic,” Nashville Banner, 1 Oct. 1918, 7.
4 “Spanish ‘Flu” Hits Nashville” Nashville Banner, 29 Sept. 1918, 10.
5 “Nine Deaths from Spanish Influenza,” Nashville Banner, 5 Oct. 1918, 2; “Very Few Deaths from Spanish Influenza,” Nashville Banner, 6 Oct. 1918, 7
6 “Theaters Closed by Authorities,” Nashville Banner, 7 Oct. 1918, 8.
7 “Schools of County Closed,” Nashville Banner, 8 Oct. 1918, 8; “County Schools are Closed to Curb Influenza,” Nashville Tennessean, 8 Oct. 1918, 1.
8 “Theaters Closed by Authorities,” Nashville Banner, 7 Oct. 1918, 8; “Amusement Places Closed,” Nashville Tennessean, 8 Oct. 1918, 6; “County Schools are Closed to Curb Influenza,” Nashville Tennessean, 8 Oct. 1918, 1.
9 “City Schools Close on Account of Epidemic,” Nashville Tennessean, 9 Oct. 1918, 4.
10 “No Prayer Meetings Because of Epidemic,” Nashville Banner, 9 Oct. 1918, 2; “Churches Close on Account of Flu,” Nashville Tennessean, 11 Oct. 1918, 8.
11 “New Grip Case on the Increase,” Nashville Banner, 15 Oct. 1918, 3; “’Flu’ Situation Greatly Improved,” Nashville Banner, 16 Oct. 1918, 10.
12 “No New Cases of Influenza Reported,” Nashville Tennessean, 22 Oct. 1918, 4.
13 “Sunday Week is Date Designated for Lifting Lid,” Nashville Tennessean, 24 Oct. 1918, 11.
14 “Flu Ban to Be Lifted on Friday,” Nashville Banner, 29 Oct. 1918, 1.
15 “Board Favors Short Holiday,” Nashville Banner, 5 Nov. 1918, 2.
16 “Deaths from Flu in County Number 659,” Nashville Tennessean, 1 Nov. 1918, 13.
17 “Will Close Books on ‘Flu’ Tomorrow,” Nashville Banner, 14 Nov. 1918, 2.
|200||Excess Death Rate (per 100,000)|
September 27, 1918
Health officials firmly believe there influenza cases are present in Nashville, however one hundred percent certainty is not possible as influenza is not a reportable disease.
September 29, 1918
The City Health Office and Dr. Robert C. Derivaux, the United States Public Health Service surgeon in charge of the campaign against influenza in Davidson County and Tennessee, report that Spanish influenza has arrived in Nashville. Officials at the Old Hickory Powder Plant dispel rumors of an epidemic at the plant. City Health Officer Dr. W.E. Hibbett has a mild case of ‘grip.’
September 30, 1918
Public gatherings are discouraged, and guards are assigned to keep lines from forming in public places. Dr. G. H. Reece of Old Hickory’s Powder Plant hospital reports mostly mild cases. Dr. W.F. Fessey, Superintendent of the City Hospital, reports over 30 cases admitted and 75 turned away. Dr. Fessey expects a serious outbreak of influenza within the week.
October 1, 1918
The President of the Nashville Academy of Medicine, Dr. Perry Bromberg, asks nurses not urgently needed in their current positions to contact Dr. G. H. Reece at the Powder Plant hospital. Superintendent of City Hospital Fessey says that male wards and almost all female wards are filled with influenza patients at the City Hospital. Health Officer Hibbett has recovered from a bout of ‘grip.’
October 2, 1918
The City Hospital turned down 50 male patients over the course of five hours because there are no more beds available. 1,100 cases are present at Old Hickory Powder Plant, according to Dr. Derivaux.
October 4, 1918
Health officials say they believe nothing would be gained by quarantining the Old Hickory Powder Plant. In response to the number of cases, facilities and medical staff at City Hospital are being increased.
October 5, 1918
According to Health Officer Hibbett there are 10,000-15,000 influenza cases in Nashville, not counting those at Old Hickory Powder Plant. Any nurses qualified for home care work are asked to report to the Red Cross. Dr. Derivaux reports the influenza situation at Old Hickory powder plant to be greatly improved. Dr. Reece reports fewer serious cases at the City Hospital.
