The forgotten history of the flu in Philadelphia

I talked to someone recently who said he’s not sure whether he’s ever had the flu. My dear, I said, if you had had the flu, you would know it.

College fever

I got the flu during my freshman year of college, 16 years ago. I remember lying awake in my dorm room after midnight. I’d been unable to go to class for a week. It was December in the Northeast burbs, but my skin felt like I was lying under a midday sun in Aruba. My temperature crept above 103 degrees despite all the ibuprofen I’d taken.

In a fever-addled conviction that my cortex was baking like a Christmas pie, I dragged myself to the bathroom, where I slumped in a cool shower, desperate to lower my temperature. The next day, a nurse visited my room and listened to my lungs for a long time. Phone calls were made. My dad arrived at the dorm early the next morning (a three-hour drive) and took me home, where everyone hoped I’d be less likely to develop pneumonia.

After ten days of coughing and aching and burning, my temperature was still 101 degrees. I wept. Clearly, I was going to die.

I did not die. But others aren’t so lucky, and I never want to go through that again.

Getting serious about the flu

The Washington Post reported that 900,000 people were hospitalized during the 2018-2019 winter season due to influenza (double the usual number of flu inpatient stays), and 80,000 people died.

We’re also marking about a century since the worst flu season in recent history: the influenza pandemic of 1918-1919 infected an estimated 500 million people worldwide (a third of the global population). At least 50 million people died, including about 675,000 in the US. There was no vaccine. There were no antibiotics for secondary infections. People living in poverty, often in unsanitary, crowded conditions, were hardest hit. And to make everything worse, a bunch of our doctors were overseas at the end of World War I.

The flu in Philly

Maybe you knew all that, but did you know that Philly had a higher mortality rate from this pandemic than any other major American city? Doctors warned us to stay away from crowds. And what did Philadelphia do? In September 1918, our city joined a national wartime fundraising effort by holding a 23-block parade that drew 200,000 people.

Three days later, every hospital bed in Philly had a flu patient in it. Within a week, there were so many bodies we couldn’t bury them all. Six weeks later, more than 12,000 people had died of the virus, and that number soared to 20,000 within six months. Almost one quarter of the city’s entire population was infected.

Spit Spreads Death

Those Philly stats are from the Mütter Museum. On October 17, it’s opening a new permanent exhibition titled Spit Spreads Death, about the 1918-19 pandemic. I hope you’ve got your flu shot, because last weekend, the Mütter kicked things off with a parade. October 12, 1918 saw Philly’s peak in flu victims: 751 people died in a single day. On September 28, Spit Spreads Death: The Parade welcomed hundreds of people who marched up Broad Street from Marconi Plaza to City Hall (the original route of the ill-fated 1918 parade), each holding a white card with the name of a person who died of the flu on that October day 101 years ago.

The march was organized in partnership with UK-based Blast Theory, and it’s the first memorial we’ve ever had to Philly folks who died in this pandemic. The strange and solemn parade flummoxed passing locals (“is that a funeral?” one man yelled from his pickup truck). It featured a world-premiere choral music piece by David Lang in a recording from Philly’s The Crossing, whose voices sang, one by one, the 751 names.

What are the chances?

I know some folks are always on the fence about getting a flu shot.

It’s just the flu, right? Yes, most people will recover after a week or two of abject suffering. But for some, it’s more serious. Tens of thousands of people are hospitalized or die each year from the flu or its complications—people who would’ve been better protected if more of us got vaccinated. There’s a baby coming in my family this winter. Nobody under six months old can receive the flu vaccine, so getting vaccinated myself is a must before I cradle that kiddo.

But the flu vaccine is a crapshoot, right? It doesn’t really work. Some people get it and they still come down with the flu, so why bother?

It’s true that the flu vaccine doesn’t guarantee your health, but that’s partly because viruses are wily things. There are many of them, including flu viruses, and they’re always evolving. Each year, researchers predict what the most common strains of the flu will be (usually three or four) and develop vaccines against them. If you get vaccinated and you still get sick, it could be that you caught a rarer strain not covered by the vaccine. Or maybe you got infected in the two-week window your body needs after vaccination to develop its antibodies. Or perhaps other health factors increased your susceptibility.

But maybe you haven’t had the flu in a long time, or you’ve never had it, so why not skip the vaccine? Take the chance if you must, but given the facts on the flu, I don’t know why you’d want to risk it—and remember the people around you, who may be more vulnerable than you are.

I like these odds

Consider this: even if you do get vaccinated and end up sick, your infection is likely to be less severe (the percentage of people who are hospitalized due to the flu is far lower among those who are vaccinated, versus those who aren’t). And even if you do catch one strain of the flu, your vaccine may have protected you from another strain.

When the annual flu vaccine strains are on target, the CDC says vaccination reduces the risk of influenza illness by up to 60 percent among the overall population. I’ll take a sore arm for those odds.

A flu vaccine is easy to get—check with your doctor, your pharmacy, a clinic, your school, or workplace. I’ve got mine. I went to a clinic recently for an ear infection, and the nurse could barely hide her glee when I also let her vaccinate me (which my insurer covers in full, as it should, if it knows what’s good for it).

If you don’t have insurance, you can get vaccinated at one of Philly’s City Health Centers. And in hopes that its new exhibition will inspire better public-health awareness and action, the Mütter will offer visitors a free flu shot on October 19, 2019.