October 7, 1918
Health Officer Hibbett closes picture shows, theaters and other non-essential places of amusement for an indefinite period. Although county schools are closed today, according to Hibbett, closing City schools and churches will be a last resort. The Red Cross issues a call for all women, trained nurses or not, to volunteer their services in Nashville.
October 8, 1918
Superintendent of Schools H.C. Weber and medical inspectors decide not to close City schools. Conditions at the Old Hickory Powder Plant are reported as greatly improved.
October 9, 1918
Nashville public schools are closed at noon today. Ministers of Nashville agree to cancel all prayer-meeting services, in compliance with a request from the Health Officer. Streetcar conductors are to ensure windows remain open to ventilate cars.
October 10, 1918
At the request of Health Officer Hibbett, the Railway and Light Company posts notices in all streetcars asking that windows remain open. A meeting is called to discuss cooperation of public health relief organizations to prevent overlap and duplication.
October 11, 1918
Dr. Olin West, Secretary and Executive Officer of the State Board of Health, says that according to reports, the influenza situation in Nashville is improving. The Ministers’ Alliance agrees to comply with Health officer Hibbett’s request to cancel all church services on Sunday (10/13). The Board of City Commissioners decides to resume the flushing of streets, a practice which stopped in August, when the water supply was very low.
October 12, 1918
A police sergeant discovers a man in the street with influenza who was nearly unconscious and suffering from a high fever. The City Hospital would only accept the patient if he had $10. The sergeant checked the man into a boarding house, administered medicine, and is credited with saving the man’s life.
October 13, 1918
Almost all church services, Sunday schools, and other religious meetings are canceled today in compliance with a request from the Health Office.
October 14, 1918
Dr. Derivaux states his belief that the epidemic peaked between 10/4 and 10/7. Health Officer Hibbett believes conditions are improving.
October 16, 1918
Dr. Derivaux says there are fewer influenza cases at the Old Hickory Powder Plant. Health Officer Hibbett says there are fewer patients in hospitals and fewer cases are being reported.
October 18, 1918
The Chief of Police is instructed to end the practice of supplying liquor as an influenza remedy. The number of deaths in Nashville is falling and undertakers report almost normal numbers.
October 19, 1918
County Circuit Court Judges receive permission to postpone opening the courts until danger from influenza has passed.
October 20, 1918
Churches are closed today upon a request from the Health Office.
October 21, 1918
No new cases of influenza are reported today.
October 24, 1918
It is announced today that if conditions continue to improve the closing ban will be lifted on Sunday, 11/3.
October 28, 1918
Health officials at Old Hickory Powder Plant hospital believe that the epidemic there is in decline.
November 1, 1918
The closing ban is lifted.
November 4, 1918
Schools reopen today for the first time in a month. The Board of Education decides to shorten the Thanksgiving vacation to make up for lost time.
November 14, 1918
Dr. Derivaux declares that the epidemic is over, but reminds the public that scattered cases are to be expected.
November 18, 1918
Dr. Derivaux assures people that any reports of an influenza flare-up are simply rumors.
December 4, 1918
The Old Hickory Powder Plant is now re-opened.
December 11, 1918
The Chief of Police reports several instances of doctors prescribing inordinately large amounts of narcotics including opium, morphine, and cocaine. The Nashville Academy of Medicine passes a resolution requesting these doctors to desist or be expelled from the academy.
December 18, 1918
Dr. Derivaux reports 22 cases of influenza at the Old Hickory Powder Plant.
January 12, 1919
Dr. Derivaux delivers a lecture on the influenza in Nashville. According to Dr. Derivaux influenza made its first appearance in Nashville on 9/16, and by 9/26 had developed to epidemic proportions. Dr. Derivaux blames congestion caused by the Old Hickory Powder Plant, bad housing, and overcrowding for the epidemic in Nashville.
January 15, 1919
Health Officer Hibbett warns residents that influenza will remain in Nashville all winter